The impact of mode of delivery on the sexual function of primiparous women: a prospective study

Aim

The purpose of this study was to evaluate the impact of mode of delivery on the sexual function of women using the Female Sexual Function Index (FSFI).

Methods

This was a prospective study of 452 nulliparous women, comparing their sexual function before and after birth. A Turkish version of the FSFI questionnaire was administered within the first 8 weeks of pregnancy, at 3 and 6 months postpartum in a face-to-face manner and subsequently at the 12th month and 24th month over the telephone.

Results

Age, BMI, education level, house income, duration of marriage, birthweight, and feeding at each time point were similar between group 1 [vaginal birth and mediolateral episiotomy (MLE)] and group 2 [caesarean section (CS)]. In the postpartum period, there were 265 and 138 participants at 3rd month, 216 and 121 participants at 6th month, 189 and 111 participants at 12th month, and 133 and 85 participants at 24th month in group 1 and 2, respectively. The FSFI total scores decreased at 3 and 6 months postpartum in both groups (27.3 to 23.1 in group 1 and 27.5 to 25 in group 2; p?<?0.05 for both). Desire, arousal, lubrication, satisfaction and pain scores were significantly decreased at 3 months postpartum in group (1) In group 1, desire, arousal and pain scores remained decreased at the 6th month compared to initial scores. Group 2 had significantly lower desire, lubrication, satisfaction and pain scores at 3 months postpartum compared to their initial scores. Decline in desire and lubrication domains persisted at the 6th month for group (2) None of the FSFI domain scores differed after 6th months when compared to pre-delivery scores in both groups. Compared with the caesarean group, the vaginal birth with MLE group had lower satisfaction and higher pain levels at 3 months postpartum (p?<?0.0001, for both). None of the FSFI domains differed at the 6th, 12th or the 24th month between the groups.

Conclusion

Our study revealed that caesarean section is not superior to vaginal birth in terms of preservation of normal sexual function, regardless of short-term postpartum effects. Women should be informed that, irrespective of their type of delivery, sexual function 6 months after childbirth is similar to that in pre-pregnancy.

     

Oxidative stress is associated with clinical severity of nausea and vomiting of pregnancy

Our objective was (1) to evaluate total oxidant status (TOS) and total antioxidant status (TAS) in women with nausea and vomiting of pregnancy (NVP) compared with healthy pregnant controls, and (2) to explore any possible relationship between oxidative stress and clinical severity of the disease. Fifty-three women with NVP and 35 healthy pregnant women were enrolled in the study. Of these 53 women, 25 women were classified as mild and 28 women were classified with moderate/severe NVP. The severity of the disease was assessed by Rhodes' index. Plasma levels of TOS and TAS were determined by using automated methods. TOS was significantly higher and TAS was significantly lower in women with NVP ( P < 0.0001, for both). The moderate/severe NVP group had higher levels of TOS and lower levels of TAS than the women with mild NVP ( P < 0.0001, for both). Moreover, Rhodes' index showed positive correlation with TOS (r = 0.563; P < 0.0001) and negative correlation with TAS (r = -0.595; P < 0.0001). These findings indicate that oxidative stress is increased in NVP. There was a strong relationship between oxidative stress and the clinical severity of the disease. Therefore, we suggest that the levels of TOS and TAS can be used as additional markers in the diagnosis and clinical severity of NVP.     

Validation of the female sexual function index in women with chronic pelvic pain

IntroductionChronic pelvic pain (CPP) is a common gynecological problem that is also associated with sexual dysfunction.AimThe purpose of this research was to investigate the validity and reliability of Female Sexual Function Index (FSFI) in women with CPP.MethodOne hundred women with CPP and 100 age-matched subjects without CPP were compared in the study.Main Outcome MeasuresSexual function was assessed by FSFI.ResultsInternal consistency (Cronbach's alpha values = 0.91–0.97) was high for all scales. There were significant differences between women with and without CPP for each of the FSFI domain and total scores with very large effect sizes (1.29–2.56) (P < 0.0001, for all). Interdomain correlations of FSFI in the CPP group corresponded well to each other (P < 0.0001, for all). Moreover, test–retest reliability (r = 0.79–0.90) was also within acceptable ranges for this population.ConclusionWe concluded that the FSFI showed good ability to discriminate between women with and without sexual dysfunctions in the CPP population. Verit FF, and Verit A. Validation of the Female Sexual Function Index in women with chronic pelvic pain.     

Low antimullerian hormone levels may be associated with cardiovascular risk markers in women with diminished ovarian reserve

There is growing evidence that diminished ovarian reserve (DOR) may be associated with cardiovascular disease (CVD). The aim of the study was to investigate whether there was any relationship between antimullerian hormone (AMH) and CVD risk markers in the study.

Ninety women with DOR and 90 women with normal ovarian reserve (NOR) attending the infertility unit at XXXX, were enrolled in the study. CVD risk markers such as insulin resistance [defined by the homeostasis model assessment ratio (HOMA-IR)], C-reactive protein (CRP), low density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglyceride (TG) were assessed. HOMA-IR, CRP, TG, LDL levels were higher and HDL and AMH were lower among patients with DOR compared with controls (p?p?There was a close relationship between low AMH and CVD risk markers in the study. Further studies with larger groups are needed to investigate the nature of this link in these patients.     

Relationship between interleukin-1 type 1 and 2 receptor gene polymorphisms and the expression level of membrane-bound receptors

The biological activity of the multifunctional cytokine interleukin-1 (IL-1) is mediated by its receptors. The aim of this study was to determine if an association exists between single nucleotide polymorphisms (SNPs) in the IL-1 type 1 and 2 receptor genes (IL1R1 and IL1R2) and the expression level of membrane-bound IL1Rs on subpopulations of mononuclear cells or serum levels of soluble IL-1 receptors. It was observed that healthy individuals with the genotype TT in SNP rs2234650:C>T had a lower percentage of intact CD14⁺ monocytes expressing IL1R1 on their surface. The SNP rs4141134:T>C in IL1R2 has also been associated with the percentage of intact CD3⁺ T cells expressing IL1R2. Furthermore, individuals carrying the CC allele of SNP rs4141134:T>C and the TT allele of SNP rs2071008:T>G in IL1R2 had a lower density of IL1R2s on the surface of CD14⁺ monocytes in lipopolysaccharide (LPS)-stimulated PBMC cultures. In summary, this study demonstrated that IL-1 receptor gene polymorphisms could be one of the factors influencing the expression of membrane-bound IL-1 receptors (IL1R) on immunocompetent cells.