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Sexual dysfunction: Prevalence and relationship with depression and other socio-demographic factors among the type II diabetic women of Pakistan

Objective: To find out the association between sexual dysfunction and depressive symptoms among the type II diabetic women of Pakistan. Methods: Study was conducted at Military hospital RWP from November 2017 to October 2018Two hundred and fiftydiabeticwomen reporting for the routine follow-upat a tertiary care hospital in Rawalpindi Pakistan were approached to participate in our study. Female sexual function index (FSFI) was used to assess the sexual function of the women who participated in our study. Presence of depressive symptoms was assessed by using the Beck depressive inventory II (BDI-II). Relationship of age, duration of diabetes, depression, education, level of family income and type of treatment (insulin or oral hypoglycemic)was assessed with the sexual dysfunction when regression analysis was applied. Results: Out of 250 diabetic women, who were administered FSFI, 35.6% had no sexual problem while 64.5% had significant dysfunction regarding their sexuality. 71.6% of the patients had presence of depressive symptoms while 28.4% were negative on screening of depression with BDI-II. Increasing age and presence of depressive symptoms had considerable association with the sexual dysfunction. Conclusion: High prevalence of sexual dysfunction was recorded among diabetic women of our part of the world. Women with psychological problems should be paid special attention in this regard.Female diabetic patients with increasing ageshould also be screened regularly for psycho-sexual problems during the course of treatment of DM. Keywords: sexual dysfunction; DM; FSFI; depressive symptoms Continuous...

Erectile Dysfunction and COVID-19: a Case Report

Coronavirus Diesease-2019 (COVID-19) infection is suspected to affect the sexual behavior and function. The vascular damage related to COVID-19 can affect the impairment of bed blood vessel of penile and finally make the erectile dysfunction (ED). This problem is one of the most common sexual problem in man, with the prevalantion between 13 until 28% at the 40-80 years old, and the incidence increases with higher age. At this time, no data about the effect of COVID-19 to sexual behavior. There was one case of COVID-19 with erectile dysfunction who was treated at Kemayoran Athletes Village COVID-19 hospital. Erectile dysfunction is influenced by several factors; including psychogenic, neurogenic, and infectious. The diagnosis of erectile dysfunction is determined based on the results of history taking and physical examination, using the standard questionnaire (IIEF-5/International index of erectile function-5). A further review is needed to exclude a particular cause, the management can be determined based on the etiology.

HIV and Sexual Dysfunction in Men

Sexual issues tend to go unaddressed in human immunodeficiency virus (HIV) management, although overt sexual dysfunctions are more prevalent in people living with HIV than uninfected people. Erectile dysfunction is the most frequent sexual problem, with a prevalence of 30–50% even in men <40 years of age, but other issues such as loss of libido and ejaculatory disorders should not be overlooked. Peculiar factors related to HIV infection (e.g., fear of virus transmission, changes in body image, HIV-related comorbidities, HIV distress and stigma), alongside classical factors non-related to HIV, should be considered when approaching sexual problems in HIV patients. For this reason, the diagnostic and therapeutic workout of sexual dysfunction in the context of HIV requires a multidisciplinary approach, involving specialists in both infectious diseases and sexual medicine. This narrative review presents an overview of current knowledge on sexual dysfunction in HIV men, deepening the factors driving and taking part in these issues, providing advice for the clinical approach, and underlining the importance of caring for sexual health to improve the quality of life of HIV patients.

Premature ejaculation - current concepts in the management: A narrative review

Premature ejaculation (PE; early ejaculation or rapid ejaculation) is a common sexual problem affecting about 20-30% of men in the sexually active age group. PE can be of four types: Primary, secondary, natural variable, and subjective PE. Various non-pharmacological and pharmacological treatment options are available to treat PE including Dapoxetine, which is specifically developed for the treatment of PE. In this review, we discuss the pathophysiology and management aspects of PE. Key words: Premature ejaculation, Cognitive behavioral therapy, Serotonin uptake inhibitors, Dapoxetine.

Penile Fracture - Our Initial Experience and Outcome

BACKGROUND Penile fractures occur when the engorged penile corpora are forced to buckle and “pop” under the pressure of a blunt sexual trauma, due to slippage of the penis out of the vagina during intercourse. Patients typically describe that a “plop” sound was followed by immediate de-tumescence, severe pain, and swelling, called as “egg-plant” deformity, as a result of the injury. The immediate surgical exploration with evacuation of the haematoma and repair of tunica albuginea defect is the ideal treatment. METHODS Over a period of more than 3 years between May 2015 and January 2019 we have treated 26 patients with penile fractures. All of them presented within 24 hours after sustaining the injury. None had associated urethral injury. Apart from clinical examination and history the investigation most commonly used by us to aid diagnosis was Ultrasound (USG) and colour doppler which helped in identifying the site and size of the defect as well as the blood collections. All were treated by surgical exploration. RESULTS Patients were discharged either on 2nd or 3rd post-operative day. None of our patients developed any postoperative wound infection. Post-operative hematoma developed in 01 patient. 01 patient had complaints of slight bend of the penis to the affected side but with no sexual problem. There was no history of erectile dysfunction in any of these patients. CONCLUSIONS To diagnose penile fracture, our study relied on history and physical examination mainly and did not recommend imaging, except for, in patients with possible urethral injuries. Immediate surgical intervention can make good functional results and surgical exploration can be considered in all cases of penile fractures. The procedure is simple with minimal morbidity, low morbidity and short hospital stay. KEYWORDS Fracture, Corpora, Tear

Putting People Down and Pushing Them Out: Sexual Harassment in the Workplace

Sexual harassment was once conceptualized solely as a sexual problem: coercive sexual advances that spring from natural feelings of sexual desire or romance. Research has since shown that by far the most common manifestation of sexual harassment is gender harassment, which has contempt at its core; this conduct aims to put people down and push them out, not pull them into sexual activity. With findings such as these, we have made many strides in the scientific study of sexual harassment. That body of scholarship is the focus of this article, which is organized around the following questions: What is sexual harassment, both behaviorally and legally? How common is this conduct in work organizations, and what are its consequences? What features of the social/organizational context raise the risk for sexual harassment? What are some promising (and not-so-promising) solutions to this pervasive problem? And finally, what are important directions for this area of research moving forward? Expected final online publication date for the Annual Review of Organizational Pscyhology and Organizational Behavior, Volume 8 is January 21, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

The Relationship Between Sexual Self-concept and Mental Body Image in Women With Breast Cancer

Objectives: Breast cancer is the most common malignancy in women. In addition, it is the most mentally powerful cancer in women due to affecting the most important female sexual part. Patients with breast cancer experience problems in their marital relationship because of their disrupted mental image and sexual relations. In this regard, this study was conducted to investigate the relationship between sexual self-concept and mental body image in women with breast cancer. Materials and Methods: This descriptive cross-sectional study was conducted on a sample of 120 women with breast cancer. Using a convenience sampling technique, patients were selected from among those hospitalized in the selected hospitals of Tehran in 2018. Data were collected using demographic details, the Multidimensional Sexual Self-Concept Questionnaire (MSSCQ), and the Fisher’s Body Focus questionnaire. Finally, the data were statistically analyzed in SPSS-21. Results: According to the descriptive and analytical statistics, women with breast cancer obtained the highest scores in avoiding risky sex and sexual problem prevention while the lowest scores in terms of sexual preoccupation. Based on the results, there was no disruption in the body image of any of the examined women. Eventually, a significant correlation was observed between sexual self-concept and body image (P<0.001, r=0.4). Conclusions: In general, body image has a positive relationship with sexual self-concept in women with breast cancer and is considered an important predictor of sexual health and behaviors of this group. Accordingly, psychological interventions, along with midwifery and sexual consultations offered by trained personnel can help empower these patients.

HUMAN SEXUALITY AND BREAST CANCER PATIENTS

Sexuality reflects a person’s personality. Cancer, regardless of its location can affect sexuality. Cancer and its treatment have a bio-psycho-social impact on a patient.3 Research has shown that poor physical health and emotional distress can affect sexual health.4 Cancer survivors were reported to have sexual problem after cancer therapy,5 following changes in body image. Materials and Methods: Subjects taken for the study were who had come for consultation regarding their physical health including sexual health. 65 subjects with breast cancer patients were included in the study. Informed consent was taken from the cases and it was approved by an Institute Ethics review Board attached to the institute. Basson’s sexual response cycle formed the basis for formulating worksheet given to the patients to record breaks in their sexual response cycle following a sexual encounter they had with their partners ( husbands).5 It takes into account the role of intimacy in understanding the women’s sexual response cycle and it is non-linear in nature. This makes the model suitable for studying sexual response cycle in women in health and disease. Based on the model the work sheet was created to understand the sexual response cycle of women with breast cancer, The Breaks in the sexual response cycle were found to be due to Biological inhibiting factors like body image, fatigue and drug therapy along with psychological factors like pain, anxiety and depression. The main motivators of sexual response were physical intimacy and care in these patients.