Categories of female sexual dysfunction

Female sexual dysfunction is a complex and common problem. Several factors influence female sexual function, including biologic and psychosocial factors. Evaluation of female sexual dysfunction should include a complete medical and psychosocial history and a physical examination. Treatment should be multidisciplinary and depends on the etiology but may include education, psychotherapy or sexual therapy, and in some cases pharmacotherapy. Further research in this area will likely lead to a better understanding of the physiology of female sexuality and to novel therapies for female sexual dysfunction.     

Prevalence and differences between type 1 and type 2 diabetes mellitus regarding female sexual dysfunction: a cross-sectional Egyptian study

Objective: To evaluate the female sexual dysfunction in both type 1 and type 2 diabetes mellitus (DM).

Methods: This cross-sectional study was carried out at Suez Canal University Hospitals from the start of February 2015 to the end of May 2016 among 189 married premenopausal women attending endocrinology and diabetology outpatient clinic for regular follow-up; 25 of whom refused to participate and 18 more were excluded due to incomplete data sets resulting in a final sample of 146 diabetic females. Ninety healthy women were recruited from the administrative staff at the hospital as a control group. Sexual dysfunction was assessed using female sexual function index (FSFI), a validated 19-item, self-administered, screening questionnaire comprising the six major sexual domains: desire, arousal, lubrication, orgasm, satisfaction and pain. Responses to each question were reported and scored on 0–5 scale with 0 representing no sexual activity and 5 suggestive of normal sexual activity.

Results: Prevalence of sexual dysfunction was significantly higher in both type 1 and 2?DM groups (44 and 25%, respectively) than in the control group (9%). FSFI mean total score was significantly lower in type 1?DM (21.1?±?3.9) than type 2?DM (26.4?±?4.2) and both were significantly lower than the control group (31.5?±?5.8). With regard to FSFI domains, mean values for desire, arousal, lubrication, orgasm, satisfaction and pain were significantly lower in both type 1 and type 2?DM groups when compared with the controls.

Conclusion: FSD is a significant health problem among premenopausal diabetic Egyptian women. Type 1?DM women were more affected than type 2?DM that in turn was more affected than healthy control females.     

Female sexual function and dysfunction

This article identifies models of sexual function, defines and categorizes sexual dysfunction, and identifies therapeutic modalities for patients who have sexual dysfunction. Additionally, it discusses some of the questionnaires used to evaluate sexual function.     

Effect of sexual diary keeping and self-evaluation on female sexual function and depression: A pilot study

Objectives The aim of the trial was to assess the effect of self-evaluation and sexual diary keeping on female sexual function and depressive symptoms in women diagnosed with sexual dysfunction.

Methods A single-arm non-randomised trial included 30 women (53 ± 7 years of age) with female sexual dysfunction (Female Sexual Function Index [FSFI] < 27) and a stable partnership duration of 5–40 years. Female sexual function was assessed by sexual, psychological and gynaecological history taking and validated questionnaires including the FSFI, Female Sexual Distress Scale (FSDS) and Hamilton Depression Scale (HDS), before and after 4 weeks of sexual diary keeping.

Results A subjective improvement in communication of sexual problems was reported by 60% of participants; no participants reported any worsening of communication. FSFI and FSDS scores were, respectively, 18.0 ± 7.7 and 22.0 ± 10.0 at baseline and 20.2 ± 7.2 and 20.6 ± 11.5 after 4 weeks. HDS score decreased from 6.0 ± 4.0 at baseline to 4.4 ± 2.7 after 4 weeks (p = 0.042).

Conclusions Self-evaluation and sexual diary keeping may improve aspects of sexual life, such as couple communication, without a direct effect on variables measured with validated questionnaires on different domains of sexual function.     

Women's use of complementary and alternative medicines during pregnancy: A cross-sectional study

Objective

to determine the prevalence of women's use of complementary and alternative medicines (CAM) during pregnancy in the UK, reasons for use, who recommended CAM, and the characteristics of women that are associated with use of CAM during pregnancy.

Design

cross-sectional questionnaire.

Setting

Birmingham Women's Hospital.

Participants

315 postnatal women were surveyed while on the postnatal ward.

Findings

the questionnaire response rate was 89% (315/355). CAM use during pregnancy was reported by 180 women (57.1%). CAM users differed significantly from non-CAM users by education level, parity and previous CAM use before pregnancy. Vitamins (34.9%), massage therapy (14.0%), yoga (11.1%) and relaxation (10.2%) were the most commonly reported uses of CAM. 33.0% of women reported they did not disclose their use of CAM to a doctor or midwife, and 81.3% were not asked by their doctor or midwife about their use of CAM during pregnancy.

Key conclusions and implications for practice

this study found a high prevalence of CAM use during pregnancy, which is within the range of findings of studies from Australia and Germany. It is important that health-care providers routinely ask about CAM use during pregnancy and are able to provide pregnant women with appropriate advice regarding CAM use.     

Postpartum female sexual function

Although many women experience sexual problems in the postpartum period, research in this subject is under-explored. Embarrassment and preoccupation with the newborn are some of the reasons why many women do not seek help. Furthermore, there is a lack of professional awareness and expertise and recognition that a prerequisite in the definition of sexual dysfunction is that it must cause distress to the individual (not her partner). Sexual dysfunction is classified as disorders of sexual desire, arousal, orgasm and pain. However, in the postpartum period the most common disorder appears to be that of sexual pain as a consequence of perineal trauma. Health care workers need to be made aware of this silent affliction as sexual morbidity can have a detrimental effect on a women's quality of life impacting on her social, physical and emotional well-being.     

Experimental models for the study of female and male sexual function

IntroductionSignificant progress has been made in the understanding of physiological and pharmacological mechanisms of human sexual functioning through preclinical research in animal models.AimTo provide an evidence-based documentation of the experimental models evaluating male and female sexual function for useful clinical translation.MethodsConsensus discussion over the past 18 months leading to summarized views of seven experts from six countries.Main Outcome MeasureReport was based on the critical analysis of scientific information available in literature and subcommittee presentations, discussions, and exchanges of ideas and feedback.ResultsFundamental research in animal models has led to considerable understanding of the physiological mechanisms underlying desire, arousal, genital, and other sexual responses and the design of rational pharmacological treatments for certain sexual dysfunctions in the male and female. Tissue and cellular in vitro systems have provided critical information on the in vivo interactions and modulations in the presence and absence of chemical, biological, vascular, neurologic, endocrine, and genetic inputs. The animal models seem indispensable for elucidating the biophysiological and etiopathological aspects of male and female sexual disorders.ConclusionsUseful insights into the human experience have been derived from basic research in ways that are far more difficult to obtain in humans, both scientifically and ethically. The animal model with a good predictive value can be used as a successful preclinical tool so long as the functional end points are homologous or analogous. The key issue is whether further evaluations are warranted to extrapolate the results in a clinical setting. Giuliano F, Pfaus J, Balasubramanian S, Hedlund P, Hisasue S, Marson L, and Wallen K. Experimental models for the study of female and male sexual function.