Cross Sectional Survey of Priapism and Sexual Dysfunction in 353 Men with Sickle Cell Disease

Introduction: In both high and low income countries, life span in sickle cell disease (SCD) is increasing and quality of life is improving. Recent research activities have focused on decreasing SCD-related morbidities. However, limited research has been done on clinical epidemiology of priapism, sexual dysfunction and libido in men with SCD. As part of our ongoing Priapism in Nigeria (PIN) cohort to assess knowledge gap in clinical epidemiology of priapism and sexual dysfunction in men with SCD, we tested the hypothesis that sexual dysfunction is high in men with SCD compared to age/race matched men without SCD. Methods: We utilized a mixed method study design (cross-sectional survey and focus group discussions) in men, aged 18-40 years, with confirmed SCD and men without SCD as comparators for the survey. Participants were recruited from the adult sickle cell clinic and general outpatients department of Aminu Kano Teaching Hospital (AKTH) and Murtala Mohammed Specialists Hospital (MMSH) in Kano, Nigeria from February to July 2019. Priapism is defined as a purposeless painful erection, unrelated to sexual desire; and mostly occurs in the stuttering or recurrent ischemic form, which lasts less than 4 hours. We used the validated International Index of Erectile Function (IIEF) questionnaire to assess erectile dysfunction in this population. Additionally, we conducted 6 focus group discussions in Nigeria (3 sessions) and United States (3 sessions), respectively; in which we asked open ended questions about symptoms, experiences, beliefs and life impacts of priapism. Data were presented as means ± standard deviation or proportions with 95% Confidence Intervals. The t-test and Chi square test were used to compare demographic data. Similarly, domain-specific scores, which included: 1) erectile function, 2) sexual desire, 3) orgasmic function, 4) overall satisfaction with sex life, and 5) intercourse satisfaction- were compared between the two groups using t-test; where higher scores indicate better sexual function. Erectile domain was further sub-classified into normal (26-30), mild ED (22-25), mild-moderate ED (17-21), moderate ED (11-16) and severe ED (0-10). We considered alpha level of significance to be <0.05. The focus group data was analyzed using an iterative inductive/deductive approach. Results: A total of 353 men with SCD and 250 men without SCD were evaluated; for the demographic features the only significant difference was in monthly income (p 0.007) with SCD being higher, table 1. The prevalence of any priapism episode (major or stuttering) in men with and without SCD was 31.72% (112 of 353) and 2% (5 of 250). Among men with SCD, 25.9% (29 of 112) and 74.1% (83 of 112) had major and stuttering priapism episodes, respectively. Based on the IIEF, the men with SCD when compared to men without SCD had significantly lower total mean scores (24.9 vs 29.6, p 0.0002), erectile function (9.9 vs 11.5, p 0.005), sexual desire (5.8 vs 7.1, p<0.0001), and overall satisfaction with sex life (2.3 vs 3.5, p<0.0001). No significant difference in orgasmic function (p=0.29) and intercourse satisfaction (p=0.12) was observed. Among the married men with and without SCD, 55% (21 of 38) and 84% (22 of 26) had normal erectile function, and 26.3% (10 of 38) and 11.5% (3 of 26) had severe erectile dysfunction, respectively. Based on the data from our focus groups with a total of 28 and 7 participants (n=35), in Nigeria and United States respectively, we were guided by biopsychosocial and socio-ecological models to develop a conceptual framework (not shown). We identified themes on cultural context, priapism (triggers, schema, episodes and coping strategies), emotional and sexual function impacts, with respective quotes (results not shown). Conclusions: In the largest cross-sectional and qualitative study of priapism in men with SCD to date, we demonstrated that priapism and sexual dysfunction are significant cause of morbidity when compared to men without SCD. Married participants with SCD have 2-fold greater proportion of severe erectile dysfunction than those without SCD. Our qualitative results revealed tremendous impact of priapism and sexual dysfunction in men with SCD. Participants with priapism experience shame, anxiety and depression, and declined sexual function. There was diversity in causal attribution and coping strategies of priapism. Disclosures Idris: Fogarty International Center: Research Funding.

Download Full-text

Sexual Dysfunction and Marital Relationship in Women With Schizophrenia in Comparison with Caregivers: A Hospital-based Study

Journal of Psychosexual Health ◽

10.1177/2631831820918133 ◽

2020 ◽

Vol 2 (1) ◽

pp. 87-92

Author(s):

Suvarna Jyothi Kantipudi ◽

Navina Suresh ◽

Poornima Ayyadurai ◽

Sathianathan Ramanathan

Keyword(s):

Sexual Dysfunction ◽

Sexual Function ◽

Sexual Functioning ◽

Cross Sectional Study ◽

Women Caregivers ◽

Cross Sectional ◽

Significant Difference ◽

Relationship Assessment ◽

The Impact ◽

The Relationship

Background: Sexual dysfunction is common in females with schizophrenia and is attributed to multiple causes, including individual psychopathology and antipsychotics. Understanding the impact of relationship satisfaction on sexual functioning is not widely studied in schizophrenia. Women caregivers also experience sexual problems and were not studied in the past. Aim: To assess the nature and occurrence of sexual dysfunction in women with schizophrenia in comparison to caregivers of males without severe mental disorder. Methods: A cross-sectional study was conducted. A total of 30 women with schizophrenia were recruited as cases and 26 age-matched controls were recruited from female caregivers. All subjects were assessed using standardized tools such as Female Sexual Function Index (FSFI) and Relationship Assessment Scale along with sociodemographic questionnaire. Results: There was a significant difference in FSFI scores and relationship scores between women with schizophrenia and caregiver control subjects. The relationship quality was better in patients with schizophrenia when compared to caregivers unlike sexual functioning. Conclusion: Sexual functioning in women is a complex phenomenon. A holistic biopsychosocial approach is necessary to understand women’s sexual function.

Download Full-text

Erectile dysfunction in psychiatric patients

European Psychiatry ◽

10.1016/s0924-9338(11)73252-7 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1548-1548

Author(s):

M. Ladea ◽

M. Bran ◽

C.M. Barbu ◽

M.C. Sarpe

Keyword(s):

Erectile Dysfunction ◽

Sexual Function ◽

Antipsychotic Medication ◽

Sexual Desire ◽

Erectile Function ◽

Psychotic Disorders ◽

Psychiatric Patients ◽

Young Patients ◽

Male Sexual Function

IntroductionErectile dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient for sexual activity.ObjectivesED is a common condition in psychiatric patients, which can modify their quality of life.AimsThe aim of this study is to assess the prevalence and the severity of ED in psychiatric patients.MethodsThis naturalistic, observational study was conducted during a six months period. The International Index of Erectile Function (IIEF) 15-item questionnaire was used to assess 144 male inpatients with different psychiatric disorders. IIEF is a brief, cross-culturally valid, self-administered scale for detecting treatment-related changes in patients with erectile dysfunction and addresses the relevant domains of male sexual function: erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. The patients were analyzed by age, psychiatric diagnosis, medication, IIEF scores at admission.ResultsThen mean age was 36.4 years. The lot included 44 patients with Psychotic Disorders, 68 with Mood Disorders, 21 with Alcohol Dependence, 11 with Personality Disorders. Severe ED was registered in 38% of investigated patients, which determined abandon of sexual attempts in 57% of cases; 12% had moderate ED, 15% had mild to moderate ED, 18% had mild ED and 17% had normal sexual function. No orgasm was reported in 32% of patients and 37% had no sexual desire. Under treatment with antipsychotic medication 78% had severe or moderate ED.ConclusionsSevere ED was correlated with age, also being seen in young patients. ED was correlated with depression, schizophrenia and antipsychotic medication.

Download Full-text

Female Sexual Dysfunction in Patients Treated with Antidepressants: A Comparison between Agomelatine and Escitalopram

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i50a33395 ◽

2021 ◽

pp. 196-204

Author(s):

Virinder Kaur ◽

Ng Chong Guan ◽

Jesjeet Singh Gill ◽

Low Sue-Yin

Keyword(s):

Sexual Dysfunction ◽

Sexual Desire ◽

Female Sexual Dysfunction ◽

Rating Scale ◽

Psychiatric Clinic ◽

Depression Severity ◽

Cross Sectional ◽

Care Clinic ◽

Significant Difference ◽

Desire Disorder

Aim: This study aims to determine and compare the prevalence of Female Sexual Dysfunction (FSD) between patients on escitalopram and agomelatine, as well as to investigate possible factors associated with their usage. Study Design: Cross-sectional. Place and Duration of Study: Psychiatric Day Care Clinic, Department of Psychological Medicine, University Malaya Medical Centre (UMMC), Malaysia, between November 1, 2020 until February 1, 2021. Methodology: This study is a cross-sectional study involving 66 women with depression from the outpatient psychiatric clinic of a university hospital; 35 of whom were prescribed with escitalopram and 31 with agomelatine. The subjects were in remission and had no significant signs or symptoms of depression for at least 2 months. The prevalence of FSD between the two groups were compared after adjusting for underlying depression severity. Results: This study showed that the overall prevalence rate of FSD was 33.3%, with the prevalence being higher for those on escitalopram (42.9%) than those on agomelatine (22.6%), but did not achieve statistical significance (P=0.081). Out of the six domains of FSD, multivariate analyses revealed that there was a significant reduction of 69% in sexual desire disorder (95% CI:0.110, 0.855), P=0.022 for those on agomelatine compared to escitalopram. Controlling for drug dosage and depression severity (as measured using Montgomery-Asberg Depression Rating Scale), the odds for patients on agomelatine developing sexual desire disorder was 0.267 (95% CI:0.091, 0.783), P=0.016. Conclusion: There was no significant difference in FSD risk between patients on agomelatine and those on escitalopram. Patients on agomelatine were however less likely to develop sexual desire disorder, which demonstrates a slightly better sexual acceptability profile of agomelatine in women in this respect compared to escitalopram.

Download Full-text

Examination of sexual functions and depressive symptoms among infertile and fertile women

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.5.615 ◽

2019 ◽

Vol 35 (5) ◽

Cited By ~ 1

Author(s):

Selda Ozturk ◽

Hatice Kahyaoglu Sut ◽

Leyla Kucuk

Keyword(s):

Depressive Symptoms ◽

Sexual Dysfunction ◽

Sexual Function ◽

Sexual Intercourse ◽

Beck Depression Inventory ◽

Female Sexual Function ◽

Cross Sectional ◽

Infertile Women ◽

Significant Difference ◽

Fertile Women

Objective: To examine the sexual functions and depressive symptoms of infertile and fertile women. Methods: This study was conducted between October 2015 and April 2016 using a descriptive, cross-sectional and comparative design. The sample of this study consisted of 96 infertile and 96 fertile women. The data were collected using an information form, the Beck Depression Inventory and the Index of Female Sexual Function. The data were analyzed The Mann-Whitney U test, chi-square test, and Spearman’s correlation analysis. Results: The rate of sexual dysfunction (87.5% vs. 69.8%) and the Index of Female Sexual Function total score (31.8 ± 7.8 vs 35.7 ± 6.3) were significantly higher in infertile women than fertile women (p=0.003, p<0.001, respectively). The sexual satisfaction and discomfort during sexual intercourse subscales of the Index of Female Sexual Function were significantly lower among infertile women than fertile women (p<0.001 for all); however, no significant difference was observed in the sexual intercourse/libido score of the Index of Female Sexual Function between infertile and fertile women (p=0.590). The correlation coefficients between the Beck Depression Inventory total score and the total and subscale scores of the IFSF did not significantly differ between infertile and fertile women (p>0.05 for all). Conclusion: The sexual dysfunction rate among infertile women was higher than that among fertile women. Sexual functions decreased when depressive symptoms increased for both infertile and fertile women. doi: https://doi.org/10.12669/pjms.35.5.615 How to cite this:Ozturk S, Sut HK, Kucuk L. Examination of sexual functions and depressive symptoms among infertile and fertile women. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.615 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download Full-text

Effect of Foot Reflexology on Sexual Function of Patients under Hemodialysis: A Randomized Parallel Controlled Clinical Trial

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/8553549 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Somayeh Zeidabadinejad ◽

Parvin Mangolian Shahrbabaki ◽

Mahlagha Dehghan

Keyword(s):

Sexual Dysfunction ◽

Sexual Function ◽

Erectile Function ◽

Sham Group ◽

Intervention Group ◽

Hemodialysis Patients ◽

Endocrine Function ◽

Controlled Clinical Trial ◽

Female Sexual Function ◽

Significant Difference

Introduction. Hemodialysis patients experience sexual dysfunction due to the nature of their disease and its complications. Dialysis patients have reported sexual dysfunction as one of the most important stressors, which leads to many psychological and physiological problems. Sexual function in hemodialysis patients has been improved with pharmaceutical and nonpharmacological therapies. Foot reflexology is a complementary and alternative treatment that can be used in conjunction with contemporary care. By activating the chemical nerve system, reflexology may balance enzymes and regulate endocrine function. Objectives. To determine the effect of foot reflexology on the sexual function of hemodialysis patients. Methods. This randomized controlled trial was conducted on 47 patients on chronic hemodialysis referred to Imam Reza Hospital in Sirjan, Iran, who were divided into two groups of reflexology (n = 24; male = 19 and female = 5) and sham (n = 23; male = 18, and female = 5). The intervention group received foot reflexology during dialysis for four weeks, three times a week, 30 minutes each time (15 minutes per foot). The sham group received nonspecific foot massage without applying pressure on standard reflex points with the same condition and duration as the intervention group. The international index of erectile function and female sexual function index was assessed before, immediately, and one month after the intervention. Results. The results showed that immediately after the intervention, male orgasm function, sexual desire, and intercourse satisfaction in the reflexology group was significantly higher than those of the sham group. There was no significant difference between the two groups regarding erectile function and overall satisfaction. Furthermore, there was no significant difference between the two groups in terms of different aspects of female sexual function. Conclusions. Foot reflexology, as an effective intervention treatment, can reduce some aspects of sexual dysfunction of male patients under hemodialysis.

Download Full-text

Female Sexual Function after Vaginal Delivery with Episiotomy and Cesarean Section

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v2i4.408 ◽

2016 ◽

Author(s):

I Made W Jembawan

Keyword(s):

Sexual Dysfunction ◽

Cesarean Section ◽

Sexual Function ◽

Vaginal Delivery ◽

P Value ◽

Female Sexual Function ◽

Chi Square ◽

Cross Sectional ◽

Significance Level ◽

Significant Difference

Objective: To determine the difference of sexual function after vaginal delivery with episiotomy and cesarean section in Sanglah Hospital, Denpasar. Method: This research was conducted using cross sectional method. Sample was collected using consecutive sampling, starting from October 2011-September 2012. Our sample consists of 86 women, 43 post-episiotomy and 43 post-cesarean section. Sexual function was assessed using FSFI (Female Sexual Function Index). Total score was analyzed using independent t-test and difference of sexual function was tested using Chi-square, with significance level p0.05). There was no significant difference between the two groups in term of sexual arousal and lubrication, with p-value 0.160 and 0.67, respectively. However, we found significant difference in other domains, namely desire (p=0.014), orgasm (p=0.045), satisfaction (p=0.018), pain (p=0.02), and total FSFI score (p=0.006). Sexual dysfunction was found in 18.60% of the episiotomy group and 2.33% of the cesarean section group, with p=0.030. Conclusion: Female sexual dysfunction was found to be significantly different between women post vaginal delivery with episiotomy and women who had cesarean section. [Indones J Obstet Gynecol 2014; 4: 199-203] Keywords: cesarean section, episiotomy, female sexual function

Download Full-text

Predictors of sexual dysfunction in HIV-infected women

Acta Facultatis Medicae Naissensis ◽

10.5937/afmnai38-25536 ◽

2021 ◽

Vol 38 (1) ◽

pp. 47-55

Author(s):

Zeinab Moshfeghy ◽

Fatemeh Dadgar ◽

Roksana Janghorban ◽

Tahereh Poordast

Keyword(s):

Domestic Violence ◽

Sexual Dysfunction ◽

Hiv Infection ◽

Sexual Function ◽

Highly Active Antiretroviral Therapy ◽

Adverse Outcomes ◽

Depression Anxiety Stress Scale ◽

Cross Sectional ◽

Infected People ◽

Significant Difference

Sexual dysfunction is more common among the people with human immunodeficiency virus (HIV) infection than in those without it. The sexual dysfunction in HIV-infected people is associated with adverse outcomes such as reduced quality of life, unprotected sexual activities, and reduced adherence to highly active antiretroviral therapy. Therefore, the present study was designed to investigate a potential predictor role of some variables such as socioeconomic status, hormonal and HIV disease profile, type of treatment, depression, anxiety, stress, domestic violence, and status of partner infection for sexual function in people with HIV infection. This descriptive cross-sectional study was conducted on 40 HIV-infected women with medical records in behavioral disease counseling centers of Shiraz University of Medical Sciences. The required data were collected using the Female Sexual Function Index (FSFI), Depression‚ Anxiety‚ Stress Scale (DASS-21), and Domestic Violence Questionnaire. To examine the CD4 cell levels and hormonal profiles, 5cc blood was taken from the patients simultaneously on days 3 - 5 of their menstrual cycles. The data were analyzed using the SPSS18 software. The mean age of the participants was 38.2 ± 5.2 years, and the frequency of sexual dysfunction was 100%. There was a statistically significant difference in the levels of the elevated variables such as estradiol, stress, anxiety, and depression. The multivariate analysis showed that only the increased estradiol level (P = 0.005, B = 0.06) was a predictor factor of sexual dysfunction. All the HIV-infected women had sexual dysfunction. The results of this study showed that in those women the increased levels of estradiol could be a predictor of sexual dysfunction.

Download Full-text

Prevalence of sexual dysfunction in women resident of a capital city in the brazilian western Amazon

Revista Eletrônica Acervo Saúde ◽

10.25248/reas.e5359.2020 ◽

2020 ◽

Vol 12 (12) ◽

pp. e5359

Author(s):

Joice Rodrigues Fagundes ◽

Siglia Sousa De França ◽

Everton Felipe do Vale Araújo ◽

Alberto Pereira Firmino Filho ◽

Charlene Cristine Rodrigues Menezes

Keyword(s):

Sexual Dysfunction ◽

Sexual Desire ◽

National Level ◽

Cross Sectional Study ◽

Self Report ◽

Capital City ◽

Average Score ◽

Cross Sectional ◽

Significant Difference ◽

Potential Risk Factors

Objective: To determine the prevalence of sexual dysfunction in non-pregnant, pregnant, and postpartum women, and its association with potential risk factors. Methods: Cross-sectional study composed of 419 women, who attend public health units, from April to August 2019, in Rio Branco, Acre. The volunteers were subjected to a self-report questionnaire previously validated at national level: The Sexual Quotient-Female version. Results: Based on the total number of responses, 35.6% of the participants had sexual dysfunction. Of those, almost half of the volunteers (42%) were unemployed (p = 0.003). In the sexual desire and orgasm domains, the average score was higher among women during pregnancy (2.8203) (3,4844) than in the puerperal women (2.3454) (2,0912), respectively (p<0,05). Regarding pain, 30.1% answered "always" for its incidence during sexual intercourse. Age alone does not influence the sexual function of the participants, (r <1 and p> 0.05). Conclusion: The present study unveiled an important percentage of sexual dysfunction, predominantly in the pain subdomain. In addition, a significant difference was found in the sexual desire and orgasm domains, with higher scores found in pregnant women compared to puerperal women. Another fact was the higher percentage of sexual dysfunction in unemployed women.

Download Full-text

Assessment of female sexual function in remote postpatum period: a cross-sectional study

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042018000200003 ◽

2018 ◽

Vol 18 (2) ◽

pp. 289-294

Author(s):

Thalita Rodrigues Christovam Pereira ◽

Elissa Hanayama Dottori ◽

Flávia Maciel de Aguiar Fernandes Mendonça ◽

Ana Carolina Sartorato Beleza

Keyword(s):

Sexual Dysfunction ◽

Sexual Function ◽

Postpartum Period ◽

Cross Sectional Study ◽

Postpartum Women ◽

Fisher Exact Test ◽

Female Sexual Function ◽

Sectional Study ◽

Cross Sectional ◽

Significant Difference

Abstract Objectives: (i) to evaluate female sexual function in remote postpartum period within Brazilian women and (ii) to compare female sexual dysfunction in relation to the mode of delivery. Methods: in this cross-sectional study, two groups of remote postpartum women, who underwent vaginal delivery (n=30) and cesarean (n=48), were studied. The sexual function of participants was assessed through an online Brazilian version of FSFI between 45 and 180 days after delivery. Data were analyzed by descriptive and inferential statistics using Fisher exact test, and Student t test. Results: based on the data of 78 women who completed the online questionnaire, 78% (n=61) showed sexual dysfunction on remote postpartum period being that the FSFI mean score for vaginal postpartum was 22.17 and for cesarean postpartum, 21.12 (p=0.443). Conclusions: the majority of remote postpartum women showed sexual dysfunction. There was no significant difference found on female sexual function between modes of delivery.

Download Full-text

Sexual Function in Men Living With a Fontan Circulation

Frontiers in Pediatrics ◽

10.3389/fped.2021.765380 ◽

2021 ◽

Vol 9 ◽

Author(s):

Imants Rubenis ◽

Derek Tran ◽

Andrew Bullock ◽

Vishva Wijesekera ◽

David Baker ◽

...

Keyword(s):

Erectile Dysfunction ◽

Sexual Health ◽

Sexual Desire ◽

Erectile Function ◽

Heart Association ◽

Population Data ◽

Final Analysis ◽

Fontan Circulation ◽

Cross Sectional ◽

Lateral Tunnel

Introduction: It is unknown if the Fontan circulation has an impact on sexual health in men. This study assessed self-reported sexual health and fertility in men with a Fontan circulation.Aims: In this prospective, cross-sectional study, Australian men ≥18 years enrolled in the Fontan Registry of Australia and New Zealand were invited to complete the International Index of Erectile Function (IIEF), alongside questions assessing fertility. These data were compared to historical, age-matched controls.Results: Of 227 eligible men, 54 completed the survey; of those 37 were sexually active and included in the final analysis. Mean age was 28 ± 3 years, age at Fontan was 5 ± 3 years. Fontan type was extra-cardiac conduit in 15 (41%), lateral tunnel in 12 (32%), and atriopulmonary connection (APC) in 10 (27%). Ventricular function was normal in 24 (83%), and all were New York Heart Association Class I (23 patients, 79%) and II (six patients, 21%). Nine participants (24%) had erectile dysfunction (IIEF-EF score ≤25). The severity was mild (IIEF 22–24) in six (16%), mild–moderate (IIEF 17–21) in two (5%), and moderate (IIEF 11–16) in one (3%). Baseline characteristics and current medication usage were similar in those with and without erectile dysfunction. Compared with historical control values, erectile function was not significantly impaired in the Fontan population (p =0.76). Men with a Fontan circulation had decreased levels of sexual desire and overall satisfaction (p < 0.001). There was no correlation between the presence of erectile dysfunction and any assessed parameter. Eleven (30%) of the cohort reported a pregnancy with a prior partner.Conclusion: In our cohort, overall erectile function was comparable between men with a Fontan circulation and historical controls, however sexual desire and overall satisfaction were reduced. There was no correlation between study parameters and the presence of erectile dysfunction. The proportion of the cohort who had a prior pregnancy was congruent with population data.

Download Full-text