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.

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.

Surgical Management of Severe Hidradenitis Suppurativa in Women: Outcome and Quality of Life Assessment

Background: Hidradenitis suppurativa (HS) or Acne inversa sometimes referred to as Verneuil’s disease, is a rare and debilitating condition arising in the intertriginous folds that bear apocrine glands (axillae, groin, perineum, pubis, ano-genital area). It has a deleterious impact on the life of affected persons who tend to be more depressive and poorly socially and sexually connected because of pain, malodor and stigmatization. Methods: We conducted a retrospective study in Henri Mondor Hospital in Créteil, France, in order to assess the effectiveness of surgery as a radical treatment and also assess the factors related to recurrence and the surgical and sexual satisfaction in women operated for severe HS of perineum and genitalia. Results: Fifty-five women were included. We got a recurrence rate of 23.6%. 66.7% of recurrence occurred after localized excision. 83% of patients were satisfied with surgery results and would undergo a revision surgery or recommend it. The factors significantly associated with recurrence were overweight (p = 0.0046), location in groin (p = 0.0040), localized excision (p = 0.02), total excision (p = 0.009), healing via secondary intention (p = 0.001) and disability due to HS (p = 0.006). Assessment of sexual response thanks to the FSFI showed an alteration of all the domains of sexual response but the composite index of 18.51 was below the threshold to diagnose pathologic sexual condition.