Sexual health in adult survivors of childhood cancer: A Project REACH study.

BACKGROUND: Sexual dysfunction is a significant complication of treatment for many adult-onset cancers. However, comparatively less is known about sexual dysfunction in adult childhood cancer survivors (CCSs). Research has been limited by the exclusion of specific cancers (e.g., central nervous system [CNS] tumors) and the lack of validated measures, which makes it difficult to understand the nature and prevalence of sexual dysfunction in CCSs. METHODS: A total of 249 adult CCSs (aged 18-65 years) enrolled in Project REACH, a prospective cohort study, and completed measures of physical and mental health, including sexual dysfunction. Participants scoring ≤19 on the Female Sexual Function Index 6 or ≤21 on the International Index of Erectile Function 5 were classified as experiencing sexual dysfunction. Analyses examined the relationships between sexual dysfunction and demographic, disease, treatment, and health variables. RESULTS: A total of 78 participants (32%) experienced clinically significant sexual dysfunction. In univariate analysis, sexual dysfunction was significantly associated with CNS tumor diagnosis (odds ratio [OR], 2.56) and surgery (OR, 1.96) as well as with health variables such as fatigue (OR, 3.00), poor sleep (OR, 2.84), pain (OR, 2.04), depression (OR, 2.64), poor physical health (OR, 2.45), and poor mental health (OR, 2.21). Adjusted analyses found that CNS tumor diagnosis (p = .001) and health variables (p = .025) contribute significantly to sexual dysfunction in CCSs. CONCLUSIONS: Approximately one third of adult CCSs report clinically significant sexual dysfunction, which underscores a significant screening and treatment need. However, because available measures were developed for survivors of adult cancers, research to create a sexual health measure specifically for adult CCSs is necessary to better identify the sexual health concerns of this vulnerable population.

Asking women with diabetes about sexual problems: An exploratory study of NHS professionals' attitudes and practice: A survey of healthcare professionals regarding communication and silences about sexual problems during the routine care of women with diabetes.

AIMS: To explore UK healthcare professionals' practice and attitudes towards asking women with diabetes about sexual health problems, including symptoms of female sexual dysfunction (FSD). METHODS: An online questionnaire to address the study aims was developed, piloted by ten healthcare professionals (HCPs) and completed by 111 eligible HCPs, recruited via professional networks and social media. Free text data were analysed and reported thematically. Two questions were analysed to test the hypothesis of differences between men's and women's responses. RESULTS: The majority of respondents did not ask women with diabetes about sexual problems. Multiple barriers to inquiry were reported, including inadequate training, time constraints, competing priorities, the perceived likelihood that questions will cause surprise or distress (especially for certain groups of women), the belief that sexual problems are to be expected as women age, and the belief that FSD is complex or untreatable, with unclear management pathways. Exploratory findings indicated significant differences in men and women's responses (men disagreed more strongly with prioritisation, and fewer reported routine inquiry about sexual problems in their usual practice). CONCLUSIONS: HCPs reported not asking women with diabetes about sexual problems during routine care. They described multiple factors reinforcing the silence about sexual health, including inadequate education and perceived social risk for individual HCPs who deviate from the patterns of topics usually discussed in diabetes consultations.

Characteristics of systemic testosterone therapy for female hypoactive sexual desire disorder-a claims database analysis.

BACKGROUND: Testosterone therapy (TTh) is recommended for postmenopausal women with hypoactive sexual desire disorder (HSDD); however, there remain insufficient data to support use of TTh in premenopausal women with sexual dysfunction. AIM: In this study, we used a large national database to evaluate prescribing trends of TTh for women with HSDD. METHODS: We conducted a cohort analysis of information from electronic health records acquired from the data network TriNetX Diamond. The study cohort consisted of women 18-70 years of age with a diagnosis of HSDD. We analyzed trends of testosterone prescriptions, routes of testosterone administration, and coadministration of testosterone with estrogen. OUTCOMES: Despite an increase in rates of testosterone prescriptions for HSDD, there remains a high degree of variability in the duration of treatment, route of administration, and coadministration of estrogen with significant underprescription of testosterone. RESULTS: Our query of the TriNetX database led to the identification of 33 418 women diagnosed with HSDD at a mean age of 44.2 ± 10.8 years, among whom 850 (2.54%) women received a testosterone prescription. The testosterone prescriptions were highly variable with regard to duration and route of administration and coadministration with estrogen. For all patients until 2015, the prevalence of testosterone prescriptions for HSDD showed a positive quadratic relation was observed. Since 2015 a linear increase in prevalence was observed, with the highest rate of increase for patients aged 41-55 years. CLINICAL IMPLICATIONS: The findings of this study reveal a significant need for further research investigating the optimal use of TTh to enhance the sexual health of women with HSDD, and further studies on the long-term effects of testosterone use must be undertaken to ensure that patients have access to safe and effective treatment. STRENGTHS AND LIMITATIONS: Limitations to this study include patient de-identification and lack of availability of testosterone dosage data. However, this study also has many strengths, including being the first, to our knowledge, to characterize the prescribing trends of testosterone for women with HSDD. CONCLUSION: Testosterone therapy should be considered as a potential therapy for premenopausal female patients with HSDD. Further studies on the long-term effects of testosterone use must be undertaken to address disparities in the management of HSDD and to ensure patients can access treatment.

The relationship between female orgasmic disorder, attention-deficit/hyperactivity disorder, and depression in Dominican women.

BACKGROUND: Female orgasmic disorder is listed in the DSM-5 and is defined as the persistent or recurrent inability to have an orgasm. Many depressed women may experience sexual dysfunction, including female orgasmic disorder. AIM: The study sought to analyze the relationship between depressive disorders and attention-deficit/hyperactivity disorder (ADHD) and their influence on the development of female orgasmic disorder. METHODS: A total of 221 Dominican women participated in this case-control study. The case group consisted of 107 women diagnosed with female orgasmic disorder, while the control group consisted of 114 women without any sexual dysfunction. OUTCOMES: The diagnosis of ADHD was obtained from the participants' medical records, previously conducted using the DSM-5-TR criteria. The Beck Depression Inventory II was used to assess the severity of depressive symptoms in both groups. RESULTS: There was a significant relationship between female orgasmic disorder and ADHD and depression. The results of multiple logistic regression indicated that the highest risk of female orgasmic disorder was observed in women with ADHD (odds ratio [OR], 4.91; 95% confidence interval [CI], 2.46-9.20; P < .001), women with severe depression (OR, 2.50; 95% CI, 1.08-6.96; P = .04), and women who had sexual intercourse that focused on penetration (OR, 2.02; 95% CI, 1.03-3.98; P = .04). CLINICAL IMPLICATIONS: These findings may have important implications for the prevention and treatment of sexual disorders in women. STRENGTHS AND LIMITATIONS: This design selected all diagnosed cases of female orgasmic disorder and did not select a specific subgroup. However, some limitations must be considered. This study was conducted in a single clinic, although it should be noted that it is the main clinic for the treatment of sexual dysfunction in the country. A further limitation could be that this type of study design does not allow for statements about causality to be made. CONCLUSION: There is an increased risk of female orgasmic disorder in women with ADHD, with severe depression, and who engage in penetrative sex.

Prevalence of and Factors Associated with Hypersexuality in Patients with Dementia: A Retrospective Cross-Sectional Study.

INTRODUCTION: The psychological and behavioral symptoms of dementia are frequently observed in clinical practice, and those related to sexuality are particularly challenging. However, few studies have evaluated the prevalence or factors associated with hypersexuality in patients with dementia. OBJECTIVES: This study aims to determine the prevalence of hypersexuality in patients with dementia, describe associated factors, and qualitatively report the most common presentations and treatments. METHODS: This retrospective cross-sectional study collected data from semi-structured charts of dementia patients who were followed up at a secondary care reference center between 2015 and 2019. Results: Of 552 total patients, 52 (9.3%) were hypersexual, which was associated with male sex (P < .000; OR 2.95, 95% CI 1.73-5.01), frontotemporal dementia (P < .007), alcohol use (P < .015; OR 2.35, 95% CI 1.16-4.73) and tobacco use (P < .000; OR 2.88, 95% CI 1.61-5.13). CONCLUSIONS: Although our findings were similar to the literature, their significant variability reflects the limited and low quality of the available evidence and a lack of standardization regarding terminology, definitions, and diagnostic criteria for hypersexuality.

Prevalence and predictors of female sexual dysfunction among sexually active women in the diabetes prevention program outcomes study.

OBJECTIVE: To determine the burden and identify correlates of female sexual dysfunction (FSD) among women with prediabetes (PreD) and type 2 diabetes (T2D) enrolled in the Diabetes Prevention Program (DPP) Outcomes Study (DPPOS). METHODS: The DPPOS visit included the Female Sexual Function Index (FSFI) to determine sexual function. Of 1464 participants, 1320 (90%) completed the (FSFI) and 426 were sexually active. A backward selection multivariable logistic regression model estimated the odds of FSD for sociodemographic, clinical, and diabetes-related covariates. RESULTS: One hundred and eighty-five (43%) had a score of ≤26.55 and met the criteria for FSD. After adjustment for DPP treatment and age, urinary incontinence (UI) (odds ratio [OR] = 1.91, 95% confidence interval [CI] = 1.15-3.17) and hysterectomy (OR = 1.89, 95% CI = 1.01-3.53) were associated with increased odds of FSD. Increased body mass index was protective for FSD (OR = 0.93 per kg/m2, 95% CI = 0.89-0.96). Michigan Neuropathy Screening Instrument-based peripheral neuropathy (mean±SD scores 1.1±1.3 vs. 0.9±1.1, p < 0.0001) and Electrocardiogram (ECG)-based autonomic dysfunction measures (mean ± SD heart rate levels 64.3 ± 6.8 vs. 65.6 ± 10.2, p = 0.008) were associated with FSD. There were no differences in diabetes rates between women who did (66.5%) and did not (66%) have (p = 0.7). CONCLUSIONS: FSD is prevalent in women with PreD and T2D. Our findings suggest that FSD is associated with neuropathic complications commonly observed in PreD and T2D.

The Impact of Atopic Dermatitis on Sexual Function and Reproductive Desires in Women.

Atopic dermatitis is a prevalent skin condition that affects up to 17% of adult population. It can lead to itching, pain, and other symptoms such as sleep disturbance, anxiety, and depression. Due to its high prevalence and limiting symptoms, atopic dermatitis often has a great impact on patients' quality of life but there is scarce information regarding how atopic dermatitis affects women's sexual health and reproductive desires. The purpose of this article was to assess the impact of atopic dermatitis on sexual function and reproductive wishes in women. A cross-sectional study was conducted from February to March 2022. A total of 102 women with atopic dermatitis were recruited through online questionnaires sent through the Spanish Atopic Dermatitis Association; 68.6% of the patients acknowledged impairment in sexual function, especially those with more severe disease and those with genital and gluteal involvement. In addition, 51% of the women considered that atopic dermatitis may have an influence on their gestational desire, particularly those with gluteal involvement. In conclusion, atopic dermatitis has a great impact on sexual function and reproductive desires in women.

Prevalence and associated factors of sexual dysfunction in female hemodialysis patients: first report from Somalia.

BACKGROUND: Sexual dysfunction is frequent in female hemodialysis patients and is related to poorer quality of life. It is often a neglected topic associated with marked distress and interpersonal difficulties. OBJECTIVE: Few studies are reported from Sub-Saharan African Countries (SSA) regarding female sexual dysfunction (FSD) in (HD) patients. The study aims to explore the prevalence and associated factors of FSD in female HD at a sole dialysis centre in Somalia. METHOD: Over a one-month period, a cross-sectional study was conducted among women with end-stage renal disease aged 18-50 years who were undergoing a dialysis program for at least three months at the dialysis center of our hospital. The participants were married, and they were living with their partners. Data regarding the sociodemographic features, clinical characteristics, frequency of sexual intercourse per week, and the Female Sexual Function Index (FSFI) scores were collected using a standard face-to-face interview questionnaire. RESULTS: During the study period, a total of 115 participants were eligible for the study's inclusion criteria. The mean patient age was 38.5 ± 9.3 years. The most common cause of ESRD was diabetes, which accounted for 53%, followed by hypertension (26.1%) and glomerulonephritis (9.6%). The mean duration of dialysis was 2.9 ± 1.4 years, and approximately two-thirds of the participants (62.5%) were in the program for more than three years. Regarding the frequency of sexual intercourse, 61.7% of female participants performed sexual intercourse less than once time/a week. The prevalence of FSD was 92.2% (n = 106) of all participants. The mean FSFI score of the participants was 16.05 ± 4.48. Longer duration of dialysis program (i.e., more than four years), increasing age (i.e., > 35 years), those with diabetes had scored lower overall FSFI scores. CONCLUSION: The prevalence of female sexual dysfunction among Somali female hemodialysis patients was very high, representing a significant problem in end-stage renal disease (ESRD). Our study findings revealed that increasing age, diabetes, and duration of dialysis negatively impact female sexual function and are significantly associated with FSD.

Polycystic ovarian syndrome elevates the distress of sexual pain in Iranian women with infertility.

BACKGROUND: Sexual dysfunction may lead to sexual distress in women with infertility, while polycystic ovarian syndrome (PCOS) may escalate this distress. This study aimed to investigate the role of PCOS in the relationship between sexual dysfunction and sexual distress in Iranian women with infertility. METHODS: The Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and Depression and Anxiety modules of the DASS-21 were cross-sectionally investigated in 190 women with infertility (103 women with PCOS and 87 women without PCOS). RESULTS: There were negative correlations between sexual function domains and sexual distress (P < .001) in the total sample. Moderation analysis revealed that higher levels of impaired desire, arousal, and pain elevated sexual distress in the PCOS group. After adjusting for depression and anxiety, only the association between sexual pain and sexual distress was moderated by PCOS condition (P = .008). CONCLUSIONS: The findings suggest that impaired sexual function is associated with increased levels of sexual distress in infertile female patients. Importantly, comorbid PCOS renders patients susceptible to sexual distress where sexual pain is increased. Further research may shed light on the physiological, psychological, and relational aspects of sexual pain and associated distress in infertile female patients with comorbid PCOS.

Education in Female Sexual Function and Dysfunction among American Urogynecologic Society Members: An Unmet Need.

OBJECTIVES: Sexual function is an important component of women's health that has not been traditionally emphasized during medical training, suggesting that further education is needed to provide comprehensive patient care. The purpose of this study was to describe education and interest in female sexual function among urogynecology providers. METHODS: Conducted in 2020, this was a cross-sectional survey of American Urogynecologic Society members assessing educational and clinical experience with female sexual function. RESULTS: Of 642 members who opened the survey, 123 (19%) completed it. Most of the respondents were fellowship trained (70%), and 74% reported ≥10% of their patients had sexual function questions or concerns unrelated to prolapse or incontinence. Most (71%) of the members strongly agreed/agreed that they were comfortable evaluating and managing these patients. This was more common in providers who saw more patients (≥25%) with sexual function concerns (83%) compared with those who saw <25% (65%; P = 0.04). Most of the respondents reported receiving ≤1 lecture on normal sexual function (82%) or sexual dysfunction (85%) during medical training. Most (67%) would expand their practice if they received additional education. The most requested topics were disorders of desire (72%), orgasm (71%), and arousal (67%). The most common reasons for not expanding practice even with additional education were female sexual function not being of significant interest (30%) and time and interruption of practice flow (28%). CONCLUSIONS: Most of the respondents felt comfortable caring for patients with sexual function concerns, but reported that they would expand their practice with additional education. The majority reported having received ≤1 female sexual function/dysfunction lecture during their medical training. This highlights a critical need and desire for more female sexual function education among the urogynecologic provider population.

Coping styles for sexual dysfunction and stress among married women of reproductive age: a cross-sectional study from Turkiye.

Objectives: To identify sexual dysfunction in married women of reproductive age, and to examine its relationship with stress coping styles. METHODS: The cross-sectional, descriptive study was conducted between February and June 2019 at the obstetrics and gynaecology outpatient clinic of Gulhane Training and Research Hospital in Ankara, Turkiye. The sample comprised married women aged 18-49 years who had an active sexual life over the preceding month, and were neither pregnant nor in the postpartum phase. Data was collected using the Female Sexual Function Index, and the Stress Coping Styles Scale. Data was analysed using SPSS 22. RESULTS: There were 216 women with mean age 33.58±6.77 years. The mean Female Sexual Function Index score was 22.29±6.08. The mean Stress Coping Styles Scale subscale scores were: self-confident 20.71±3.53, helpless 18.07±4.27, submissive 12.13±3.00, optimistic 13.70±2.35, and seeking social support 11.89±2.01. The total Female Sexual Function Index score had a positive, significant correlation with self-confidence (r=0.15; p=0.03) and seeking social support subscales (r=0.18; p=0.01) and a negative, significant correlation with submissive subscale (r=-0.17; p=0.02) of the Stress Coping Styles Scale. CONCLUSIONS: Establishing awareness among women about sexual dysfunction and improving effective coping styles may contribute to improved sexual health among women.

Female sexual function index for screening of female sexual dysfunction using DSM-5-TR criteria in Thai women: A prospective cross-sectional diagnostic study.

Thai Female Sexual Function Index discrimination using the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria has not been investigated. This study aimed to evaluate the Female Sexual Function Index as a tool for assessing sexual symptoms and to determine the prevalence of female sexual dysfunction in Thai women using the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria. This prospective cross-sectional diagnostic study included sexually active women aged ≥18 years, interviewed from January to June 2023. The participants completed the Thai version of a comprehensive of the Female Sexual Function Index questionnaire encompassing general information and self-reported assessments of female sexual function, followed by a semi-structured interview of distress symptom severity. Female sexual function was determined by screening of the total Female Sexual Function Index score, whereas female sexual dysfunction was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria. Using receiver operating characteristic curves, a clinical cutoff for the Female Sexual Function Index score of 23.1 was determined to identify female sexual dysfunction (area under the curve, 0.76; 95% confidence interval, 0.71-0.80; sensitivity, 75.6%; specificity, 67.7%; positive predictive value, 77.7%; negative predictive value, 65%). A prevalence of 40.2% for female sexual dysfunction was observed in the study population. The results of this study could be used as practical guidance for the screening of women affected by female sexual dysfunction in Thailand in the future.

Sexual dysfunction among people with mental illness in Africa: A systematic review and meta-analysis study.

BACKGROUND: Sexual dysfunction is the most frequent health problem among psychiatric patients. This could be the result of both the nature of the illness itself and the side effects of prescribed psychotropic medications. It also significantly affects an individual's general well-being, interpersonal relationships, self-esteem, and treatment outcomes. Therefore, the current systematic review and meta-analysis was conducted to determine the combined prevalence of sexual dysfunction and its correlated factors among people with mental illness. METHODS: We retrieved eligible primary studies using various search databases like PubMed, EMBASE, Science Direct, African Journal Online, Google Scholar, and Psychiatry Online. The report of this systematic review was reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We used standardized data extraction checklists and STATA version 14 for data extraction and analysis, respectively. The I-squared statistics test was used to check statistical heterogeneity within the included articles. Publication bias was assessed using a funnel plot and the Egger test. To estimate the overall prevalence and correlated factors of sexual dysfunction, a random effects model meta-analysis was employed. RESULTS: In this meta-analysis, a total of 15 primary studies with 2849 psychiatric patients were included. The overall pooled prevalence of sexual dysfunction among psychiatric patients in Africa was 58.42% (95% CI: 49.55, 67.28). Having older age (OR = 1.92, 95% CI: 1.28, 2.87), longer duration of illness (OR = 2.60, 95% CI: 1.14, 5.93), history of relapse (OR = 3.51, 95% CI: 1.47, 8.43), poor quality of life (OR = 3.89, 95% CI: 2.15, 7.05), and antipsychotic medications (OR = 2.99, 95% CI: 1.84, 4.86) were significantly associated with sexual dysfunction. CONCLUSION: This meta-analysis revealed that approximately two-thirds of psychiatric patients in Africa are affected by sexual dysfunction. Therefore, the findings of this study recommend that when evaluating psychiatric patients, health professionals should focus more on sexual dysfunction. It is also essential to promote awareness and incorporate sexual health assessment and intervention into mental health services to reduce the overall burden of the problem.

The Impact of Childhood Sexual Abuse on Adult Female Sexual Function and Sexual Distress: A Systematic Review and Meta- Analysis. / Çocukluk Çaginda Cinsel Istismara Maruz Kalmanin Kadin Cinsel Islevi ve Cinsel Sikintisi Üzerine Etkisi: Bir Sistematik Gözden Geçirme ve Meta-Analiz.

OBJECTIVE: In this study, it was aimed to examine the impacts of exposure to childhood sexual abuse (CSA) on women's sexual function and sexual distress. METHOD: In this systematic review and meta-analysis study, eight international (EBSCO, Psyc-Info, Proquest, PubMed, Science Direct, Scopus, Ovid, Web of Science) and two national electronic databases (Dergipark and Thesis Database of the Turkish Council of Higher Education) were searched. Studies reporting outcomes of sexual function and sexual distress in women with and without a history of CSA were included. The data were synthesized by meta-analysis and narrative methods. RESULTS: Two dissertations and five research articles published between 2010 and 2021 were included in the study. In some studies that were not included in the meta-analysis, it was reported that there was no difference in the prevalence of sexual dysfunction, and sexual satisfaction in women with and without a history of CSA. Meta-analysis results demonstrated lower sexual function (sexual arousal, MD: -0.83, p<0.001; sexual desire, MD: -0.55, p<0.001; lubrication, MD: -0.78, p<0.01; pain, MD: -0.52, p<0.001) and more sexual distress (SMD: -0.79, p<0.05) in women with CSA history. CONCLUSION: This study showed that CSA negatively affects female sexual function and increases sexual distress. Healthcare professionals should be aware that women with a CSA history may have worse sexual functions and more sexual distress. More research is needed on the role of CSA in the etiology of sexual function problems and its possible mechanisms of action.

Sexual dysfunction among Nigerian women living with HIV infection.

INTRODUCTION: Sexual dysfunction in women with HIV is a necessary but understudied aspect of HIV complications in women living with HIV. This study reports the prevalence, pattern, and risk factors for sexual dysfunction in women living with HIV in southwest Nigeria. METHODS: A validated Female Sexual Function Index was used to determine sexual dysfunction in a cross-sectional study design involving 2926 adult women living with HIV in a large, publicly funded tertiary HIV treatment centre in Lagos, Nigeria. A score of less than 26.5 indicated sexual dysfunction. Multivariate logistic regression analysis was performed to identify risk factors for sexual dysfunction. P<0.05 was considered statistically significant at a 95% confidence interval (CI). RESULTS: The prevalence of sexual dysfunction was 71.4%. The types of dysfunctions detected included disorder of desire (76.8%), sexual arousal (66.0%), orgasm (50.0%), pain (47.2%), lubrication (47.2%), and satisfaction (38.8%). Multivariate analysis showed that menopause (aOR: 2.0; 1.4-4.1), PHQ score of 10 and above (aOR: 2.3; 1.7-3.2), co-morbid medical conditions (aOR: 1.8; 1.4-2.7), use of protease inhibitor-based antiretroviral therapy (aOR: 1.3; 1.2-2.1) and non-disclosure of HIV status (aOR: 0.7; 0.6-0.8) were factors associated with sexual dysfunction. CONCLUSIONS: Sexual dysfunction is common among Nigerian women living with HIV. Menopause, use of protease inhibitor-based regimens, PHQ score of at least 10, co-morbid medical condition, and non-disclosure of HIV status were associated with sexual dysfunction. National HIV programmes, in addition to incorporating screening and management of sexual dysfunction in the guidelines, should sensitise and train health workers on the detection and treatment of sexual dysfunction.

Female sexual function in long-term cervical cancer survivors compared with healthy women and women affected by benign gynecological disorders.

OBJECTIVE: To compare the female sexual function between cervical cancer survivors and healthy women or with benign gynecological diseases. STUDY DESIGN: From January 1, 2010 to January 31, 2019, a case-control study was conducted to compare the female sexual function of 106 cervical cancer survivors from a tertiary hospital and 185 women admitted to a gynecological outpatient clinic from the same health area for a routine gynecological examination (n=46) or for a benign gynecological disorder (symptomatic, n=113; asymptomatic, n=26). We prospectively assessed the female sexual function using the Female Sexual Function Index (FSFI). For the contrastive analysis hypothesis, we employed R statistical software. RESULTS: Cervical cancer survivors reported lower sexual activity rates than controls, in general, did (47.12% vs. 88.65%, p=0.0001), and, particularly, compared with healthy and symptomatic controls (47.12% vs. 82.61%, p=0.003; 47.12% vs. 87.61%, p=0.0001, respectively). Sixty and fifty-eight hundredths percent of the cervical cancer survivors experienced female sexual dysfunction, mainly due to hypoactive sexual desire (93.27%). Female sexual dysfunction was diagnosed in 64.32% of the controls, with sexual arousal disorders being the most common diagnosis (44.86%). Compared with controls, cervical cancer survivors exhibited considerably lower FSFI total scores and in sexual desire and lubrication domains (p <0.000; p <0.0001; p=0.023). CONCLUSIONS: Cervical cancer survivors had worse female sexual function and less sexual activity than controls did, although scores in both groups were in range of FSD. Rates of female sexual dysfunction were similar across cervical cancer survivors and controls, with hypoactive sexual desire and sexual arousal disorders as the most common diagnoses, respectively.

Compulsive sexual behaviour in Iranian married women: Prevalence, sociodemographic, sexual, and psychological predictors across-country.

Background and Aims: This study addresses the scarcity of research on Compulsive Sexual Behavior Disorder (CSBD) in non-Western cultures and women, exploring its prevalence, sociodemographic, sexual history characteristics, and sexual and psychological health factors in Iranian married women. Methods: A cross-sectional study involving 772 heterosexual married women was conducted between 2022 and 2023, covering all 31 provinces of Iran. Participants were categorized as CSBD+ (at-risk individuals) and CSBD- (low-risk individuals) based on a pre-established cut-off point of ≥18 by the Compulsive Sexual Behavior Disorder Scale -7. Depression, anxiety, obsessive-compulsive disorder, self-esteem, sexual distress, sexual satisfaction, relationship satisfaction, and sexual dysfunction were assessed as psychological and sexual health variables by standardized scales. Results: The prevalence of CSBD was 3.8% in women. Linear regression analysis showed that lower education, being jobless, substance use, pornography use, paraphilic behaviors, conflict on sex frequency, relationship, orgasm and sexual dissatisfaction, higher sexual arousal, depression, and obsessive-compulsive symptoms were positively associated with CSBD. The univariate analysis, at a stringent significance level of 0.005, mirrored the regression findings. Additionally, women with CSBD+ exhibited lower religiousness and higher anxiety compared to those without CSBD-. Discussion and Conclusions: Raising awareness of CSBD is crucial for health systems and individuals for better policy-making and help-seeking behavior. Identifying risk factors like substance use presents opportunities for prevention, and the association of CSBD with sexual and mental health variables suggests addressing co-occurring issues for improved treatment outcomes. Recognizing culture and gender-specific sexual and psychological correlates enables targeted and effective treatment approaches.

Sexual anxiety mediate relationship between sexual schemas and body image with sexual function in Iranian women.

BACKGROUND: Sexual function is one of the most critical challenges in human society, especially among women. The problems associated with sexual function are significantly ambiguous in a society like Iran. This study investigated the mediating role of sexual anxiety in relationship between sexual schemas and body image with female sexual function. METHOD: The research method was correlational and specifically path analysis. The statistical population included women aged 25-45 in Rasht, Iran, 2021. 365 women were selected using Cochran's formula and the convenience sampling method. The Female Sexual Function Index (FSFI), Sexual Self-Schema Scale for Women (SSSS), Body Image Scale (BIS), and Multidimensional Sexual Self-Concept Questionnaire (MSQ) were used for data collection. For data analysis, SPSS-26 and LISREL 10.2 software were used. RESULTS: Descriptive data analysis showed that mean and standard deviation were for further passionate-romantic schema 22.96 and 4.83, open-direct schema 27.64 and 5.09, embarrassed-conservative 20.93 and 4.61, body image 128.96 and 27.35, sexual anxiety 13.13 and 3.91 and sexual function 49.83 and 8.67. According to the results of path analysis, passionate-romantic (ß = 0.51), explicit-comfortable (ß = 0.27), shy-conservative (ß = -0.59), and body image (ß = -0.62) schemas showed a significant relationship with sexual function. Sexual function anxiety as a mediating variable also had a significant role (ß = -0.41) in female sexual function. CONCLUSION: Sexual function anxiety, negative body image, and negative sexual schema negatively affect women's sexual function, and positive sexual schemas and body image positively affect sexual function anxiety.

Let's talk about sex! Why should healthcare professionals address sexual distress in breast cancer patients and survivors?

PURPOSE: Sexual distress impacts the quality of life (QoL) of breast cancer patients but is often overlooked in standard care pathways. This study evaluated the prevalence and factors of sexual distress among Dutch breast cancer patients, compared them to the general population, and explored how sexual distress is discussed in clinical settings from the perspectives of patients and healthcare professionals (HCPs). METHODS: Questionnaires containing the Female Sexual Distress Scale (FSDS) and demographic variables were distributed to women with breast cancer. The effect of breast cancer on sexual distress was assessed with a Mann-Whitney U test. Multivariable linear regression was used to analyze variables associated with FSDS. The Sexuality Attitudes and Beliefs Survey (SABS) was sent to HCPs. RESULTS: Breast cancer patients reported significantly higher sexual distress compared to a Dutch non-breast cancer cohort, respectively 16.38 (SD 11.81) and 23.35 (SD 11.39). Factors associated with higher sexual distress were psychological comorbidities, the body image scale, and being diagnosed >10 years ago. Sexual distress was not discussed as often as patients needed. Barriers to addressing sexual distress were time constraints, HCPs' confidence in their ability to address sexual distress, and uncertainty about who is responsible for initiation. CONCLUSIONS: Breast cancer patients showed significantly higher sexual distress compared to the Dutch population. However, it was not frequently addressed in the consultation room. While some barriers have been identified, this study highlights the importance of further exploring obstacles to integrating discussions about sexual distress into routine care to improve QoL of breast cancer patients.