The Effect of Yoga and Pelvic Floor Muscle Exercise on Sexual Function and Sexual Self-esteem of Reproductive-age Women: A Randomized Clinical Trial.

Background: Sexual function is a part of sexual health which is an important aspect of the quality of life. Physical activity is one of the healthiest activities that can effectively reduce the risk of sexual disorders. Therefore, this study was conducted with the aim of evaluating the effect of yoga and pelvic floor muscle exercises on the sexual function and sexual self-esteem of reproductive-age women. Methods: This randomized clinical trial study was conducted from September to December 2023 on 46 women of reproductive age working in the Shahrekord University of Medical Sciences and its affiliated health centers. Multi-stage cluster sampling was used to select the subjects; later, they were randomly divided into two intervention groups A (N=21) and B (N=25). Participants in intervention groups A and B performed pelvic floor muscle exercises at home using an educational pamphlet 3 times a week for 6 weeks, with 3 times a day repetition. In addition, women in the intervention group A participated in a yoga training program for 2 sessions per week for 6 weeks. Data collection tools included a demographic information form, the Female Sexual Function Index, and Sexual Self-Esteem Inventory for women. Questionnaires were completed by both groups before, immediately, and one month after the intervention. The data were analyzed using the chi-square test, fisher's exact test, independent two-sample t-test, repeated measures test, and analysis of covariance in SPSS software version 16. A significance level of less than 0.05 was considered. Results: The results showed no statistically significant difference between the two groups in sexual function (P=0.21) and sexual self-esteem (P=0.22) scores before the intervention. Also, the results showed no statistically significant difference between the two groups in terms of sexual function (P=0.35) and sexual self-esteem (P=0.59) scores one month after the intervention. However, the mean score of the sexual function index immediately after intervention showed a statistically significant difference between the intervention groups A (31.43±3.76) and B (29.41±2.38) (P<0.001). The mean score of the sexual self-esteem immediately after the intervention showed a statistically significant difference between the intervention groups A (181.19±19.90) and B (171.32±15.02) (P<0.001). Conclusion: Adding yoga exercises to pelvic floor muscle exercises can improve the sexual function and sexual self-esteem of women at their reproductive age. Trial Registration Number: IRCT20100524004015N1.

Gender differences in sex drive: Reply to Conley and Yang (2024).

Our meta-analysis on gender differences in sex drive found a stronger sex drive in men compared to women (Frankenbach et al., 2022). Conley and Yang (2024) criticized how we interpreted the findings and provided suggestions regarding the origins of these gender differences, an undertaking that we had refrained from doing in our original work. We concur with several important points made by Conley and Yang (2024): (a) women's sexual experiences are generally more negative than men's, which could partly explain why men report more sex drive; (b) lack of statistical moderation by some sociocultural variables does not imply that the sex drives of men and women are generally unaffected by the social environment; and (c) gender differences in sexuality are likely smaller than they are often portrayed in research, and that the practical impact of this difference is largely unknown. Still, we reject other assertions made by Conley and Yang (2024): (a) we did not frame our findings in support of the view that gender differences in sex drive are determined by biology, (b) we did not conflate response bias with sociocultural biases more broadly, and (c) we did not fail to incorporate and consider gendered cultural messages about sexuality in our methods and discussion. We make several suggestions about future research on these matters. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

[The role of seminal vesicles in male sexual function].

The seminal vesicle is an important accessory gland of the male reproductive system. In the past, some scholars focused more on its role in the fertilization process and neglected its relationship with male sexual function. Researches show that the seminal vesicle is involved in multiple processes such as sexual desire, penile erection, and ejaculation. Treatment of sexual dysfunction by medication targeting the seminal vesicle has achieved certain therapeutic effects. This article discusses the relationship between the seminal vesicle and sexual function in terms of physiopathology, clinical study and basic research, hoping to provide some new ideas on the clinical diagnosis and treatment of sexual dysfunction.

Inclusion of genital, sexual, and gender diversity in human reproductive teaching: impact on student experience and recommendations for tertiary educators.

Western societal norms have long been constrained by binary and exclusionary perspectives on matters such as infertility, contraception, sexual health, sexuality, and gender. These viewpoints have shaped research and knowledge frameworks for decades and led to an inaccurate and incomplete reproductive biology curriculum. To combat these deficiencies in reproductive systems-related education, our teaching team undertook a gradual transformation of unit content from 2018 to 2023, aiming to better reflect real diversity in human reproductive biology. This initiative involved intentional modifications, including clear use of pronoun self-identification by staff. We addressed the historical lack of representation of genital variation and helped students interrogate oversimplified reproductive biology binaries. A novel assignment was also introduced, prompting students to apply reproductive physiology knowledge to propose innovative assisted reproductive technology solutions for diverse demographics. The collective impact of these innovations had a positive effect on student learning. With improved lecture content and inclusive language, the proportion of inclusive group assignment topics chosen by students more than doubled in 2021. By 2022, coinciding with assessment topic changes, the percentage of inclusive assignments topics surpassed 50%. Further development of laboratory activities on intersex genital variation and genital modification raised further understanding of genital, sexual, gender, and cultural diversity. While implementing these changes posed challenges, pushing both staff and students out of their comfort zones at times, collaboration with relevant organizations and individuals with lived experience of queer identity proved integral. Ultimately, these relatively simple adjustments had a substantial impact on student experiences and appreciation for diversity.NEW & NOTEWORTHY We outline the teaching innovations that we have implemented to improve inclusion of diversity in reproductive biology and physiology contexts. This includes improved representation of genital, sexual, and gender diversity considerations in the curriculum. There is a critical need for these innovations as how we teach fundamentally shapes the understanding of our future medical and health professionals and researchers and thus influences the quality of future medical care and research.

Hormonal and cycle phase predictors of within-women shifts in self-perceived attractiveness: Tests of alternative functional models.

Prior research has produced mixed findings regarding whether women feel more attractive during the fertile phase of the menstrual cycle. Here, we analyzed cycle phase and hormonal predictors of women's self-perceived attractiveness (SPA) assessed within a daily diary study. Forty-three women indicated their SPA, sexual desire, and interest in their own partners or other potential mates each day across 1-2 menstrual cycles; saliva samples collected on corresponding days were assayed for estradiol, progesterone, and testosterone; and photos of the women taken at weekly intervals were rated for attractiveness. Contrary to some prior studies, we did not find a significant increase in SPA within the estimated fertile window (i.e., cycle days when conception is possible). However, within-cycle fluctuations in progesterone were significantly negatively associated with shifts in SPA, with a visible nadir in SPA in the mid-luteal phase. Women's sexual desire and SPA were positively associated, and the two variables fluctuated in very similar ways across the cycle. Third-party ratings of women's photos provided no evidence that women's SPA simply tracked actual changes in their visible attractiveness. Finally, for partnered women, changes in SPA correlated with shifts in attraction to own partners at least as strongly as it did with shifts in fantasy about extra-pair partners. Our findings provide preliminary evidence for the idea that SPA is a component of women's sexual motivation that may change in ways similar to other hormonally regulated shifts in motivational priorities. Additional large-scale studies are necessary to test replication of these preliminary findings.

Diversity and representation within the literature on sexual dysfunction in multiple sclerosis: A systematic review.

INTRODUCTION: Sexual dysfunction (SD) is a common and distressing symptom for people living with multiple sclerosis (MS). Populations included in existing studies of SD may not fully reflect the diversity of people living with MS, with important implications for wider applicability. We aimed to evaluate reporting of sex, gender identity, sexual orientation, and ethnicity across studies of SD in MS. METHODS: A systematic search of four databases was performed. Two independent authors evaluated all papers. Reporting of sex and gender identity, sexual orientation, and ethnicity were recorded. RESULTS: A total of 419 papers were reviewed, and 204 studies with 77,902 participants met the criteria for evaluation. Of 204 studies, 98 (48.0%) included both male and female participants; 78 (38.2%) included females only, and 27 (13.2%) males only. In 19 (9.3%) studies, participants were asked their gender. No studies reported asking a two-step question on sex and gender identity. No studies reported including non-binary patients or gender identities other than male or female. No studies reported including intersex patients. Only 10 (4.9%) studies reported the inclusion of homosexual or bisexual participants, or participants from other sexual minority groups. The overwhelming majority of studies (181; 88.7%) did not report ethnicity or race of participants. CONCLUSION: Sex, gender identity, sexual orientation, and ethnicity are poorly reported in studies on SD in MS. These variables must be adequately evaluated to ensure research applies across diverse MS patient populations.

Anticipation of sexually arousing visual event leads to overestimation of elapsed time.

Subjective estimates of duration are affected by emotional expectations about the future. For example, temporal intervals preceding a threatening event such as an electric shock are estimated as longer than intervals preceding a non-threatening event. However, it has not been unequivocally shown that such temporal overestimation occurs also when anticipating a similarly arousing but appealing event. In this study, we examined how anticipation of visual erotic material influenced perceived duration. Participants did a temporal bisection task, where they estimated durations of visual cues relative to previously learned short and long standard durations. The color of the to-be-timed visual cue signalled either a chance of seeing a preferred erotic picture at the end of the interval or certainty of seeing a neutral grey bar instead. The results showed that anticipating an appealing event increased the likelihood of estimating the cue duration as long as compared to the anticipation of a grey bar. Further analyses showed that this temporal overestimation effect was stronger for those who rated the anticipated erotic pictures as more sexually arousing. The results thus indicate that anticipation of appealing events has a similar dilating effect on perceived duration as does the anticipation of aversive events.

Unlocking the psycho-social-dermal axis: A double blinded randomized placebo controlled study unveiling the influence of a novel topical formulation on skin quality, attractiveness, quality of life, and sexual satisfaction.

BACKGROUND: Improved skin appearance is closely linked to higher self-esteem, favorable first impressions, and enhanced quality of life, with skincare products often being formulated with biostimulatory and regenerative ingredients to both enhance skin health and provide psychological benefits. Certain components, such as phospholipids and botanicals, may not only improve skin quality, but also impact mood, romantic bonding, and sexual attraction. AIMS: To assess whether a novel topical skin care product formulated with a proprietary combination of proteins, lipids, and botanical derivatives, can potentially result in a robust psycho-social-dermatological benefit via modulation epidermal oxytocin and pheromonal pathways. PATIENTS/METHODS: In this single-center prospective, randomized, controlled, double-blinded study, 40 female subjects were randomly assigned to use of either active novel skincare products, or placebos, for 4-8 weeks. Skin assessments, standardized photography, first impression ratings, and questionnaires on confidence and sexual satisfaction were conducted. RESULTS: Thirty-nine subjects completed the study and demonstrated a statistically significant improvement in skin quality following 4 and 8 weeks of use, with improvements of greater magnitude demonstrated with a longer duration of use. Product users projected a better first impression and appeared on average 3 years younger than their actual age, with 86% of subjects reporting increased confidence. Product users found random people of the opposite sex to be more attractive 88% of the time and reported improvement in sexual satisfaction in 90% of the categories. CONCLUSIONS: The use of this novel topical product culminated in statistically significant improvements in skin quality, confidence, sexual relationship satisfaction, perceived attractiveness, and youthfulness, highlighting its potential in anti-aging and mood enhancement.

A 5-year evaluation of quality of life, pelvic discomfort, and sexual function following posterior pericervical repair.

The aim of this study was to evaluate the quality of life, pelvic discomfort, and sexual function of patients who underwent posterior pericervical repair or level I to III surgical procedures for pelvic organ prolapse (POP) after 5 years of follow-up. This retrospective cohort study enrolled 107 women with POP who were referred to the Imam Khomeini Hospital Complex, an academic center affiliated with the Tehran University of Medical Sciences, Tehran, Iran, from 2014 to 2021. The patients underwent transvaginal surgery using native tissue, in which the rectovaginal fascia was attached to the pericervical ring. The Pelvic Floor Distress Inventory-20 (PFDI-20) and Lower Urinary Tract Symptoms Module (ICIQ-FLUTSsex) questionnaires were completed by each patient before and 5 years after surgery. Of the 107 patients, only 78 completed the 5-year follow-up. The mean PFDI-20 scores before, 12 months, and 5 years after surgery were 141.87 ± 34.48, 100.87 ± 26.48, and 37.49 ± 56.39, respectively, indicating a significant improvement in the patients' symptoms after surgery (P < 0.001). The total mean score of ICIQ-FLUTSsex was 3.67 ± 3.63 (range, 0-10). In total, 22 (28.2%) women had an ICIQ-FLUTSsex score of 0, indicating no problems. The attachment of the rectovaginal fascia to the pericervical rings can be an effective surgical technique for correcting posterior vaginal wall prolapses, without significant morbidity. The PFDI-20 score improved significantly from before surgery to 12 months and 5 years after surgery.

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.

Women`s sexual function during the postpartum period: A systematic review on measurement tools.

BACKGROUND: Sexual health is a critical component of overall well-being, yet discussions around sexual function, especially in the context of postpartum recovery, are often taboo or sidelined. The aim was to review measurement tools assessing women's sexual function/health during the postpartum period. METHODS: We did a systematic search according to preferred reporting items for systematic reviews and meta-analyses 2020 guidelines in different databases, including PubMed, Web of Science, Scopus, Embase, ProQuest and Open Access Thesis and Dissertations, and Google scholar search engine until June 2023. Also, the reference list of the related reviews has been screened. Eligible studies included observational studies or clinical trials that evaluated women`s sexual function during the postpartum period using existing tools. Data extraction covered study characteristics, measurement tools, and their validity and reliability. RESULTS: From 3064 retrieved records, after removing duplicates and excluding ineligible studies, and reviewing the reference list of the related reviews, 41 studies were included in this review. Tools measuring sexual function were developed from 1996 to 2017. Sexual activity questionnaire, female sexual function index (FSFI), sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, and sexual function questionnaire's medical impact scale and Carol scale. CONCLUSION: Sexual activity questionnaire, FSFI, sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, sexual function questionnaire's medical impact scale, and Carol scale are valid and reliable measuring tools to assess sexual function or sexual health during postpartum period, which can be used in primary studies according to the study aim and objectives.

The association between female sexual function and metabolic features of the polycystic ovary syndrome in Turkish women of reproductive age.

OBJECTIVE: To investigate the association between female sexual function and metabolic features among women with polycystic ovary syndrome (PCOS) during reproductive age. METHOD: This was a cross-sectional study in which 288 women with PCOS and 180 women without PCOS between the ages of 20 and 40 years were evaluated. All women had serum total testosterone, androstenedione, DHEA-S, fasting glucose, total cholesterol, HDL-C, LDL-C, and triglyceride levels analyzed. The McCoy Female Sexual Questionnaire (MFSQ) was applied to all studied women. Exploratory factor analysis and reliability analysis were done after data collection. The factor loadings of MFSQ domains were compared between women with PCOS and controls. RESULTS: Average factor loadings of the MFSQ sexuality domain and MFSQ sexual partner domain were significantly lower in the PCOS group when compared to controls. There was no correlation between the two sexual function domains of the MFSQ and the PCOS features either in the PCOS group or the controls. CONCLUSION: PCOS is a heterogeneous disease with different metabolic components, such as insulin resistance, obesity, and hyperandrogenism. Although sexual function among women with PCOS was lower than controls, no differences were found in metabolic features of the PCOS and non-PCOS groups with relation to sexual function determined by the MFSQ.

Endorphins, Sexuality, and Reproduction.

Beta-endorphin is secreted from the hypothalamus and pituitary in both mother and newborn. The placenta produces numerous pituitary hormones from the third month of pregnancy, one of which is ßE. It has been suggested that ßE has a role in the appetitive and precopulatory phase of sexual behavior in animals. An increase in endorphin levels during sexual activity in humans may contribute to attachment and bonding between partners, but contradictory reports in the literature question the association between sexuality and ßE levels. The level of ßE also increases during pregnancy, rises in early labor, peaks in late labor, and drops in the postpartum period. This fluctuation provides natural analgesia, raises the pain threshold, decreases the sensation of pain, or suppresses pain, and decreases fear levels during labor and birth. Beta-endorphin also protects the fetus from hypoxia during labor and birth and potential neural damage by aiding blood flow to the brain under hypoxic conditions. It has been suggested that a variety of pharmacologic and nonpharmacologic complementary therapies, when used in pregnancy, labor, and birth, activate the opioid receptors in the CNS and alter the sensation of pain during labor and birth, affect the mother-child attachment and affect sexual function. These studies report contradictory results that will be discussed in this chapter.

The impact of male genital self-image on depression, anxiety and sexual functions.

AIM: This study aims to examine the relationship between male genital self-perception and sexual functioning and depression anxieties. METHOD: The study included male patients who were referred to the andrology outpatient clinic between March 2022 and June 2022. Demographic data of the patients were recorded. Cigarette and alcohol consumption was also noted. The Male Genital Self Image Scale (MGSIS) questionnaire was used for the Genital Self Image(GSI) assessment, which consists of 7 questions. The International Index of Erectile Function (IIEF), composed of 15 questions, was used to evaluate sexual function. STAI-I, STAI-II, and BECK scales were used for depression and anxiety. The penis size of the patients was measured in a flask and stretched condition, and the midpenile circumference was recorded. Patients were compared with respect to GSI, depression, anxiety, and sexual functioning. RESULTS: A total of 75 patients were included in the study. The mean age of the patients was 46.69 ± 11.32 (26-72), and the mean BMI was 27.82 ± 3.79 (22.46-40.40) kg/m2. A slightly positive correlation was found between the patients' flask penis size and MGSIS-total scores (r = 0.260, p = .024) and IIEF-SF scores (r = 0.240, p = .038). There was a moderately positive correlation between the stretched penis size and IIEF-OS (r = 0.403, p < .001) and IIEF-SF (r = 0.354, p = .002). While the MGSIS-total score and the STAI-I and STAI-II scores had a moderate negative correlation, there was an advanced negative correlation between the MGSIS-total score and the BECK score. CONCLUSION: Disruption of men's genital self-perception is moderately related to their susceptibility to depression and anxiety. This situation affects the person's sexual performance and causes orgasm problems to increase.

Maternal caregiving stress and metabolic health: Sexual activity as a potential buffer.

Chronic stress lead to dysregulation of metabolic hormones, creating risk for obesity and type 2 diabetes. Based on previous work suggesting the potential for sexual activity to relieve psychological stress and reduce stress-related neuroendocrine activity, the present research explored sexual activity as a protective factor. We focused on chronic stress in the form of caregiving stress, comparing premenopausal mothers of a child with an autism spectrum disorder vs. a neurotypical child, in relation to metabolic hormones - insulin (and insulin resistance as assessed by HOMA), leptin, and ghrelin. Then, we explored the moderating role of sexual activity. Our results showed that high-stress mothers showed higher levels of insulin, insulin resistance, and lower levels of ghrelin compared to low-stress mothers. However, sexual activity modulated these associations such that among mothers who were sexually active (as coded from their daily diaries), no significant differences in these outcomes were observed between groups. This buffering effect of sexual activity was distinguishable from the buffering effect of physical activity and independent of global relationship satisfaction. Together, our findings provide novel evidence supporting the potential protective effects of sexual activity from chronic stress-related metabolic disease risk.

Victim Sexual Arousal During Nonconsensual Sex: A Scoping Review.

Sexual arousal in male and female victims during nonconsensual sex is an understudied phenomenon with many potential psychological, clinical, and legal implications for survivors. The aim of this scoping review was to assess the literature to determine whether we could estimate the frequency and circumstances of physiological sexual arousal (e.g., erection, lubrication, ejaculation, orgasm) among victims during nonconsensual sex. Six reference database and hand searches led to the screening of 13,894 articles and other reports. Eight articles and one book published between 1977 and 2019 included relevant data from 136 male survivors and 250 female survivors. Results confirmed that physiological sexual arousal (only genital responses were mentioned) can occur in both male and female victims during nonconsensual sex. The frequency of these responses could not be determined because of the widely different methodologies used. In addition, it was not possible to determine the circumstances in which victim sexual arousal was more likely to occur although some were inferred. The results of the scoping review highlight that physiological sexual arousal during nonconsensual sex does occur for victims but has not been studied systematically. There is a clear need to properly assess the type, circumstances, consequences, and frequency of sexual arousal during nonconsensual sex in large and diverse populations of male and female survivors.

Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus.

The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI - encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable.

Women and men with distressing low sexual desire exhibit sexually dimorphic brain processing.

Distressing low sexual desire, termed Hypoactive Sexual Desire Disorder (HSDD), affects approximately 10% of women and 8% of men. In women, the 'top-down' theory of HSDD describes hyperactivity in higher-level cognitive brain regions, suppressing lower-level emotional/sexual brain areas. However, it is unknown how this neurofunctional disturbance compares to HSDD in men. To investigate this, we employed task-based functional MRI in 32 women and 32 men with HSDD to measure sexual-brain processing during sexual versus non-sexual videos, as well as psychometric questionnaires to assess sexual desire/arousal. We demonstrate that women had greater activation in higher-level and lower-level brain regions, compared to men. Indeed, women who had greater hypothalamic activation in response to sexual videos, reported higher psychometric scores in the evaluative (r = 0.55, P = 0.001), motivational (r = 0.56, P = 0.003), and physiological (r = 0.57, P = 0.0006) domains of sexual desire and arousal after watching the sexual videos in the scanner. By contrast, no similar correlations were observed in men. Taken together, this is the first direct comparison of the neural correlates of distressing low sexual desire between women and men. The data supports the 'top-down' theory of HSDD in women, whereas in men HSDD appears to be associated with different neurofunctional processes.

Evidence for the Impact of Stress and Trauma on Sexual Function in Women: Review and Clinical Recommendations.

Stressors occur in a spectrum, ranging from daily hassles to life-threatening experiences, and can significantly impact sexual functioning. Thus, this review summarizes the intricate relationship between trauma spectrum experiences and women's sexual functioning. Biological mechanisms are described to elucidate the physiologic complexity that manifests because of trauma-related experiences. Additionally, both psychological and social implications are discussed. Treatment recommendations for practitioners working with women are discussed, underscoring the importance of adopting a trauma-informed care model.

Sexuality and Infertility.

Infertility diagnoses and treatment can lead to psychological distress and relationship strain. Infertility is commonly associated with disruptions in sexual function and satisfaction among women, in part due to overlapping etiologic factors (eg, comorbid medical conditions). Women and couples with infertility should be screened for sexual problems and provided education on the relationship between infertility and sexuality. Sexual dysfunction in the context of infertility is often best addressed using an interdisciplinary approach. This article provides a summary on the relationship between sexuality and infertility and recommendations for the assessment and management of sexual dysfunction in women with infertility.