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PubMed2000

Women's sexual health after childbirth.

OBJECTIVE: To investigate the impact of childbirth on the sexual health of primiparous women and identify factors associated with dyspareunia. DESIGN: Cross-sectional study using obstetric records, and postal survey six months after delivery. SETTING: Department of Obstetrics and Gynaecology, St George's Hospital, London. POPULATION: All primiparous women (n = 796) delivered of a live birth in a six month period. METHODS: Quantitative analysis of obstetric and survey data. MAIN OUTCOME MEASURES: Self reported sexual behaviour and sexual problems (e.g. vaginal dryness, painful penetration, pain during sexual intercourse, pain on orgasm, vaginal tightness, vaginal looseness, bleeding/irritation after sex, and loss of sexual desire); consultation for postnatal sexual problems. RESULTS: Of the 484 respondents (61% response rate), 89% had resumed sexual activity within six months of the birth. Sexual morbidity increased significantly after the birth: in the first three months after delivery 83% of women experienced sexual problems, declining to 64% at six months, although not reaching pre-pregnancy levels of 38% . Dyspareunia in the first three months after delivery was, after adjustment, significantly associated with vaginal deliveries (P = 0 x 01) and previous experience of dyspareunia (P = 0 x 03). At six months the association with type of delivery was not significant (P = 0 x 4); only experience of dyspareunia before pregnancy (P < 0 x 0001) and current breastfeeding were significant (P = 0 x 0006). Only 15% of women who had a postnatal sexual problem reported discussing it with a health professional. CONCLUSIONS: Sexual health problems were very common after childbirth, suggesting potentially high levels of unmet need.

Adolescent↗
PubMed1994

Sexuality and pregnancy. An interview study.

This paper reports the interview research which formed the basis for a large recently completed study of sexuality and pregnancy by questionnaire. Semistructured interviews were conducted with 25 couples who presented at a large hospital antenatal clinic in the first trimester. Of these couples, 15 participated in second trimester interviews and 12 couples were interviewed between 38 and 40 weeks' gestation. The results showed a substantial decline in sexual interest amongst women that was not matched by their male partners but was reflected in a marked reduction in frequency of intercourse. The range of sexual activities also diminished during pregnancy. The majority (19 or 76%) regularly practised oral sex and 3 men (12%) regularly practised anal intercourse. A key observation is that 7 males (28%) did not always achieve orgasm during sexual intercourse per se.

Adolescent↗
PubMed1991

Sexual headaches: case report, review, and treatment with calcium blocker.

A case is reported in which a patient with sexual and orgasmic headaches was treated successfully with a calcium channel blocker, diltiazem. To the best of our knowledge, this is the first case of successful treatment of sexual headaches with calcium channel blockers reported in the English medical literature. The literature on sexually related headaches is reviewed, and classification, evaluation, differential diagnosis, pathophysiology, differential diagnosis, and treatment of sexual headaches are discussed.

Adult↗
PubMed1993

Sexuality of alcoholic women with menstrual cycle function: effects of duration of alcohol abstinence.

Although improvement in sexual function has been reported to occur in postmenopausal alcoholic women after long-term sobriety, little is known about the role alcohol abstinence may play in terms of improving sexual functioning in alcoholic women with menstrual cycle function. The responses of 58 menstruating alcoholic Italian women to a standardized questionnaire that included questions related to sexual function, behavior, and performance are reported. Women were categorized as alcohol abstinent (AA) for > 1 year (long AA, n = 22) or < 1 year (short AA, n = 36). In both groups, 100% reported that they had a regular sexual partner, and the response rate to the sexuality questions was > 99%. Compared with short AA women, long AA women were significantly older at the time of study, at menarche, and at onset of heavy drinking, alcohol dependence, and alcohol abstinence. Sexual desire was defined as willingness to engage in sexual activity; sexual capacity was defined as the ability to become sexually aroused; sexual responsiveness was defined as the ability to achieve orgasm. On all three measures, ts well as intercourse frequency, both long AA and short AA women improved significantly with alcohol abstinence. These findings suggest that sobriety, even of relatively short duration, improves sexual function in menstruating alcoholic women.

Adult↗
PubMed1985

Sexual behaviour in a centre for epilepsy.

The sexual behaviour and hormonal profiles in 97 patients with chronic epilepsy from an epilepsy centre were studied. Sexual behaviour relating to numbers of sexual contacts, orgasms, spontaneous erections, and early morning erections, whether there was difficulty in obtaining or maintaining an erection, or in ejaculation, was assessed at interview. Hormonal profiles consisted of LH, FSH, prolactin, total testosterone, free testosterone, and SHBG. Information was obtained relating to type of seizure, seizure frequency, age of onset, likely pathology, IQ, and medication. The study showed that this patient group was profoundly hyposexual and had a high level of sexual dysfunction. Serum free testosterone levels were low, and it is suggested that the high level of sexual dysfunction and lack of sexual interest may well have a hormonal basis. The reasons for this are discussed.

Adolescent↗
PubMed1998

Sexual dysfunction in stroke patients.

OBJECTIVES: A marked decline in sexual activity has been reported in stroke patients. Little information, however, is available on clinical correlates of sexual dysfunction, changes in the sexual life of spouses of stroke patients, and abnormalities of nocturnal penile erections. MATERIAL AND METHODS: In this prospective 6-month follow-up study, we assessed the impact of stroke on libido, sexual arousal, coital frequency and satisfaction with sexual life in 50 stroke patients (38 men, 12 women, aged 32 to 65 years) and in their spouses. We also measured nocturnal penile erections of the male patients using a strain gauge attached around the penis. RESULTS: All the analyzed aspects of sexuality, i.e., libido, coital frequency, erection, ejaculation, vaginal lubrication, orgasm and satisfaction with sexual life, were commonly decreased as a consequence of stroke both in the patients and in their spouses. Fourteen (28%) patients at 2 months post-stroke and 6 (14%) patients at 6 months had ceased having sexual intercourse. Nocturnal erections at 2 months post-stroke were normal in 17 (45%) of the 38 male patients and impaired in 21 (55%) patients, but all of the patients had some nocturnal erections. Sexual dysfunction correlated significantly (P<0.05) with the presence of the sensory hemisyndrome. CONCLUSIONS: Sexual dysfunction and dissatisfaction with sexual life seems to be common both in male and female stroke patients and in their spouses. Decreased libido, sexual arousal and satisfaction are related particularly to the presence of the hemisensory syndrome. The etiology for sexual dysfunction after stroke is multifactorial including both organic and psychosocial factors.

Adult↗
PubMed1976

Treatment of vaginismus by i.v. diazepam (Valium) abreaction interviews.

A new method of treatment of vaginismus by using intravenous diazepam abreaction interviews is reported. Four patients between the ages of 19 and 28 were interviewed. The duration of their main complaint varied from 6 months to 3 years. Three to six abreaction interviews were conducted; the maximum dosage of Valium used was from 20-30 mg. All of these patients reported having successful intercourse after these interviews. Individual psychotherapy continued after the interviews on a weekly basis, and marital therapy on a monthly basis, for a period of 2 to 6 months. Three out of four women reported being orgasmic for the first time. It is the opinion of the author that this new method of treatment of vaginismus is greatly beneficial.

Abreaction↗
PubMed1997

Citalopram in the treatment of obsessive-compulsive disorder: an open pilot study.

Obsessive-compulsive disorder (OCD) is a common anxiety disorder, which often causes significant impairment of the affected individual's social, occupational or interpersonal functioning. Previous reports suggest that the disorder may be treated with the tricyclic antidepressant clomipramine, and also with the more recently introduced selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, fluvoxamine, sertraline and paroxetine. The present 24-week open pilot study was designed to examine the efficacy, appropriate dose range, side-effects and clinical usefulness of citalopram in OCD. A total of 29 OCD patients were included in the study, of whom 76% showed alleviation of symptoms as evaluated by various self- and observer-rated scales, such as the Yale-Brown Obsessive Compulsive Scale. In most cases the citalopram doses used were in most cases 40 or 60 mg daily, and the treatment was well tolerated. The most commonly experienced adverse events during the study were nausea, vomiting, increased dreaming and decreased sleep. Diminished sexual desire and orgasmic dysfunction were also reported. Despite having the limitations of an open study, our results suggest that citalopram may be effective in the treatment of obsessive-compulsive disorder.

Adult↗
PubMed2004

Possible correlation between type 1 diabetes mellitus and female sexual dysfunction: case report and literature review.

INTRODUCTION: Sexual dysfunction in diabetic women has received less attention in clinical research than the sexual symptoms of diabetic men. Although conflicting results have been reported, several studies suggest an increased prevalence of deficient vaginal lubrication in women with diabetes mellitus. As support to the hypothesis of a potential diabetes-related arousal dysfunction caused by a decrease in vaginal lubrication of women with Type 1 diabetes mellitus, we describe the following case report. METHODS: A 29-year-old white woman was found with a sexual arousal disorder of sudden onset, complicated by loss of orgasm and sexual desire, in absence of any marital, relational, psychological, or gynecological cause. RESULTS: One month later she was diagnosed with severe Type 1 diabetes. With the correction of diabetes and without other treatment of the sexual dysfunction, she experienced a full recovery of her sexual complaints. CONCLUSIONS: The case illustrates the importance of being aware of female sexual dysfunction as an early symptom of diabetes mellitus and suggests that a good glycemic control would be fundamental to restore a normal sexual activity in diabetic women. It also demonstrates the need to take into account, not only in males, a sexual history in the management of diabetes mellitus.

Adult↗
PubMed2004

Summary of the recommendations on sexual dysfunctions in men.

INTRODUCTION: There are few published guidelines for the management of sexual dysfunctions in men and women, despite the prevalence and lack of attention to these problems. Disorders of sexual function in men include erectile dysfunction, orgasm/ejaculation disorders, priapism, and Peyronie's disease. AIM: To provide evidence-based and expert-opinion consensus guidelines for the clinical management of men's sexual dysfunctions. METHODS: An International Consultation in collaboration with major urological and sexual medicine societies assembled over 200 multidisciplinary experts from 60 countries into 17 consultation committees. Committee members established the scope and objectives for each chapter. Following intensive review of available data and publications, committees developed evidence-based guidelines in each area. MAIN OUTCOME MEASURE: New algorithms and guidelines for assessment and treatment of men's sexual dysfunction were developed. The Oxford system of evidence-based review was systematically applied. Expert opinion was based on systematic grading of the medical literature, in addition to cultural and ethical considerations. RESULTS: Recommendations and guidelines for men's sexual dysfunction are presented. These guidelines were developed as evidence-based, patient-centered, and multidisciplinary in focus. For the clinical assessment and diagnosis of ED, a basic evaluation was recommended for all patients, with optional and specialized testing reserved for special cases. A new treatment algorithm is proposed. This algorithm provides a clinically relevant guideline for managing ED in the large majority of men. New treatment guidelines and algorithms are provided for men's orgasm and ejaculation disorders, including premature ejaculation, retrograde and delayed ejaculation. Finally, expert opinion-based guidelines for the clinical management of priapism and Peyronie's disease are provided. CONCLUSIONS: Additional research is needed to validate and extend these guidelines. Nonetheless, this summary encompasses the recommendations concerning men's sexual dysfunctions presented at the 2nd International Consultation on Sexual Medicine in Paris, France, June 28-July 1, 2003.

Algorithms↗
PubMed2005

Practical aspects in the management of vaginal atrophy and sexual dysfunction in perimenopausal and postmenopausal women.

INTRODUCTION: The decline in circulating estrogen levels in peri- and postmenopause has a wide range of physiological effects, including atrophy of tissues in the urogenital tract. Vaginal atrophy is an important contributor to postmenopausal sexual dysfunction. AIM: To provide a framework for clinical evaluation and clinical management of sexual dysfunction secondary to vaginal atrophy. METHOD: Conduct a brief overview of literature on evaluation and treatment of vaginal atrophy, augmented with the authors' clinical observations and experience. RESULTS: Estrogen decline disrupts many physiological responses characteristic of sexual arousal, including smooth muscle relaxation, vasocongestion, and vaginal lubrication; genital tissues depend on continued estrogen and androgen stimulation for normal function. An upward shift in vaginal pH as the result of vaginal atrophy alters the normal vaginal flora. Reduced lubrication capability and reduced tissue elasticity, in addition to shortening and narrowing of the vaginal vault, can lead to painful and/or unpleasant intercourse. At the same time, diminished sensory response may reduce orgasmic intensity. Other contributors to peri- and postmenopausal sexual dysfunction include reduced androgen levels, aging of multiple body systems, and side-effects of medications. Workup of sexual health problems starts by taking a comprehensive sexual, medical, and psychosocial history, followed by complete physical examination and laboratory evaluation. Clinical management includes measures to preserve and enhance overall health, adjustment of medication regimes to reduce or avoid side-effects, and topical or systemic hormone supplementation with estrogens and/or androgens. CONCLUSIONS: No single therapeutic approach is appropriate for every woman with peri- or postmenopausal sexual dysfunction; instead, treatment should be based on a comprehensive evaluation and consideration of medical and psychosocial contributors to the individual's dysfunction. Further research is required to establish optimal regimens of hormonal and nonhormonal agents, including dosages/dosage forms and duration of treatment, for specific subtypes of sexual dysfunction.

Administration, Intravaginal↗
PubMed2005

Testosterone therapy in erectile dysfunction and hypogonadism.

INTRODUCTION: Laboratory experiments indicate that the nitric oxide erectile pathway is testosterone-dependent. Castration induces erectile dysfunction (ED) and reduction in nitric oxide synthase and in phosphodiesterase type 5 (PDE5) in the erectile tissue. Furthermore, castration causes apoptosis adversely affecting smooth muscle content and penile hemodynamics leading to veno-occlusive dysfunction. Testosterone therapy reverses these structural, biochemical, and physiological changes. In humans, testosterone therapy improves erectile function in men with hypogonadism. However, the efficacy of testosterone monotherapy may not be adequate because of the multifactorial nature of the pathophysiology of ED. METHODS: Preliminary data from a number of studies have been reviewed. RESULTS: There are emerging evidence-based benefits to using the combination of testoterone and PDE5 inhibitors. A recently published multicenter, randomized, placebo-controlled study evaluated the safety and efficacy of testosterone gel 1% plus sildenafil vs. placebo gel plus sildenafil, in producing an erectile response in hypogonadal men who had failed prior sildenafil alone for ED. Screening yielded a prevalence of hypogonadism in ED patients who failed prior sildenafil. Following randomization, the double-blinded treatment phase was 12 weeks. Testosterone therapy with testosterone gel significantly improved erectile function in response to sildenafil. In addition, it significantly improved orgasmic function and patient satisfaction. CONCLUSION: It is important to screen all men with ED for hypogonadism, especially those with a history of inadequate response to prior PDE5 inhibitors. The combination of testosterone plus PDE5 inhibitors may be considered for the treatment of ED in men with low to low-normal testosterone levels, who had inadequate response to prior treatment with PDE5 inhibitors alone.

Androgens↗
PubMed2005

Women's sexual function improves when partners are administered vardenafil for erectile dysfunction: a prospective, randomized, double-blind, placebo-controlled trial.

INTRODUCTION: There are limited data concerning the sexual function of women whose male partners receive pharmacological treatment for erectile dysfunction (ED). AIM: One objective of this research was to prospectively compare the efficacy of vardenafil vs. placebo administered to men with ED in improving men's and women partners' sexual function and satisfaction. Another goal was to assess the relationship of erectile function changes in men with ED receiving treatment with sexual function changes in women partners not directly receiving treatment. METHODS: A randomized, double-blind, placebo-controlled, multi-institutional comparison of vardenafil vs. placebo was performed in 229 couples (treated man with ED>6 months and untreated woman partner). Co-primary outcomes for which this research was statistically powered were Sexual Encounter Profile (SEP3) (treated man with ED) and Sexual Life Quality Questionnaire (mSLQQ-QOL) (untreated woman partner). MAIN OUTCOME MEASURES: Erectile function changes in men with ED receiving vardenafil vs. placebo were compared at last observation carried forward (LOCF) in SEP3, International Index of Erectile Function (IIEF-EF) and Erection Quality Scale (EQS). Sexual function at LOCF in women partners was determined by mSLQQ-QOL and Female Sexual Function Index (FSFI). RESULTS: Compared with placebo at LOCF, vardenafil significantly increased least square (LS) mean scores in: (i) overall per-treated male SEP3 success rate, IIEF-EF, and EQS; and (ii) mSLQQ-QOL, total FSFI and sexual desire, subjective arousal, lubrication, orgasm and satisfaction FSFI domains in untreated women partners. Treatment-related improvement in erectile function as assessed by IIEF-EF and EQS was correlated reliably with improvement in women partners' FSFI total and individual domain scores. CONCLUSIONS: Vardenafil is an effective ED treatment in men that also significantly improves sexual function/satisfaction in untreated women partners. Women partners' sexual function improvements relate significantly and consistently to treatment-related improvements in men's erectile function. ED management should emphasize both members of the couple.

Adult↗
PubMed2006

Prevalence of psychiatric illness in women in an oncology sexual health population: a retrospective pilot study.

INTRODUCTION: Oncology patients often present to healthcare providers with a history of pre-existing psychiatric conditions. Associated treatments are well known to impact sexual functioning. The identification of these confounding conditions and medications is an integral part of the comprehensive management of sexual dysfunction in oncology patients. AIM: To report the prevalence of psychiatric diagnoses and agents in an oncology sexual health clinic. METHODS: A retrospective review was performed using 204 sequential charts of patients who attended the Sexual Health Program at Memorial Sloan-Kettering Cancer Center from March 2003 through August 2004. MAIN OUTCOME MEASURES: All patients were evaluated by a sexual medicine gynecologist and received an extensive medical history, psychosexual assessment, and a focused gynecologic examination. RESULTS: Fourteen patients (7%) did not have cancer and were excluded from further analysis. Of the remaining 190 patients, the median age at initial visit was 48 years (range 22-76) and the majority of patients were menopausal (87%). The most common diagnosis was breast cancer (44%). One hundred twenty-eight patients (67%) had prior pelvic surgery and 43 (23%) had prior pelvic radiation. The most frequently encountered sexual complaints were dyspareunia (65%), vaginal dryness (63%), hypoactive desire disorder (46%), and orgasmic dysfunction (7%). At initial presentation, 52 patients (27%) reported having a prior or concurrent psychiatric diagnosis and 72 (38%) were taking an anti-depressant and/or an anxiolytic. Treatment recommendations for sexual dysfunction consisted of psychosexual counseling, psychiatric referral, vaginal moisturizers and lubricants, hormonal therapy with minimally absorbed vaginal estrogen suppositories, vaginal dilators, and/or skilled exercise. CONCLUSION: Psychiatric conditions are commonly encountered in the oncology population as are the medications to treat them. Because it is well established that these medications are often implicated in sexual dysfunction, further research is needed to determine the mechanism of action within the desire pathway of the cancer patient and treatment of such disorders.

Adaptation, Psychological↗
PubMed2005

The impact of aging on sexual function and sexual dysfunction in women: a review of population-based studies.

INTRODUCTION: Scientific interest in the impact of aging on women's sexual function and dysfunction has increased in the half century since Kinsey described age-related changes in women's sexual activities. However, a range of methodological issues limit the conclusions that can be drawn from many published studies in this area. AIM: To review community-based studies investigating changes in women's sexual function and sexual dysfunction with age, taking into account confounders to aging and methodological limitations. METHODS: Electronic databases were searched for published studies investigating changes in sexual function and dysfunction with age. A critical review was carried out. MAIN OUTCOME MEASURES: Age-related changes in sexual function and dysfunction. RESULTS: There are inconsistencies in the way sexual function and sexual dysfunction are measured. Validated scales are infrequently used. Low response rates, limited age ranges, and restrictive inclusion criteria limit the generalizability of many studies. Confounders are often either not measured or not analyzed. Longitudinal studies are rare, making it difficult to separate the effects of birth cohort and aging. The evidence indicates that a woman's sexual function declines with age. This decline begins in a woman's late 20s to late 30s. Specifically, desire, frequency of orgasm, and frequency of sexual intercourse decrease with age. However, it is not clear whether arousal decreases or remains relatively constant. In longitudinal studies, decline in women's sexual function has also been detected, but patterns of stability and improved sexual function have also been observed for short periods of time. The prevalence of most sexual difficulties or dysfunctions changes little with age, with the exception of sexual pain, which may decrease. CONCLUSIONS: Age-related changes in sexually related personal distress may help explain why the prevalence of sexual dysfunctions remains constant with age while sexual function declines. More research is needed to demonstrate this.

Adult↗
PubMed2005

Persistent sexual arousal syndrome associated with increased soy intake.

INTRODUCTION: Persistent sexual arousal syndrome is an uncommon sexual complaint. Patients with this disorder can be distressed by the escalation of tension in the pelvic region and the prevailing necessity to diminish the pressure by self-stimulation. Patients frequently suffer from guilt or shame and often do not seek medical care. There are many potential causes of this disorder; however, a definitive etiology has yet to be elucidated. CASE: The patient is a 44-year-old female who presented to her gynecologist for evaluation of dysmenorrhea and menometrorrhagia. During the review of systems, the patient reported 5-6 months of increased pelvic tension, not associated with an increase in desire that required her to self-stimulate to orgasm approximately 15 times daily. Upon further inquiry, the patient disclosed that her dietary regimen included soy intake in excess of 4 pounds per day that began approximately 1 month prior to the onset of symptoms. RESULTS: Treatment consisted of supportive counseling and dietary modification. At the 3-month follow-up visit, the patient's menstrual difficulties and sexual complaints resolved. CONCLUSIONS: Although no known cause or cure of persistent sexual arousal syndrome has been identified to date, the success of reducing dietary of phytoestrogens in this patient may provide insight into the etiology of the disorder and suggest potential treatments.

Adult↗
PubMed2006

Sexual dysfunction in patients with gynecologic neoplasms: a retrospective pilot study.

INTRODUCTION: Little is known regarding the impact of a sexual health program on the sexual functioning of patients with a history of a gynecologic malignancy. AIM: To evaluate as a pilot study the prevalence of common sexual health symptoms and evaluate the effects and compliance with clinical recommendations in gynecologic oncology patients. METHODS: A retrospective cohort study of 259 female cancer patients who attended a survivorship program at an academic medical center from March 1, 2003 through December 31, 2004. Patients received symptomatic treatment recommendations including hormone therapy alternatives, psychosexual counseling, minimally absorbed vaginal estrogen suppositories, and vaginal dilators. MAIN OUTCOME MEASURES: Patient self-report of the severity of sexual symptomology at follow-up visit. RESULTS: Ninety-six patients (37%) had gynecologic neoplasms and the most common gynecologic malignancy seen was ovarian (27%). Median age at initial visit was 51 years (range 25-76) and 88 patients (92%) were postmenopausal. The most frequent presenting complaint encountered was dyspareunia (72%), atrophic vaginitis (65%), hypoactive desire (43%), and orgasmic dysfunction (17%). At a median of 6 months (range 0-20), 60 patients (63%) received follow-up, and of them 42 (70%) self-reported improvement in their symptoms. CONCLUSIONS: The establishment of a well-structured sexual health program in a cancer setting can result in a 63% compliance rate with a 70% subjective improvement in sexual health complaints. Further research with objective measures of sexual dysfunction is needed to better evaluate patients' progress in this setting.

Adult↗
PubMed2006

Hypoactive sexual desire disorder in menopausal women: a survey of Western European women.

INTRODUCTION: The prevalence of hypoactive sexual desire disorder (HSDD) in menopausal women and the frequency of sexual activity, sexual behavior, and relationship or sexual satisfaction associated with HSDD have not been studied using validated instruments to identify women with HSDD. AIMS: To determine: (i) the prevalence of HSDD among women who have undergone hysterectomy and bilateral oophorectomy (surgical menopause) with that of premenopausal or naturally menopausal women; (ii) the relationship between low sexual desire and sexual activity and behavior; and (iii) the relationship between low sexual desire and sexual or partner relationship satisfaction. METHODS: Cross-sectional survey of 2,467 European women aged 20-70 years, resident in France, Germany, Italy, and the United Kingdom. Measures were the Profile of Female Sexual Function (PFSF), Personal Distress Scale (PDS), and a sexual activities measure. OUTCOME MEASURES: Clinically derived cutoff scores for the desire domain of the PFSF and the PDS were used, sequentially, to classify women as having low sexual desire and to further classify these women with low desire as distressed or nondistressed. Thus, women with HSDD had low sexual desire and were distressed by their low desire. The analysis population included 1,356 women who had current sexual partners and were surgically menopausal, regularly menstruating, or naturally postmenopausal. RESULTS: A greater proportion of surgically menopausal women had low sexual desire compared with premenopausal or naturally menopausal women (odds ratio [OR] = 1.4; confidence interval [CI] = 1.1, 1.9; P = 0.02). Surgically menopausal women were more likely to have HSDD than premenopausal or naturally menopausal women (OR = 2.1; CI = 1.4, 3.4; P = 0.001). Sexual desire scores and sexual arousal, orgasm, and sexual pleasure were highly correlated (P < 0.001), demonstrating that low sexual desire is frequently associated with decreased functioning in other aspects of sexual response. Women with low sexual desire were less likely to engage in sexual activity and more likely to be dissatisfied with their sex life and partner relationship than women with normal desire (P < 0.001). CONCLUSIONS: Surgically menopausal women are at increased risk for HSDD. HSDD is associated with diminished sexual and partner relationship satisfaction and negative emotional states.

Adult↗