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Background： Female sexual dysfunction （FSD） is a highly prevalent and often underestimated problem. However, large-scale, population-based epidemiological surveys of FSD are scarce in China. The present study was conducted to evaluate the prevalence and the potential risk factors of FSD across a selection of social groups in Beijing, China, based on the Female Sexual Function Index （FSFI）. Methods： A cross-sectional study based on the multiple-stage cluster sampling was performed with adult women throughout the Dongcbeng and Shunyi districts of Beijing. The Chinese version of FSFI was used, as well as questions on demographic characteristics, the disease-related context, and social relationships. Results： A total of 6000 consecutive women entered this study, with an actual response from 5024 women, corresponding to a response rate of 83.7%. A total of 4697 （78.3%） questionnaires were effective. The prevalence of adult FSD in Beijing was 2973 （63.3%） using a score of 26.55 as the boundary value, whereas the total mean FSFI score was 23.92 ~ 6.37. However, 1423 （30.3%） women did not seek help. By multivariate logistic regression analysis, the possible potential risk factors included age （odds ratio [OR] = 1.051 ）, dissatisfaction with the spouse＇s sexual ability （OR = 3.520）, poor marital affection （OR = 2.087）, spouse sexual difficulties （OR = 1.720）, dissatisfaction with married life （OR = 1.476）, living in a rural area （OR = 1.292）, chronic pelvic pain （OR = 1.261）, chronic disease （OR = 1.534）, previous pelvic surgery （OR = 1.605）, vaginal delivery （OR = 2.285）, lower education （OR = 3.449） and postmenopausal （OR = 3.183）. Conclusions： As suggested by the FSFI scores, female sexual problems are highly prevalent in Beijing. Dissatisfaction with the spouse＇s sexual ability, poor marital affection, sexual difficulties of the spouse, dissatisfaction with the marriage, rural life, CPP, and postmenopausal were conceivable risk factors for FSD in Beijing women.

Purpose of the Review The World Health Association declared COVID-19 a pandemic more than 1 year ago. We conducted a systematic review of the literature on the topic of women’s sexual health during the pandemic, with a focus on sexual function and sexual pleasure. Our aim is to describe current findings and to discuss implications for women’s sexual health during this period. Recent Findings Thirty-four articles, from 18 countries, were identified. These studies addressed topics ranging from individual aspects, such as cognitive, emotional, and personality factors affecting sexuality during the pandemic, to contextual factors, including relationship, childrearing, and employment status in this period. Summary Research identified a deterioration of women’s sexual function across countries, with an emphasis on sexual desire. Most studies found decreases in the frequency of sexual intercourse during the pandemic and increases in solitary sexual behavior. Many women also experienced declines in sexual satisfaction and relationship satisfaction. Findings suggested that gender inequalities contributed to lower indices of sexual function and satisfaction, and might have exacerbated the pleasure gap between men and women.

Background: Reports from India on the prevalence and determinants of female sexual dysfunction (FSD) are scant. Aims: To determine the prevalence and risk factors for FSD. Settings and Design: A cross-sectional survey in a medical outpatient clinic of a tertiary care hospital. Materials and Methods: We administered a Tamil version of the Female Sexual Function Index (FSFI) to 149 married women. We evaluated putative risk factors for FSD. We elicited participant′s attributions for their sexual difficulties. Statistical Analysis: We estimated the prevalence of possible FSD and sexual difficulties from published FSFI total and domain cut-off scores. We used logistic regression to identify risk factors for possible FSD. Results: FSFI total scores suggested FSD in two-thirds of the 149 women (73.2%; 95% confidence intervals [CI] 65.5% to 79.6%). FSFI domain scores suggested difficulties with desire in 77.2%; arousal in 91.3%; lubrication in 96.6%; orgasm in 86.6%, satisfaction in 81.2%, and pain in 64.4%. Age above 40 years (odds ratios [OR] 11.7; 95% CI 3.4 to 40.1) and fewer years of education (OR 1.2; 95% CI 1.0 to 1.3) were identified by logistic regression as contributory. Women attributed FSD to physical illness in participant or partner, relationship problems, and cultural taboos but none had sought professional help. Conclusions: Sexual problems suggestive of dysfunction, as suggested by FSFI total and domain scores, are highly prevalent in the clinic setting, particularly among women above 40 and those less educated, but confirmation using locally validated cut-off scores of the FSFI is needed.

Purpose of Review There is a growing body of evidence-based research in the area of female sexual arousal that has led to improved understanding of the female sexual arousal response and the development of FDA-approved treatments for female sexual dysfunction. The purpose of this paper is to review the existing literature on female sexual arousal and response with a focus on local genital arousal and the mechanisms underlying vaginal lubrication. Recent Findings From May 2000 to May 2020, PubMed and Cochrane databases were reviewed and manuscripts selected, based on keywords, content, references, and relevance to the topic. Vaginal lubrication occurs due to vasodilation of the major branches of iliohypogastric and pudendal arterial beds. The increase in intravascular and vaginal wall pressure forces fluid to pass through the vaginal intraepithelial gap junctions, forming a transudate of plasma. The fluid coalesces to form water-like droplets that lubricate the entire vaginal canal, allowing for ease of penetration during sexual intercourse. Vaginal lubrication is a fundamental component of female sexual arousal and directly correlates with subjective levels of satisfaction and enjoyment. Summary The female sexual arousal response is a complex reflex involving multiple organs and bodily functions. There are numerous age-related, metabolic, environmental, hormonal, and other factors that can negatively impact female sexual arousal and vaginal lubrication. As women age, vaginal lubrication declines due to declining genital blood flow and serum hormone levels. Concomitant reduction in physical activity and other medical comorbidities can also negatively impact vaginal blood flow and lubrication. The new and evolving treatment modalities for female sexual arousal disorder are directed toward optimizing vaginal health, function, and lubrication.

Purpose of Review To evaluate the medical literature regarding the effects of cannabis use on female sexual function in order to provide healthcare professionals with a summary of the most recent data. Recent Findings Limited data has shown that there is a correlation between cannabis use and an improvement in female sexual function in some settings at moderate doses. Cannabis use at moderate doses may positively affect several domains of sexual function, such as orgasm, libido, and arousal, dissimilarly. Cannabis use at high doses may have negative effects on female sexual function. Summary Small studies of poor quality have determined that the use of moderate amounts of cannabis during the sexual experience may improve female sexual function. However, further research is needed, specifically randomized, placebo-controlled trials, to determine the effects of cannabis on different domains of sexual experiences as well as the sexual experience as a whole. Current data has shown that cannabis may have both positive and negative effects depending on the dosage, frequency of use, and domain of sexual experience in question. Nonetheless, with cannabis becoming legalized and used frequently in more states, it is imperative that we understand its effects on female sexuality.

Purpose of Review Sleep and sexual problems in women are common. They often co-exist and may negatively impact women’s quality of life. The aim of this review is to present the current evidence on the associations of sleep and sexual problems in women. Recent Findings Despite the heterogeneity in the aims and methodologies, most of the research has supported an association between sleep disturbances and sexual problems in women. Some studies specifically demonstrated an association between obstructive sleep apnea and worse sexual function in women. Poor sleep quality was associated with worse sexual arousal and orgasm in women, as well as more sexual dissatisfaction and sexual distress. Furthermore, the treatment of sleep apnea and good sleep quality were linked with better sexual function in women. It is possible that other psychosocial or biological factors that impact both sleep and sexual function may be mediating the relationship between these outcomes. Summary The collective evidence presented supports an association between sleep and sexual problems in women. Specifically, both obstructive sleep apnea and poor sleep quality are associated with risk for sexual problems in women. Thus, clinicians should be aware of these associations and consider screening for sexual dysfunction in women with these sleep issues. Additional research utilizing tools that assess distress as part of the determination of sexual dysfunction and are followed longitudinally may provide further insights into the relationships identified.

Purpose of Review The purpose of this study is to provide a comprehensive summary of the latest developments in the experimental brain study of human sexuality, focusing on brain connectivity during the sexual response. Recent Findings Stable patterns of brain activation have been established for different phases of the sexual response, especially with regard to the wanting phase, and changes in these patterns can be linked to sexual response variations, including sexual dysfunctions. From this solid basis, connectivity studies of the human sexual response have begun to add a deeper understanding of the brain network function and structure involved. Summary The study of “sexual” brain connectivity is still very young. Yet, by approaching the brain as a connected organ, the essence of brain function is captured much more accurately, increasing the likelihood of finding useful biomarkers and targets for intervention in sexual dysfunction.

The present paper gives an overview of the methodology and results of the first decade of research into Internet-based interventions for women’s sexual dysfunction. The interventions, retrieved in a literature search, were mostly well grounded on common theoretical models of sexual dysfunction and psychological disorders, and most ingredients of the interventions were theory-informed. Most interventions offered Web-based therapeutic content within a more or less preprogrammed structure. Most of these also offered prescheduled and/or participant-initiated contact with a sexual health care professional. Comparative effect studies showed improvements in sexual functioning as well as relational functioning at the point of termination of the intervention period. Improvements at posttreatment were generally maintained for several months after termination of the active intervention period. The results of this review seem to warrant further development of Internet-based interventions for women’s sexual dysfunctions.

Hysterectomy remains the most common major gynecological surgery. Postoperative sexual function is a concern for many women and their partners. In this respect, a beneficial effect of hysterectomy for benign disease independent of surgical techniques or removal of the cervix has been demonstrated in the past decade by the majority of studies. For about 20 % of women, deteriorated sexual function has been reported and current research is attempting to identify mechanisms and predictive factors explaining these postoperative changes. Alternative treatments of benign uterine disorders or uterus preserving surgery for genital prolapse appeared to have similar outcomes in terms of sexual function. Concomitant oophorectomy had negative effects on sexual function and long-term health, particularly in premenopausal women. This may not be reversed by estrogen replacement. Hysterectomy performed for malignancy had a detrimental effect on sexual function. Individualized risk assessment and information should be aimed at during preoperative decision making.

Purpose of Review This review summarizes the recent literature and empirical studies on psychopharmacological approaches to treating female sexual interest/arousal disorder (FSIAD). Recent Findings Several new drugs for FSIAD that are intended to increase sexual responsiveness by influencing central excitatory and inhibitory neuromodulatory processes are under development. Studies on flibanserin resulted in the first approved medication for the treatment of low sexual desire in premenopausal women. New drugs under development are testosterone combined with sildenafil or buspiron, bremelanotide, BP101, and nasal testosterone (TBS-2). Summary Although pharmacological enhancement of sexual responsiveness may be potentially helpful in the treatment of FSIAD, the observed effects of flibanserin and other new drugs under development seem limited in terms of clinical significance. Given the multifactorial character of FSIAD, it may be important to integrate psychopharmacological treatment with sex therapy for optimal treatment efficacy.