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Objective Endometriosis is a common disease in women of childbearing age, leading to sexual dysfunction or loss of libido. We aimed to evaluated the effect of endometriosis on women’s sexual function. Methods We performed a prospective case–control study to determine the effect of endometriosis on women’s sexual function using a self-administered questionnaire from September 2017 to August 2018. The simplified Chinese version of the Female Sexual Function Index (FSFI) was used to assess sexual function. Results We found that sexual function of women in the endometriosis group (n=77) in all dimensions was significantly lower compared with that in the control group (n=63). The total FSFI score in patients was 25.5, which tended to be lower than that in the control group (26.7). Sexual arousal, sexual pain, and satisfaction were significantly different between the two groups. Sexual arousal and sexual pain scores were significantly lower in the endometriosis group than in the control group at the ages of 31 to 40 years. Conclusion Women with endometriosis suffer from sexual dysfunction, especially those aged 31 to 40 years. Our findings suggest that the quality of sexual life in this subpopulation needs to be improved.

In the shadows of the cultural obsession with male erections, women’s vaginal lubrication and experiences of wetness have received surprisingly little academic attention. Framed largely as a biological or normative behavioral “sexual function” issue and not as a subjective experience, no previous qualitative studies have asked women to discuss their feelings about their vaginal lubrication and wetness. This study analyzed semi-structured interviews with 20 women from a diverse 2014 community sample collected in a large Southwestern U.S. city in order to examine American women’s subjective feelings about their own vaginal lubrication and wetness, particularly the sensations they experience and the meanings they make around wetness. Results revealed four themes in how women described vaginal lubrication: (1) wetness as pleasure, joy, and connection; (2) wetness as physical and biological phenomenon; (3) anxiety about insufficient wetness; and (4) having excessive or “too much” wetness. Tensions surrounding women’s sexual anxieties and where they place responsibility for “too little” wetness is discussed in tandem with analyses of how pleasure and arousal may (or may not) overlap with feelings about sexual normality and health. Ultimately, renewed attention to the complexities of women’s sexual arousal and function, particularly in stark contrast with pharmaceutical efforts to medicate women’s sexual arousal and reduce it to “brain chemistry,” are examined.

Objective Sexual dysfunction (SD) is a common but often overlooked symptom in multiple sclerosis (MS). The aim of this study was to estimate the frequency, type, and intensity of SD in our patients with MS and to investigate its influence on all the domains of quality of life. Methods The study population comprised a cohort of 109 patients with MS (McDonald's criteria, 2001). SD was quantified by a Szasz sexual functioning scale. Health-related quality of life was measured by a disease-specific instrument MSQoL-54 (Serbian version). Results The presence of at least one symptom of SD was found in about 84% of the men and in 85% of the women. The main complaints in women were reduced libido, difficulties in achieving orgasm, and decreased vaginal lubrication; in men, the main complaints were reduced libido, incomplete erections, and premature ejaculation. In women, statistically significant negative correlations between the presence and level of SD and quality of life domains were reached for all subscales ( P Conclusions Our results reveal that frequent occurrence of SD in MS patients prominently affects all aspects of their quality of life.

Diabetes is a chronic illness that affects all aspects of human sexuality. As an integral part of a woman's day-to-day life, sexuality may be adversely affected by diabetes in ways that are detrimental to her total health, her relationships, and her self-esteem. This descriptive study was conducted to describe the physical effects of diabetes on sexuality in women with insulin-dependent diabetes or non-insulin-dependent diabetes. A sample of 20 women were interviewed and data were analyzed to identify themes. Problems reported by subjects affecting sexuality were fatigue, changes in perimenstrual blood glucose control, vaginitis, decreased sexual desire, decreased vaginal lubrication, and an increased time to reach orgasm. Continued research is recommended to further explore these findings.

Sexual health is an important, but often neglected, component of diabetes care. In contrast to erectile dysfunction among men with diabetes, female sexual dysfunction has not been well studied among diabetic women. The aim of this study was to assess the prevalence of sexual dysfunction in women with type 2 diabetes compared to that in an age-matched control group. In all, 50 married women with type 2 diabetes attending the outpatient endocrine clinic of Ghaem Hospital between April 2007 and March 2008 were selected. Fasting plasma glucose and glycosylated haemoglobin were measured and sexual function was assessed by questionnaire. Scores in each domain of sexual function were compared with those of 40 non-diabetic controls. Sexual function scores for the sexual drive, arousal, vaginal lubrication, orgasm and overall satisfaction domains were all lower in the diabetic women (p value < 0.05). Duration of diabetes and age correlated negatively with all domains of sexual function. There was no significant relationship between sexual function and body mass index (BMI), glycaemic control, education or employment status. Diabetes significantly impairs the sexual performance of diabetic women. Determinants of sexual function include age and duration of diabetes.

It is now nearly 40 years since the Internet was born. It was originally used in 1969 to network university computers in the United States of America. Since then, the introduction of email and the World Wide Web have made the Internet more widely available. Latest statistics suggest that there are nearly 1.5 billion users worldwide. The proportion of the population who are potential Internet users is now over 68% in the UK and over 72% in the USA. Australia achieves almost 80% penetration and Canada almost 85%. With ready access to such enormous numbers of people, researchers have seen the Internet as a potentially useful area for studying various populations. However, with Internet surveys, the problem of bias is difficult to overcome, particularly when the responders to any online survey are self-selected. The potential for bias arises because the Internet population may not be representative of a general population and the participants self-select (volunteer effect). In addition, there is often a low uptake of such surveys on the Internet, which further questions their validity. The use of a checklist for reporting Internet surveys (CHERRIES) has the potential to improve understanding and quality of such reports. By describing how the survey was performed, how the answering population was constituted and how it may differ from a randomly assigned population, we can judge the relevance of any particular report and be aware of potential biases. In this issue of Menopause International, the paper by Cumming et al. looks at the responses of women who accessed the menopause website (menopausematters.co.uk) to a questionnaire about their libido. Over 3000 responses were collected over 38 weeks and their results are reported. In line with other studies, this paper showed that sexual problems in women are common and increase with advancing age. It has been estimated that sexual problems affect one in two women overall. Sexual activity is known to decline with age. The commonest sexual problems reported are low sexual desire (43%), difficulty with vaginal lubrication (39%) and inability to climax (34%). In the paper by Cumming et al., almost 80% of periand postmenopausal women admitted to their libido being affected by the menopause, with most (86%) reporting a worsening, and 81% being distressed by this. Only 27% had discussed their problems with a health-care professional, although this was more common among postmenopausal rather than preor perimenopausal women and in those who were sexually active. Loss of libido is undoubtedly multi-factorial in origin and consequently no single treatment will be helpful for all. In this survey, it was clear that vaginal dryness was a factor in many women’s sexual problems but that they had not sought treatment. Hormone replacement therapy and testosterone replacement were helpful for some women, but not all. This study went on to offer the Brief Profile of Female Sexual Function (B-PFSF) questionnaire to see if women had hypoactive sexual desire disorder and empowered such women to seek help through their health-care provider. As long as account is taken of the selection bias such as in web-based surveys, there is little doubt that they represent a useful way of surveying ‘real people’ and as a tool to guide women with problems to an appropriate source of help.

Background Sexual dysfunction is a common complaint in patients with advanced liver disease. The impact of orthotopic liver transplantation on sexual function has not been well described. Aim To determine the impact of liver transplantation on sexual function and identify the most frequent complaints and possible related factors. Methods Telephone survey of patients who have undergone liver transplantation at the University of Tennessee, Memphis, from 1998 to 2004. A five-page questionnaire including questions related to biological function, sexual function, and specific sexual dysfunction was used. Specific sexual dysfunction included loss of libido, poor vaginal lubrication, dyspareunia, inability to reach orgasm, difficulty achieving erections, loss of early morning erections, and premature ejaculation. Results Ninety-one of 183 living patients who underwent liver transplantation from 1/1998 to 4/2004 were interviewed. M/F 65/26, age mean 53.1, range 27-75, hep C: 47/non-hep C: 44. Overall 67/91 (83.5%) of patients reported complaints of sexual dysfunction after transplantation, 60/65 (92%) men and 16/26 (62%) female (p = .001). The main specific sexual dysfunction was inability to maintain erections in men (59%) and decreased vaginal lubrication in females (38%) (Table 1). Only 13/91 (14%) patients had improved sexual function after transplantation. No significant difference was found in this group in regard to age and etiology of the liver disease. Conclusions Sexual dysfunction continues to have a high prevalence in patients after liver transplantation. Male gender is significantly associated with sexual dysfunction after liver transplantation.