The prevalence and correlates of low sexual functioning in women on hemodialysis: A multinational, cross-sectional study

Abstract

Sexual dysfunction may affect 80% of women in hemodialysis. However the specific patterns and clinical correlates of sexual functioning remain poorly described. The aim of this study was to assess prevalence and correlates of the individual domains of sexual functioning in women treated with hemodialysis. We recruited, into this multinational cross-sectional study, women treated with long-term hemodialysis (Collaborative Working Group on Depression and Sexual dysfunction in Hemodialysis study). Self-reported domains of sexual functioning were assessed by the Female Sexual Function Index, which is routinely administered within the network of dialysis patients followed by the working group. Lower scores represented lower sexual functioning. Socio-demographic and clinical correlates of each domain of sexual functioning were identified by stepwise multivariable linear regression. Sensitivity analyses were restricted to women who reported being sexually active. We found that of 1309 enrolled women, 659 (50.3%) provided complete responses to FSFI survey questions and 232 (35%) reported being sexually active. Overall, most respondents reported either no sexual activity or low sexual functioning in all measured domains (orgasm 75.1%; arousal 64.0%; lubrication 63.3%; pain 60.7%; satisfaction 60.1%; sexual desire 58.0%). Respondents who were waitlisted for a kidney transplant reported scores with higher sexual functioning, while older respondents reported scores with lower functioning. The presence of depression was associated with worse lubrication and pain scores [mean difference for depressed versus non-depressed women (95% CI) -0.42 (-0.73 to -0.11), -0.53 (-0.89 to -0.16), respectively] while women who had experienced a previous cardiovascular event reported higher pain scores [-0.77 (-1.40- to -0.13)]. In conclusion, women in hemodialysis reported scores consistent with marked low sexual functioning across a range of domains; the low functioning appeared to be associated with comorbidity.

Sexual Dysfunction and Associated Anxiety and Depression in Female Hemodialysis Patients: A Cross-Sectional Study at Karachi Institute of Kidney Diseases

“…These findings implicit that sexual satisfaction has not just been boosted by increased sexual desire; additive analysis is required to evaluate biological, social, and other parameters influencing women's sexual satisfaction. Similar results were also seen in a study conducted by Saglimbene et al [20] and Weisbord [21]. On account of sexual inactivity, median scores were nil across arousal, orgasm, lubrication, and pain subscales of FSFI, whereas the satisfaction score was still raised.…”

Curved TVs improved watching experience when display curvature radii approached viewing distances: Effects of display curvature radius, viewing distance, and lateral viewing position on TV watching experience

“…A stepwise multiple linear regression analysis was performed to examine the degree to which user satisfaction variability (satisfaction associated with watching TV) was accounted for by the other six TV watching experience elements. A p-value of 0.1 (for each predictor to enter or leave the model) was applied as a threshold during the construction of the stepwise multiple linear regression model [78,79]. All statistical analyses were performed using JMP™ (v12, SAS Institute Inc., NC, USA), with a significance threshold of p < 0.05.…”

Investigation of minor psychiatric symptoms in patients with chronic kidney disease on hemodialysis treatment

“…Sexual libido is understood by psychoanalytic theory as a drive for life, which leads the subject to the recognition of himself/herself, his/her desires and that which can be produced by him/her. Thus, the reduction of the sexual libido awakens feelings of loss of satisfaction/pleasure, and feelings of helplessness [15][16][17]. Studies by Dalgalarrondo [18] and Gabbard [19] show that there is a predominant presence of depressive symptoms in the general population, which can be observed in the neurovegetative dimensions, and may be associated with decreased sexual libido, erectile dysfunction, delayed orgasm or anorgasmia.…”