MATERIAL AND METHODS: This is a prospective study of women undergoing bariatric surgery, between May 2017 and April 2018. FSD was diagnosed using the Malay version of Female Sexual Function Index (MVFSFI) questionnaire. Patients filled up the questionnaire before and 6 months after surgery. Association between BMI reduction and FSFI score improvement was measured using Fisher's exact test. Outcomes between types of surgery (sleeve gastrectomy and gastric bypass) was compared.
RESULTS: Fifty-two women completed the study. The mean age was 38.77 ± 6.7. There were 44 (84.6%) Malay patients, 7 (13.5%) Indian patients, and 1 (1.9%) Chinese patient. There was a significant reduction in mean BMI, 39.89 ± 6.9 pre-surgery to 30.32 ± 5.4 post-surgery (p value
METHODS: A total of 316 participants were administered a self-report questionnaire that collected data on sociodemographic attributes, personal characteristics, COVID-19-related stressors, religious coping, and clinical characteristics. In addition, the Multidimensional Scale of Perceived Social Support (MSPSS) and the 21-item Depression, Anxiety and Stress Scale (DASS-21) were administered.
RESULTS: Regarding depression, 15.5%, 11.7%, and 9.2% of the participants reported mild, moderate, and severe to extremely severe depression, respectively. For anxiety, 7.0%, 16.5%, and 13.2% of the respondents had mild, moderate, and severe to extremely severe anxiety, respectively. Moreover, 26.3% of participants had mild stress, 9.5% had moderate stress, and 6.6% had severe to extremely severe stress. The multiple linear regression model revealed that frustration because of loss of daily routine and study disruption and having preexisting medical, depressive, and anxiety disorders were associated with elevated depressive symptoms, while a greater degree of family and friends social support was associated with less depressive symptoms after adjusting for age, gender, and marital status. It was also found that frustration because of study disruption and having preexisting medical, depressive, and anxiety disorders were associated with elevated anxiety symptoms, while being enrolled in medicine-based courses and having a greater degree of family support were factors associated with less anxiety symptoms after adjusting for age, gender, and marital status.
CONCLUSION: There is a need to conduct a longitudinal study in the future to confirm the causal relationship between the significant predictive factors and depression and anxiety identified in this study, and maintenance of a persistent flow of academic activities and social interaction may be of utmost importance to safeguard the mental wellbeing of university students.
AIM: To review the existing literature to definitively examine sexual dysfunction in women with hypertension, in both treated and untreated subjects.
METHODS: We performed a systematic search for published literature of 3 electronic databases (Scopus, EBSCOhost Medline Complete, and Cochrane Library) in August 2018. The search terms with relevant truncation and Boolean were developed according to a population exposure-comparator-outcome model combining pilot searches. The quality of included studies was assessed with the McMaster Critical Review Form for Quantitative Studies. Initial search, limited to the English language, included a total of 2,198 studies. 31 studies (18,260 subjects) met our inclusion criteria and were included in the review. Sexual dysfunction in these studies was measured using different tools. We extracted information of study setting, country, number of subjects, participants' age and blood pressure, comparators, and outcome. We ran a meta-analysis on the presence of sexual dysfunction as an outcome from the following comparisons: (i) hypertensive vs normotensive (ii) treated vs untreated hypertension, and (iii) exposure vs absence of specific class of anti-hypertensive drug.
MAIN OUTCOME MEASURES: Women with sexual dysfunction and hypertension were included.
RESULTS: We found significant sexual dysfunction in women with hypertension compared with the normotensive group (pooled odds ratio [OR] = 2.789, 95% CI = 1.452-5.357, P = .002). However, there was no statistical difference of sexual dysfunction in women with treated or untreated hypertension (OR = 1.229, 95% CI = 0.675-2.236, P = .5). Treatment with alpha-/beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, and diuretics resulted in no statistical difference in sexual dysfunction in hypertensive women.
CLINICAL IMPLICATIONS: Because sexual dysfunction is prevalent in women with hypertension, it is imperative to address the underlying medical condition to manage this important clinical problem.
STRENGTH & LIMITATIONS: Many studies had to be excluded from the meta-analysis, due to unavailability and incompleteness of data. Nevertheless, results of the review are useful to derive recommendations for alerting physicians of the need to routinely assess the sexual functioning of women with hypertension.
CONCLUSION: We conclude that women with hypertension are at increased risk for sexual dysfunction, and our findings imply that evaluation for sexual dysfunction needs to be part of the clinical management guidelines for women with hypertension. Choy CL, Sidi H, Koon CS, et al. Systematic Review and Meta-Analysis for Sexual Dysfunction in Women With Hypertension. J Sex Med 2019;16:1029-1048.