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Sexual Dysfunction (sexual + dysfunction)
Kinds of Sexual Dysfunction Selected AbstractsFemale Sexual Dysfunction: Knowledge Development and Practice ImplicationsPERSPECTIVES IN PSYCHIATRIC CARE, Issue 3 2009Janet Ambrogne Sobczak PhD, PMHCNS PURPOSE., Sexual dysfunctions are thought to be common in the population. However, the majority of research on sexual dysfunctions has focused on male problems. Consequently, women's sexual function is poorly understood. This article aimed to (a) provide a historical overview of the knowledge development of female sexual function, (b) describe the current state of knowledge pertaining to sexual problems in women, and (c) discuss implications for the assessment of sexual problems in women. CONCLUSIONS., A women's sexual response may differ from current conceptualizations. PRACTICE IMPLICATIONS., A sexual history should be included in routine health assessments. Information specific to contextual and relational factors is particularly important for women. [source] Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 10 2010Article first published online: 4 OCT 2010 No abstract is available for this article. [source] Sexual Dysfunction in an Internet Sample of U.S. Men Who Have Sex with MenTHE JOURNAL OF SEXUAL MEDICINE, Issue 9 2010Sabina Hirshfield PhD ABSTRACT Introduction., Relatively little is known about sexual dysfunction (SD) in men who have sex with men (MSM). Aim., In order to better understand SD symptoms in MSM, we assessed self-reported SD symptoms, individually and by latent class analysis (LCA). Methods., In 2004,2005 an Internet sample of U.S. MSM was recruited from gay-oriented sexual networking, chat and news websites. The analytic sample comprised 7,001 men aged 18 or older who reported lifetime male sex partners and oral or anal sex with a male partner in their most recent encounter within the past year. Main Outcome Measures., Seven questions on SD symptoms that occurred during the past 12 months inquired about low sexual desire, erection problems, inability to achieve an orgasm, performance anxiety, premature ejaculation, pain during sex, and sex not being pleasurable. Results., Self-reported symptoms of SD were high. Overall, 79% of men reported one or more SD symptoms in the past year, with low sexual desire, erection problems, and performance anxiety being the most prevalent. Four distinct underlying patterns of sexual functioning were identified by LCA: no/low SD, erection problems/performance anxiety, low desire/pleasure, and high SD/sexual pain. High SD/sexual pain was distinguished from the other patterns by club drug use and use of prescription and non-prescription erectile dysfunction medication before sex in the past year. Additionally, men associated with the high SD/sexual pain group were younger, single, more likely to have poor mental and physical health, and more likely to have been diagnosed with a sexually transmitted infection in the past year compared to men in the no/low SD group. Conclusions., LCA enabled us to identify underlying patterns of sexual functioning among this sample of MSM recruited online. Future research should investigate these distinct subgroups with SD symptoms in order to develop tailored treatments and counseling for SD. Hirshfield S, Chiasson MA, Wagmiller RL, Remien RH, Humberstone M, Scheinmann R, and Grov C. Sexual dysfunction in an internet sample of U.S. men who have sex with men. J Sex Med 2010;7:3104,3114. [source] Sexual Dysfunction after Rectal Surgery: A Retrospective Study of Men without Disease RecurrenceTHE JOURNAL OF SEXUAL MEDICINE, Issue 9 2010Vahudin Zugor MD ABSTRACT Introduction., Sexual dysfunction is a frequent complication of visceral surgery after rectal resections as a result of carcinoma of the rectum. Aim., The purpose of our study is to assess the incidence and form of sexual dysfunction in our own population of patients. Methods., The study comprised all patients who had undergone surgery for carcinoma of the rectum at the Erlangen Surgery University Hospital, Germany, in the period 2000,04. All male patients were retrospectively surveyed and asked to complete standardized (International Index of Erectile Function 15) questionnaires regarding their pre- and postsurgical sexual function. One hundred and forty-five questionnaires could be analyzed. The statistical evaluation was conducted with aid of the SPSS statistics program. The univariate analysis was carried out with the chi-square test and the U -test (Mann,Whitney Test). Main Outcome Measures., Erectile dysfunction, libido, and ability to have and sustain ejaculation and orgasm (both before and after surgery in each case) were among the dependent variables when compiling the data. The impact various surgical procedures and radiochemotherapy had on the severity of the sexual dysfunctions was analyzed. The scope of the postoperative urological care given was also assessed. Results., Erectile dysfunction was confirmed in N = 112 patients (77.3%) after surgery (P -value < 0.001). Other parameters such as orgasm capacity (4.1% vs. 16.5%), ejaculation ability (1.4% vs. 12.4%) and libido (3.4% vs. 22%) also showed a marked deterioration postoperatively. Postoperative erectile dysfunction was present in 77% of the patients with a colostomy and in 88.5% of the patients who had received neoadjuvant radiation. Conclusions., Male erectile dysfunction is a frequent complication after rectal resection as a result of carcinoma of the rectum. The high incidence of sexual dysfunctions results from the radical nature of the procedure and from additional radiation or colostomy therapy. These patients need accompanying urological care for treatment of their sexual dysfunction. Zugor V, Miskovic I, Lausen B, Matzel K, Hohenberger W, Schreiber M, Labanaris AP, Neuhuber W, Witt J, and Schott GE. Sexual dysfunction after rectal surgery: A retrospective study of men without disease recurrence. J Sex Med 2010;7:3199,3205. [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 8 2010Article first published online: 2 AUG 2010 No abstract is available for this article. [source] ORIGINAL RESEARCH,WOMEN'S SEXUAL HEALTH: Prevalence of Sexual Dysfunction and Impact of Contraception in Female German Medical StudentsTHE JOURNAL OF SEXUAL MEDICINE, Issue 6 2010Christian W. Wallwiener MD ABSTRACT Introduction., Female sexual dysfunction (FSD) is a very common disorder, with an estimated prevalence of having at least one sexual dysfunction of about 40%. Aim., To investigate the prevalence and types of FSD and the relationship between hormonal contraception (HC) and FSD in female German medical students. Main Outcome Measures., Female Sexual Function Index (FSFI) with additional questions on contraception, sexual activity, and other factors that may influence sexual function. Methods., An online questionnaire based on the FSFI was completed by students from six medical schools. Obtained data were screened for inconsistencies by programmed algorithms. Results., A total of 1,219 completed questionnaires were received, and 1,086 were included in the analyses after screening. The mean total FSFI score was 28.6 +/, 4.5. 32.4% of women were at risk for FSD according to FSFI definitions. Based on domain scores, 8.7% for were at risk for FSD concerning orgasm, 5.8% for desire, 2.6% for satisfaction, 1.2% for lubrication, 1.1% for pain and 1.0% for arousal. The method of contraception and smoking were factors with significant effect on the total FSFI score whereby hormonal contraception was associated with lower total FSFI scores and lower desire and arousal scores than no contraception and non-hormonal contraception only. Other variables such as stress, pregnancy, smoking, relationship and wish for children had an important impact on sexual function as expected according to earlier studies. Conclusions., The prevalence of students at high risk for FSD was consistent with the literature although domain subscores differed from samples previously described. The contraception method has a significant effect on the sexual functioning score and women using contraception, especially hormonal contraception, had lower sexual functioning scores. Stress and relationship among other variables were found to be associated with sexual function and may thus provide insight into the etiology of sexual disorders. Wallwiener CW, Wallwiener L-M, Seeger H, Mück AO, Bitzer J, and Wallwiener M. Prevalence of sexual dysfunction and impact of contraception in female german medical students. J Sex Med 2010;7:2139,2148. [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 5 2010Article first published online: 23 APR 2010 No abstract is available for this article. [source] ORIGINAL ARTICLES: Definitions/Epidemiology/Risk Factors for Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 4pt2 2010Ronald W. Lewis MD ABSTRACT Introduction., Accurate estimates of prevalence/incidence are important in understanding the true burden of male and female sexual dysfunction and in identifying risk factors for prevention efforts. This is the summary of the report by the International Consultation Committee for Sexual Medicine on Definitions/Epidemiology/Risk Factors for Sexual Dysfunction. Aim., The main aim of this article is to provide a general overview of the definitions of sexual dysfunction for men and women, the incidence and prevalence rates, and a description of the risk factors identified in large population-based studies. Methods., Literature regarding definitions, descriptive and analytical epidemiology of sexual dysfunction in men and women were selected using evidence-based criteria. For descriptive epidemiological studies, a Prins score of 10 or higher was utilized to identify population-based studies with adequately stringent criteria. This report represents the opinions of eight experts from five countries developed in a consensus process and encompassing a detailed literature review over a 2-year period. Main Outcome Measures., The study aims to provide state-of-the-art prevalence and incidence rates reported for each dysfunction and stratified by age and gender. Expert opinion was based on the grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. Results., A wealth of information is presented on erectile dysfunction, its development through time, and its correlates. The field is still in need of more epidemiological studies on the other men's sexual dysfunction and on all women's sexual dysfunctions. Conclusions., A review of the currently available evidence from epidemiological studies is provided. Lewis RW, Fugl-Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira ED Jr., Rellini AH, and Segraves T. Definitions/Epidemiology/Risk Factors for Sexual Dysfunction. J Sex Med 2010;7:1598,1607. [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 4pt1 2010Article first published online: 7 APR 2010 No abstract is available for this article. [source] Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2010Article first published online: 1 MAR 2010 No abstract is available for this article. [source] ORIGINAL RESEARCH,ENDOCRINOLOGY: A Comparative Study of the Effects of Local Estrogen With or Without Local Testosterone on Vulvovaginal and Sexual Dysfunction in Postmenopausal WomenTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2010Chitra Raghunandan MD ABSTRACT Introduction., A significant number of postmenopausal women suffer from distressing problems because of urogenital atrophy secondary to the decline in circulating estrogen levels. Treatment with topical hormones may provide relief in such women when used judiciously. Aim., To study the effects of local estrogen with or without local testosterone on urogenital and sexual health in postmenopausal women. Methods., Seventy-five postmenopausal women symptomatic for urogenital atrophy and sexual dysfunction were randomly divided into two study groups and one control group. The women in study group 1 received local estrogen cream; study group 2 received local estrogen and testosterone cream; the control group received nonhormonal lubricant KY gel for 12 weeks. The urogenital and sexuality score, along with the vaginal health index and the vaginal maturation index (VMI), was calculated at the beginning of therapy and 12 weeks later. Main Outcome Measures., Changes in the urogenital and sexuality score along with vaginal health index and VMI. Results., After 12 weeks of therapy, there was a significant improvement in all the four study parameters, which correlated well with the improvement in symptoms of urogenital atrophy and sexual dysfunction in both the study groups as compared with the control group. Improvement in sexuality score was greatest with combined estrogen,androgen therapy. There were no adverse effects and the therapies were well accepted without any compliance issue. Conclusion., Local estrogen either alone or with androgen is highly effective in relieving symptoms of urogenital atrophy and in improving sexual function in symptomatic postmenopausal women. Raghunandan C, Agrawal S, Dubey P, Choudhury M, and Jain A. A comparative study of the effects of local estrogen with or without local testosterone on vulvovaginal and sexual dysfunction in postmenopausal women. J Sex Med 2010;7:1284,1290. [source] Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 1pt1 2010Article first published online: 5 JAN 2010 No abstract is available for this article. [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 12 2009Article first published online: 24 NOV 200 [source] Frequency and Correlates of Sexual Dysfunction in Women with Diabetes MellitusTHE JOURNAL OF SEXUAL MEDICINE, Issue 12 2009Anthonia Okeoghene Ogbera MPH, FACP ABSTRACT Introduction., Sexual dysfunction (SD) in women with diabetes mellitus (DM) is an important but understudied aspect of DM complications in women with DM. Aim., This report is an attempt to document the prevalence, clinical correlates, and determinants of SD in a cross sectional study of women with diabetes mellitus (DM). Main Outcome Measures., The main outcome measures were demographic, clinical parameters, psychological morbidity, and frequency of SD. Methods., A total of 58 married women with type 2 DM and 30 age-matched women who did not have DM had their sexual function and psychological status assessed using the Female Sexual Function Index (FSFI) and General Health questionnaires (GHQ 12) respectively. Glycemic control was assessed using glycosylated hemoglobin. Results., The prevalence of SD in women with DM and in the control population was 88% and 80%, respectively. The mean (standard deviation) FSFI score in the women with DM was significantly lower than that of the control group (16.2 [9.5] vs. 21 [8.5], P = 0.02). Women with DM attempted sex less frequently than those in the control group. Poor mental health status which was found to be associated with SD was noted more in women with DM than those in the control group. Conclusions., SD is high in women with and without DM. A possible determinant of SD in women with DM is psychological morbidity. Ogbera AO, Chinenye S, Akinlade A, Eregie A, and Awobusuyi J. Frequency and correlates of sexual dysfunction in women with diabetes mellitus. J Sex Med 2009;6:3401,3406. [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 11 2009Article first published online: 29 OCT 200 [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 10 2009Article first published online: 6 OCT 200 [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 8 2009Article first published online: 27 JUL 200 [source] Hysterical Traits Are Not from the Uterus but from the Testis: A Study in Men with Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 8 2009Elisa Bandini MD ABSTRACT Introduction., The relationship between testosterone (T) and psychopathology in subjects with sexual dysfunction has not been completely clarified. Aim., To evaluate the association between T levels and different psychopathological symptoms and traits in men seeking treatment for sexual dysfunction. Methods., A consecutive series of 2,042 heterosexual male patients (mean age 51.8 ± 13) consulting an outpatient clinic for sexual dysfunction was retrospectively studied. Main Outcome Measures., Several hormonal, biochemical, and instrumental parameters were investigated, including testis volume (Prader orchidometr) and penile blood flow (penile Doppler ultrasound). Patients were interviewed, prior to the beginning of any treatment, with the previously validated Structured Interview on Erectile Dysfunction (SIEDY), and ANDROTEST (a structured interview for the screening of hypogonadism in patients with sexual dysfunction). They also completed the Middlesex Hospital Questionnaire (MHQ) a brief self-reported questionnaire for the screening of the symptoms of mental disorders in nonpsychiatric setting. Results., T levels showed a negative correlation with depressive and anxiety (somatized and phobic) symptoms. Conversely, histrionic/hysterical traits were strongly and positively associated with elevated T. Men with histrionic/hysterical traits had higher androgenization, as suggested by both higher total and free T, higher testis volume and a lower ANDROTEST score. They were also characterized by better self-reported sexual functioning and penile blood flow. Accordingly, when SIEDY scales were considered, SIEDY scale 2 (relational domain) was significantly lower in subjects with histrionic/hysterical traits further indicating a more satisfying sexual relationship. Conclusions., In men consulting for sexual dysfunction, histrionic/hysterical personality is associated with higher androgenization and better sexual functioning. Hysteria, previously considered as a typically feminine psychopathological trait (the uterine theory), should now be considered as an index of better masculine sexual well-being. Bandini E, Corona G, Ricca V, Fisher AD, Lotti F, Sforza A, Faravelli C, Forti G, Mannucci E, and Maggi M. Hysterical traits are not from the uterus but from the testis: A study in men with sexual dysfunction. J Sex Med 2009;6:2321,2331. [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 7 2009Article first published online: 24 JUN 200 [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 5 2009Article first published online: 27 APR 200 [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 4 2009Article first published online: 25 MAR 200 [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2009Article first published online: 24 FEB 200 [source] The Influence of Testosterone Combined with a PDE5-inhibitor on Cognitive, Affective, and Physiological Sexual Functioning in Women Suffering from Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2009Flip Van Der Made MD ABSTRACT Introduction., Women with female sexual dysfunction have a reduced sensitivity to sexual stimuli. Activation of central mechanisms may open a window for phosphodiesterase type 5 inhibitors (PDE5) to be effective; as a consequence, the combination of testosterone and a PDE5 inhibitor will restore sexual function. Aim., To demonstrate that the combination of testosterone and vardenafil will increase the sensitivity for sexual stimuli and will improve the desire and arousal components of the sexual response. Methods., In a double-blind randomly assigned placebo-controlled crossover design, 28 women with desire and/or arousal disorder underwent four different drug treatments on four separate experimental days. A masked version of the emotional Stroop task with sexual and nonsexual words was used to measure sensitivity for sexual content. Neutral and erotic film fragments were used to determine genital,physiological and subjective reactions. Main Outcome Measures., A masked version of the emotional Stroop task, vaginal pulse amplitude. For subjective measurement, responses were collected continuously with a lever and two self-report measures were used. Results., In two subgroups, which were differentiated on the basis of their initial preconscious attentional bias for sexual cues, a different sexual response profile was found. In an initially low-attention group, preconscious attentional bias for sexual cues increased under the testosterone condition. In these women, the combination of testosterone and vardenafil caused an improvement in genital response and subjective indices of sexual functioning. In the group that had initially a high attention for sexual cues, preconscious attentional bias for sexual cues decreased under the condition of testosterone. In these women, the combination of testosterone and vardenafil had no effect on any of the indices of their sexual functioning. Conclusion., In women suffering from low sexual desire,associated with low attention for sexual cues,the combination of testosterone and vardenafil may be a promising new treatment. van der Made F, Bloemers J, Yassem WE, Kleiverda G, Everaerd W, van Ham D, Olivier B, Koppeschaar H, and Tuiten A. The influence of testosterone combined with a PDE5-inhibitor on cognitive, affective, and physiological sexual functioning in women suffering from sexual dysfunction. J Sex Med 2009;6:777,790. [source] Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 12 2008Article first published online: 3 DEC 200 [source] Prolactin, Subjective Well-Being and Sexual Dysfunction: An Open Label Observational Study Comparing Quetiapine with RisperidoneTHE JOURNAL OF SEXUAL MEDICINE, Issue 12 2008Jens Westheide PhD ABSTRACT Introduction., Sexual dysfunction is a frequent side effect of antipsychotic treatment. Increased prolactin levels are believed to be responsible for this sexual impairment despite contradictory results. Aim., The primary objective of the present study was to examine the relationship between sexual dysfunction, subjective well-being and prolactin levels in patients with schizophrenia treated either with risperidone or quetiapine. The secondary objective was to explore the relationship between testosterone and the severity of positive and negative symptoms of schizophrenia in male patients. Methods., In a 4-week nonrandomized open label observational study, 102 inpatients with schizophrenia were recruited. Sexual functioning, subjective well-being and endocrinological parameters were assessed as well as psychopathological characteristics. Main Outcome Measures., Two self-rating questionnaires concerned with sexual functioning ("Essener Fragebogen zur Sexualität") and Subjective Well-Being Under Neuroleptic Treatment Scale (SWN) were completed by the patients. Plasma levels of prolactin in male and female patients were measured. Furthermore, in male patients testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were determined. Positive and Negative Symptom Scale (PANSS) was applied. Results., After 4 weeks, patients treated with quetiapine reported less severe sexual impairment, as well as lower PANSS negative and general score compared with patients treated with risperidone. Additionally, emotional regulation as measured with the SWN was higher in patients treated with quetiapine. Risperidone was significantly associated with elevated prolactin levels. Prolactin levels were not correlated either with sexual dysfunction or PANSS. However, in the group of patients treated risperidone, sexual impairment was significantly associated with the SWN subscale emotional regulation. Conclusions., Increased prolactin levels do not seem to be decisive for antipsychotic induced sexual dysfunction. Improvement of severity of illness and regaining the ability to regulate one's own emotion have positive influence on sexual functioning. Westheide J, Cvetanovska G, Albrecht C, Bliesener N, Cooper-Mahkorn D, Creutz C, Hornung W-P, Klingmüller D, Lemke MR, Maier W, Schubert M, Sträter B, and Kühn K-U. Prolactin, subjective well-being and sexual dysfunction: An open label observational study comparing Quetiapine with Risperidone. J Sex Med **;**:**,**. [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 9 2008Article first published online: 2 SEP 200 [source] Continuing Medical Education: Sexual Function: Diagnosis and Management of Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2008Article first published online: 25 FEB 200 [source] ORIGINAL RESEARCH,FSD PHARMACOTHERAPY: Tibolone and Transdermal E2/NETA for the Treatment of Female Sexual Dysfunction in Naturally Menopausal Women: Results of a Randomized Active-Controlled TrialTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2008Esme A. Nijland MD ABSTRACT Introduction., There are some data to suggest that tibolone improves sexual function in postmenopausal women. However, evidence about the effects of tibolone on female sexual dysfunction is lacking. Aim., To compare the efficacy on sexual function of tibolone 2.5 mg to continuous combined transdermal estradiol (E2)/norethisterone acetate (NETA) (50 µg/140 µg) in naturally postmenopausal women with sexual dysfunction. Main Outcome Measure., Differences between treatment groups in the change from baseline for the composite subscore of the arousal, desire, and satisfaction domains of the self-reported Female Sexual Function Index (FSFI). Methods., A multicenter, double-blind, randomized, clinical trial was performed. Sexual function was assessed with the FSFI at baseline, week 12, and week 24. The outcomes of the Female Sexual Distress Scale (FSDS) and the frequency of satisfying sexual events (daily diaries) were secondary end points. Results., Four hundred three women, mean age 56, were included. Both therapies improved sexual function assessed by the FSFI. In the per protocol analysis, but not in the intent-to-treat analysis, the increase in FSFI scores was significantly larger in the tibolone group when compared with the E2/NETA patch group at week 24 (P = 0.036 and P = 0.025 for the composite subscore and total FSFI score, respectively). The satisfying sexual event rate increased from three to four times per 28 days at week 24 (P < 0.001 from baseline for both groups), with no difference between groups. The FSDS showed a significant decrease from baseline (P < 0.001), which was comparable for both treatment groups. Conclusions., Both treatments resulted to improved overall sexual function, as determined by scores on the FSFI, an increase in the frequency of sexual events, and a reduction in sexuality-related personal distress. The statistically significant higher FSFI scores in the tibolone group, when compared to the E2/NETA group, may be because of tibolone's combined estrogenic and androgenic properties. Nijland EA, Schultz WCMW, Nathorst-Boös J, Helmond FA, Van Lunsen RHW, Palacios S, Norman RJ, Mulder RJ, and Davis SR for the LISA study investigators. Tibolone and transdermal E2/NETA for the treatment of female sexual dysfunction in naturally menopausal women: Results of a randomized active-controlled trial. J Sex Med 2008;5:646,656. [source] EDITORIAL: Sexual Dysfunction: Looking Beyond the ObviousTHE JOURNAL OF SEXUAL MEDICINE, Issue 1 2008Irwin Goldstein MD Editor-in-Chief [source] Female Sexual Dysfunction in Urogenital Prolapse Surgery: Colposacropexy vs.THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2008Hysterocolposacropexy ABSTRACT Introduction., Colposacropexy (CSP), with or without hysterectomy, is a valid technique for the repair of severe urogenital prolapse. For many years, uterine prolapse has represented an indication for hysterectomy, apart from the presence or absence of uterine disease and the patient's desires. Nevertheless, sparing the uterus is essential to women not only to have normal sexual functioning but to maintain physical and anatomical integrity as well. Aim., To assess sexual function in a group of patients who underwent CSP or hysterocolposacropexy (HSP). Materials and Methods., We enrolled 37 patients who underwent surgery for urogenital prolapse (15 HSP, mean age 53 years; 22 CSP, mean age 56 years). Based on a preliminary sexual history and sexual questionnaire, all patients were sexually active before surgery. At a mean follow-up of 39 months, we reassessed the patients using the Female Sexual Function Index (FSFI). Main Outcome Measure., We considered sexual activity with a score of 30 = good, 23,29 = intermediate, and <23 = poor. Results., In patients who underwent CSP and HSP, sexual activity was good in 13% and 26%, intermediate in 33% and 21%, and poor in 54% and 53%, respectively; considering also five patients who no longer had sexual activity postoperatively. Nevertheless, the statistical analysis, performed based on the data obtained from the FSFI questionnaire, showed that there were no significant differences between the two groups of points in terms of total score,CSP 21.1 (1.2,33.5) vs. HSP 22.8 (3.6,34.5),and single domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) (P = not significant). Conclusions., Our data demonstrated no substantial differences regarding sexual activity in patients in which the uterus has been spared as opposed to those in whom it has been removed. Furthermore, in a small percentage of cases, surgery actually reduced regular sexual activity. Zucchi A, Costantini E, Mearini L, Fioretti F, Bini V, and Porena M. Female sexual dysfunction in urogenital prolapse surgery: Colposacropexy vs. hysterocolposacropexy. J Sex Med 2008;5:139,145. [source] | |||||||||||||