Studies assessing sexual dysfunction in type 2 diabetic women are scanty. This study was designed to evaluate the prevalence and correlates of female sexual function in a quite large population of diabetic women. A total of 595 women with type 2 diabetes completed a questionnaire of self-report measures of sexual dysfunction and were analyzed in this study. Their age was 57.9 ± 6.9 (mean and s.d.), duration of diabetes was 5.2 ± 1.5 years and mean hemoglobin A1c (HbA1c) level was 8.3±1.3%. Female sexual dysfunction (FSD) was assessed by the Female Sexual Function Index instrument with a cut-off score of 23. The overall prevalence of FSD among the diabetic women was 53.4%, significantly higher in menopausal women (63.9%), as compared with nonmenopausal women (41.0%, Po0.001). There was no association between HbA1c, duration of diabetes, hypertension, or cigarette smoking status and FSD; on the contrary, age, metabolic syndrome and atherogenic dyslipidemia were significantly associated with FSD. Both depression and marital status were independent predictors of FSD, while physical activity was protective. Further studies are needed to elucidate in full the mechanisms underlying the evident differences between male and female sexual function. In the meantime, evaluation of female sexuality should become a routine evaluation in women with type 2 diabetes, such as other diabetic complications.
Introduction Hyperandrogenism produces change in quality of life of women. Aim To prespectively determine the changes of the sexual behaviour of hyperandrogenic women using an oral contraceptive containing 30 µg ethinylestradiol and 2 mg chlormadinone acetate (EE/CMA). Methods Seventy-two volunteer women (age range, 18–32 years), with moderate to severe hirsutim and acne were treated with EE/CMA for 9 cycles. Main Outcomes Measure(s) To assess hirsutism, the Ferriman-Gallwey (F-G) scoring system was used. Serum FSH, LH, estradiol, total and free testosterone, DHEAS, androstenedione, and SHBG levels were measured at baseline and at the 9th cycle of pill intake. The Short Personal Experience Questionnaire (SPEQ), the Short Form-36 (SF-36), and a visual analog scales questionnaires were used to assess the QoL, at baseline and after 3, 6 and 9 cycles of pill use. Result(s) A reduction of 65% and 81% in the total mean F-G score was observed after the 6th cycle and the 9th cycle, respectively. The serum Androstenedione, and total and free testosterone levels decreased, and SHBG levels increased after the 9th cycle (p < 0.05). The SF-36 score was higher after 6 (p < 0.05) 9 cycles (p < 0.001) with respect to baseline. Frequency of sexual intercourse and of orgasm by intercourse increased, and the frequency of masturbation decreased during the 6th (p < 0.05) and the 9th cycle (p < 0.001). Conclusion(s) The EE/CMA pill has anti-androgenic properties reducing the anti-aesthetic effect of hyperandrogenism and improving female sexual and social self-esteem.
This paper focuses on the entrepreneurial ecosystem as a set of interdependent and coordinated factors in a territory enabling entrepreneurship. To date, academic research has failed to produce methodologies for evaluating and comparing entrepreneurial ecosystems from different perspectives that can highlight the underlying factors. Moreover, there is a lack of empirical analysis that discriminates between factors according to their importance. Taking into account these two gaps, the aim of the paper is twofold. First, it proposes the application of an accurate, robust and reliable measurement technique, namely Stochastic Multicriteria Acceptability Analysis (SMAA). It considers the variability of weights that can be assigned to the different factors, producing a probabilistic ranking to obtain a comparison among entrepreneurial ecosystems. This ranking is more reliable than a single ranking proposed by the usual composite indices that take into account a single vector of weights. Second, the paper presents a new methodology, SMAA for strategic management analytics and assessment, or SMAA squared (SMAA-S), which detects the relation between entrepreneurial ecosystem factors and growth-oriented start-ups in a territory. The results show that the most relevant entrepreneurial ecosystem factors enabling the birth and activity of high-growth start-ups, and so impacting on technology, economy and society, can be identified in cultural and social norms, government programs, and internal market dynamics.
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