肾移植后生育期女性的月经、性生活及生育状况

背景:理论上讲成功的肾移植可以使生育年龄段女性月经正常化,性生活明显改善,肾移植后可以生育,但国内报道不多。目的:通过自制的"生育年龄段女性肾移植后的月经、性生活、生育状况调查表"并配合生活质量评分表、女性性功能指标量表调查不同生育年龄段女性肾移植前后月经、性生活及移植后生育状况,探讨其影响因素。方法:选择2006年1月至2011年12月在长征医院施行肾移植的生育年龄段患者68例,依据年龄段分为低年组(n=41)和中年组(n=27),以自制的"生育年龄段女性肾移植后的月经、性生活、生育状况调查表"并配合生活质量评分表、女性性功能指标量表进行门诊和电话随访,观察两组患者移植后3年与血液透析期的月经、性生活、生育状况,并分析其影响因素。结果与结论:54例在肾移植后(3.46±1.23)个月月经改善(低年组38例,中年组16例),11例改善不明显(低年组3例,中年组8例),3例较透析前恶化(低年组0例,中年组3例),其中因月经量过多2例行诊刮术,1例行宫腔镜止血术;45例在肾移植后(3.43±1.27)个月性生活改善(低年组34例,中年组11例),11例无明显改善(低年组2例,中年组9例),12例移植后无性生活史(低年组5例,中年组7例)。7例肾移植后(30.24±7.86)个月受孕(低年组5例,中年组2例),其中2例生育子女(均为低年组),5例流产。通过患者肾移植后及移植前进行SF-36量表的调查比较,发现受者在躯体功能、生理职能、躯体疼痛、总体健康、活力领域分值均较移植前明显升高(P<0.05),但在情感职能、心理健康及社会功能领域分值与移植前比较,差异无显著性意义(P>0.05)。肾移植后与肾移植前患者FSFI量表评分比较,发现肾移植后患者性生活质量各指标中,性欲望、性兴奋、阴道润滑、高潮、满意度分值升高,疼痛分值下降,差异均有显著性意义(P<0.05)。结果可见年龄较大受者月经、性生活状况改善也不明显,在严密监护并认真掌控受孕标准的情况下,女性肾移植受者妊娠是可行、安全的。

口服避孕药对多囊卵巢综合征患者性功能的影响

目的评估口服避孕药(oral contraceptives,OCs)对多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者性功能的影响,并分析其女性性功能障碍(female sexual dysfunction,FSD)发生的危险因素。方法研究共纳入210例门诊PCOS患者,其中服用口服避孕药者126例(OC组),未服用者84例(NOC组)。采用网络女性性功能指数(Female Sexual Function Index,FSFI)量表,并补充附加问题,评估参与者的基本信息、避孕方法、性伴侣关系稳定程度、孕产史等多个女性性功能的潜在影响因素。结果OC组FSFI总分中位数为26.35分,50.79%表现为FSD高风险;NOC组FSFI总分中位数26.85分,47.62%显示FSD高风险;两组得分相比差异无统计学意义(P=0.635)。在口服避孕药使用者中,服用35μg炔雌醇/2 mg醋酸环丙孕酮、30μg炔雌醇/3mg屈螺酮、30μg炔雌醇/150μg去氧孕烯三种不同成分口服避孕药的患者之间,FSFI得分差异无统计学意义。经Logistic回归分析,性生活是否主动、伴侣关系是否稳定是PCOS患者性功能的影响因素。结论 PCOS患者中,是否服用口服避孕药、服用不同类型口服避孕药的患者之间性功能评分差异均无统计学意义。PCOS患者性功能的潜在影响因素中,性生活是否主动、伴侣关系是否稳定与FSD高风险的发生相关。

腹腔镜下两种阴道成形术治疗MRKH综合征的临床研究

目的比较腹腔镜辅助乙状结肠阴道成形术与腹膜阴道成形术治疗36例MRKH综合征(MRKHs)的临床效果。方法 2006年4月～2010年2月对该院36例先天性无阴道患者实施腹腔镜辅助阴道成形术,其中22例实施腹腔镜辅助乙状结肠阴道成形术(乙状结肠阴道成形术组),14例实施腹腔镜辅助腹膜阴道成形术(腹膜阴道成形术组),比较两组术中及术后的情况。结果腹腔镜腹膜阴道成形术组手术时间、术后排气时间、术后住院天数明显短于腹腔镜辅助乙状结肠阴道成形术组;术中出血量少于乙状结肠阴道成形术组;住院费用低于乙状结肠阴道成形术组;术后体温恢复时间,两组差异无显著性;人工阴道长度乙状结肠阴道成形术组长于腹膜阴道成形术组。对术后有性生活的患者采用女性性功能指标量表(FSFI)评分,两组相比差异无显著性,与正常女性比较亦差异无显著性。结论腹腔镜阴道成形术治疗MRKH综合征是微创、安全的。与腹腔镜辅助乙状结肠阴道成形术相比,腹腔镜腹膜阴道成形术具有出血少、手术时间短、住院费用低及合并症少的优势。

妇科良性疾病与女性性功能障碍相关性分析

目的探讨妇科良性疾病与女性性功能障碍(FSD)相关性,为防治FSD的发生及防治提供理论依据。方法采用横断面调查方法,选取中等收入城市及农村居民区20岁及其以上女性进行问卷调查,收集其人口学特征及目前所患妇科疾病(经诊断确诊过的疾病)等信息。采用中文版女性性功能量表(FSFI)进行FSD评估,总分小于26.55说明存在FSD。应用多因素非条件Logistic回归模型分析妇科良性疾病与FSD相关性。结果发放问卷1 130份,收回1 068份(回收率94.5%),去除不符合要求问卷80份,共纳入有效问卷988份。988例被访者中妇科良性疾病患者占39.8%(393/988),为患病组,其余为健康组。393例患者中,性功能障碍者占71.2%(280/393),高于健康组性功能障碍患病率(P<0.05)。与健康组相比,患病组在总分及性欲、性唤起、性高潮方面的评分分值均较健康组低(P<0.05)。多因素非条件Logistic回归分析显示,妇科良性疾病、年龄(≥40岁)及绝经是FSD的独立危险因素,较高的教育水平是其保护性因素。结论 FSD是一个重要的公共卫生问题,甘肃省在妇科良性疾病者中FSD现患率较高,应加强性健康教育,降低FSD发生率。

苓芍枣仁配方颗粒联合酒石酸托特罗定治疗女性膀胱过度活动伴性功能障碍临床观察

目的:初步评价苓芍枣仁配方颗粒联合酒石酸托特罗定治疗青年女性膀胱过度活动症伴性功能障碍患者的临床疗效。方法:选择2017年4月至2017年11月中国中医科学院西苑医院泌尿外科门诊治疗的符合膀胱过度活动症诊断(膀胱过度活动症状评分问卷(OABSS)总得分≥3分,尿急症状得分≥2分。)年龄范围26岁～40岁的女性、有性生活史、女性性功能指数(FSFI)<25分、病程≥3个月例的患者10例。给予酒石酸托特罗定缓释片,每日一次,每次1片。同时配合口服苓芍枣仁配方颗粒。每天2次,每次1袋,连续治疗4周。比较10例患者治疗前后的OABSS评分、女性性功能指数(FSFI)评分。结果:治疗4周后10例患者的OABSS评分总分、尿急评分、尿失禁评分、FSFI评分总分,和治疗前相比较,差异具有统计学意义(P <0. 001)。其中FSFI评分中的性高潮评分和治疗前相比较,差异无统计学意义(P=0. 03)。性欲评分、性兴奋评分、阴道润滑评分、性交疼痛评分、性满意度评分和治疗前相比较,均有显著升高,差异具有统计学意义(P <0. 05)。结论:苓芍枣仁配方颗粒联合酒石酸托特罗定缓释片不仅可以缓解患者的尿频、尿急症状,也具有对患者的性功能障碍存在治疗作用。

女性性功能障碍的影响因素研究

目的研究女性性功能障碍(female sexual dysfunction,FSD)的影响因素,为围绝经期和绝经后女性生活质量的改善方法提供临床依据。方法纳入2020年4月至2021年3月在首都医科大学附属北京妇产医院及两家医联体医疗机构就诊的女性902例。收集社会人口学资料、生物学、临床特征和躯体测量指标。根据女性性功能指数(Female Sexual Function Index,FSFI)量表评估FSD将研究对象分为2组:有FSD和无FSD。根据“生殖衰老研讨会分期+10”将研究对象分期、改良Kupperman评分表(Modified Kupperman Index,KMI)评估更年期症状、心理健康问卷-9量表评价抑郁状态、国际尿失禁咨询委员会尿失禁问卷(International Consultation on Incontinent Questionnaire,ICIQ)量表评估女性压力性尿失禁、膀胱过度活动症评分(Overactive Bladder Symptom Score,OABSS)量表评估膀胱过度活动症。FSD的影响因素应用二元Logistic回归多因素分析。结果多因素分析结果显示:KMI评分(OR=1.061,95%CI:1.039~1.083)、血清卵泡刺激素(follicle stimulating hormone,FSH)(OR=1.008,95%CI:1.002~1.014)、高中以下学历(OR=1.446,95%CI:1.019~2.052)、抑郁(OR=1.814,95%CI:1.156~2.845)、绝经后早期(OR=1.717,95%CI:1.106~2.667)、绝经后晚期(OR=1.905,95%CI:1.008~3.602)、婚姻关系一般(OR=2.422,95%CI:1.711~3.429)和婚姻关系不满意(OR=1.945,95%CI:1.018~3.717)是FSD的重要危险因素(P<0.05);绝经后早期应用芬吗通治疗是FSD的重要保护因素(OR=0.229,95%CI:0.059~0.889,P<0.05)。结论FSD受心理、生理、社会等多种因素的影响,卵巢衰竭是FSD的重要危险因素,绝经后女性早期应用绝经激素治疗是FSD的保护因素。

应用分类树模型分析女性性功能障碍的影响因素

目的采用分类树模型分析女性性功能障碍(female sexual disorders,FSD)的影响因素,探讨盆底功能障碍性疾病对女性性功能障碍的影响,为临床医师有效识别女性性功能障碍提供科学依据,改善患者的生活质量。方法选择甘肃省6个地区20岁及其以上的5 073名女性为研究对象。采用问卷调查方法,收集其人口学特征等信息;采用中文版女性性功能量表(CV-FSFI)对研究对象进行FSD评估,总分小于23.45分表明存在FSD。根据是否诊断为女性性功能障碍,将5 073名女性分为病例组和对照组。采用病例对照研究,应用分类树模型的卡方自动交互检测方法,探讨女性性功能障碍的影响因素。结果分类树模型共有3层、24个节点、5个终末节点,共筛选出年龄、分娩次数、职业、文化程度、高血压、UI类型6个解释变量,发现高龄、低文化程度、高血压疾病、压力性尿失禁/急迫性尿失禁、多次分娩和不同职业与FSD发生相关。分类树模型Risk统计量0.358,拟合效果尚可。结论分类树模型不仅可以拟合女性性功能障碍发病风险预测模型,针对不同特点人群明确不同影响因素。临床医师应当主动评估高龄、文化程度低、高血压和患有盆底功能障碍性疾病患者的性功能。

输尿管肾镜术后放置JJ管对女性性功能指数的影响

目的目前,影响女性性功能的各种病因已经被广泛研究,但是输尿管肾镜手术对女性性功能障碍的影响尚不清楚。本研究旨在探讨输尿管肾镜术后留置JJ管对女性性功能的影响。方法采用前瞻性研究,前瞻性选取2014年9月至2017年11月苏州大学附属第一医院和盐城市中医院诊治的年龄大于22岁有规律性生活的确诊输尿管结石的已婚中青年女性患者67例作为研究对象。根据患者结石负荷、是否为孤立肾、术中输尿管损伤或输尿管梗阻严重影响肾功能等情况选择是否术后放置JJ管。67例患者分为两组:研究组35例,行输尿管镜碎石术与JJ管置入术;对照组32例,行输尿管镜取石术术后不留置JJ管。术前、术后第一个月和第三个月使用女性性功能指数(female sexual function index,FSFI)评估性功能。记录和评估患者的总体满意度、年龄、手术时间、支架留置时间、体重指数(body mass index,BMI)、结石负荷、月收入状况、受教育程度和心理状态等临床资料。结果两组患者年龄、BMI、住院时间、月收入状况和受教育程度比较,其差异均无统计学意义(均P>0.05);两组患者结石负荷比较,差异具有统计学意义(P<0.05)。研究组和对照组术前FSFI总评分分别为(22.2±0.86)、(24±0.71);术后第一月FSFI总评分分别为(13±0.71)、(23.4±0.98);术后第三月FSFI总评分分别为(22.6±0.81)、(22.2±1.32)。术前和术后第三个月FSFI总评分,两组间比较差异无统计学意义(P>0.05);术后第一月FSFI总评分,两组间比较差异有统计学意义(P<0.05)。在术后第一月FSFI 6个具体领域方面,研究组的主观性唤起能力、性高潮和性生活满意度下降,性交痛增加,这四个领域与对照组分别比较,差异具有统计学意义(P<0.05);在性欲、性活动时阴道润滑度两个领域,两组间比较差异无统计学意义(P>0.05)。研究组术前、术后第一月、术后第三月的性功能障碍发生率分别为34.29%、85.71%、37.14%;对照组分别为31.25%、37.5%、34.38%。研究组在术后第一个月性功能障碍发生率显著升高,与对照组分别比较,差异有统计学意义(P<0.05);术前和术后第三个月,两组间比较差异无统计学意义(P>0.05)。研究组术前、术后第一个月和第三个月的Beck抑郁自评量表(beck depression inventory,BDI)评分分别为(6.2±1.4)、(4.5±1.6)、(5.2±1.1);对照组分别为(5.5±1.7)、(5.1±1.7)、(5.3±0.9),两组间比较差异均无统计学意义(均P>0.05)。结论输尿管肾镜(包含硬镜、软镜、PNL)术后留置JJ管对女性性功能会产生相当大的负面影响。虽然性功能的下降是暂时性的,通常会在输尿管镜手术后第三个月恢复,因此,应当尽量避免放置JJ管或缩短JJ管留置的时间。如果病情必须放置JJ管,那么术前应该告知患者在术后第一个月有一定程度的性功能障碍,通常会在术后三个月左右恢复,并且要尽可能缩短JJ管放置的时间。

不同生殖衰老分期及激素替代治疗的绝经期女性性功能障碍状况分析

目的调查不同生殖衰老分期女性性功能障碍(female sexual dysfunction,FSD)以及应用激素替代治疗(hormone replace therapy,HRT)的绝经后女性FSD的现状。方法本研究为多中心临床研究,纳入2019年6月至2020年8月在首都医科大学附属北京妇产医院及两家医联体医疗机构就诊且符合纳入和排除标准的女性902例。根据生殖衰老分期(Stages of Reproductive Aging Workshop,STRAW+10)及绝经后女性是否应用激素替代治疗(hormone replace therapy,HRT),将研究对象分为7组:生育期组(reproductive group,R)146例、绝经过渡期早期组(early menopausal transition group,ET)199例,绝经过渡期晚期组(late menopausal transition group,LT)87例,绝经后早期组(early postmenopause group,EP)183例,绝经后晚期组(late postmenopause group,LP)41例,绝经后早期应用HRT组(early postmenopausal women using HRT,EP-HRT)207例应用雌二醇片2 mg/雌二醇地屈孕酮片(2 mg:10 mg),绝经后晚期应用HRT组(late postmenopausal women using HRT,LP-HRT)39例应用雌二醇屈螺酮片(1 mg:2 mg)。女性性功能指数(Female Sexual Function Index,FSFI)量表评估FSD。结果EP组和LP组的FSD、性欲障碍、阴道润滑障碍、性满意度障碍以及性交痛的比例均明显高于R组、ET组和LT组,LP组性唤起障碍和性高潮障碍的比例、EP组性唤起障碍的比例高于R组、ET组,LT组性欲障碍和性唤起障碍的比例、EP组性高潮障碍的比例高于R组,LP组的阴道润滑障碍和性交痛的比例均高于EP组(P<0.05)。EP-HRT组的FSD、性欲障碍和性满意度障碍的比例明显低于EP组(P<0.05)。LP-HRT组的阴道润滑障碍、性满意度障碍以及性交痛的比例明显低于LP组(P<0.05)。结论女性FSD的比例随生殖衰老分期的提高而显著升高,应用HRT可降低绝经后女性FSD的比例。

Study on Female Sexual Dysfunction in Type 2 Diabetic Chinese Women

Objective To investigate the female sexual dysfunction(FSD)in type 2 diabetes patients,by comparing the sexual function between type 2 diabetic women and non-diabetic women with Female Sexual Function Index(FSFI).Methods 215 type 2 diabetic women and 107 age-matched non-diabetes women were enrolled with similar backgrounds.Their sexual functions were evaluated with FSFI.Metabolic parameters such as body mass index,blood lipid profile,hemoglobin AlC,plasma glucose were also collected.Results Total score of FSFI of the type 2 diabetic women were significantly lower than that of the non-diabetic controls(18.27±8.96 vs.23.02±5.78,P=0.000).Scores of the FSFI domains(desire,arousal,lubrication,orgasm,satisfaction,pain)of the type 2 diabetic group were also lower than those of the control group.According to the FSD criterion(FSFI〈25)available in China,the percentage of FSD in the type 2 diabetic group was significantly higher than that of the control group(79.2%vs.55.0%,P〈0.001).These trends seemed more prominent in pre-menopause subgroups.The logistic regression analysis indicated that age and diabetes were independent risk factors of FSD.Body Mass Index(BMI)also had influence in the diabetes group.Conclusion Findings from this study showed that there are more FDS in Chinese type 2 diabetic women than in their non-diabetic counterparts,especially in pre-menopause participants.

电针治疗盆腔瘀血综合征的临床观察

【目的】观察电针治疗盆腔瘀血综合征的临床疗效。【方法】将70例盆腔瘀血综合征患者随机分为观察组和对照组,每组各35例,观察组给予电针治疗,对照组给予阴道低频电脉冲刺激盆底肌肉治疗。1个月为1个疗程,避开月经期,连续治疗3个疗程。治疗3个月后,观察2组患者治疗前后视觉模拟量表(VAS)评分的变化情况,以及痛经症状量表(CMSS)评分、女性性功能指数调查量表(FSFI)评分和盆底肌力测定(PFMST)评分的变化情况。比较2组患者治疗前后子宫壁间静脉内径、附件围静脉丛曲张面积、子宫壁间静脉血流速度和髂内静脉血流速度的变化情况。【结果】(1)研究过程中,观察组失访2例,对照组失访3例。最终观察组33例、对照组32例纳入统计。(2)治疗后,2组患者的VAS评分明显改善(P<0.05),且观察组在改善VAS评分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的CMSS严重程度和持续时间评分均明显改善(P<0.05),且观察组在改善CMSS严重程度和持续时间评分方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者FSFI的总分及各项评分(包括性欲、性唤起、阴道润滑、性高潮、性满意度、性交痛)均明显改善(P<0.05),且观察组在改善FSFI的总分及各项评分方面明显优于对照组,差异有统计学意义(P<0.05)。(5)治疗后,2组患者的PFMST评分明显改善(P<0.05),且观察组在改善PFMST评分方面明显优于对照组,差异有统计学意义(P<0.05)。(6)治疗后,2组患者的子宫壁间静脉内径和附件围静脉丛曲张面积均显著降低,且观察组在降低子宫壁间静脉内径和附件围静脉丛曲张面积方面明显优于对照组,差异有统计学意义(P<0.05)。治疗后,2组患者的子宫壁间静脉血流速度和髂内静脉血流速度均显著升高,且观察组在提高子宫壁间静脉血流速度和髂内静脉血流速度方面明显优于对照组,差异均有统计学意义(P<0.05)。【结论】电针治疗盆腔瘀血综合征,能明显改善患者的疼痛症状,提高盆底肌功能,改善患者盆腔静脉血流情况,疗效显著。

腹膜透析患者性功能现状及其影响因素分析

目的:探究腹膜透析患者性功能现状并分析其影响因素,为提高腹膜透析患者性生活质量提供依据。方法:选取2022年03月—07月于广东省中医院采用腹膜透析进行治疗的患者作为研究对象。采用一般资料调查表、综合医院焦虑抑郁测定量表(HADS)、国际勃起功能指数-5(IIEF-5)、女性性功能指数量表中文版(CV-FSFI)收集患者的社会人口学资料、焦虑抑郁情况和性功能得分,并记录患者血液生化结果。通过单因素和多元线性回归分析腹膜透析患者性功能现状及其影响因素。结果:共纳入117例腹膜透析患者,男70例,女47例,平均年龄为(47.42±8.76)岁。其中男性性功能障碍的发生率为85.7%,女性为83.0%。患者焦虑发生率为34.2%,抑郁发生率为27.4%;多元线性回归分析显示,年龄、月收入、原发肾病、认知是影响男性性功能的危险因素;年龄和认知是影响女性性功能的危险因素。结论:腹膜透析患者性功能障碍发生率较高,在提高腹膜透析患者生活质量的过程中,其性生活质量不容忽视。

产后盆底康复护理在自然分娩产妇产后恢复中的应用效果

目的:观察产后盆底康复护理在自然分娩产妇产后恢复中的应用效果。方法:选取2019年4月至2020年4月该院接收的180例自然分娩产妇进行前瞻性研究,按照随机数字表法分为对照组和观察组各90例。对照组产后采取常规护理,观察组在对照组基础上采取产后盆底康复护理,护理3个月后,比较两组盆底功能障碍性疾病发生率、护理前后盆底肌功能指标水平,随访12个月时的性生活质量[女性性功能指数量表(FSFI)]评分和护理满意度。结果:护理后,观察组盆底功能障碍性疾病发生率为5.55%,低于对照组的16.66%,差异有统计学意义(P<0.05);两组阴道静息压和阴道收缩压均高于护理前,且观察组高于对照组,两组阴道收缩持续时间均长于护理前,且观察组长于对照组,差异有统计学意义(P<0.05);随访12个月,观察组性欲、性交疼痛、性高潮、性唤起、阴道的润滑度和性生活的满意度等FSFI评分均高于对照组,差异有统计学意义(P<0.05);观察组护理满意度为96.67%,高于对照组的86.67%,差异有统计学意义(P<0.05)。结论:在常规护理基础上采取产后盆底康复护理可提高自然分娩产妇产后FSFI评分和护理满意度,改善盆底肌功能指标水平,降低盆底功能障碍性疾病发生率,效果优于单纯常规护理。

An overview of structure-soil-structure dynamic interaction research

The concept of structure-soil-structure dynamic interaction was introduced and the research methods were summarized.Based on lots of documents,a systematic summary of the history and current situation of structure-soil-structure dynamic interaction research considering adjacent structures was proposed as reference for researchers.The existing matter and the prospect of future research trend in this field was also examined.

新型射频治疗女性性交痛的疗效分析

目的探讨新型射频技术对女性性交痛的临床疗效分析。方法回顾性分析2020年8月至2021年4月就诊于浙江中医药大学附属第二医院的21例女性性交痛患者,治疗选用新型射频(每次25分钟,每10-14天治疗一次,5次为一个疗程),治疗前及治疗后10周后行FSFI评分及疼痛评分,观察其治疗效果。结果患者治疗后FSFI评分由(12.5±5.0)分上升至(25.6±4.0)分,疼痛评分由(7.0±1.2)降至(2.9±1.3),治疗前后差异具有统计学意义(P<0.05)。结论新型射频在治疗女性性交疼痛方面均具有显著的临床疗效,能够极大改善患者的性生活质量,提升家庭幸福感。

Relationship between Female Sexual Function and Depression or Anxiety in Japan

Background: Sexual dysfunction is sexual complaints or disorders. There are various causes, but the onset leads to deterioration of relationships and quality of life with partners. There is still a deep-rooted awareness that sexuality is a secret in Japan. Aim: This study aims to clarify the relationship between female sexual function and depression or anxiety. Method: Four hundred and fifty-eight Japanese healthy women who worked in four randomly selected medical institutions in Okinawa Prefecture in Japan from March to May 2012 were asked to agree to a consent form of their own free will and participate in self-reported questionnaires. For their evaluation, the Female Sexual Function Index (FSFI;Rosen et al. 2000, which includes the six domains of desire, arousal, lubrication, orgasm, pain, and satisfaction) and the Kessler Psychological Distress Scale (K6;Kessler, 2002, which includes the following six items: felt nervous, hopeless, restless or fidgety, worthless, depressed, and felt that everything was an effort) was used. Moreover, participants’ characteristics showed age, marriage, menopause, annual income, and drinking. In addition, JMP16.2 and R 4.2.0 was used to perform Pearson’s chi-square test, Fisher’s exact test, Mann-Whitney U test, Kruskal-Wallis test, Steel-Dwass test, Spearman’s Rank-Order Correlation, and Cronbach’s alpha. This study was approved by the university and the medical institutional review board (IRB). Results: 178 women were included in the final analysis, and the median (IQR, interquartile range) was 39 (32 - 48) years old, and the mean ± SD (standard deviation) was 40.2 ± 10.4 years old. The median (IQR) and mean ± SD of FSFI Total Score were 22.0 (9.3 - 26.6) and 19.2 ± 9.6. The median (IQR) and the mean ± SD of K6 Total Score were 3 (0 - 7) and 4.2 ± 4.5. 16% of all women with a K6 Total Score of 10 and more, and 5% of all women with a K6 Total Score of 13 and more considered a serious mental illness. There was no clear association between female sexual function and depression or anxiety in all health worker participants between FSFI Total Score and K6 Total Score by Spearman’s Rank-Order Correlation Coefficient (ρ). However, there was a moderate correlation between the K6 Total Score and the FSFI Total Score in health worker participants with a K6 Total Score of 11 or more (n =19, ρ = ?0.62, P = 0.005). Moreover, there was a weak correlation between them in both married and drinking women or married and non-menopausal women. In the Mann-Whitney U test where few participants had morbid depression, significant relationships were found in the association between a sexual function with high depression or anxiety, whereas the low group had a K6 cut-off value of 11. Conclusion: Female sexual morbidity for high depression or anxiety should be managed with interventions. Especially, the intervention for decreasing female sexual function in the K6 Total Score of 11 or more will be needed, and a randomized study is required for more evidence.

Dynamics of Female Sexuality;Hidden Emotional Issues

Sexual satisfaction following Laser or RF vaginal rejuvenation is usually assessed by straightforward self-report questionnaires that may not offer a deeper insight into female dynamics. Our randomized double-blind longitudinal clinical trial on 14 menopausal women with high FSFI satisfaction scores following laser or RF vaginal interventions, demonstrated a high positive correlation between the subjects’ FSFI scores and the Hy (hysteria), D (Depression) and L (Lie) validity scales of the MMPI-2. Such high positive correlation between the FSFI and the L-scale negates the reported increase in female sexual satisfaction following laser or RF vaginal rejuvenations. The high positive correlations of the FSFI with the Hy and D scales indicate that despite reports of increased sexual satisfaction, the vaginal procedures did not improve psychological wellbeing or quality of life. Results on the Differential Emotions Scale (DES) reveal that 98% of the subjects were organized around the emotions of shame, sadness and joy. Such results indicated a multilayered emotional organization that possibly reflects joy on the outside and shame and sadness on the inside. Results of Laser or RF vaginal rejuvenation procedures should be evaluated by a battery of tests that take into account females’ often prominent tendency to focus on satisfying their partners rather than themselves. Going down the path that starts with a dismissal of self-fulfillment to focus on their partners’ satisfaction, may bring several women to the endpoint of disingenuous interpersonal relationships tainted by repressed disillusionment.

Female Sexual Function after Surgical Treatment of Urinary Incontinence

Introduction: Urinary incontinence is a common problem that can affect the quality of life of women of all ages and can negatively influence the exercise of sexuality. Aim: The aim of this study was to compare sexual function of women before and after surgical treatment for urinary incontinence. Method: The sample consisted of 38 women with urinary incontinence and surgical treatment (Burch or Sling procedure). The Female Sexual Function Index (FSFI) was used to evaluate sexual dysfunction before and after surgical treatment. Results: The mean age of the women in the study was 48 ± 8.8 years, and 58% were 50 years old or younger. By analyzing FSFI, it was observed that the majority of subjects had an overall index of sexual dysfunction (score < 26 points) before surgery. The desire and arousal domains improved significantly after surgery for all women included in the study. It was also observed that women with higher levels of education had more positive results related to desire. Conclusions: In our sample, in general, sexual function improved after surgical treatment of urinary incontinence, regardless of technique used, particularly in the discounter and pain domain. There was a substantial improvement of the sexual function among women who had presented with cystocele. Desire and arousal improved significantly after surgery, very likely due to the improvement of self-esteem after surgery.

Assessment of Female Sexual Dysfunction in Patients with Premenopausal Female Pattern Hair Loss

Introduction: Female sexual dysfunction (FSD) is a serious problem that affects negatively the quality of life, interpersonal relationships and female self- confidence and might be a direct cause of psychopathological disturbances. Female pattern hair loss (FPHL) is a common cosmetically disturbing condition affecting many women with social and psychological consequences. Aim of the Work: Assessment of the relationship between female sexual dysfunction and Female pattern hair loss in premenopausal females. Methods: A case-control study was carried on 47 female patients with FPHL and 43 age- matched control women without FPHL among premenopausal women attending dermatology and Andrology outpatient’s clinics, Suez Canal University hospital during the period from May 2018 to January 2019. History taking, clinical examination and hormonal investigation (Free Testosterone, Total Testosterone, and SHBG) were performed to all participants in the study. Main Outcome Measures: The Female Sexual Function Index (FSFI) was used to assess the key aspects of female sexual function in patients and controls. FPHL was diagnosed and graded by Ludwig’s classification. Results: Mean age of patients group was 30.12 ± 5.49 years, Regarding FPHL grading, 55.3%, 42.6% & 2.1% of patients were grades 1, 2 and 3 Ludwig’s classification respectively. FSD was found in 44.7% of patients while it was 44.2% in control group (P > 0.05). FSFI score in patients group was 26.40 ± 4.61 and in control group was 27.05 ± 3.12 (P > 0.05). Correlation between FSD prevalence and grade of FPHL by Ludwig’s classification was statistically insignificant. FSD was significantly compromised by increasing age and parity in patients and control groups (P < 0.05). Conclusions: The present study suggests that FSD was not significantly related to FPHL. Increased age and parity may have strong impact on sexual function in premenopausal women, while androgen hormones levels were not determinant factor.

Sexuality of Women with Rheumatoid Arthritis in a West African Hospital

Background: Rheumatoid arthritis is a chronic autoimmune disease that causes socio-economic, psychological and sexual problems. It imposes limitations on sexual relationships and these issues are still taboo in African society. Objective: The objective is to assess the impact of rheumatoid arthritis (RA) on women’s sexuality at the Ignace Deen National Hospital. Patients and Methods: This was an analytic case-control study of 8 months (from April 6, 2020 to December 11, 2020). All patients followed for rheumatoid arthritis diagnosed according to 2010 ACR/EULAR criteria for RA had been included. Results: One hundred and five women (52 RA patients and 53 controls) were collected. The two groups were comparable in terms of demographic characteristics. Sexual dysfunction was found in 69.2% of cases versus 35.8% of controls. Women with RA had poorer sexual functioning in the categories of desire, arousal, lubrication, orgasm, satisfaction, and pain of the FSFI score compared to healthy women (p = 0.01;p = 0.7;p = 0.3;p = 0.8;p = 0.1;and p = 0.3 respectively). Patients were 4 times more likely to have sexual dysfunction than healthy individuals and this result was statistically significant with a p-value less than 0.05. Conclusion: Sexual dysfunction was noted in a large number of RA patients surveyed at the rheumatology department of the Ignace Deen national hospital. A larger study is needed to better assess this issue and seek management solutions.