Sexual function among distressed women struggling to conceive without medical intervention

Infertility is disproportionately associated with distress in women, yet there has been limited research focusing on sexual function in this population. Two hundred and thirty women with infertility who were attempting to conceive without medical assistance were recruited via social media. Women completed the Fertility Quality of Life, Revised Dyadic Adjustment Scale, Female Sexual Functioning Index, State-Trait Anxiety Inventory, and Patient Health Questionnaire. Over half of the women with infertility met the clinical cut-off for sexual dysfunction. Sexual function was positively associated with relationship adjustment and infertility-related quality of life and negatively associated with anxiety and depression. Sexual function moderated the relationship between time trying to conceive and psychological outcomes. These findings highlight several domains of sexual functioning that could be manipulated via psychological interventions to potentially improve distress among women struggling to conceive.

Insights from Assessment Type of Sexual Problems and Sexual Satisfaction in Women: A Pilot Study

Female sexual functioning and satisfaction are impaired by the presence of sexual difficulties. Current study aims to analyze the differences on sexual satisfaction in women according to types of sexual problems (absence of sexual problems, self-perceived and assessed by the FSFI cut-off). A total of 329 women answered to a specific question about presence of self-perceived sexual problems, the Sexual Satisfaction Scale for Women, and the Female Sexual Functioning Index. Main findings revealed that sexually health women had better levels of sexual satisfaction when compared to women who self-report sexual difficulties and women who scored clinical levels in FSFI. Also, women who scored clinical levels in FSFI scored lower on sexual satisfaction compared to women who self-report sexual difficulties. Female sexual satisfaction was negatively affected by sexual difficulties assessed according to the FSFI cut-off. Although with lower impact, self-perceived sexual problems also affect negatively sexual satisfaction in women.

Gynecological and psycho-sexual aspects of women with history of anorectal malformations

Purpose Women with anorectal malformation (ARM) are expected to have a normal life span, therefore, gynecological and psycho-sexual issues are also important. Aim of the study was to assess these aspects in adult females with history of ARM. Methods Thirty-seven women from two ARM referral centers, aged ≥ 16, were identified. Gynecologic visit, cervicovaginal swab, pelvic ultrasound, FSH, LH, prolactin, progesterone, 17–β–estradiol, DHEAS, testosterone, TSH during follicular and luteal phases, and administration of FSFI questionnaire to screen the female sexual functioning were performed. Data were compared with six controls. Results Nineteen patients, mean age 21.7 (16–45), participated to the study. Associated anomalies, mostly affecting limbs, vertebrae and genitalia, were present in 57.8% of cases. Mullerian anomalies were retrieved in 36.8%. Hormones’ levels were normal. Concerning sexual functioning, four women (21%) reported dyspareunia or impossible penetration, four did not answer the FSFI questionnaire due to lack of confidence about their sexuality, and three scored lower than the cut-off value for female sexual function. Conclusion This study confirms the importance of a multidisciplinary long-term follow-up for ARM patients, including a careful study of the reproductive tract to detect and treat those conditions that could affect the fertility. Moreover, an appropriate psychological support should be provided.

Transobturator tape and mini-sling methods in stress urinary incontinence: Results of a randomized clinical trial

Background: Stress urinary incontinence is one of the most common types of incontinence in premenopausal women, accounting for almost 50% of such cases. Mid-urethral slings are currently the most widely used surgical method for stress urinary incontinence. This study aimed at comparing the efficacy, complications, urodynamic changes and the sexual function status between mini-sling surgery and transobturator tape to help us select the best method in such patients. Method: In this randomized controlled trial, 80 cases were studied and randomly assigned to either the mini-sling or transobturator tape group (n = 40). A full medical history was taken and the Q.tip and cough tests were performed for each patient to record their urinary incontinence and hypermobility. Abdominal and pelvic ultrasound study was requested by specifying PVR and urodynamic testing. The International Consultation on Incontinence Modular Questionnaire-6 was filled by the patients and the Female Sexual Functioning Index questionnaire by the physician. The patients were followed-up 8 weeks after discharge by urodynamic tests, ultrasound study, and the International Consultation on Incontinence Modular Questionnaire test. Results: The mean age, body mass index, and parity were not significantly different between the two groups. The mean surgical time, amount of bleeding, hospitalization period, and pain index were significantly less in the mini-sling group. The International Consultation on Incontinence Modular Questionnaire and Female Sexual Functioning Index indices before and after surgery showed no significant difference between the two groups. The difference in urodynamic test parameters was also insignificant. Conclusion: In the mini-sling method which is a less invasive method compared to transobturator tape, the intraoperative bleeding, surgical time, hospitalization period, pain, and surgical complications were far less while its efficacy was similar to transobturator tape; therefore, it is recommended in treating stress urinary incontinence among women.

Depression across pregnancy and the postpartum, antidepressant use and the association with female sexual function

BackgroundThere is an established relationship between depression and sexual functioning in women. However, there is limited research examining the relationship between perinatal depression and sexual functioning.MethodsThis study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 211 women recruited in early pregnancy and followed to 12 months postpartum. Women were assessed for depression using the Structured Clinical Interview for the DSM-IV, repeated measurement of depressive symptoms using the Edinburgh Postnatal Depression Scale and sexual functioning using the Female Sexual Functioning Inventory. Data were also collected on antidepressant use, mode of delivery, history of childhood trauma, breastfeeding and partner support.ResultsWomen showed a decline in sexual functioning over pregnancy and the first 6 months postpartum, which recovered by 12 months. For women with depression, sexual functioning was lower throughout pregnancy and continued to be lower at 6 months postpartum than those without depression. Ongoing depressive symptoms at 12 months were also associated with lower sexual functioning. Sexual functioning was not predicted by mode of delivery, antidepressant use or childhood trauma. Breastfeeding predicted lower sexual functioning only at 6 months. Higher partner support predicted higher female sexual functioning.ConclusionsPregnancy and the postpartum are a time of reduced sexual functioning for women; however, women with depression are more likely to have lower levels of sexual functioning and this was not predicted by antidepressant use. In women with perinatal depression, consideration of the impact on sexual functioning should be an integral part of care.