Posttraumatic Growth in Women With a Long-Standing Experience of Involuntary Childlessness in the Czech Republic

This qualitative research study aimed to examine aspects of posttraumatic growth (PTG) in women with a long-standing experience of involuntary childlessness. In-depth semi-structured interviews, lasting an average of 53 min, were conducted in the Czech Republic. Twenty-four women, averaging 38.8 years old with an average of 6.2 years of infertility experience, participated. They were asked how involuntary childlessness affected/changed their partnerships, sexual life, job, future plans, attitude to children/values/faith, and leisure time. Participants shared both positive and negative aspects of the infertility experience. Data were analyzed using thematic analysis. Five main themes of PTG were identified: strengthening of partnership, greater humility, deeper self-appreciation, reassessment of relationships, and changes in the philosophy of life. These findings could be useful to mental health providers to facilitate the PTG process in patients.

Dyadic Satisfaction and Shared Affectivity Are Associated with Psycho-Sexual Functioning in Elderly Men and Women

Objectives The quality of sexual life of elderly people represents an understudied topic of sexual medicine and of psycho-sexology. Hence, we aimed to evaluate the association of specific psycho-relational variables, such as intimacy, increased affective gestures towards a partner (AGtP), daily shared activities, and dyadic satisfaction, with the psychosexual wellbeing of elderly people, expressed in terms of sexual satisfaction. Methods: A cohort of elderly people was selected from a sample of a broader study evaluating the role of sexual activity in protecting the emotional wellbeing of a population subjected to quarantine due to the COVID-19 pandemic. Specifically, the presence of sexual dysfunctions, the emotional wellbeing (i.e., absence of anxiety and/or depression), and the quality of the partners’ relationships were studied. For the study’s purpose, the Sexual Health Inventory for Males (SHIM), the Female Sexual Function Index (FSFI), the Orgasmometer and the Orgasmometer-F, the Generalized Anxiety Disorder scale (GAD-7), the Patient Health Questionnaire (PHQ-9), and the Dyadic Adjustment Scale were adopted. Results: A group of 124 elderly subjects (≥60) was selected for the study’s purposes. Among these, 84% were males (120/124), and 16% were females (20/124). All the subjects declared to be in a stable relationship and to be sexually active during the first lockdown period. Gender differences were found for the Dyadic Satisfaction subscale (males: 37.04 ± 6.57; females: 32.85 ± 10.04; p < 0.05) and the Orgasmometer (males: 7.64 ± 1.30; females: 6.60 ± 2.46; p < 0.01). Linear regression analysis showed the association between higher Orgasmometer scores and: (i) the absence of sexual dysfunctions (β = −1.213; SE = 0.271; p < 0.0001), (ii) higher dyadic satisfaction (β = 0.042; SE = 0.019; p < 0.05), and (iii) reduced shared activities with partner (β = −0.463; SE = 0.143; p < 0.01) and increased affective gestures towards partner (DAS measured AGtP) (β = 0.595; SE = 0.065; p < 0.0001). Post hoc analysis of ANCOVA with the Bonferroni correction method showed a significant difference in the Orgasmometer scores between subjects with and without sexual dysfunction (mean difference: 2.102; SE = 0.340; pBonf < 0.001), with healthy subjects reporting higher scores compared to dysfunctional ones. Conclusions: It is reasonable to suppose that, beyond the presence of sexual dysfunctions, the sexual health of elderly people may benefit from the quality of the relationship, and, specifically, from the presence of affective gestures towards the partner and the dyadic satisfaction. To the contrary, the quantity of time spent together, sharing specific activities, may be considered a factor worsening relational and sexual health. These data should be considered during the evaluation of sexual health among elderly people.

The Overall Quality of Life and Oncological Outcomes Following Radical Hysterectomy in Cervical Cancer Survivors Results from a Large Long-Term Single-Institution Study

(1) Background: Cervical cancer patients have been found to have worse quality of life (QoL) scores due to cancer treatment, not only when compared to the general population, but also when compared to other gynecological cancer survivors. In Eastern European developing countries, the health care system often cannot afford the uppermost standardized treatment for these patients. In the absence of a comparable study in our country, the authors’ aim for this retrospective cross-sectional observational study was to evaluate the overall survival (OS) and the QoL o cervical cancer survivors; (2) Methods: 430 patients were analyzed. The first objective is to evaluate the OS rates of patients with cervical cancer stages IA2 to IIB undergoing radical hysterectomy (RH) +/− neoadjuvant or adjuvant radiotherapy +/− chemoradiotherapy treatment combinations. The second objective is to assess their QoL, using two standardized questionnaires issued by the European Organisation for Research and Treatment of Cancer (EORTC), namely QLQ-C30 and QLQ-CX24. (3) Results: The mean age of the participants was 51 years (22–76) and the average follow-up time was 65 months (2–128). At the time of the analysis, 308 out of 430 patients were alive, with a mean five-year OS of 72.4%. The multivariate Cox regression analysis identified stage IIB, parametrial invasion, and the lymph node metastases as independent prognostic risk factors negatively impacting the OS. Of the 308 patients still alive at the time of the analysis, 208 (68%) answered the QoL questionnaires. The QLQ-C30 shows a good long-term Global QoL of 64.6 (median), good functioning scores, and a decent symptom scale value. However, the EORTC QLQ-CX24 showed high values of cervical cancer-specific symptoms, namely: lymphedema, peripheral neuropathy, severe menopausal symptoms, and distorted body-image perception. The results also indicate a significant decline in the quality of sexual life with a low sexual enjoyment and decreased level of sexual activities. (4) Conclusion: Despite a good OS, in this setting of patients, cervical cancer survivors have a modest QoL and sexual function. Our study may provide a comparison for future randomized, controlled trials in Eastern European countries needing to confirm these results.

The Global Impact of the COVID-19 Pandemic on Individuals' and Couples' Sexuality

The COVID-19 pandemic and its related restrictions significantly impacted individuals' health, wellbeing, and security. Isolation, limitation of movement, social distancing, and forced cohabiting have had a strong influence on all areas of people's lives as well as on their sexuality. Investigating how the COVID-19 outbreak and its consequences impacted people's sexuality was the primary aim of this review. Particularly, we focused on: (1) the variables associated with the improvement or the deterioration of individuals' and couples' lives during the pandemic; (2) the use of sex as a coping strategy; (3) the impact of COVID-19 outbreak on LGBT people. Results have shown that the worsening of sexual life seems to be related to couples' conflict, emotions and psychological difficulties, being female, being single or away from the partner, being a health care worker, and having children. Moreover, a detrimental effect on sexuality was associated with stress, forced cohabitation, routine, anxiety and worry about the job and the pandemic, feeling partner distance, being unhappy with their partner, and lack of privacy. On the other hand, improvements in sexuality were associated with living happily with a partner, being happy and satisfied with a partner, feeling less stressed and more bored, having more free time, having fewer recreation opportunities, and having minor workload. During the pandemic, there was an increase in using sex toys, pornography consumption, masturbating, and trying sexual experimentations. Among LGBT people, an increase was found in the number of casual sexual partners potentially due to the perceived lower likelihood of transmission through sex. Moreover, the increase in sexual activity may have represented a coping strategy to quarantine-related distress.

Factors associated with sexual practices and positions performed by pregnant women: a cross-sectional study

ABSTRACT Objectives: to identify factors associated with the sexual practices and positions performed by pregnant women. Methods: a cross-sectional, quantitative study conducted with 354 pregnant women, in the interior of Ceará, Brazil, in 2016. For data collection, a form and a Pregnancy Sexuality Questionnaire were used. Results: there was a reduction in the sexual initiative of the woman, sexual disposition of the couple, sexual practices and most of the sexual positions, while the maintenance of preliminary sexual activities and initiative to perform them was verified. Sexual practices and positions decreased (p<0.0001): preliminary sexual activities, sexual disposition, lubrication, orgasm, pain or discomfort, sexual positions, sexual practices, and sexual satisfaction. Sexual practices and positions increased (p<0.0001) as a function of: education, number of deliveries, sexual life, desire and arousal, and sexual disposition of the pregnant woman, frequency of orgasm and of sexual practices (p<0.0001). Conclusions: sexual practices and positions of pregnant women were affected by domains of sexual function, sexual, reproductive, physical, and psychological aspects.

Gynecological morbidity in girls and adolescent girls in a large industrial city

The results of randomized complex clinical andlaboratory examination of 1540 girls and juveniles are drawn, which characterize the rate and the structure of gynecological pathology under conditions of an industrial city. Gynecological morbidity proved to be closely associated with the state of somatic health in girls. Disorders of menstrualfunction occupy the most important place in the structure of gynecological pathology, dysfunctional uterine bleedings prevailing over other kinds of pathology. Anonymous questionnaire of 1700juveniles revealed some peculiarities of their reproductive and contraceptive behavior. The age of the beginning of sexual life at the average comes up to 14,6 0,5 years in the city of Ufa (an average age over Russia 16,1 years), the rate of juveniles who use adequate contraceptives being very low (9,5%). The article gives light to the problems of elaborating the system of organizational and medico-prophy lactic measures for girls and juveniles with gynecological pathology andputtingthem into practice.

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Protection of Human Sexual Autonomy in the Draft of Criminal Code of Ukraine: A Critical View

The article is devoted to the analysis of the foundations of the framework regulation of sexual crimes in the draft of the new Criminal Code of Ukraine. The application of critical optics to the provisions of the project problematizes the issues of protecting human sexual autonomy and understanding the zones of theoretical and practical reflection in which they are rooted. To assess the proposed reforms of the criminal code, modern ideas about sexuality as a gendered phenomenon with a deep social interpretation are applied. The appeal to international standards for protecting human sexual autonomy and combating sexual violence focuses on paradigmatic shifts in assessing the legitimacy of sexual relations, centered around the concepts of "autonomy" and "consent", and the need to improve the draft Criminal Code in this aspect. The title of the section of the new Criminal Code of Ukraine "Criminal Offenses against Human Sexual Autonomy" is offering as more relevant with modern notions of sexuality and internationally recognized standards for determining the parameters of permissible sexual communication. The author stressing that if the nature of the sexual act is understood only as a desire to satisfy the libido, then some variants of illegal sexual behavior remain outside the scope of the Criminal Code, in particular, in situations where sexual violence is used as a tool to control and convey repressive messages. The propose to base the regulation of sexual crimes in new Criminal Code not on the concept of libido, but on the approach of the Istanbul Convention, according to which a sexual act is an act that has a sexual connotation, is supporting in this article. The absence of voluntary consent as a constitutive feature of sexual violence emphasizes the fundamental importance of the concept of "voluntary consent", by which consensual sexual act differs from non-consensual and illegal. In this regard the author, analyzing the problem of legal regulation of sexual relations with minors 14 to 16 year-olds, when their sexual life before reaching the age of consent seems outwardly voluntary, suggests discussing the possibility of introducing into the draft of Criminal Code the construct "limited voluntary consent", which will take place when a person is fully not capable to express a voluntary agreement to engage in the sexual activity and to understand the nature and significance of it’s decision regarding sexual relations.

How Does Contraceptive Use Affect Women’s Sexuality? A Novel Look at Sexual Acceptability

Among the components of a healthy life, sexuality is an essential part, contributing not only to psychophysical well-being, but also to the social well-being of women and, consequently to their quality of life. A poorly investigated standpoint is the acceptability of a contraceptive method, not only in terms of tolerability and metabolic neutrality, but also concerning the impact that it can have on sexual life. In this context, we will provide an overview of the different methods of contraception and their effects on female sexuality from the biological changes, to organic, social, and psychological factors, which can all shape sexuality.A MEDLINE/PUBMED review of the literature between 2010 and 2021 was conducted using the following key words/phrases: hormonal contraception, contraceptives, female sexual function, libido, sexual arousal and desire, and sexual pain. Recent studies have supported the effects of contraceptives on women&rsquo;s sexuality, describing a variety of positive and negative events on several domains of the sexual function (desire, arous-al, orgasm, pain, enjoyment). However, satisfaction with sexual activity depends on factors that extend beyond sexual functioning alone. A more holistic approach is needed to better under-stand the multitude of factors linked to women&rsquo;s sexuality and contraception. Contraceptive counselling must necessarily consider these important elements since they are closely related to good compliance.