Construction and Initial Structure of Sexual Dysfunctions Tendencies Measure

Disclosure of sexual dysfunctions is difficult due to shame and social stigma.The instruments to measure sexual dysfunctions so far were quite backdated and lengthy.Moreover,there was no specific instrument available that could evaluate all the sexual dysfunctions on the Diagnostic and Statistical Manual of Mental Disorders’criteria in a single scale;separate for men and women.The objective to develop the scale was to provide the non-clinical population with a short and straight-forward measure in English which could help them in deciding about seeking professional help.The constructed scale comprised of 7 items for males and 7 for females and employed 6-points Likert scale for responses.The study involved 79 men and 105 women(N=184;Kaiser-Meyer-Olkin Measure of Sample Adequacy=0.682 for males and 0.618 for females).The inclusion criteria were the practical involvement of the participants in sexual practices and ability to respond to a questionnaire in English.Exploratory Factor Analysis was conducted to measure the reliability and validity of the scale.While employing Principal Component Analysis for extraction and Oblimin with Kaiser Normalization as Rotation,Exploratory Factor Analysis was conducted on 7 items for males and 7 items for females separately.Sampling adequacy was found good and the adequacy of correlations between items and was found highly significant.The Cronbach’s Alpha reliability was satisfactory.4 factors were extracted for males with 78.65%variance explained.3 factors were extracted for females with 66.57%variance explained.The communalities for all the 14 items ranged between 0.554 to 0.937.The study established that Sexual Dysfunctions Tendencies Measure is a valid and reliable tool to measure sexual dysfunctions with the criteria of the Diagnostic and Statistical Manual of Mental Disorders.

Sexual dysfunctions and their treatment in liver diseases

Sexual dysfunction(SD)is a prevalent but very commonly ignored aspect in the treatment of liver diseases and cirrhosis.The etiology of SD is multifactorial and therefore treatment strategies are complex,especially in females.Phosphodiesterase inhibitors are useful and effective in erectile dysfunction in males but in females,no single drug is available for SD,therefore multimodal treatment is required depending upon the cause.The foremost and fundamental requirement in both genders is to be stress-free and have adequate control of liver diseases.Improved quality of life is helpful in improving SD and vice versa is also true.Therefore,patients suffering from liver diseases should come forward and ask for treatment for SD,and physicians should actively enquire about SD while history taking and evaluating these patients.SD results in deterioration of quality of life,and both are modifiable and treatable aspects of liver diseases,which are never addressed actively,due to social taboos and fears of SD treatment in the presence of liver diseases.The diagnosis of SD does not require costly investigations,as the diagnosis can be established based on validated questionnaires available for both genders,therefore detailed targeted history taking using questionnaires is essential.Data are emerging in this area but is still at an early stage.More studies should be dedicated to SD in liver diseases.

Therapeutic Approach in Female Sexual Dysfunctions in an Outpatient Clinic of Sexology in the Public Health System: A Longitudinal and Prospective Study

INTRODUCTION: Sexuality is one of the parameters of quality of life, and it is essential to include care for sexual dysfunctions in primary health care. OBJECTIVE: To evaluate the therapeutic approach in female sexual dysfunction in a public health outpatient clinic. DESIGN: A prospective cohort of women with sexual dysfunctions in an outpatient clinic of sexology in the Public Health System. The Female Sexual Function Index (FSFI) and scored 0 - 10 their sexual satisfaction were applied at the beginning and end of the follow-up. RESULTS: Eighty-nine women were included with a median age of 45 years, 69 (77.5%) had less than 11 years of schooling and 95.5% lived with a partner. The main reasons for referral for follow-up at the outpatient clinic of sexuality were dysfunction of hypoactive sexual desire disorder in 67.4% and pain related to sexual function in 46%. The average number of consultations was five and the main therapeutic interventions were guidance and clarification on sexuality (86.5%), use of topical estrogen (56.2%), and relaxation techniques (37.1%). All FSFI-19 domains had better post-intervention rates (p ≤ 0.005). Considering the domains of the FSFI-19, the medians of desire, arousal, lubrication, orgasm, pleasure and pain were higher in the post-intervention period in relation to the pre-intervention period (p ≤ 0.0001 for all analysis). In addition, the score given by the participant on their sexual satisfaction was higher at the post-intervention time compared to the pre-intervention period (p ≤ 0.0001). CONCLUSION: In public health, even with the care being performed by different professionals in each consultation, we conclude that through simple interventions, it is possible to improve the sexualities of the women attended. Still, offering care in sexuality is fundamental as part of primary health care and the training of medical professionals.

Prospective randomized study to evaluate and compare the post-procedural sexual function in patients undergoing semi-rigid ureterorenoscopy for distal ureteric stones in three different operating room settings

Objective:To evaluate and compare the effect of semi-rigid ureterorenoscopy on post-procedural sexual function with three different operating room settings.Methods:In this prospective randomized study,consecutive sexually active patients with normal pre-operative sexual function undergoing uncomplicated semi-rigid ureterorenoscopy for distal ureteric stones were randomized into three groups,with three different operating room settings.Procedure-related anxiety and sexual function were assessed pre-operatively using Amsterdam Preoperative Anxiety and Information Scale and Brief Sexual Function Inventory(in males)and Female Sexual Function Index-6(in females),respectively.All the participants were stented following the procedure,and the stent was removed after 3 weeks.Post-procedural sexual function and general discomfort were assessed and compared between three groups at 1 week,3 weeks,and 12 weeks.The effect of surgery-related anxiety,preoperative sexual function,age,and general discomfort(including stent-related discomfort)on post-procedural sexual function were analyzed using multiple regression analysis.A p-value of less than 0.05 was considered statistically significant.Results:Totally,327 eligible patients were randomized into three groups.The group of patients who underwent the procedural with a screen separating the operating area from the patient vision,while the patient could watch the endoscopy through a separate monitor,had better post-procedural sexual function compared to those who had total vision of the operating area as well as to those whose eyes were blocked.This difference was statistically significant.This post-procedural reduction in sexual function could not be attributed to in situ stent alone.Conclusions:Our study showed that semi-rigid ureterorenoscopy can have significant negative effect on sexual function,which can be reduced with proper preoperative counseling and an ideal operating room settings.

Association between depressive mood and body image and menopausal symptoms and sexual function in perimenopausal women

BACKGROUND Perimenopausal is the period when women's ovarian function begins to decline before and after menopause.During this period,women experience a series of mental state changes,such as decreased hormone levels,decreased libido,and even female sexual dysfunction(FSD)in severe cases,which reduces their quality of life.Factors affecting the occurrence of FSD include physiological and nonphysiological factors,among which physiological factors are uncontrollable.Therefore,it is particularly important to ascertain the related non-physiological factors that affect the occurrence of FSD for improving the quality of sexual life of perimenopausal women.AIM To investigate the mediating effect of depressive mood and body image on menopausal symptoms and sexual function in perimenopausal women.METHODS A total of 186 perimenopausal women were enrolled between January 2019 and January 2021 and divided into the FSD(134 cases)and control(52 cases)groups based on the presence and absence of FSD.Clinical data were compared between the two groups.FSD-related factors were analyzed using logistic regression analysis.Hamilton Depression Scale(HAMD),Body Image Scale(BIS),and Menopause Rating Scale(MRS)scores were compared among women with different FSD scores.The correlation of the MRS score with the BIS and HAMD scores and the mediating effect of the BIS and HAMD scores on the MRS score and female sexual function index(FSFI)were analyzed.RESULTS The HAMD and BIS scores were higher in the FSD group than in the control group,and the difference in monthly income between the two groups was statistically significant(all P<0.05).Monthly income of<2000 yuan[odds ratio(OR)=26.586,P=0.000],BIS score(OR=1.590,P=0.000),and HAMD score(OR=1.884,P=0.000)were independent risk factors for FSD.MRS scores were positively correlated with BIS and HAMD scores(r=0.358 and 0.244,P=0.000 and 0.001,respectively)and negatively correlated with FSFI scores(r=-0.433,P=0.000).Body image and depressive mood had partial mediating effects,accounting for 39.90%of the total effect.CONCLUSION Depression and body image play mediating roles between menopausal symptoms and sexual function in perimenopausal women.

Sexual function history taking in medicine

Sexual history taking is important for the proper diagnosis and treatment of sexual dysfunction.It is often neglected in a clinical setting and it is also underre-ported by patients due to stigma and hesitation.Here we have described how we should take sexual function history taking during any sexual dysfunction.

Epidemiology of Male Sexual Dysfunction (MSD) in Patients Consulting in Some Health Services in the City of Douala, Cameroon

Sexual dysfunction is a group of diseases, disorders or difficulties experienced by men or women during any stage of normal sexual activity. In Africa in general and Cameroon in particular, statistical data concerning the prevelance and the main causes of male sexual dysfunction are rare due to socio-cultural and religious burdens and sometimes self-medication. The objective of this work was to determine the prevalences, comorbidities and the risk factors of the main sexual dysfunction in some hospitals in city of Douala. Through a descriptive retrospective study carried out from Novembre 2019 to June 2021, sociodemographic parameter, reasons of consultation, risk factors and type of male sexual dysfunction (erectile dysfunction or erectile dysfunction (ED), ejaculation disorders (EjD), libido disorders (LD) and disorders of sexual activity with pain or painful sexual intercourse (PSI)) were collected in the medical files of patients who have made urological consultation between 2016 and 2020 at the Deido District hospital, Laquintinie Douala Hospital and Douala General hospital respectively. At the end of our data collection, out of a total of 24995 consultations, 2743 (10.98%) patients were suffering from at least one male sexual dysfunction. Moreover, sexual disorders were the 2nd reason of urological consultation (13.69%) after urinary disorders (33.85%). Among sexual disorders, erectile (76%) and ejaculatory (20%) disorders were the predominant pathologies recorded with the prevalences of 9.79 et 2.62% respectively, and were mostly represented in patients from [41 - 50] for erectile dysfunction, and [18 - 30] years old for ejaculative dysfunction. In addition, the number of patients with ejaculatory and erectile dysfunctions was more important in patients from [18 - 30] and [31 - 40] years old respectively. Among patients presenting sexual disorders, several risk factors or pathologies were associated with the dysfunction: benign prostatic hyperplasia and metabolic syndrome (in patients over 50 years old);psychosocial problems, infections, and alcohol (in patients under 50 years old). These findings could be useful in the elaboration of therapeutic strategies for the management of the Cameroonian population suffering from sexual dysfunctions.

A Double-Blind, Placebo-Controlled Study of the Effectiveness of Mate Endurance TM Dietary Supplement on Sexual Satisfaction, Ejaculatory Control, and Distress in Men with Premature Ejaculation

Background: To assess the efficacy of the dietary supplement Mate Endurance on sexual satisfaction, ejaculatory control, and sexually related personal distress in patients with premature ejaculation. Methods: In a double-blind, randomized, placebo-controlled study, 68 patients between 21 and 60 years old with premature ejaculation were randomized to receive either Mate Endurance or placebo treatment for three months. The patients were provided a questionnaire at the start of the study and again three months post commencement of the study. The questionnaires were comprised of the Index of Premature Ejaculation (IPE) and the PE Diagnostic Tool (PEDT). Results: Participants in the treatment group experienced a significant improvement in symptoms often associated with premature ejaculation versus those in the placebo group. The treatment was widely used with limited adverse effects. Conclusions: The results of the study demonstrate the effectiveness of the dietary supplement Mate Endurance in improving symptoms associated with premature ejaculation, including general sexual satisfaction and distress associated with sexual encounters.

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.

How to recognize late-onset hypogonadism in men wit sexual dysfunction

Late-onset hypogonadism （LOH） has been considered the most common form of male hypogonadism with a prevalence of approximately 1 in 100 men. Diagnosis of LOH should be made in symptomatic men with unequivocally low serum testosterone （T） levels. However, its clinical presentation is often insidious and difficult to recognize because it is characterized by nonspecific symptoms that make differential diagnosis with physiological ageing problematic. Sexual dysfunction is the most important determinant for medical consultation and the most specific symptom associated with low T. We therefore analysed a consecutive series of 1734 subjects who attended our unit for sexual dysfunction to investigate the associations between low T （different thresholds）, sexual parameters, medical history data （delayed puberty, pituitary disease or cryptorchidism） and their physical exam results. Metabolic parameters, in particular waist circumference, display the greatest accuracy in detecting low T. We found that only the association of several symptoms and signs could significantly raise the clinical suspicion of low T. Structured inventories, which cluster together symptoms and signs of hypogonadism, can help clinicians suspect androgen deficiency. In particular, structured interviews, such as ANDROTEST, have been demonstrated to have a greater accuracy when compared to self reported questionnaires in detecting low T levels.

Sexual Dysfunction among Chinese Nurses:Prevalence and Predictors

This study aimed to estimate the prevalence of and identify the factors influencing female sexual dysfunction （FSD） among Chinese nurses. A cross-sectional survey was conducted from March 2013 to May 2014 among 6 hospitals in Suzhou, China. In total, 2,030 married female nurses were included in the analysis.

Urinary and sexual function changes in benign prostatic hyperplasia patients before and after transurethral columnar balloon dilatation of the prostate

BACKGROUND Transurethral columnar balloon dilatation of the prostate(TUCBDP) is a new surgical treatment, but its efficacy remains controversial because of limited clinical application.AIM To investigate the clinical effect of TUCBDP for benign prostatic hyperplasia(BPH).METHODS Overall, 140 patients with BPH who underwent surgical treatment were included in the study. A random number table was used to divide the participants into study and control groups(n = 70 per group). The study group underwent TUCBDP. The prostate resection surgical time, intraoperative blood loss, bladder irrigation time, catheter indwelling time, length of hospital stay, International Prostate Symptom Score(IPSS), maximum urine flow rate(Qmax), residual urine volume(RUV), changes in the International Erectile Function Score(ⅡEF-5) score, serum prostate-specific antigen(PSA), quality of life(QOL) score, and surgical complications were compared in both groups.RESULTS The operation time, intraoperative blood loss volume, bladder flushing time, urinary catheter indwelling time, and length of hospital stay were significantly lower in the study group than in the control group(P < 0.05). There were no significant differences in the IPSS, Qmax, and RUV measurements between the study and control groups(P > 0.05). However, at 3 mo post-surgery, the IPSS and RUV measurements were both lower(P < 0.05) and Qmax values were higher(P < 0.05) compared to the pre-surgery results in both groups. The ⅡEF-5 scores before and 3 mo after surgery were not significantly different between the study and control groups(P > 0.05). At 1 mo after surgery, the ⅡEF-5 score was higher in the study group than in the control group(P < 0.05). The serum PSA levels and QOL scores before treatment and at 1 and 3 mo after treatment were not significantly different between the study and control groups(P > 0.05). However, lower serum PSA levels and QOL scores were observed after 1 and 3 mo of treatment compared to pre-treatment levels in the study group(P < 0.05). The surgical complication rate of the study group(4.29%) was lower than that of the control group(12.86%;P < 0.05).CONCLUSION TUCBDP for BPH and transurethral resection of the prostate can achieve better results, but the former method is associated with less surgical trauma.

Multiple sclerosis and sexual dysfunction

Multiple sclerosis （MS） is a chronic inflammatory demyelinating disorder of the central nervous system characterized by episodic and progressive neurologic dysfunction resulting from inflammatory and autoimmune reactions. The underlying pathogenesis of MS remains largely unclear. However, it is currently accepted as a T cell-mediated autoimmune disease. Among other clinical manifestations, sexual dysfunction （SD） is a painful but still underreported and underdiagnosed symptom of the disorder. SD in MS patients may result from a complex set of conditions and may be associated with multiple anatomic, physiologic, biologic, medical and psychological factors. SD arises primarily from lesions affecting the neural pathways involved in physiologic function. In addition, psychological factors, the side effects of medications and physical symptoms such as fatigue, muscular weakness, menstrual changes, pain and concerns about bladder and bowel incontinence may also be involved. Since MS primarily affects young people, SD secondary to MS may have a great impact on quality of life. Thus, maintaining a healthy sexual life with MS is an important priority. The treatment of SD requires multidisciDlinarv teamwork and coooeration amone specialists,individual patients, partners and the society.

Use of a Natural Compound Made of Ecklonia bicyclis Seaweed, Tribulus terrestris and Water-Soluble Chitosan Oligosaccharide, in Male Sexual Asthenia with Mild or Mild-Moderate Erectile Dysfunction and Serum Testosterone Levels at the Lower Limit of Normal

Objectives: to evaluate the effectiveness of a natural compound made of Ecklonia bicyclis Seaweed, Tribulus terrestris and water-soluble chitosan oligosaccharide, in the male sexual asthenia with mild or mild-moderate erectile dysfunction and serum testosterone levels between 280 and 350 ng/dl. Materials and Methods: 84 male patients affected by reduced libido and serum testosterone levels at the lower limit of normal, were recruited. We have separated patients in three different age groups: group A (18 - 45 years), group B (45 - 59 years), group C (>60 years). All subjects answered the International index of erectile function questionnaire (IIEF-5) and underwent determination of serum total testosterone before and after 30 days of treatment. Results: Before treatment, the group A showed mean (± standard deviation) total testosterone 321.9 ± 19.2 ng/dl and mean IIEF-5 18.6 ± 1.97, in the group B it was 318.5 ± 18.1 ng/dl and 16.3 ± 2.66, and finally in the group C it was 305.4 ± 13.1 ng/dl and 14.2 ± 1.95 respectively. After treatment mean total testosterone and mean IIEF-5 were respectively: group A (448 ± 111.46 ng/dl and 21.84 ± 3.41);group B (453.8 ± 105.23 ng/dl and 20.4 ± 3.81);group C (385.8 ± 87.29 ng/dl and 16.7 ± 3.84). Conclusions: The treatment with Ecklonia bicyclis, Tribulus terrestris and water-soluble chitosan oligosaccharide might represent a safe and effective option on the improvement of libido and erectile function in man with testosterone level at the lower limit of normal.

Effects of rectal cancer resection on male sexual function and urinary function

Objective： To investigate the changes in sexual function and urinary function following rectal cancer resection in male patients. Methods： 48 male patients with rectal cancer under 65 years old were included in the study and postoperative sexual function and urinary function were investigated through questionnaires and telephone interviews following resection of rectal cancer and the results were analyzed retrospectively. Results： The overall sexual dysfunction rate was 58.33%. The overall urinary dysfunction rate was 56.25%. No statistically significant differences in the incidences of sexual dysfunction and urinary dysfunction were found in the comparison between participants under 50 and above 50 years old, between those who received Mile＇s operation and Dixon＇s operation, and among those at different tumor stages respectively. Conclusion： The incidences of sexual dysfunction and urinary dysfunction in male patients following resection of rectal cancer are high. The age, ways of surgical management and stages of tumor are not apparently contributed to these complications.

Beneficial Effects of Tibolone on Sexual Dys-function in Women with Premature Ovarian Failure (POF)

Introduction: Premature Ovarian Failure (POF) is cessation of ovarian functions before the age of 40 years old with consequent cessation of menstruation. Objective of study: The aim of this study was to evaluate the association between Premature Ovarian Failure and sexual dysfunctions and outcome of management with tibolone. Patients and Methods: Thirty-one women with Premature Ovarian Failure seen at the outpatient clinic of Maternity Hospital were enrolled into the study with 31 healthy women as control group. The instrument of data collection included two types of questionnaires to assess the effect of Premature Ovarian Failure on sexuality. All the women with POF had oral tibolone 2.5 mg for at least one year and the second questionnaire and the profiles were repeated. Results: Of the 31 women with POF that presented with sexual dysfunction (SD), 27 (87.1%) complained of one or more SD domains such as reduced frequency of coitus, dyspareunia, vaginal dryness, reduced libido and general sexual satisfaction (P < 0.01), amenorrhea (P < 0.01) and hot flashes compared to 5 (16.1%) control women (P < 0.01). Administration of tibolone was associated with significant increase in frequency of coitus, reduced dyspareunia and vaginal dryness, increase libido and general satisfaction and happiness. Reduction of sexual dysfunction was predicated on the estrogenic, progestogenic and androgenic metabolite of tibolone through the reduction of serum level of FSH and LH and increased levels of estrogen and testosterone (P < 0.01). Tibolone had no adverse effect on serum lipid profile. Conclusion: Premature Ovarian Failure is associated with sexual dysfunction. Tibolone provides an effective means of treating sexual dysfunction caused by Premature Ovarian Failure.

Sexuality after childbirth: Gaps and needs

Childbirth is a stressful event for a majority of women and can have many consequences one of which is female sexual dysfunction. The main aim of pre- and postnatal health services is to fulfl physical and emo-tional needs of mothers and babies but not sexual function of women. Also, the fact that sexual satisfaction is part of general well being and mental health is generally neglected. Sexual function of women not only is affected by childbirth, but also is infuenced by many other factors. One of these factors is culture and religion. Women’s sexual life after childbirth has different meaning in different cultures. In many conservative so-cieties with certain cultural and religious beliefs women are prohibited from having sex after childbirth. In these societies, women hear conflicting stories about risks and benefts of having sexual intercourse during post-partum period the majority of which may not be true. It has been reported that some women may be at greater risk of postpartum sexual dysfunction as neurobiologi-cal factors and genetics have been recently suggested to impact female sexual functioning. Considering the multidimensional nature of female sexual dysfunction, this problem cannot be resolved by a simple solution and not all postpartum women can be treated by the same protocol. Various treatment options, such as the use of medications, behavioural interventions and psy-chotherapy have been investigated in research studies and there is still controversy over the issue. Regarding the fact that sexually satisfed women are more men-tally healthy, routine screening during prenatal, ante-natal and postnatal visits are suggested to uncover hid-den diffculties with sexual functioning of women and improve their quality of life.

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.

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.

Impaired of Sexuality in Premenopausal Breast Cancer Patients

Introduction: The treatment modalities for Breast cancer may impair the sexual function of women, especially in the pre-menopausal period. Treatment in this group of women has a huge impact in quality of life. The main objective of this study was to evaluate the prevalence of sexual dysfunction (SD) after treatment for breast cancer among women who were premenopausal at the diagnosis of neoplasia. Material and Methods: All women diagnosed with premenopausal breast cancer at one outpatient clinic from March 2019 to September 2020 were selected. Participants answered two sexual function questionnaires (the Female Sexual Function Index [FSFI-19] and Female Sexual Quotient [QS-F]) and a quality of life [QOL] questionnaire [EORTC QLQ-C30]). Sociodemographic and tumor characteristics were also studied. Results: Fifty-eight pre-menopausal women were included. Sexual dysfunction (SD) was observed in 43 participants (74.1%) according to the FSFI-19, while 31 (53.4%) had SD according to the QS-F. The functional and general health scales of the EORTC QLQ-C30 were positively related to the FSFI-19 and QS-F scores, while the symptom scale was negatively related to the FSFI-19 and QS-F scores. There was no relationship between chemotherapy, hormone therapy, or surgery with the FSFI-19 and QSF scores. A diagnosis of depression was negatively related to the total FSFI-19 scores. Conclusion: Pre-menopausal breast cancer women showed high rates of female SD. None breast cancer treatment modality was related to SD. The only studied variable associated with SD was depression.