Evaluation of sexual dysfunction in gynecologic cancer survivors using DSM-5 diagnostic criteria

Abstract Background In gynecologic cancer survivors, female sexual dysfunction (FSD) remains under-investigated. We attempted to estimate the prevalence of FSD associated with distress in gynecologic cancer survivors using diagnostic and statistical manual of mental disorders fifth edition (DSM-5) diagnostic criteria and to identify women at risk for FSD. Methods We conducted a cross-sectional analysis of premenopausal women aged 20–50 with various gynecologic cancers at least one year after treatment between January 2017 and December 2019. Data of sociodemographics and physical conditions were collected via face-to-face interview during outpatient clinic visits. The domains we used to define FSD were based on DSM-5 diagnostic criteria. Statistical analysis was carried out using Student's t test, Chi-square test and multiple logistic regression. Results A total of 126 gynecologic cancer survivors with a mean age of 42.4 years were included for analysis and 55 of them (43.7%) were diagnosed as having FSD associated with distress based on DSM-5 criteria. More than half of women (65.1%) reported decreased sexual satisfaction after cancer treatment. According to DSM-5 definition, the most common female sexual disorders were sexual interest/arousal disorder (70.9%), followed by genitopelvic pain/penetration disorder (60.0%), and orgasmic disorder (20.0%). In multiple logistic regression model, endometrial cancer diagnosis was the only independent factor predicting less influence of cancer treatment on FSD (OR 0.370; 95% CI 0.160, 0.856). Conclusion The first study to use DSM-5 criteria for estimation of FSD prevalence. This enables clinicians to identify which women are actually needed to seek medical help. A prevalence of 43.7% of FSD associated with distress was found in a group of gynecologic cancer survivors with the most common being sexual interest/arousal disorder. Endometrial cancer survivors were at low risk for developing FSD after treatment.

Download Full-text

Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin

International Journal of Risk & Safety in Medicine ◽

10.3233/jrs-210023 ◽

2021 ◽

pp. 1-12

Author(s):

David Healy ◽

Audrey Bahrick ◽

Maarten Bak ◽

Angelo Barbato ◽

Rocco Salvatore Calabrò ◽

...

Keyword(s):

Sexual Dysfunction ◽

Diagnostic Criteria ◽

Sexual Desire ◽

Serotonin Reuptake ◽

Sexual Interest ◽

Case Series ◽

Mirror Image ◽

Genital Arousal ◽

Reductase Inhibitors ◽

Sexual Symptoms

BACKGROUND: A set of enduring conditions have been reported in the literature involving persistent sexual dysfunction after discontinuation of serotonin reuptake inhibiting antidepressants, 5 alpha-reductase inhibitors and isotretinoin. OBJECTIVE: To develop diagnostic criteria for post-SSRI sexual dysfunction (PSSD), persistent genital arousal disorder (PGAD) following serotonin reuptake inhibitors, post-finasteride syndrome (PFS) and post-retinoid sexual dysfunction (PRSD). METHODS: The original draft was designed using data from two published case series (Hogan et al., 2014 and Healy et al., 2018), which represent the largest public collections of data on these enduring conditions. It was further developed with the involvement of a multidisciplinary panel of experts. RESULTS: A set of criteria were agreed upon for each of the above conditions. Features of PSSD, PFS and PRSD commonly include decreased genital and orgasmic sensation, decreased sexual desire and erectile dysfunction. Ancillary non-sexual symptoms vary depending on the specific condition but can include emotional blunting and cognitive impairment. PGAD presents with an almost mirror image of unwanted sensations of genital arousal or irritability in the absence of sexual desire. A new term, post-SSRI asexuality, is introduced to describe a dampening of sexual interest and pleasure resulting from a pre-natal or pre-teen exposure to a serotonin reuptake inhibitor. CONCLUSIONS: These criteria will help in both clinical and research settings. As with all criteria, they will likely need modification in the light of developments.

Download Full-text

Psychosocial Determinants of Marital Satisfaction Among Gynecologic Cancer Survivors in Malaysia

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.744922 ◽

2021 ◽

Vol 12 ◽

Author(s):

Sidi Hatta ◽

Luke Sy-Cherng Woon ◽

Nik Mohd Nor Nik Sumayyah ◽

Shafiee Mohamad Nasir

Keyword(s):

Sexual Dysfunction ◽

Marital Satisfaction ◽

Cancer Survivors ◽

Sex Education ◽

Gynecologic Cancer ◽

University Hospital ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Low Education ◽

The Relationship

Introduction: Marital issues among gynecologic cancer survivors are common but complex. This study aimed to investigate the relationship between sociodemographic and clinical factors, including sexual dysfunction and marital satisfaction among Malaysian gynecologic cancer survivors.Methods: A cross-sectional survey of married women with gynecologic cancers was conducted at a Malaysian university hospital. Sociodemographic and clinical data were gathered. Sexual dysfunction was measured using the Malay Version Female Sexual Function Index (MVFSFI), while marital satisfaction was evaluated with the Malay Version Golombok Rust Inventory for Marital Satisfaction (MVGRIMS).Results: A total of 116 patients participated in this study. The median age was 59.0 years (Interquartile range, IQR: 49.0–67.0 years); the median duration of marriage was 32 years (IQR: 20.0–40.8 years). 80.2% had a secondary and lower level of education. 37.9% of study subjects (n = 44) reported poor-and below-levels of marital satisfaction, which was equivalent to MVGRIMS transformed scores of >5. The median FSFI total score was 49.9 (IQR: 2.0–63.0). MVGRIMS transformed score correlated significantly with all MVFSFI sub-scores. In logistic regression, lower educational levels were associated with poor marital satisfaction [primary, (adjusted Odds Ratio) aOR = 12.67, 95% CI: 1.40–114.87; secondary: aOR = 11.52, 95% CI: 1.39–95.72], while higher MVFSFI total score reduced the likelihood of poor marital satisfaction (aOR = 0.979, 95% CI: 0.964–0.994).Conclusion: Both sexual dysfunction and low education level may affect marital satisfaction among gynecologic cancer survivors. Targeted efforts focusing on sex education for patients may help to improve marital satisfaction.

Download Full-text

DEVELOPMENT OF ARTERIAL HYPOTENSION IN PREMATURE INFANTS WITH EARLY ONSET BACTERIAL INFECTIONS: TOOLS OF CLINICAL PREDICATION

Wiadomości Lekarskie ◽

10.36740/wlek201905222 ◽

2019 ◽

Vol 72 (5) ◽

pp. 1068-1073

Author(s):

Valeriy Pokhylko ◽

Olena Kovalova ◽

Yuliia Cherniavska ◽

Svitlana Tsvirenko ◽

Yuliia Klymchuk

Keyword(s):

Blood Pressure ◽

Logistic Regression ◽

Blood Glucose ◽

Diagnostic Criteria ◽

Premature Infants ◽

Early Onset ◽

Bacterial Infections ◽

Prognostic Model ◽

Multiple Logistic Regression ◽

Premature Babies

Introduction: The safe thresholds of blood pressure in preterm neonates are still unclear. The aim of our study was to substantiate the diagnostic criteria for the syndrome of arterial hypotension (AH) and indications for the appointment of hemodynamic support in premature infants with early onset bacterial infections. Materials and methods: A prospective cohort study was conducted. 2 experimental groups were formed –premature babies with early onset bacterial infections and AH (n = 58), and control group (n = 62), premature babies without AH. The subjects of the study were a number of risk factors. Simple and multiple logistic regression analyses were used. Results: In premature infants with AH, compared with those without AH, there are significantly lower values of stroke index of left ventricle (SILV), index of resistance (IR) of the middle cerebral artery, pH, significantly higher level of urea in serum and a higher proportion of children with hypoglycemia. Multiple logistic regression analysis was used to develop a clinical prognostic model for the AH-syndrome. Only prognostic model, which included SILV, blood pH and blood glucose, had high prognostic characteristics and the largest area under the ROC curve. Conclusions: The following diagnostic criteria can be used for the appointment of medical support for hemodynamics: the digital value of the level of mean blood pressure, expressed in mmHg, is less than the gestational age in weeks, and at least one of the following indicators –pH is less than 7.2, blood glucose level is less than 2.8 mmol/l, SILV is less than the normal ranges.

Download Full-text

Timed intercourse in infertile couples doing more harm than benefits in terms of sexual dysfunction and time to pregnancy: a cohort study

10.22541/au.160621930.00220662/v1 ◽

2020 ◽

Author(s):

Sujoy Dasgupta ◽

Leila Frodsham ◽

Paramita Patra ◽

Abhyuday Chanda

Keyword(s):

Cohort Study ◽

Sexual Dysfunction ◽

Sexual Interest ◽

Time To Pregnancy ◽

Medical Disorders ◽

Arousal Disorder ◽

Female Orgasmic Disorder ◽

Reproductive Techniques ◽

Infertile Couples ◽

Natural Conception

Objective: To study the differences in sexual dysfunction (SD) and time to pregnancy (TTP) between infertile couples pursuing timed intercourse (TI- around the time of ovulation) and regular intercourse (RI- at least twice a week). Design: Prospective cohort study Setting: Infertility clinics of Kolkata over three years Population or Sample: Infertile couples pursuing TI (n=283) or RI (n=88), having no preexisting sexual or psychiatric illness, and no medical contraindications to frequent intercourse. Methods: At the first visit, SD of both the partners was assessed using the Arizona Sexual Experiences Scale (ASEX) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). The couples for whom natural conception was possible were followed up to determine TTP using Kaplan Meier Analysis. Main Outcome Measure: Differences in SD and differences in TTP. Results: TI significantly increased the risk of SD than RI for both males (Odds ratio [OR] 15.24, 95% confidence interval [CI] 7.96-29.15) and females (OR 5.52, 95% CI 2.38- 12.78). This difference persisted even after adjusting for age, medical disorders, obesity, smoking, cause of infertility, and previous assisted reproductive techniques. TI carried a higher risk of developing ED, premature ejaculation, male hypoactive sexual dysfunction, female sexual interest-arousal disorder, and female orgasmic disorder. IIEF-5 score was significantly better in the RI group than in the TI. The TTP for natural conception was similar between them (Log-rank p= 0.1365). Conclusions: TI increased the risk of sexual dysfunction without accelerating the time to achieve pregnancy, compared with RI.

Download Full-text

Proposed DSM-5 sexual interest/arousal disorder versus DSM-IV distinct HSDD and FSAD

PsycEXTRA Dataset ◽

10.1037/e512622013-028 ◽

2011 ◽

Author(s):

Anita H. Clayton

Keyword(s):

Sexual Interest ◽

Dsm 5 ◽

Arousal Disorder ◽

Dsm Iv

Download Full-text

Sexual function and sexual interest in endometrial cancer survivors: Does a physical activity intervention help?

Gynecologic Oncology ◽

10.1016/j.ygyno.2016.04.087 ◽

2016 ◽

Vol 141 ◽

pp. 24

Author(s):

S. Armbruster ◽

J. Song ◽

K.H. Lu ◽

K.M. Basen-Engquist

Keyword(s):

Physical Activity ◽

Endometrial Cancer ◽

Sexual Function ◽

Cancer Survivors ◽

Physical Activity Intervention ◽

Sexual Interest

Download Full-text

Psychosocial Profile Of Subjects Presenting With Sexual Dysfunctions In Psychiatry Outpatient Department Of A Teaching Hospital In Nepal

Journal of Psychiatrists Association of Nepal ◽

10.3126/jpan.v10i1.40365 ◽

2021 ◽

Vol 10 (1) ◽

pp. 72-75

Author(s):

R. Poudel

Keyword(s):

Sexual Dysfunction ◽

Teaching Hospital ◽

Sexual Interest ◽

College Teaching ◽

Well Being ◽

Outpatient Department ◽

Sexual Dysfunctions ◽

Sexual Medicine ◽

Medical College ◽

Arousal Disorder

Introduction: Sexuality is way people experience and express themselves sexually. It influences psychological, physical and social well-being of both men and women. Sexual dysfunctions are believed to be among the commonly prevalent psychological disorders in the general population but there is a lack of published research papers and literature related to sexuality and sexual medicine from Nepal. The aim of the present study was to descriptively analyze the nature of sexual dysfunctions in a teaching hospital. Material And Method: Retrospective analysis of data from subjects attending the psychiatry outpatient department in Nepalgunj Medical College Teaching Hospital, Kohalpur over the calendar year 2019 was done. Sociodemographic and clinical parameters of the subjects were obtained from the OPD register. Diagnosis was made using the DSM-5. Results: Out of total 54 subjects, 92.6% were male while 7.4% were female. Married subjects constituted 79.6% while single/unmarried 20.4%. Premature ejaculation was the most common sexual dysfunction encountered (55.5%) followed by erectile disorder (33.3%) and female sexual interest/arousal disorder (5.5%). Male hypoactive sexual desire disorder was seen in 3.7% and genito-pelvic pain/penetration disorder was seen in 2%. Conclusion: Males more commonly seek medical help for sexual dysfunction than females. People especially females, hesitate to discuss and seek medical help for sexual dysfunctions. There is lack of research on sexual medicine and sexuality from Nepal and prevalence of various sexual dysfunctions is not known.

Download Full-text

Difference or dysfunction?: Deconstructing desire in the DSM-5 diagnosis of Female Sexual Interest/Arousal Disorder

Feminism & Psychology ◽

10.1177/0959353521989536 ◽

2021 ◽

Vol 31 (1) ◽

pp. 81-98 ◽

Cited By ~ 1

Author(s):

Emily J Thomas ◽

Maria Gurevich

Keyword(s):

Sexual Desire ◽

Conceptual Analysis ◽

Female Sexuality ◽

Sexual Interest ◽

Women's Bodies ◽

Dsm 5 ◽

Female Sexual Desire ◽

Arousal Disorder ◽

Healthy Female ◽

Sociocultural Contexts

This article answers ongoing calls within critical sexuality scholarship to explore how constructions of women’s bodies influence and are influenced by broader sociocultural contexts. Specifically, this article offers a conceptual analysis of female sexual desire, highlighting the deeply political nature of its pathologization. We briefly explore dominant definitions and models of sexual desire to highlight the erasure of embodied desire as an important part of healthy female sexuality. The DSM-5 diagnosis of Female Sexual Interest/Arousal Disorder is critically analyzed to highlight how desire differences are framed as gendered, individual problems which sidelines relational, contextual, and sociopolitical factors contributing to individual distress. When the language of desire is displaced by the language of interest (particularly when framed as receptivity), the capacity to theorize wanting and entitlement is undermined. We argue that the pathologization of diverse desires obscures possibilities for embodied wanting and neglects the consideration that all types of desire (absent, frequent, physical, emotional) may represent normal sexual variations.

Download Full-text