Agnieszka Drosdzol

Quality of life and sexual functioning of Polish infertile couples

Objectives To evaluate the influence of infertility on the quality of life (QoL) and sexual functioning of infertile couples. Methods The research group consisted of 206 infertile couples and the control group of 190 fertile couples. A specific questionnaire was used as a research tool. It gathered information about socio-demographic features and infertility status, and included validated scales: Short Form-36 Health Survey, Female Sexual Function Index and International Index of Erectile Function. Results The QoL parameters in all categories were generally lower for infertile women than for those of the control group. Clinical sexual dysfunctions were not significantly more common among infertile than fertile women (17.5% versus 12.1%, p = 0.13). Clinically relevant erectile dysfunctions were diagnosed in 23.9% of infertile men and in 13.7% of the controls. Male infertility had the most significant negative effect on mens sexual functioning. Conclusions The risk groups for decreased QoL are infertile women and older subjects with lower education and occupationally inactive. Clinically relevant sexual disorders in the infertile population most frequently affect older men, with a lower educational level and with previously diagnosed male infertility.

Depression and anxiety among Polish infertile couples – an evaluative prevalence study

Aim. The aim of this study was to evaluate the influence of infertility on the severity of anxiety and depression in infertile couples. Material and methods. This was a cross-sectional study of differences between infertile couples (206 women and 188 men) and fertile couples (n = 190) with symptoms of depression and anxiety, as measured by the Beck Depression Inventory and Beck Anxiety Inventory. Results. Infertile women (35.44%) scored above the cut-off for severe symptoms of depression, compared with 19.47% of fertile women. In the case of anxiety evaluation there was significant total prevalence among infertile women (15.53%). In the male groups there was a comparable frequency of negative results for depression and anxiety and their intensity. Among Female Infertile, depression occurred most frequently in combined infertility, whilst among Male Infertile in male infertility, with a time-frame of 3–6 years causing the creation and severity of depressive symptoms. Conclusion. The risk factors of depression and anxiety in infertility include: female sex, age over 30, lower level of education, lack of occupational activity, diagnosed male infertility and infertility duration of 3–6 years.

Diabetes Mellitus and Sexuality—Does it Really Matter?

INTRODUCTION The extent to which diabetes may influence sexuality has not yet been established. Identifying the risk factors of female sexual dysfunctions will facilitate the introduction of effective therapeutic models that aim to normalize the glycemic control and will enhance sexual functioning. AIMS To evaluate the influence of diabetes mellitus on female sexual functions, behaviors and depressive symptoms as well as to establish the predictors for female sexual dysfunctions in diabetic subjects. MAIN OUTCOME MEASURES To asses reported female sexual dysfunctions by using Female Sexual Function Index in diabetic females. METHODS A total of 544 females living in the upper Silesia region aged 18-55 years old were eligible for this questionnaire-based, retrospective, cross-section study. The study group included females with diabetes mellitus (N = 264), regardless its type and duration; healthy non-diabetic subjects were controls. The Blatt-Kuppermann Index was used to evaluate climacteric symptoms, the Back Depression Inventory-to screen for depressive symptoms and the Female Sexual Function Index-for sexual dysfunction in female (FSD). RESULTS Multiple logistic regression revealed that the risk of desire and arousal dysfunction was lower in respondents for whom having a satisfactory sexual life was extremely important compared to those for whom it was slightly important or not important at all (referent) (OR: 0.05 and 0.01, respectively). Respondents highly satisfied with sexual contacts with their partner were at lover risk of desire, arousal, and orgasmic disorders and FSD compared to referent subjects (OR: 0.12; 0.03; 0.01 and 0.03 respectively). Depressive symptoms were associated with higher prevalence of arousal disorders and FSD (OR: 13.6 and 3.57, respectively), diabetes-orgasmic dysfunctions (OR = 10.1). CONCLUSIONS In women, the presence of diabetes is an independent predictor of orgasmic dysfunctions. However, the presence of depressive symptoms, individual perception of sexual needs and partner-related factors are stronger predictors of female sexual dysfunctions.

Biopsychosocial functioning of women after mastectomy.

AIMS The aim of this work was to identify the problems of women after total mastectomy and partial mastectomy with regard to various factors and intensity of discomfort which affect the quality of life. BACKGROUND The loss of the attribute of femininity, maternity and sexuality, as the mammary gland is perceived by patients, is a highly traumatic experience, frequently resulting in re-evaluation of life and functioning to date. DESIGN AND METHODS The survey encompassed 494 women after operational treatment of breast cancer with varying time since the procedure. The research group consisted of women after radical mastectomy, and the control group consisted of patients after partial mastectomy. RESULTS The intensity of post-traumatic stress was an important factor affecting the level of depression and anxiety. This correlation appeared to be statistically highly significant in the group of women after total mastectomy. Life satisfaction, the level of depression and anxiety in women after such an operation were dependent on the intensity of post-traumatic stress and they caused inferior biopsychosocial functioning. CONCLUSIONS Women after mastectomy require professional long-term support; this need should result in the enhancement of services provided in relevant womens support groups. RELEVANCE TO CLINICAL PRACTICE When evaluating holistically the life of women after mastectomy, all spheres of everyday functioning should be taken into account: physical, cognitive, emotional and social.

The influence of physical activity level on climacteric symptoms in menopausal women.

Objective To evaluate the relationship between physical activity level and climacteric symptoms in menopausal women. Methods A study was conducted on 336 healthy women aged 45–55 years. They were asked to complete a questionnaire consisting of two parts: (1) a socioeconomic and obstetric/gynecological survey, and (2) the International Physical Activity Questionnaire long form and the Blatt–Kupperman Index. Results The women assigned to the high physical activity group felt better and had less severe climacteric symptoms; 52.08% of the women had no climacteric symptoms. The majority of women in this group were assigned to the total high physical activity group. Significant differences were observed in the relationship between physical activity level and climacteric symptoms. In each domain, women with no climacteric symptoms were classified into either the high or the moderate physical activity level group. In the work domain, 25.30% of the women had a moderate, 20.53% a high, and 6.25% a low physical activity level. In the transportation domain, 32.72% of the women had a moderate, and 19.36% a low physical activity level. In the domestic chores domain, 30.06% of the women had a moderate, 16.07% a high and 5.95% a low physical activity level. In the leisure-time domain, 25.61% of the women had a moderate, 16.95% a high and 9.52% a low physical activity level. Conclusions Physical activity is associated with less menopausal symptoms. It is important to encourage regular physical activity as it is beneficial to health and relieves menopausal symptoms.

Quality of life, mental health and self-esteem in hirsute adolescent females

Aims. The aim of the study was to evaluate the influence of hirsutism on general quality of life, self-esteem and the prevalence of anxiety and depressive symptoms among adolescent girls. Methods. Fifty adolescent females with hirsutism, aged 13–18 years, were enrolled in the research group. The control group comprised 50 non-hirsute adolescents. A specific questionnaire was used as the research tool. It included self-evaluation inventories: Short Form-36 Health Survey Version 2, Hospital Anxiety and Depression Scale and Rosenberg Self-Esteem Scale. Results. Quality of life indices for hirsute girls scored lower than for the controls and statistically significantly so with regard to physical functioning (p = 0.04), general health (p = 0.002) and social functioning (p = 0.007). Anxiety was diagnosed in 26% in the group of hirsute girls as compared with 10% of the controls (p = 0.03). The study analysis revealed more clinically significant problems of low self-esteem in hirsute adolescents compared with non-hirsute girls (14% vs. 2%). Conclusions. Hirsutism is associated with a decreased quality of life, a higher prevalence of anxiety disorder and lower self-esteem in adolescent females. The mothers level of education is associated with the quality of life in adolescent girls.

Evaluation of the quality of life and sexual functioning of women using a 30-μg ethinyloestradiol and 3-mg drospirenone combined oral contraceptive

Objectives To evaluate the effect of a 30-μg ethinyloestradiol and 3-mg drospirenone (EE 30 μg/drsp 3 mg) combined oral contraceptive (COC) on the quality of life (QoL) and sexual functioning. Methods Sixty-one women using this COC were assessed. The control group consisted of 65 women using different types of COC. A questionnaire with a Polish version of the Short Form-36 Health Survey (SF-36), Female Sexual Function Index (FSFI) and Mell–Krat Scale (SFK-K) evaluating QoL and sexuality was used as the research tool. Results QoL indices for women using EE 30 μg/drsp 3 mg scored higher than for the controls and statistically significantly so with regard to improved general health and mood (p < 0.02), and mental health (p < 0.01). Women taking EE 30 μg/drsp 3 mg functioned sexually better, particularly with regard to sexual arousal (p < 0.006). Using the SFK-K scale, sexual dysfunctions were diagnosed in 66.2% of the women in the control group and 48.3% of those in the EE 30 μg/drsp 3 mg group (p < 0.05). Conclusions The intake of the COC containing 30 μg ethinyloestradiol and 3 mg drospirenone is associated with an improvement of general QoL and female sexual functioning. However, the limitations of this study should be taken into account.

Physical activity and sexuality in perimenopausal women

Objectives To determine if there is a link between physical activity and sexual functioning in perimenopausal women, by comparing groups of women with low, moderate and high physical activity levels with regard to selected domains of their sexual functioning. Methods The research involved 400 healthy Polish women, aged 45–55 years. The final analysis encompassed 336 women who fulfilled all the inclusion criteria. The research tool was a two-part questionnaire. The first part covered the socio-economic status, patient history, and gynaecological-obstetric history. Part two consisted of an extended version of the International Physical Activity Questionnaire long form, evaluating the level of physical activity over the last seven days, and the Female Sexual Function Index. Results The mean age of the respondents was 50.56 ± 2.33 years. The analysis showed statistically significant differences between all the domains of physical activity and the FSFI of the studied women. In the group of women without sexual disorders, respondents with a low physical activity level in all questionnaire domains were the least numerous. Conclusions In perimenopausal women an association is seen between high levels of general physical activity and better sexual functioning.

Sexual Satisfaction in Females with Premenstrual Symptoms

INTRODUCTION The impact of premenstrual symptoms, such as the premenstrual syndrome (PMS) and the premenstrual dysphoric disorder (PMDD), on sexual satisfaction, sexual distress, and sexual behaviors has not yet been established. AIMS To assess the correlates and risk factors of sexual satisfaction and to evaluate sexual behaviors among Polish women with premenstrual symptoms. METHODS 2,500 females, aged 18 to 45 years, from the Upper Silesian region of Poland were eligible for the questionnaire-based, prospective population study. All the inclusion criteria were met by 1,540 women who constituted the final study group. The participants were further divided into two subgroups: PMS+ (749 females) and PMS- (791 healthy subjects). Two additional subgroups were created: PMDD+ encompassing 32 subjects diagnosed with PMDD, and PMDD- comprising 32 healthy women, matched to the PMDD+ females for age, marital status, education level, employment status, place of living, and body mass index. A multiple logistic regression analysis was performed to evaluate the influence of PMS on sexual satisfaction and adjust for potential confounders. MAIN OUTCOME MEASURE To evaluate risk factors for sexual dissatisfaction in a population of Polish females of reproductive age, diagnosed with PMS and PMDD. RESULTS Women from the PMS+ group were less sexually satisfied than PMS- (77.73% vs. 88.66%, P=0.001) and reported more sexual distress (28.65% vs. 15.24%, P=0.001). There were no significant differences in sexual satisfaction between PMDD- and PMDD+. Sexual satisfaction correlated positively with a higher frequency of sexual intercourses and a higher level of education. The presence of PMS correlated negatively with sexual satisfaction, even after adjusting for potential confounders in the multivariate logistic regression model (odds ratio=0.48; confidence interval: 0.26-0.89; P=0.02). CONCLUSIONS The presence of PMS is a risk factor for sexual dissatisfaction in Polish women of reproductive age.

The complexity of premenstrual dysphoric disorder - risk factors in the population of Polish women

BackgroundPremenstrual dysphoric disorder has multiple determinants in the biological, psychological and socio-cultural domains. The aim of the study was to evaluate the risk factors for premenstrual dysphoric disorder in Polish women, considering their reproductive history, socio-economic factors, as well as lifestyle and health-related factors.Methods2,500 females, aged 18 to 45, from the Upper Silesian region of Poland were eligible for the prospective population study. The final study sample was 1,540 individuals. The research was based on a questionnaire containing socio-economic status, general health, lifestyle, medical and reproductive history, premenstrual symptoms based on the American Psychiatric Associations criteria for diagnosing premenstrual dysphoric disorder, and patient prospective daily ratings of symptoms. The Statistica 8.0 computer software was used for statistical analysis. The value of p < 0.05 was adopted as the level of statistical significance.ResultsThe mean age of the studied population was 31.9 +/- 7.3 years. The majority of the studied women were married (57.9%), lived in large cities (42.0%) and had tertiary education (43.2%). The results of the study indicated that the prevalence of premenstrual dysphoric disorder was 2.1%. The final statistical analysis revealed that only tertiary education decreased the risk of premenstrual dysphoric disorder (OR = 0.08; p < 0.05).ConclusionsOur research showed that women with tertiary education are less vulnerable to premenstrual dysphoric disorder than women with a lower level of education. Reproductive and lifestyle factors seem to be play a lesser role.