Search Results (87)

Background: This study analyzes the effects of bariatric surgery on female sexual function, assessed using the Female Sexual Function Index (FSFI), and explores the impact of adherence to the Mediterranean diet during the postoperative period. Patients and methods: A retrospective observational study was conducted using a prospectively collected database, including heterosexual women with morbid obesity undergoing bariatric procedures. The FSFI questionnaire was applied before the intervention and 24 months after surgery. Adherence to the Mediterranean diet was evaluated using the PREDIMED questionnaire. Results: Among the 240 participants, 70.8% presented preoperative sexual dysfunction, which decreased to 20.5% two years post-surgery. Significant improvements were observed in all FSFI domains except for pain. Good adherence to the Mediterranean diet was associated with higher scores in the lubrication, orgasm, and satisfaction domains. Conclusions: Bariatric surgery significantly improves female sexual function, with the Mediterranean diet enhancing these benefits during the postoperative period. Future studies must investigate additional variables such as psychological factors, physical activity, and other lifestyle changes that may also influence sexual function. Full article

Many primary studies and reviews have been published on the influence of chronic diseases (CDs) on sexual dysfunction (SD), but CDs not involving the genitals are less well represented in the literature. Aim: To determine the prevalence of SD in patients with non-genital CD and assess the overall impact on sexual functioning. Methods: An umbrella review was performed of published systematic reviews on the relationship between the occurrence of CDs not involving the genitals and patients’ sexual functioning, following the PRISMA guidelines. PubMed, EMBASE, the Cochrane Library, PsycInfo, Scopus, and CINAHL were used to find publications for inclusion in the review, with two independent researchers performing the search and selection of articles, data extraction, and quality assessment. The relative risk (RR) or odds ratio (OR) with 95% confidence was used as an indicator of the association between CD and SD across studies. The quality of studies included in the review was assessed using Amstar-2. Outcomes: Forty-three systematic reviews, thirty of which included a meta-analysis, met the inclusion criteria, representing a total of 880,586 patients (756,629 (85.9%) men, 68,388 (7.8%) women, and 55,569 (6.3%) unspecified). Results: Among men, CD is associated with erectile dysfunction, and among females, with lower levels of desire, arousal, lubrication, orgasm, and sexual satisfaction and with increased pain during intercourse. For both men and women, depression, anxiety, and fatigue are also reported, while women with CD are more affected by a poor body image than men. Clinical implications: Patients with CD, especially females, should be more routinely assessed for the impact of their condition on sexual functioning. The impact of CD on men’s sexuality has been extensively studied in terms of erectile capacity, but other aspects of their sexuality are largely neglected. Strengths and limitations: This is the first umbrella review to bring together the documented findings regarding sexual dysfunction among patients with various non-genital CDs. While the heterogeneity of the CDs makes the study unique and clinically relevant, it renders the interpretation of the results more difficult. The overrepresentation of men in existing studies reflects the current state of research but limits the applicability of the findings for women. Conclusion: Women and men with non-genital CDs can suffer from SD or reduced sexual function. Health professionals should pay more attention to managing these sexual disorders, even when the disease does not affect the genitals. Full article

Background: The female orgasm is a highly understudied phenomenon that is linked to both wellbeing and relationship satisfaction in women. Although orgasm has been associated with interoception—the sense of the physiological condition of the body—very few studies have directly examined the influence that interoception has on orgasm. Objectives: This study investigates how the subjective experience of one’s interoceptive capacities (called interoceptive awareness) is associated with self-reported orgasm frequency and satisfaction in people who identify as women. Methods: In a dataset of 318 women, orgasm frequency and satisfaction were both rated significantly higher for solitary as compared to partnered sexual experiences. Results: Analysis of how dimensions of interoceptive awareness correlated with orgasm frequency and satisfaction showed that (1) ‘Noticing’ predicted orgasm frequency (but not satisfaction) across both solitary and partnered interactions, (2) ‘Attention Regulation’ predicted greater frequency and satisfaction of solitary orgasm (but not partnered interactions), and (3) ‘Body Trusting’ predicted orgasm satisfaction (but not frequency) across both solitary and partnered contexts. Conclusions: Findings underscore the importance of moving beyond orgasmic dysfunction research by investigating how interoception is associated with healthy—and potentially even optimal—orgasmic functioning in women. Full article

Background and Objectives: The impact of gynaecological cancer and its treatments on sexual intimacy can be profound on female sexuality. However, very few registered clinical trials have addressed sexual intimacy among this cohort. Materials and Methods: This preliminary randomised control trial (RCT) and content analysis assessed the effectiveness of a brief online mindful compassion group intervention adjunct with cannabis suppositories. Eighty-three participants aged between 18 and 50+ years who were at least six months post-cancer treatment were randomly allocated to one of four groups, depending on whether they were already using cannabis suppositories. These included a cannabis-only group (CO), a mindful-compassion group (MC), a combined mindful-compassion and cannabis suppositories group (COCM) and a care-as-usual group (CAU). Measurements of sexual function, sexual self-efficacy, mindful compassion, well-being and quality of life were taken at weeks 0, 4 and 12. Results: Sexual function, including arousal, lubrication and orgasms, improved for both the MC p = 0.002 and COCM p ≤ 0.001 groups; in addition, sexual pain was reduced in the COCM p = 0.008 and CO p ≤ 0.001 groups compared to the CAU and MC groups, where p ≥ 0.05. Feedback suggested that cannabis mediated the effects of mindful compassion and supported well-being, sexual self-efficacy, and quality of life. Participants also voiced a preference for cannabis suppositories when using dilators as part of their treatment and the use of sex toys instead of dilators, suggesting that dilators had negatively impacted their sexuality. Conclusions: These preliminary and exploratory outcomes look promising and provide a foundation for future research to develop varied healthcare options to improve mental health service delivery and quality of life for this cohort. Full article

Sexual shame negatively affects women’s sexual functioning, impacting arousal, desire, orgasm, and pain. This review summarizes the existing literature, highlighting the multiple, interacting factors contributing to sexual shame including sociocultural messages, body and genital self-image, sexual self-schemas, sexual pain, comorbid chronic disease, illness, medical disorders, and sexual trauma. The relationship between sexual shame and sexual functioning is often reciprocal, demonstrating sexual shame as a potential causal and maintaining mechanism underlying women’s sexual difficulties. We present a model proposing the mechanisms by which sexual shame affects sexual functioning, underscoring the need for comprehensive approaches to mitigate the impact of sexual shame and foster sexual well-being for women. Growing research emphasizes emotional processes in models of sexual function, and emotional pathways underlying sexual difficulties and dysfunction. Given the impact of sexual shame on women’s sexual functioning, therapeutic approaches that target sexual shame are recommended to help alleviate difficulties with sexual arousal, desire, orgasm, and sexual pain. Full article

Background: In the literature, female anorgasmia (AO) is closely related to obsessive–compulsive disorder (OCD), but no publication has explored the role of individual obsessive traits that may also be typical of other disorders, assuming that repetitive thoughts and compulsions must necessarily correspond to an obsessive-type neurotic profile. It is worth investigating and assessing the specific weight of other morbid conditions involved, beyond OCD. Materials and Methods: This study was conducted during 2022–2023 by selecting 208 Italian clinical patients from private databases. They submitted to individual clinical interviews and two psychometric questionnaires (Perrotta Integrative Clinical Interviews 3, PICI-3-TA, and Perrotta Individual Sexual Matrix Questionnaire, PSM-Q). Results: Among the 208 patients (M: 39.05 years), divided into subgroups by age and obsessive symptomatology, no significant differences were found between the subgroups in the comparisons of the data obtained from the administration of the PSM-Q. Conclusions: This study confirms that it is not OCD that correlates with OA but obsessive traits, which are also common to other psychopathological disorders, such as bipolar disorder, borderline disorder, manic, and psychotic disorders and, therefore, in psychotherapy, it is necessary to intervene with a clinical approach that has in mind the patient’s psychopathological personality picture and the causes that originated or reinforced OA. Full article

Background/Objectives: Multiple sclerosis (MS) frequently results in both urinary and sexual dysfunction, which significantly impairs quality of life. Conventional treatments for bladder dysfunction often prove insufficient, leading to the exploration of alternative therapies such as percutaneous tibial nerve stimulation (PTNS). This study aimed to assess the impact of PTNS on sexual function and bladder symptoms in female MS patients with neurogenic detrusor overactivity (NDO) and female sexual dysfunction (FSD). Methods: A total of 65 female MS patients with NDO were evaluated and underwent 12 weeks of standardized PTNS treatment. Sexual function was assessed using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R), while bladder symptoms were evaluated using the OAB-v8 questionnaire. Participants were grouped based on the presence of sexual dysfunction and distress and compared to a control group of 20 patients who declined PTNS. Results: Significant improvements were observed in FSFI scores across multiple domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) in the treatment groups (p < 0.05). Additionally, 58.46% of patients showed positive responses to PTNS regarding overactive bladder symptoms (OAB-v8 score), while the control group showed no significant changes. Conclusions: PTNS appears to be an effective therapeutic option for improving sexual function and urinary symptoms in female MS patients with NDO and FSD, offering a promising non-invasive alternative for managing these conditions. Full article

Miltefosine, an orally administered drug, is an important component of the therapeutic arsenal against visceral and mucosal forms of leishmaniasis. However, data regarding the safety and tolerability of miltefosine treatment for cutaneous leishmaniasis (CL) are relatively limited. The aim of this study was to evaluate the tolerability, safety, and adverse events (AEs) of miltefosine treatment in patients with CL. In this cohort study, we reviewed the medical records of all miltefosine-treated patients between 1 January 2016 and 31 December 2022, at Israel Defense Forces military dermatology clinics and the dermatology and Tropical Medicine Clinics at Chaim Sheba Medical Center, Ramat-Gan, Israel. A total of 68 patients (54 males, 79%) with a median age of 30.3 ± 15.6 years (range: 18–88) were included in this study. Leishmania species were identified as L. major (n = 37, 54.4%), L. tropica (n = 12, 17.6%), L. braziliensis (n = 18, 26.5%), and L. infantum (n = 1, 1.5%) using polymerase chain reaction (PCR). Miltefosine tablets were administered orally at a dose of 50 mg, three times daily, for 28 days. Overall, 44 patients (65%) completed the 28-day treatment, and the remaining patients required dose reduction or early discontinuation of treatment. AEs (of any degree) were common, reported in 91% of patients. Both previously reported and previously unreported AEs were documented. Gastrointestinal symptoms (66.1%) and malaise (23.5%) typically occurred during the first two weeks of treatment and tended to subside. Other AEs, including acute renal failure (20.6%), sudden and severe pleuritic chest pain (7.6%), acne exacerbation (11.8%), suppuration of CL lesions (17.8%), and AEs related to the male genitourinary system (39.6% of males), typically occurred towards the end of treatment. The latter included testicular pain, epididymitis, diminution or complete absence of ejaculate, inability to orgasm, and impotence. Severe AEs necessitated treatment discontinuation (29.4%) or hospitalization (10.3%). URTI-like symptoms, arthritis, cutaneous eruption, pruritus, and laboratory abnormalities were also observed. Overall, the cure rate (for all patients combined) evaluated 3 months after the completion of treatment was 60%. The tolerability of miltefosine treatment for CL is low. Close clinical and laboratory monitoring is required during treatment, as severe AEs are not uncommon. As new insights regarding its toxicities emerge, further studies are required to define the role of miltefosine in the treatment of CL. Full article

(1) Background: Female sexual dysfunction (FSD) and overactive bladder (OAB) are prevalent disorders that significantly impair women’s quality of life. While pelvic floor muscle training (PFMT) is a well-established treatment for OAB, its effectiveness for FSD remains uncertain. Recent studies suggest that intravaginal electrical stimulation (IVES) may enhance the effects of PFMT. Therefore, this study aimed to evaluate the efficacy of combining IVES with PFMT to improve sexual function and bladder control in women with OAB and FSD. (2) Methods: A total of 40 women with FSD and OAB as determined by the Female Sexual Function Index (FSFI) and Overactive Bladder Symptom Score (OABSS) were randomized into two groups: group 1, the intravaginal electrical stimulation group (IVESG) (n = 20), and group 2, the placebo control group (CG) (n = 20). Patients in both groups received PFMT during the trial, and the IVESG underwent 10 weeks of electrical stimulation. The primary outcome was the change in the FSFI score from baseline to week 4 and week 10. The secondary outcome was a comparison of the OABSS values at week 4 and week 10 of the trial. (3) Results: After treatment, the IVESG scores for the total FSFI, sexual arousal and orgasm, increased significantly (p < 0.05). After 10 weeks of treatment, the OABSS values for IVESG were significantly lower (p < 0.01). After 10 weeks of treatment, the percentage of patients with mild OAB in the IVESG and CG increased by 53.33% and 60%, respectively, while the percentage of patients with both moderate and severe OAB decreased, especially in the IVESG, where patients with severe OAB were non-existent after 10 weeks of treatment. (4) Conclusions: IVES combined with PFMT improved objective and subjective measures of FSD and OAB. There was a significant improvement in FSD (including arousal and orgasmic domain scores). This study concludes that IVES is an effective conservative treatment. Full article

Background: Hereditary breast and ovarian cancer syndrome (HBOC) predisposes women to an increased risk mainly of breast and tubo-ovarian cancer. The aim of the study is to investigate whether being diagnosed with HBOC syndrome is itself a risk factor for sexual dysfunction. Methods: An ad hoc questionnaire, including baseline demographic and clinical data, and the Sexual Function Questionnaire 28 (SFQ28) were administered to HBOC female carriers (study group) and to a control group. Results: After propensity score matching (1:1), we enrolled 202 women, 101 in the study group and 101 in the control group. In a multivariate analysis, we finally found that menopausal status was the only risk factor for a significant low score in the domains Desire (HR 0.66; CI95% 0.47–0.93; p = 0.017), Arousal (Lubrication) (HR 0.52; CI95% 0.34–0.80; p = 0.003), Arousal (Cognitive) (HR 0.64; CI95% 0.44–0.95; p = 0.027), and Orgasm (HR 0.33; CI95% (0.16–0.70; p = 0.004), independent of risk-reducing surgery for gynecological malignancy. Psycho-oncology support is a protective factor for the Enjoyment domain (HR 1.38; CI95% 1.05–1.81; p = 0.022). Conclusions: HBOC syndrome itself does not affect SFQ28 domains, while menopausal status significantly influences sexual health, with potential mitigating effects of psycho-oncological support. Full article

Sexual dysfunction is a common side effect of antidepressants, significantly impacting patients’ quality of life and treatment adherence. This study investigates the relationship between sexual dysfunction and antidepressants by analyzing data from VigiBase™, the World Health Organization’s global database of individual case safety reports. In this study, we examined, for the first time, reports related to sexual response—desire, arousal, and orgasm—by grouping appropriate side effect terms and calculated the reporting odds ratios (RORs) for various antidepressants. The findings of this study highlight a high disproportional reporting of sexual dysfunction, particularly with selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors. In contrast, agents such as agomelatine, bupropion, and mirtazapine showed a lower association. Furthermore, we investigated the correlation between reporting odds ratios and the binding affinities of antidepressants to specific neurotransmitter receptors and transporters, unveiling significant relationships that provide insights into the pharmacodynamic pathways underlying these adverse effects. For instance, a positive correlation was observed between the serotonin transporter and side effects in the category desire: r (19) = 0.67, p = 0.001 These insights underscore the necessity for clinicians to consider sexual side effects when prescribing antidepressants and to monitor and address these issues to improve patient outcomes. Full article

Lung cancer (LC) is one of the most prevalent cancers in both men and women and today is still characterized by high mortality and lethality. Several biomarkers have been identified for evaluating the prognosis of non-small cell lung cancer (NSCLC) patients and selecting the most effective therapeutic strategy for these patients. The introduction of innovative targeted therapies and immunotherapy with immune checkpoint inhibitors (ICIs) for the treatment of NSCLC both in advanced stages and, more recently, also in early stages, has revolutionized and significantly improved the therapeutic scenario for these patients. Promising evidence has also been shown by analyzing both micro-RNAs (miRNAs) and the lung/gut microbiota. MiRNAs belong to the large family of non-coding RNAs and play a role in the modulation of several key mechanisms in cells such as proliferation, differentiation, inflammation, and apoptosis. On the other hand, the microbiota (a group of several microorganisms found in human orgasms such as the gut and lungs and mainly composed by bacteria) plays a key role in the modulation of inflammation and, in particular, in the immune response. Some data have shown that the microbiota and the related microbiome can modulate miRNAs expression and vice versa by regulating several intracellular signaling pathways that are known to play a role in the pathogenesis of lung cancer. This evidence suggests that this axis is key to predicting the prognosis and effectiveness of ICIs in NSCLC treatment and could represent a new target in the treatment of NSCLC. In this review, we highlight the most recent evidence and data regarding the role of both miRNAs and the lung/gut microbiome in the prediction of prognosis and response to ICI treatment, focusing on the link between miRNAs and the microbiome. A new potential interaction based on the underlying modulated intracellular signaling pathways is also shown. Full article

Background: The COVID-19 pandemic brought significant changes to daily life in Poland, with restrictions affecting various sectors, including entertainment, education, and travel. The pandemic’s impact extended to intimate aspects of life. This study aimed to compare the sexual functioning of young adults in Poland before and during the pandemic, using the Changes in Sexual Functioning Questionnaire (CSFQ-14). Methods: The research involved an online survey with demographic questions, the CSFQ-14 for pre-pandemic sexual functioning, and modified CSFQ-14 questions for the pandemic period. Sexual dysfunction was determined using predefined cutoff scores. Results: Overall, the study found no significant difference in the sexual functioning of young Poles during the COVID-19 pandemic compared to before. However, there were gender-specific trends. Women reported enhanced pleasure, satisfaction, and orgasm during lockdown, while men faced challenges with erection and ejaculation. A higher proportion of women experienced overall sexual dysfunction compared to men, both before and during the pandemic. This research provides insights into the impact of the COVID-19 pandemic on the sexual lives of young Poles. While overall sexual functioning remained relatively stable, specific aspects varied by gender. Conclusions: The study emphasizes the need to consider demographic factors, such as age and gender, when assessing the effects of external stressors like a pandemic on sexual health. Further research is essential to fully grasp these complexities and their potential long-term consequences. Full article

Background: Erectile dysfunction (ED) most often has vascular etiology and usually is the earliest symptom of vascular dysfunction. The aim of this study was to evaluate vascular dysfunction with the use of the Flow-Mediated Skin Fluorescence (FMSF) technique in men with and without ED. Methods: Included were 39 men (median age 53) with ED and 40 men (median age 41.5) without ED. Medical interview, physical examination, and anthropometrical measurements were performed for all participants. The serum total testosterone, LH, and SHBG determinations were performed in patients with ED, and the Free Testosterone Index (FTI) was calculated. The FMSF technique was used to measure the microcirculatory oscillations at the baseline and to determine the flowmotion (FM) and vasomotion (VM) parameters. The Normoxia Oscillatory Index (NOI) was calculated, which represents the contribution of the endothelial (ENDO) and neurogenic (NEURO) oscillations relative to all oscillations detected at low-frequency intervals (<0.15 Hz): NOI = (ENDO + NEURO)/(ENDO + NEURO + VM). Results: In men with ED were found significantly lower FM and VM parameters, but the NOI was significantly higher in comparison to men without ED. VM and FM correlated significantly positively with erectile function, orgasmic function, and general sexual satisfaction in the whole group and the FTI in the ED group. The thresholds of 53.5 FM (AUC = 0.7) and 8.4 VM (AUC = 0.7) were predictive values for discriminating men with ED. Conclusions: It was shown that the FMSF diagnostic technique may be helpful in the early diagnosis of microcirculation dysfunction due to impaired vasomotion caused by decreased testosterone activity. Full article

Background: We aimed to determine whether patients with postural orthostatic tachycardia syndrome (POTS) have sexual dysfunction compared to age-matched healthy controls. Methods: Utilizing online COMPASS-31 to evaluate dysautonomia symptom severity, Beck’s Depression Inventory Second Edition (BDII), Female Sexual Function (FSF), and International Index of Erection Function (IIEF) questionnaires, we compared sexual function scores in patients with POTS to scores obtained from sex- and age-matched healthy controls via a cross-sectional case–control study. Results: A total of 160 women with POTS, mean age 30.2 ± 7.9 (range 21–50 years), had lower FSF scores than 62 healthy age-matched female controls. IIEF scores in 29 male patients with POTS with a mean age of 30.1 ± 6.0 (range 21–47) were significantly lower than in 27 healthy age-matched male controls. Female POTS patients had significantly lower scores in the sub-domains of desire, arousal, and satisfaction, while male POTS patients had significantly lower scores in erectile and orgasmic function, desire, and satisfaction than healthy controls. Predictive factors of sexual dysfunction were depression in women and age in men. The severity of autonomic symptoms correlated with sexual dysfunction in women, but this effect disappeared after controlling for depression. Conclusions: Compared to healthy controls, women and men with POTS have significant sexual dysfunction, which needs to be considered in the diagnostic and therapeutic approaches as part of comprehensive patient care. Full article