Acupuncture in Premenopausal Women with Hypoactive Sexual Desire Disorder

INTRODUCTION:

Female sexual dysfunction affects up to 43% of women in the United States and hypoactive sexual desire disorder (HSDD) is the most common type; however, we lack treatment options showing improvement for this condition.

AIMS:

To investigate whether acupuncture therapy could improve HSDD.

METHODS:

Premenopausal women with a primary diagnosis of HSDD were included in a single-arm prospective pilot study that was approved by the institutional review board. After providing informed consent, subjects completed validated questionnaires. Participants underwent 25-minute twice-weekly acupuncture sessions for 5 weeks with one certified acupuncturist. Questionnaires were completed again 6 weeks after onset of treatment.

MAIN OUTCOME MEASURES:

Based on a statistically significant change in the desire domain of the Female Sexual Function Index from 2.0 (at baseline) to 2.4 (after intervention with a specialist) in our population of patients diagnosed with HSDD, a sample of 13 was determined, with 90% power and α 0.05.

RESULTS:

Fifteen women were enrolled and 13 completed the study. Mean age was 36.9 ± 11.4 years. Most were white (n = 9, 60%), heterosexual (n = 15, 100%), and non-smokers (n = 14, 93%). Most were sexually active more than four times per month (n = 8, 53%) and none had a history of sexual abuse (n = 15, 100%). Participants received a mean acupuncture needle application of 17 ± 2 at each session. Sexual function improved after intervention, particularly desire (2.1 ± 0.6 to 3.3 ± 1.2, P < .0001), arousal (P < .0001), lubrication (P = .03), and orgasm (P = .005).

CONCLUSION:

In this cohort of premenopausal women with HSDD, 5 weeks of acupuncture therapy was associated with significant improvements in sexual function, particularly desire. This supports a role for acupuncture as a therapeutic option for women with low desire.

Purchase full article at:   http://goo.gl/lpuH4s

By:  Oakley SH¹, Walther-Liu J², Crisp CC³, Pauls RN³.

¹Female Pelvic Medicine and Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH, USA. Electronic address: susan.oakley@stelizabeth.com.

²Acupuncture and Holistic Health, TriHealth, Cincinnati, OH, USA.

³Female Pelvic Medicine and Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH, USA.

Sex Med. 2016 Mar 28. pii: S2050-1161(16)00032-5. doi: 10.1016/j.esxm.2016.02.005. [Epub ahead of print]

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Sexual Function after Partial Penectomy: A Prospectively Study From China

The Purpose of this study was to evaluate the sexual function after partial penectomy for penile carcinoma patients. 

Between January 2010 and May 2013, patients treated with partial penectomy at our institution were prospectively enrolled in this study. Sexual function (IIEF-15), age, body mass index, penile length in the flaccid state after partial penectomy (PL), treatment, having a partner and psychological factors (SAS scores and SDS scores) were assessed. Univariate and multivariate linear regression analyses were performed. 43 patients were included in our study. 

The median age was 56 years, and the median PL was 4 cm. The preoperative IIEF-15, SAS, SDS scores were significantly different from the postoperative scores. There was no statistically significant difference between the patients treated with partial penectomy and partial penectomy+ lymphadenectomy on IIEF-15 scores. Age was negatively associated with erectile function, sexual desire, and overall satisfaction; PL was positively associated with intercourse satisfaction; SAS score was negatively associated with erectile function, orgasmic function, sexual desire, and intercourse satisfaction. 

Our preliminary findings suggest that the sexual function after partial penectomy was significantly reduced. The sexual function was negatively affected by age and anxiety but positively affected by PL.

Full article at:  http://goo.gl/PO8ZMV

By:  Cui Yu,1 Chen Hequn,1 Liu Longfei,1 Chen Minfeng,1 Chen Zhi,1 Zeng Feng,1 Chen Jinbo,1 Qi Lin,1 and Zu Xiongbinga,1

¹Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410000, China

^aEmail: moc.621@yxbxuz

Sci Rep. 2016; 6: 21862.

Published online 2016 Feb 23. doi:  10.1038/srep21862

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Sexual Anatomy and Function in Women With and Without Genital Mutilation

INTRODUCTION:

Female genital mutilation (FGM), the partial or total removal of the external genitalia for non-medical reasons, can affect female sexuality. However, only few studies are available, and these have significant methodologic limitations.

AIM:

To understand the impact of FGM on the anatomy of the clitoris and bulbs using magnetic resonance imaging and on sexuality using psychometric instruments and to study whether differences in anatomy after FGM correlate with differences in sexual function, desire, and body image.

METHODS:

A cross-sectional study on sexual function and sexual anatomy was performed in women with and without FGM. Fifteen women with FGM involving cutting of the clitoris and 15 uncut women as a control group matched by age and parity were prospectively recruited. Participants underwent pelvic magnetic resonance imaging with vaginal opacification by ultrasound gel and completed validated questionnaires on desire (Sexual Desire Inventory), body image (Questionnaire d'Image Corporelle [Body Image Satisfaction Scale]), and sexual function (Female Sexual Function Index).

MAIN OUTCOME MEASURES:

Primary outcomes were clitoral and bulbar measurements on magnetic resonance images. Secondary outcomes were sexual function, desire, and body image scores.

RESULTS:

Women with FGM did not have significantly decreased clitoral glans width and body length but did have significantly smaller volume of the clitoris plus bulbs. They scored significantly lower on sexual function and desire than women without FGM. They did not score lower on Female Sexual Function Index sub-scores for orgasm, desire, and satisfaction and on the Questionnaire d'Image Corporelle but did report significantly more dyspareunia. A larger total volume of clitoris and bulbs did not correlate with higher Female Sexual Function Index and Sexual Desire Inventory scores in women with FGM compared with uncut women who had larger total volume that correlated with higher scores.

CONCLUSION:

Women with FGM have sexual erectile tissues for sexual arousal, orgasm, and pleasure. Women with sexual dysfunction should be appropriately counseled and treated.

Below:  Vulvar appearance of (A) a woman without female genital mutilation (arrow = glans of clitoris) and (B) a woman with female genital mutilation type IIb (arrow = palpable clitoral stump hidden under the scar). Panel C shows a corresponding sagittal proton density-weighted fat-saturated magnetic resonance image of the woman without female genital mutilation. Depicted are the clitoral crus (white arrowhead), bulb (black arrowhead), intact clitoral glans (short black arrow), ultrasound gel in the distal vagina (black spherical mark), and symphysis pubis (long black arrow). Panel D shows a T2-weighted magnetic resonance image of the woman with female genital mutilation. The distal part of the clitoral body (white arrows) is covered by the scar. The clitoris is not in direct contact with the ultrasound gel in the distal vagina (black spherical mark). Also depicted is the symphysis pubis (white arrowheads)

Full article at:   http://goo.gl/f4D99t

By:  Abdulcadir J1, Botsikas D2, Bolmont M3, Bilancioni A4, Djema DA5, Bianchi Demicheli F4, Yaron M4, Petignat P4.

• 1Department of Obstetrics and Gynecology, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address: jasmine.abdulcadir@hcuge.ch.
• 2Department of Obstetrics and Gynecology, Geneva University Hospitals, Geneva, Switzerland; Division of Radiology, Department of Imaging, Geneva University Hospitals, Geneva, Switzerland.
• 3Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland.
• 4Department of Obstetrics and Gynecology, Geneva University Hospitals, Geneva, Switzerland.
• 5Division of Radiology, Department of Imaging, Geneva University Hospitals, Geneva, Switzerland. 
• J Sex Med. 2016 Jan 27. pii: S1743-6095(15)00058-2. doi: 10.1016/j.jsxm.2015.12.023.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Breast Cancer and Sexual Function

As the most common malignancy affecting women within the United States, breast cancer can bring about multiple physical and psychological challenges. Among the greatest challenges are those associated with female sexual function. 

Chemotherapy, endocrine therapy, surgeries and radiation can all have a large effect in altering a woman's sexual health and function. Sexual concerns result in significant emotional distress, including sadness/depression, issues related to personal appearance, stigma, and negative impacts on personal relationships. 

In this article, we discuss some of the specific challenges that present with each type of treatment and the socio-physical impact they have on survivorship. Among the most detrimental to sexual function, are the use of chemotherapy and endocrine therapy. Additionally, anatomical changes that transpire in patients who have undergone surgery or radiation therapy (RT), disrupt perceptions of body image. Here we will discuss and also review the contemporary literature to determine effective management and treatment of sexual dysfunction.

Below:  Sexual health in women

Clinical trials of interventions in breast cancer survivors

Intervention	N	Trial	Results
Topical testosterone (25)	21	Phase I/II	Significant improvement in dyspareunia and dryness
Transdermal testosterone (26)	150	RCT	Compared to placebo, no difference in sexual function scores at 4 or 8 weeks of intervention
Vaginal dehydroepiandrosterone (33)	441*	RCT	Compared to placebo, improvement in sexual satisfaction scores
Aqueous 4% lidocaine (30,31)	49	RCT	Compared to normal saline, significant improvement in pain; resumption of sexual intercourse in 17 of 20 women who had previously abstained
Vaginal pH-balanced gel (28)	86	RCT	Compared to placebo, nonsignificant improvement in vaginal dryness and dyspareunia
Polycarbophil-based vaginal moisturizer (29)	45	RCT	Compared to placebo, trend towards improved dyspareunia scores. Both groups had improvement in average vaginal dryness

RCT, randomized controlled trial. *, breast and gynecologic cancer survivors included in this study.

Full article at:   http://goo.gl/MMyGHu

By:  Boswell EN1, Dizon DS1.

• 1 Dana-Farber Cancer Institute, 2 The Oncology Sexual Health Program, The Massachusetts General Hospital Cancer Center, Boston, MA 06114, USA.
• Transl Androl Urol. 2015 Apr;4(2):160-8. doi: 10.3978/j.issn.2223-4683.2014.12.04. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Sexual Excitation & Sexual Inhibition as Predictors of Sexual Function in Women

To date no longitudinal studies have evaluated the predictive value of the two factors of the Dual Control Model-sexual excitation (SE) and sexual inhibition (SI)-for future sexual function. 

The aims of the present study were to investigate the associations between SE/SI and sexual function and estimate their predictive value for future sexual function in a sample of women. Overall, 2,214 women participated in a web-based survey that assessed SE, SI, and sexual function as well as symptoms of depression. The one and two-year follow-up surveys included 396 and 380 participants, respectively. Correlational analyses and hierarchical regression analyses were conducted to analyze the relationships between predictor and outcome variables. 

Four factors of SE (Arousability, Partner Characteristics, Sexual Power Dynamics, and Setting) and two factors of SI (Concerns about Sexual Function and Arousal Contingency), as well as symptoms of depression and partnership status were significant predictors of concurrent and future sexual function. Several subscales of SE and SI contributed to the prediction of future sexual function above and beyond prior sexual function levels. 

Our study provides the first supportive evidence for the assumptions of the Dual Control Model that propensities for low SE and high SI influence future sexual function.

Purchase full article at:   http://goo.gl/hxlU8z

By:  Velten J1, Scholten S1, Graham CA2, Margraf J1.

• 1 Mental Health Research and Treatment Center, Ruhr-Universität Bochum , Bochum , Germany.
• 2 Department of Psychology , University of Southampton , Southampton , UK. 
• J Sex Marital Ther. 2016 Jan 6:0. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Sexual Function of Women Practicing Sex in Nonconventional Settings - Conjugal Visits

The quality of sexual intercourse in the context of conjugal visits by women to their jailed partners is unknown. This study aimed to assess the quality of the sex lives and psychological conditions of women attending conjugal visits with their jailed inmate partners. 

This controlled study involved 124 women between the ages of 18 to 40 years who engaged in sexual relations with their inmate partners (conjugal visit group) or with their partners at home (control group). Sexual function was assessed using a semi-structured questionnaire and the Female Sexual Function Index, and psychological parameters were evaluated using the Hospital Anxiety and Depression scale. The total Female Sexual Function Index scores was similar in the 2 groups. The percentage of women reporting good quality of the relationship was significantly higher in the conjugal visit group. 

Also, the Hospital Anxiety and Depression scale scores were higher in the conjugal visit group. Depression was a risk factor for sexual dysfunction and had a negative effect on scores in the desire, excitement, lubrication, and sexual satisfaction domains, whereas anxiety was associated with lower sexual desire scores. 

A regular + poor quality of the relationship and being religious were factors associated with sexual dysfunction. Sexual practices in jail were not a risk for sexual dysfunction in this sample.

Purchase full article at:   http://goo.gl/nnInvt

By:   Silveira LR1, Romão AP, Vieira CS, de Sá Rosa E Silva AC, Reis RM, Ferriani RA, Navarro PA, Lara LA.

• 1a Sexual Medicine Service of the Sector of Human Reproduction, Department of Gynaecology and Obstetrics, Faculty of Medicine of Ribeirão Preto , São Paulo University , Ribeirão Preto , Brazil. 

More at:  https://twitter.com/hiv_insight

And: http://twitter.com/Prison_Health

Effectiveness of a Low Dose Testosterone Undecanoate to Improve Sexual Function in Postmenopausal Women

Background

Adding testosterone to hormonal therapy could improve sexual function and general well-being among women during climacteric. We evaluated the effectiveness of testosterone undecanoate on sexual function in postmenopausal women utilizing the standardized questionnaire FSFI score.

Methods

Postmenopausal women with sexual complaints and Female Sexual Function Index (FSFI) ≤ 26.5 were enrolled in to this randomized, double-blinded, placebo-controlled trial. Participants were randomly assigned to 8-week treatment with either oral testosterone undecanoate 40 mg or placebo twice weekly with daily oral estrogen. The FSFI scores before and after treatment were compared to assess any improvement of sexual function.

Results

Seventy women were recruited of which each group had 35 participants. The baseline characteristics and baseline FSFI scores were comparable between both groups. After 8 weeks of treatment, the FSFI scores significantly improved in both groups when compared to the baseline but the FSFI scores from the testosterone group were significantly higher than in the placebo group post-treatment (28.6 ± 3.6, 25.3 ± 6.7, respectively, p = 0.04). There was no difference in adverse effect between the two groups.

Conclusions

The twice weekly addition of testosterone undecanoate to daily oral estrogen was associated with a significant improvement in sexual function among postmenopausal women than the use of the estrogen alone.

Full article at:  http://goo.gl/pZONtz

By:  Reuthairat Tungmunsakulchai^1*, Sukanya Chaikittisilpa¹, Thiti Snabboon², Krasean Panyakhamlerd¹, Unnop Jaisamrarn¹ and Nimit Taechakraichana¹

¹Menopause Research Unit, Reproductive Medicine Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Bangkok 10330, Thailand

²Endocrinology and Metabolism Unit, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Bangkok 10330, Thailand

More at:  https://twitter.com/hiv_insight

And:        http://twitter.com/Prison_Health

Examining the Psychometric Properties of the Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) in a Sample of Lesbian and Bisexual Women

The Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) assesses propensities for sexual excitation (SE) and inhibition (SI). Previous research utilizing the SESII-W included samples comprised exclusively or almost entirely of heterosexual women. 

The purpose of this study was to examine the psychometric properties of the SESII-W and assess its relation to aspects of sexual function within a sample of lesbian and bisexual women. The sample included 974 self-identified bisexual (n = 733) or lesbian/homosexual (n = 241) women who completed an online survey including items assessing women's sexual behaviors, feelings, and functioning, sociodemographics, and the SESII-W. The sample was split; exploratory factor analyses were conducted on the first half, yielding eight lower-order factors with two higher-order factors. Confirmatory factor analysis was conducted on the second half and suggested reasonable model fit. 

SI was positively correlated with sexual problems and negatively correlated with sexual pleasure; the correlations were significant but small. Hierarchical regression analyses were conducted to examine the relationships between SESII-W scores and sexual problems/sexual pleasure, controlling for age, relationship duration, and relationship status. Four lower-order factors predicted reports of sexual problems. 

Findings indicated the SESII-W has similar psychometric properties among sexual minority women as it does among heterosexual women.

Purchase full article at: http://goo.gl/JrBAhk

By: Jozkowski KN1,2, Sanders SA2,3,4, Rhoads K1, Milhausen RR2,3,5, Graham CA2,3,6.

• 1Department of Health, Human Performance, and Recreation , University of Arkansas.
• 2The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University.
• 3Rural Center for AIDS/STD Prevention , Indiana University.
• 4Department of Gender Studies , Indiana University.
• 5Department of Family Relations and Applied Nutrition , University of Guelph.
• 6Department of Psychology , University of Southampton.  

More at:  https://twitter.com/hiv_insight

A Prospective Evaluation of Female External Genitalia Sensitivity to Pressure following Labia Minora Reduction and Clitoral Hood Reduction

Little research has been conducted into the effects of labiaplasty on sensitivity of external genitalia. This study aimed to determine the effect of labia minora and clitoral hood reduction using the edge resection technique on external genitalia sensitivity.

Female subjects electing to undergo labia minora and clitoral hood reduction were enrolled. Subjects underwent sensitivity testing using monofilaments at five locations (one at the clitoral hood and four labial with each labium measured 0.5 cm from the leading edge and 1.5 cm distal to the hymen) at baseline; 2 weeks; and 3, 6, and 12 months postoperatively. Self-evaluations using the Sexual Function Questionnaire were performed at baseline and 3, 6, and 12 months postoperatively.

Thirty-seven subjects undergoing labia minora and clitoral hood reduction were enrolled. Subjects experienced a median increase in sensitivity at month 6 of 0.118 mN at the 0.5-cm right labial location (p = 0.027) and 0.059 mN at the 0.5-cm left labial location (p = 0.046) compared with baseline. No change in sensitivity was demonstrated at the clitoral hood or either of the 1.5-cm labial locations. At 6 months, an increase in the number of sexual relations was observed in 44.1 percent of subjects (p = 0.011), an improvement in orgasm frequency was exhibited by 35.3 percent of subjects (p = 0.013), and an increase in orgasm strength was observed in 35.3 percent of subjects (p = 0.006).

Labia minora and clitoral hood reduction as performed by the trim/edge resection method does not result in diminished sensitivity.

Via:  http://ht.ly/SHZyv Purchase full article at: http://goo.gl/FLiUhm

By: Placik OJ1, Arkins JP.

• 1Chicago and Arlington Heights, Ill. From Northwestern University Feinberg School of Medicine; and Associated Plastic Surgeons, S.C.

More at:  https://twitter.com/hiv_insight

Female Sexual Function Before and After Bariatric Surgery

Via:   http://ht.ly/PNvXJ  HT @NCBI 

The median (Q1, Q3) FSFI score did not differ significantly between the preoperative (26.9 [24.3, 30.7]) and postoperative groups (26.9 [22.6, 30.0]). There was no difference in the prevalence of FSD between groups. However, median scores in FSFI domains of desire and arousal were significantly higher in the postoperative group. There were no differences in the other FSFI domains. The median SQoL-F was significantly higher in the postoperative group.

The FSFI score did not predict the SQoL-F score. The prevalence of FSD was comparable in the two groups. The higher SQoL-F score in the postoperative group may be the result of an improvement in self-esteem, which in turn leads to greater interest in sex and more intense feelings of desire and arousal.

Below:  FSFI distribution by domain in preoperative and postoperative groups.FSFI Female Sexual Function Index. *p < 0.05