UNASSIGNED: Female sexual interest and arousal disorder (FSIAD) is the most prevalent female sexual dysfunction in the postmenopause.
UNASSIGNED: The aim of this review is to provide a summary of the currently available evidence on the use of testosterone in the treatment of FSIAD in postmenopausal women.
UNASSIGNED: A narrative review on the topic was performed. Only randomized controlled trials (RCTs) and systematic reviews and meta-analysis were considered. 123 articles were screened, 105 of them assessed for eligibility, and finally 9 were included in qualitative synthesis following the PRISMA declaration.
UNASSIGNED: Current evidence recommends, with moderate therapeutic benefit, the use of systemic transdermal testosterone within the premenopausal physiological range in postmenopausal women with Hypoactive Sexual Desire Disorder (HSDD), the previous entity for low desire dysfunction, not primarily related to modifiable factors or comorbidities such as relationship or mental health problems. The available evidence is based on studies with heterogeneity on their design (different testosterone doses, routes of administration, testosterone use in combination and alone, sexual instruments of measurement). There is no data indicating severe short-term adverse effects, although long-term safety data is lacking.
UNASSIGNED: Despite having testosterone as a valuable tool, therapeutic strategies are lacking in the pharmacological field of HSDD/FSIAD. Neuroimaging studies could provide valuable information regarding the sexual desire substrate and suggest the potential application of already approved drugs for women with a good safety profile. The use of validated instruments for HSDD in postmenopausal women, considering the level of distress, is necessary to be able to draw robust conclusions on the evaluated treatments.

BACKGROUND: Sexual dysfunction may lead to sexual distress in women with infertility, while polycystic ovarian syndrome (PCOS) may escalate this distress. This study aimed to investigate the role of PCOS in the relationship between sexual dysfunction and sexual distress in Iranian women with infertility.
METHODS: The Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and Depression and Anxiety modules of the DASS-21 were cross-sectionally investigated in 190 women with infertility (103 women with PCOS and 87 women without PCOS).
RESULTS: There were negative correlations between sexual function domains and sexual distress (P < .001) in the total sample. Moderation analysis revealed that higher levels of impaired desire, arousal, and pain elevated sexual distress in the PCOS group. After adjusting for depression and anxiety, only the association between sexual pain and sexual distress was moderated by PCOS condition (P = .008).
CONCLUSIONS: The findings suggest that impaired sexual function is associated with increased levels of sexual distress in infertile female patients. Importantly, comorbid PCOS renders patients susceptible to sexual distress where sexual pain is increased. Further research may shed light on the physiological, psychological, and relational aspects of sexual pain and associated distress in infertile female patients with comorbid PCOS.

暂无摘要。

BACKGROUND: Flibanserin, approved for the treatment of hypoactive sexual desire disorder (HSDD) in females, has demonstrated diverse therapeutic and adverse effect (AE) prospects in the extant randomized controlled trials (RCTs). This meta-analysis aimed to characterize the outcomes of flibanserin use in these patients comprehensively.
METHODS: RCTs involving women with HSDD receiving flibanserin in the intervention arm and placebo in the control arm were sought after throughout the electronic databases. The primary outcomes were the changes from baseline in satisfying sexual events (SSE) per month and sexual desire score per month measured using an electronic diary (eDiary).
RESULTS: From 478 initially screened articles, data from 8 RCTs involving 7906 women with HSDD were analyzed. In premenopausal women, flibanserin 100 mg was superior to placebo in improving the number of SSE per month (mean difference, MD 0.69, 95% CI [0.39, 0.99]), eDiary sexual desire score (MD 1.71, 95% CI [0.43, 2.98]), Female Sexual Function Index (FSFI) desire domain (FSFI-d) score (MD 0.30, 95% CI [0.29, 0.31]), FSFI total score (MD 2.51, 95% CI [1.47, 3.55]), Female Sexual Distress Scale-Revised (FSDS-R) Item 13 score (MD -0.30, 95% CI [-0.31, -0.29]), and FSDS-R total score (MD -3.30, 95% CI [-3.37, -3.23]). Compared to placebo, a higher number of premenopausal women using flibanserin 100 mg achieved improvements in the Patient\'s Global Impression of Improvement score (OR 1.93, 95% CI [1.58, 2.36], P < .00001) and responded positively at Patient Benefit Evaluation (PBE) (odds ratio, OR 1.76, 95% CI [1.34, 2.31], P < .0001). Postmenopausal women receiving flibanserin 100 mg also benefited in terms of the number of SSE per month, FSFI-d and total scores, FSDS-R Item 13 and total scores, and PBE response. Although flibanserin use was associated with higher risks of dizziness, fatigue, nausea, somnolence, and insomnia, these adverse events were mild in nature; the serious AEs and severe AEs were comparable between the flibanserin and placebo groups.
CONCLUSIONS: While flibanserin has demonstrated efficacy in the treatment of HSDD in both pre- and postmenopausal women, its therapeutic advantages may be overshadowed by the higher likelihood of AEs.

UNASSIGNED: Obesity is thought to be a negative predictor of sexual function, but the relationship between body mass index (BMI) and sexual function has been inconsistent. Other factors such as body image and self-esteem may mediate this relationship. This study examined the association of BMI, body image and self-esteem with sexual function in young women.
UNASSIGNED: A total of 514 sexually active women aged 21 to 35 years completed an anonymised online questionnaire that used 3 scales to assess body image, self-esteem and female sexual function: Body Image States Scale (BISS), Rosenberg Self-Esteem Scale (RSES) and Female Sexual Function Index (FSFI). Higher scores for BISS, RSES and FSFI indicate more positive body image, higher self-esteem and better sexual function, respectively. Spearman correlation assessed the association among BMI, BISS and RSES scores, and with FSFI scores. Linear and multivariable logistic regression identified risk factors associated with sexual dysfunction (FSFI <26.55).
UNASSIGNED: BISS and RSES scores significantly correlated with FSFI scores (r=0.27 and r=0.32, respectively; both P<0.001), indicating that better body image and self-esteem were associated with better sexual function. Risk factors for sexual dysfunction were lower BISS and RSES scores, being married (odds ratio [OR] 1.52; 95% confidence interval [CI] 1.07-2.15), having 1 child (OR 2.45; 95% CI 1.26-4.77) and having a perceived mental condition (OR 3.02; 95% CI 1.44-6.33). Factors in lack of sexual dysfunction include being of Malay ethnicity (OR 0.38; 95% CI 0.21-0.71) and being overweight (OR 0.46; 95% CI 0.27-0.78).
UNASSIGNED: Women with poorer body image and lower self-esteem were more likely to have sexual dysfunction. These perceptions and states did not correlate with being overweight, and were better predictors over BMI to identify the population at-risk.

暂无摘要。

Atopic dermatitis is a prevalent skin condition that affects up to 17% of adult population. It can lead to itching, pain, and other symptoms such as sleep disturbance, anxiety, and depression. Due to its high prevalence and limiting symptoms, atopic dermatitis often has a great impact on patients\' quality of life but there is scarce information regarding how atopic dermatitis affects women\'s sexual health and reproductive desires. The purpose of this article was to assess the impact of atopic dermatitis on sexual function and reproductive wishes in women. A cross-sectional study was conducted from February to March 2022. A total of 102 women with atopic dermatitis were recruited through online questionnaires sent through the Spanish Atopic Dermatitis Association; 68.6% of the patients acknowledged impairment in sexual function, especially those with more severe disease and those with genital and gluteal involvement. In addition, 51% of the women considered that atopic dermatitis may have an influence on their gestational desire, particularly those with gluteal involvement. In conclusion, atopic dermatitis has a great impact on sexual function and reproductive desires in women.

暂无摘要。

Objective: Sexual dysfunction (SD) can interfere with sexual desire and satisfaction and is associated with an impairment in one\'s emotional, mental, physical, and social function. Despite its importance, SD remains understudied in Lebanon, possibly due to its sensitive nature. Therefore, this research aimed to address this gap by examining the relationship between SD and certain psychological and behavioral factors. The objective was to investigate the relationship between SD and eating attitudes, depression, anxiety, and mindfulness among university students in Lebanon using a cluster analysis approach.
Methods: This cross-sectional study was carried out between July and September 2021. Using the snowball technique, a sample of 363 Lebanese university students was recruited. SD was measured using the Sexual Dysfunction Questionnaire, with higher scores indicating higher sexual arousal/desire. Eating attitudes, anxiety, depression, and mindfulness were measured using the Eating Attitude Test, Lebanese Anxiety Scale, Patient Health Questionnaire, and Freiburg Mindfulness Inventory, respectively.
Results: Participants were divided into 3 clusters: cluster 1 \"moderate well being\" (n = 109, 30.0%) was characterized by moderate eating attitudes, anxiety, depression, and mindfulness; cluster 2 \"positive well-being\" (n = 186, 51.2%) was characterized by having the lowest mean eating attitude, anxiety, and depression scores, while having the highest mean mindfulness score; and cluster 3 \"negative well-being\" (n = 68, 18.7%) was characterized by the highest mean eating attitude, anxiety, and depression scores, while having the lowest mean mindfulness score. Females compared to males (β = -0.87) and belonging to cluster 2 (β = -1.32) or cluster 3 (β = -1.32) were significantly associated with less sexual arousal.
Conclusion: The results align with previous findings suggesting that mindfulness has a role in SD. The current study highlights the importance of taking into consideration factors that interplay with SD. Mental health providers should consider integrating aspects of mindfulness into their practice when working with patients with SD. Additionally, addressing the taboo surrounding sexual health will be crucial to destigmatize this topic. The findings emphasize the need for accessible campaigns by sexual health organizations to raise awareness.
Prim Care Companion CNS Disord 2024;26(3):23m03682.
Author affiliations are listed at the end of this article.

BACKGROUND: Hypersexuality (HS) accompanying neurological conditions remains poorly characterized despite profound psychosocial impacts. Objective We aimed to systematically review the literature on HS in patients with neurological disorders. Study selection and analysis We conducted a systematic review to identify studies that reported HS in neurological disorders. HS was defined as a condition characterized by excessive and persistent preoccupation with sexual thoughts, urges, and behaviors that cause significant distress or impairment in personal, social, or occupational functioning. Data on demographics, assessment techniques, associated elements, phenotypic manifestations, and management strategies were also extracted. Findings The final analysis included 79 studies on HS, encompassing 32 662 patients across 81 cohorts with neurological disorders. Parkinson\'s disease was the most frequently studied condition (55.6%), followed by various types of dementia (12.7%). Questionnaires were the most common assessment approach for evaluating HS, although the techniques varied substantially. Alterations in the dopaminergic pathways have emerged as contributing mechanisms based on the effects of medication cessation. However, standardized treatment protocols still need to be improved, with significant heterogeneity in documented approaches. Critical deficiencies include risks of selection bias in participant sampling, uncontrolled residual confounding factors, and lack of blinded evaluations of reported outcomes. Conclusions and clinical implications Despite growth in the last decade, research on HS remains limited across neurological conditions, with lingering quality and methodological standardization deficits. Key priorities include advancing assessment tools, elucidating the underlying neurobiology, and formulating management guidelines.
UNASSIGNED: CRD42017036478.