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.

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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]

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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

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Delusional Disorder over the Reproductive Life Span: The Potential Influence of Menopause on the Clinical Course

Background and Objectives. Recent evidence supports an association between estrogen levels and severity of psychopathology in schizophrenia women. Our main goal was to investigate whether delusional disorder (DD) women with premenopausal onset and those with postmenopausal onset differ in demographic and clinical features. 

Methods. Psychopathological symptoms were assessed in 80 DD women (DSM-IV-TR), at baseline and after six and 24 months. Scores in the PANSS, PSP for functionality, HRSD 17 items, C-SSRS for suicide, and the SUMD were considered outcome variables. For comparison purposes, t- and χ²-tests were performed and nonparametric tests when necessary. Analysis of Covariance (ANCOVA) was conducted for multivariate comparisons. 

Results. 57 out of 80 DD women completed the study. When unadjusted, DD with premenopausal onset had a longer DUP, higher educational level, and a tendency toward higher rates of gynaecological disorders. Erotomanic type was most frequent in DD women premenopausal onset, and somatic and jealous types were most frequent in those with postmenopausal onset. After 24 months, DD women with premenopausal onset showed higher depressive symptoms and a tendency toward higher rates of psychotic relapses. 

Conclusions. Our results support that some aspects of psychopathology and insight may differ according to the onset of DD and the reproductive status.

Below:  Assessment of psychotic symptoms after 24 months by groups

Full article at:   http://goo.gl/S9r0ze

By:  Alexandre González-Rodríguez, 1 Oriol Molina-Andreu, 2 Rafael Penadés, 3 , 4 Marina Garriga, 5 Alexandre Pons, 3 , 4Rosa Catalán, 3 , 4 , * and Miguel Bernardo 3 , 4

¹Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic of Barcelona, University of Barcelona, 170 Villarroel Street, 08036 Barcelona, Spain

²Department of Mental Health, Hospital Universitari Mútua de Terrassa, 5 Doctor Robert Street, 08221 Terrassa, Spain

³Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic of Barcelona, Department of Psychiatry and Clinical Psychobiology, University of Barcelona, 170 Villarroel Street, 08036 Barcelona, Spain

⁴Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 149 Rosselló Street, 08036 Barcelona, Spain

⁵Barcelona Clinic Schizophrenia Unit (BCSU), Bipolar Disorders Unit, Neurosciences Institute, Hospital Clinic of Barcelona, University of Barcelona, 170 Villarroel Street, 08036 Barcelona, Spain

*Rosa Catalán: Email: se.bu.cinilc@nalatacr

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Vasomotor & Sexual Symptoms in Older Australian Women: A Cross-Sectional Study

To determine the prevalence and severity of vasomotor symptoms (VMS) and sexual symptoms in community-dwelling older women, and to explore factors associated with VMS.

A total of 1,548 women aged 65-79 years.

The presence and self-rated severity of VMS (hot flashes, night sweats, or sweating), and sexual symptoms (intimacy, desire, and vaginal dryness) were determined with the use of the Menopause Quality of Life (MenQOL) questionnaire.

All items of the vasomotor and the sexual MenQOL domains were completed by 1,532 and 1,361 of the study participants, respectively. Menopausal hormone therapy (MHT) use was reported by 6.2% of the women, and 6.9% reported using vaginal estrogen. Among the 1,426 women not using MHT, at least 1 VMS was reported by 32.8%. The prevalence of VMS rated as moderately to severely bothersome was 3.4%. A total of 54.4% of currently partnered women had sexual symptoms, and 32.5% reported vaginal dryness during intercourse in the past month. In the multivariate analysis, factors significantly associated with VMS were age, obesity, being a caregiver for another person, and bilateral oophorectomy.

VMS and vaginal atrophy symptoms are common in community-dwelling older women, but they are predominantly untreated. The degree of distress caused by sexual symptoms among older women needs further exploration.

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By: Zeleke BM1, Bell RJ2, Billah B3, Davis SR4.

• 1Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
• 2Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
• 3Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
• 4Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. Electronic address: susan.davis@monash.edu.  

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Overweight, Obesity & Female Sexuality in Perimenopause: A Preliminary Report

Below: The relation between domain of sexual desire and BMI among women

Below: The relation between domain of sexual arousal and BMI among women

Below: The relation between lubrication domain and BMI among women

Below: The relation between orgasm domain and BMI among women

Below: The relation between domain of sexual satisfaction and BMI among women

Below: The relation between domain of sexual pain and BMI among women

Below: The relation between total Female Sexual Function Index (FSFI) and BMI among women

Material and methods

Sixty-one women during the perimenopausal period filled out the survey, with the average age of these women being 51 years. Forty-two of the examined women had an appropriate body mass index (BMI), i.e. between 18.5 and 25, while for 19 of the women, the BMI was above normal. For statistical analysis and in order to assess the differences between the two above-mentioned groups of patients, the nonparametric Mann-Whitney test was applied. A statistically significant value was assumed at p < 0.05. The results of the conducted research indicated no such difference between the women with differing BMI for the specific domains of the FSFI test.

Results

The results obtained show that research in the area needs to be continued.

Conclusions

All the hitherto existing scientific studies also seem to indicate that the influence of overweight and obesity on female sexuality during the perimenopause has not yet been unambiguously proven. Beyond any doubt, however, sexual disorders appear in women at this time of life and the factors which determine them can vary greatly. Given the character of the situation, women ought to be supported both by a team of specialists representing different branches of medicine as well as by their relatives. The whole situation also calls for more research of the important subject matter.

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