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Location: Capitol Ballroom F-H

The Contributions of Maternal Morbidity in Pregnancy, Age and Parity to Pregnancy Outcome in a South-West Nigerian Community (#034)

A. Amosu

034
The Contributions of Maternal Morbidity in Pregnancy, Age and Parity to Pregnancy Outcome in a South-West Nigerian Community
Amosu, A1; Degun, A2; Goon, D3
1: University of Venda, South Africa; 2: University of Ibadan, Nigeria; 3: University of Forte Hare, South Africa

Objective: The study was carried out to examine the effects of maternal morbidity, age and parity on pregnancy outcome. The high prevalence of low birth weight (LBW) babies is a major public health problem. The impact of maternal morbidity, age and parity on pregnancy outcome are analysed and discussed.
Materials and Methods: This is a cross-sectional retrospective study of pregnant mothers who delivered in eight randomly selected health facilities located within four randomly selected local government areas (Yewa North, Yewa South, Ifo and Ado-Odo Ota ) in Ogun State, Nigeria.. It involved the examination of 13,903 case notes of mothers who delivered in the eight randomly selected health facilities with fairly complete records. All available records of normal and assisted deliveries were used including the associated maternal and infant characteristics for the period 2009-2011. These included the birth weight of each of the infants, infant survival at birth, maternal age and parity, and all properly diagnosed illnesses suffered by the mothers during pregnancy. Data collected were analyzed using the SPSS package version 17.0 to generate frequencies, means, standard deviations, chi-square tests, and regression models.
Results: The overall incidence of low birth weight (LBW) was 17.3% with mothers below 20 years of age and primiparous mothers recording the highest LBW incidences of 9.86% and 11.4% respectively. LBW incidence for pregnant mothers diagnosed for malaria was 7.25%, those with iron deficiency anaemia recorded 2.89%, sexually transmitted infections (STIs) patients had 3.56%, while pregnancy related hypertensive patients accounted for 2.38% of the LBW incidence. Pregnant mothers diagnosed for STIs, malaria and iron deficiency anaemia delivered 209, 143 and 140 stillborn babies respectively. Also, primiparous (182) and Para 1(169) mothers recorded most of the stillborn deliveries when compared with multiparous mothers. Maternal morbidity, parity and age, were all found to be significant for LBW and stillbirths (p<0.001).
Conclusion: Highest incidence of LBW newborns are observed in primiparous mothers and those below 20 years of age. Malaria, iron deficiency anaemia in pregnancy and STIs have detrimental effects on foetal growth.

Disclosure:
Work supported by industry: no.
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Relationship between Mental Health & Sexual Dysfunction in Women with Breast Cancer (#035)

S. Behzadi Pour

035
Relationship between Mental Health & Sexual Dysfunction in Women with Breast Cancer
Behzadi Pour, S1; Piraye, L1; Naziri, G1
1: Shiraz Islamic Azad University, Iran

Objective: Breast cancer is a quarter most common cancer among women and the second leading cause of cancer deaths in women. Several problems creates for women with this disease such as sexual dysfunctions. This study was performed to investigate the relationship between the prevalence of sexual dysfunctions and mental health status in women with breast cancer.
Material and Methods: The research method was descriptive. The population was consisted all women with breast cancer that had been admitted to cancer diseases centers in Shiraz in the year 2014. 80 women with breast cancer were purposefully selected from this community and they were responded both questionnaire, Female Sexual Function Index and General Health Questionnaire. The research instruments were two questionnaires: 1) General Health Questionnaire (GHQ-28) have been used and reliability of this questionnaire was reported 0/91 with using test-retest. 2) The second questionnaire was Female sexual function index (FSFI) and it's reliability was 0/79.
Result: Results showed that there was a significant negative relationship between sexual dysfunction and it's subscales and mental health In women with breast cancer (p<0/05).
Conclusions: According to this study's results and the results of previous studies, which is consistent with the survey results, women with breast cancer have high levels of sexual dysfunctions that this feature is part of their present illness and it reduced mental health.

Disclosure:
Work supported by industry: no.
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Effective of Cognitive Behavior Therapy on Sexual Satisfaction in Women with Breast Cancer (#036)

S. Behzadi Pour

036
Effective of Cognitive Behavior Therapy on Sexual Satisfaction in Women with Breast Cancer
Behzadi Pour, S1; Piraye, L1
1: Shiraz Islamic Azad University, Iran

Subjective: The purpose of this study was to determine of the effectiveness of cognitive behavior therapy on sexual satisfaction in women with breast cancer.
Material and Method: The present study was a semi-experimental study that design with pre test-post test ,experimental and control group was used. The statistical population included all women who referred to breast cancer center in Shiraz. Among the subjects, 32 persons were randomly selected and then assigned to two equal experimental and control group. The experimental group received 10 sessions of cognitive behaviour teaching. The control group did not receive psychological intervention. The research instruments were the sexual satisfaction questionnaire. The questionnaire was administered at pre-test and post test stages.
Result: There was a significant difference between both groups for the mean of differential scores of sexual satisfaction that is, the educational program was significantly effective on increasing sexual satisfaction in women with breast cancer.
Discussion and Conclusion: Given the effect of cognitive behavioral teaching on the improvement of sexual satisfaction in women with breast cancer.

Disclosure:
Work supported by industry: no.
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Sexual Function and Self-disclosure in Unconsummated Marriages (#037)

S. Behzadi Pour

037
Sexual Function and Self-disclosure in Unconsummated Marriages
Behzadi Pour, S1; Naziri, G1; Piraye, L1
1: Shiraz Islamic Azad University, Iran

Objectives: The research goal was to study the relationship between the unconsummated marriage and couples' sexual function and sexual self-disclosure.
Material and Method: A total of 20 couples selected via an accessible sampling method answered to Spouses Sexual Disclosure Scale (SSDS), International Index of Erectile Function (IIEF) and Female Sexual Function Index (FSFI).
Results: There was a positive significant relationship between unconsummated marriage and the couples' low sexual performance and couples' low sexual self-disclosure. The relationship between the couples' sexual performance and their low sexual self-disclosure was not significant.
Discussion: In couples with unconsummated marriage sexual function and sexual self-disclosure are extremely low, and these variables have interactive effects over each other.

Disclosure:
Work supported by industry: no.
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A Cycle of Risk? The Role of Social Drinking Factors in the Relationship between Incapacitated Sexual Assault and Drinking Before Sex (#038)

E.R. Bird

038
A Cycle of Risk? The Role of Social Drinking Factors in the Relationship between Incapacitated Sexual Assault and Drinking Before Sex
Bird, ER1; Gilmore, AK2; George, WH1; Lewis, MA3
1: Department of Psychology, University of Washington, USA; 2: VA Puget Sound Health Care System, Seattle Division, USA; 3: Department of Psychiatry and Behavioral Sciences, University of Washington, USA

Objectives: Sexual assault rates on college campuses are extremely high and in recent years have been highlighted by the White House Council as a high priority issue in need of immediate attention. Alcohol use in sexual situations can be a risk factor for sexual assault victimization and revictimization, which is associated with compounding negative mental health consequences. Previous research has yet to examine increased drinking before sex in association with incapacitated sexual assault (ISA) and has largely neglected factors related to the social contexts in which alcohol consumption and sexual activity occur on college campuses. The current study examined the relationship between ISA and drinking before sex. Additionally, social-related drinking factors including drinking to conform motives, social drinking motives, and perceived drinking norms were examined as being associated with ISA history and drinking before sex.
Material and Method: Six hundred and three undergraduate college women completed a survey online. Participants were recruited from introductory psychology courses for a study about "drinking and sexual behaviors."
Results: Path analysis indicated that both ISA before college and since entering college were associated with higher perceived drinking norms, more social drinking motives, and more drinking to conform. However, only drinking norms and social drinking motives indirectly associated ISA history with more drinking before sex.
Conclusions: As hypothesized, a history of more ISA was associated with more drinking before sexual activity. Also as hypothesized, social-related drinking factors played a significant role in this relationship. In the effort to prevent sexual assault on college campuses, links between social drinking norms, social motivations to drink, and the "hook-up culture" are important factors to consider due to the cultural specificity that characterizes college environments. Additionally, because a history of more ISA was associated with increases in social-related drinking factors, future research should seek to understand unique characteristics and risks of women with a sexual assault history who drink in college settings. Future work should also examine these relationships using longitudinal data collection methods. These social factors can be easily targeted through brief interventions and these findings can inform future programming to promote more careful use of alcohol in sexual situations.

Disclosure:
Work supported by industry: no.
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Impact of a Longitudinal Educational Experience on Medical Students' Knowledge, Comfort Level, Attitudes and Opinions (#039)

Anita H. Clayton, MD, IF

039
Impact of a Longitudinal Educational Experience on Medical Students' Knowledge, Comfort Level, Attitudes and Opinions
Clayton, A1
1: University of Virginia, USA

Objective: Measure changes in attitudes, comfort level, and sense of knowledge related to human sexuality/sexual medicine across a longitudinal, 15-month medical school experience.
Materials and Methods: On-line administration of a sexual health topics assessment prior to initiation of classes (August 2013) in the first year of medical school and following the 15-month systems-based curriculum (November 2014) which includes pre-recorded lectures, in-class role-playing experiences, case-based discussions, patient panels, and senior student/provider dialogues. Aggregate change in medical students responses reflecting the role of physicians, attitudes regarding sexual behaviors, opinions about sexual and reproductive situations, level of comfort with sexual issues, knowledge about sexual medicine, and demographics will be evaluated to determine programmatic quality and potential modifications/improvements.
Results: To be determined after completion of the second survey administration in November 2014.
Conclusions: A longitudinal educational experience in sexuality/sexual medicine in the first 15 months of medical school affects students' comfort level, knowledge, attitudes, and opinions.

Disclosure:
Work supported by industry: no.
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Sexual Function and Sexual Satisfaction are Impaired in Female Partners of Men with Peyronie's Disease (#040)

S. Davis

040
Sexual Function and Sexual Satisfaction are Impaired in Female Partners of Men with Peyronie's Disease
Davis, S1; Ferrar, S2; Binik, Y3; Carrier, S3
1: University of Toronto, Canada; 2: Concordia University, Canada; 3: McGill University, Canada

Objectives: Peyronie's disease (PD) causes significant changes in penile appearance and may prevent penetrative sex. There is significant impact of PD on the sexual and mental health of men, but no studies have examined partner effects. The present study examined the impact of PD on the sexual function, sexual satisfaction, and relationship satisfaction, of the partners of men with PD.
Materials and Methods: Men with PD and their partners were given the following questionnaires: Dyadic Adjustment Scale (DAS), Global Measure of Sexual Satisfaction (GMSEX) and also asked to assess the degree to which PD interfered with a variety of sexual activities. In addition, women filled out the Female Sexual Function Index (FSFI) and men filled out the International Index of Erectile Function (IIEF). Hierarchical regression analyses were used to predict women's sexual function, sexual satisfaction, and dyadic adjustment.
Results: A total of 41 couples returned the survey. The mean FSFI score was 22.5 which is indicative of sexual dysfunction and the mean GMSEX score was 25.9, which is below previous samples of healthy women. The mean DAS score was 51.0, which is within healthy norms. There were no significant differences in men and women's GMSEX or DAS scores. Women's sexual dysfunction was significantly predicted by greater age, shorter relationship length, less sexual satisfaction, and greater male perceived sexual interference. Women's sexual satisfaction was predicted by greater relationship length, less female perceived sexual interference, and better sexual function. There were no significant predictors of DAS.
Discussion: Based on these results, it appears that PD is also associated with sexual dysfunction and lower satisfaction in female partners, but not relationship function. As has been found in the male literature, the degree to which PD interferes with sexual intercourse is an important predictor of sexual function and satisfaction, more so than men's erectile function, which was not predictive of any outcomes. Interestingly, relationship length was also an important predictor of sexual function and satisfaction, which may indicate that couples that have been together for longer are able to more effectively find ways of maintaining better sexual function and satisfaction despite the development of PD. Future exploration of dyadic influences would be important information for maintaining quality of life in men with PD and their partners.

Disclosure:
Work supported by industry: no. The presenter or any of the authors act as a consultant, employee (part time or full time) or shareholder of an industry.
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Practices and Perceptions of Contraceptive use Among University Students in Lebanon (#041)

N. El Salibi

041
Practices and Perceptions of Contraceptive use Among University Students in Lebanon
El Kak, F1El Salibi, N1; Yasmine, R1; Ghandour, L1
1: American University of Beirut, Lebanon

Objectives: Investigate perceptions and practices related to contraceptive use among university students in Lebanon.
Methods: Cross-sectional online survey on sexual practices, attitudes, and perceptions among undergraduate and graduate students, aged18-30, attending the 4th largest private university in Lebanon.
Results: Out of 713 participants, 547 (77%) reported having had sexual intercourse without a condom during their lifetime with females twice more likely to do so as compared to males (p-value=0.003). Among those, 57% did not use condom the last time they had sexual intercourse (anal/vaginal sex). 96% of students have engaged in oral sex, 85% had vaginal sex, and 45% had anal sex. Sexual activity was more likely to occur among an unfamiliar and with multiple partners. As compared to females, males who reported non condom use were five to seven times more likely to engage in first oral (p-value=0.000), anal (p-value=0.000), and vaginal sex (p-value=0.000) with an unfamiliar partner. Also, they were two times more likely to report having had 3-5 partners in their lifetime (p-value=0.000) and ten times more likely to report 6-11+ partners within the past 12 months as compared to their female counterparts (p-value=0.003). While the majority (92%) of students perceived birth control pills and condom use as effective in preventing pregnancy, women were two times more likely to experience an unplanned or unwanted pregnancy (p-value=0.044), 90% of whom resorted to abortion. 55% of participants agreed that it is a big deal to have sex without a condom once in a while; however, adjusting for socio-demographics, males were two times more likely than females to agree that unless you have a lot of sexual partners you don't need to use condoms (p-value=0.003) . Transmission of sexually transmitted infections was perceived risky through vaginal or anal intercourse (73%). Yet, males were twice more likely to perceive that oral sex is not as big of a deal as sexual intercourse (p-value=0.0035).
Conclusions: Effective use of contraceptive methods is critically important for reducing the risk of unintended pregnancy and promoting sexual health and wellbeing among youth. Despite the high prevalence of sexual activity and considering that our sample consists of university students, results clearly show that youth are still engaging in unsafe sexual behaviors and lacking knowledge with regard to safe sexual practices. Strategies addressing contraceptive use among youth should enable both males and females to make informed choices that respect and fulfill their sexual rights.

Disclosure:
Work supported by industry: yes, by Ford Foundation (industry funding only - investigator initiated and executed study).
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Vestibular Anesthesia Test (VAT) for Suspected Neuroproliferative Vestibulodynia (#042)

Irwin Goldstein, MD, IF

042
Vestibular Anesthesia Test (VAT) for Suspected Neuroproliferative Vestibulodynia
Goldstein, I1; Gagnon, C2; Minton, JN2; Espenscheid, C2
1: Alvarado Hospital, USA; 2: San Diego Sexual Medicine, USA

Objectives: Neuroproliferative vestibulodynia should be a rule out diagnosis of other conditions associated with provoked vestibulodynia such as abnormal hormones, dermatologic disorders, infections, hypertonic pelvic floor, allergies, desquamative inflammatory vaginitis, vulvar granuloma fissuratum. In neuroproliferative vestibulodynia, increases of mast cells in vestibular mucosa has been noted, thought to lead to proliferation of C-afferent nociceptors and significant diffuse but vestibule-limited allodynia. A vestibular anesthesia test (VAT) may be consistent with neuroproliferative vestibulodynia if absence of pain during: Q-tip testing of the vestibule; digital palpation of the vestibule; penetration at the introitus with vaginal dilator; maneuvers historically resulting in pain. We examined short-term clinical experience with the VAT in 17 consecutive women.
Material and methods: A long-acting local anesthesia was administered submucosally to vestibular tissue; no local anesthesia was administered to vulva or vagina. The vestibule boundary was carefully delineated with a marking pen. Multiple syringes were filled with bupivacaine (1.3%) in liposome isuspension. Submucosal injections were made at 1 o'clock utilizing only 1–2 mL volume at a time, allowing the region to become numb. Clockwise administration of local anesthesia was followed until the entire vestibule was numb to Q-tip testing.
Results: Approximately 10 minutes following VAT sensation in the perineum, vulva, and vagina was tested and found to be intact in all 17 women. 12 patients had a positive VAT. A negative VAT, pain during: Q-tip testing of the vestibule and/or digital palpation of the vestibule was found in 3 patients. Pain during penetration at the introitus with vaginal dilator and/or other maneuvers historically associated with pain was noted in 2 patients.  Thus 12/17 patients had a positive VAT and were considered as having neuroproliferative vestibulodynia. Side effects of the procedure included pain, bruising and swelling that resolved in several days. Of the 12 patients, 7 had complete vestibulectomy with vaginal advancement flap and 6 are currently pain-free post-op.
Conclusion: A positive VAT may indicate pathology exclusively in the vestibule caused by neuroproliferative vestibulodynia. Future studies are needed to see if predictions can be made regarding pain-free patients after surgical removal of the diseased vestibular tissue and healthy vagina anastomosed to healthy vulva..

Disclosure:
Work supported by industry: no.
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Recurrent Ischemic Low Flow Clitoral Priapism – Update of Management Strategies (#043)

J.R. Gonzalez

043
Recurrent Ischemic Low Flow Clitoral Priapism – Update of Management Strategies
Gonzalez, JR1; Goldstein, I2
1: San Diego Sexual Medicine, USA; 2: Alvarado Hospital, USA

Objectives: Ischemic, low flow clitoral priapism is an unusual sexual health medical emergency, a closed compartment syndrome associated with peripheral clitoral arousal persisting for hours to months despite the absence of sexual stimulation. There is associated significant swelling, pain and tenderness in the clitoral shaft and crurae, with no involvement of the glans clitoris. Pathophysiology is based on unrelenting corporal veno-occlusion related primarily to hematologic disorders or psychotropic medications, or may be idiopathic. The latter is hypothesized as clitoral corporal smooth muscle cell dysfunction with inability to contract once relaxed, likely a genetic problem of intracellular calcium transport. Patient management requires prompt intervention to reduce symptoms and reduce irreversible structural and functional cavernosal tissue damage. The aim is to review medical and surgical management strategies for recurrent ischemic low flow clitoral priapism.
Materials and Methods: Two women presented to our clinic in the last year with ischemic recurrent low flow clitoral priapism.
Results: A 56-year old woman presented with > 6 months of recurrent ischemic, low flow clitoral priapism. She was on psychotropic drugs for obsessive compulsive disorder. She was initially managed with repeated clitoral shaft intracavernosal injections (3:00, 9:00 o'clock) of phenylephrine 100 mcg or oral long-acting Sudafed. After each injection clitoral shaft pain and swelling resolved, cavernosal arterial inflow increased, but the adrenergic effect lasted only 12-15 hours. She was eventually successfully managed by cavernosoglanular shunt with snake maneuver with resolution of signs and symptoms and documentation by post-op Doppler ultrasonography of excellent cavernosal artery blood flow bilaterally. A 31-year old woman presented with idiopathic, recurrent episodes of ischemic low flow priapism. She has had 2 episodes in 15 months that have occurred upon wakening in the AM. She was managed medically for the acute symptoms with clitoral shaft intracavernosal injections (3:00, 9:00 o'clock) of phenylephrine 100 mcg and she has used oral long-acting Sudafed as needed to prevent recurrence. She has been trained in self-injection of intracavernosal phenylephrine (100 ug) for emergency use.
Conclusions: Medical (adrenergic-based) and surgical (corporaglanular shunt with snake maneuver-based) treatments have successfully treated two women with distressing signs and symptoms of recurrent ischemic low flow clitoral priapism.

Disclosure:
Work supported by industry: no.
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The Biomechanics and Physiology of Vaginal Tightening Procedures as They Relate to Orgasm and Sexual Satisfaction (#044)

M. Goodman

044
The Biomechanics and Physiology of Vaginal Tightening Procedures as They Relate to Orgasm and Sexual Satisfaction
Goodman, M1
1: Caring For Women Wellness Center, Davis, CA, USA

Objectives: Vaginal tightening procedures promise improved sexual pleasure for women and include narrowing of vaginal caliber via repair of the pelvic floor, re-approximation of levator muscles and elevation of the perineal body in women who note vaginal laxity adversely effecting sexual enjoyment and orgasmic ability. Sexual dysfunction or decreased sexual sensation may be an early symptom suffered in the progression of prolapse. (1) This paper discusses the biomechanical effects of vaginal tightening on the physiology of sexual pleasure/orgasm.
Materials/Methods: Literature review; biomechanical and physiological analysis.
Results: The literature is scant and mostly retrospective (2,3), but suggests enhancement of sexual pleasure and orgasmic ability via a surgical "tightening" procedure. The one prospective study in the literature alludes to improvement of both body image and sexual function at 6 months. (4) A better powered 2 year follow-up study (submitted for publication) is confirmatory. Post-operative results show elevation of perineal body, downward vaginal tilt, and diameter narrowing with increase in frictional forces.
Conclusion: "Vaginal tightening operations" are variations on traditional site-specific anterior and posterior colporrhapies and perineorrhaphies. Modifications include 3-layer closure designed to re-approximate levator musculature, elevate the perineal body, diminish vulvar vestibular size, and re-establish the downward tilt of the vagina for improved stretch of clitoral bulb/crurae and autonomic receptors in vaginal walls, especially anterior wall (AVW), and cervix. Variations may also include proximal vaginal narrowing. Results are improved by addition of post-operative pelvic floor exercises.
Applying O'Connel et al's "unification" theory of the clitero-urethro-vaginal complex (5) with dual skeletal and autonomic innervation of erectile and glandular elements, and applying Buisson et al (6) and Brody's (7) research, greater intra-vaginal distension via increased penile size or decreased vaginal diameter results in greater "stretch," increasing the vaginocavernosis reflex and direct pressure on the AVW and clitoral structures. Increased inflation from penile size or decreased vaginal caliber increases vaginal orgasmic ability caused by stretch of the internal erectile clitoral structures in the AVW. (8) The tighter the vaginal barrel and stronger the perineal body, the greater "force" and stretch on the clitoro-vaginal complex.

Re-establish angle; increase AVW, cervical pressure.

Disclosure:
Work supported by industry: no.
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Kisspeptin Antagonist, Peptide 234, Blocks both Kisspeptin-10 and Nesfatin-1-induced Luteinizing Hormone Release in the Female Rats (#045)

H. Kelestimur

045
Kisspeptin Antagonist, Peptide 234, Blocks both Kisspeptin-10 and Nesfatin-1-induced Luteinizing Hormone Release in the Female Rats
Kelestimur, H1; Sahin, Z1; Bulmus, O1; Ozcan, M1; Canpolat, S1
1: Turkey

The aim of this study was to determine the modulatory effects of peptide 234 (an antagonist of GPR54 receptors) on the kisspeptin-10 and nesfatin-1-induced luteinizing hormone secretion in the female rats.
The pre-pubertal Sprague-Dawley female rats were weaned on day 21. They were intracerebroventricularly cannulated under general anesthesia with ketamine 60 mg/kg plus xylazine (rompun) 5 mg/kg. In the first experiment, the combined gonadotropin-releasing effects of kispeptin-10 and peptide 234 were explored. Groups of female rats (n=7 per group) were injected with kisspeptin-10 (1 nmol), peptide 234 (50 pmol), or kişsspeptin-10 plus peptide 234, daily. In the second experiment, the female rats (n=7) were injected with nesfatin-1 (25 nmol), peptide 234 (50 pmol), or nesfatin-1 plus peptide 234, daily. Rats injected with physiological saline served as controls. Blood samples were obtained from day 60 when diestrus, which was determined by vaginal smears, was observed. Serum LH levels were measured by ELISA.
Kisspeptin-10 and nesfatin-1 elicited significant (P≤0.001) elevations of circulating LH levels, being 8.28±0.64 ng/ml and 7.22±0.32 ng/ml, respectively compared to controls (4.31±0.34 ng/ml). Coadministrations of peptide 234 and kisspeptin-10 or peptide 234 and nesfatin-1 decreased significantly (P≤0.001) LH levels, being 4.7±0.47 ng/ml and 4.82±0.31, respectively.
In conclusion, kisspeptin antagonist, peptide 234, modulates not only the effect of kisspeptin on gonadotropin secretion but also the effect of nesfatin-1, and nesfatin-1 seems to exert its effects on reproductive functions by means of kisspeptin/GPR54 system in the female rats.

Disclosure:
Work supported by industry: yes, by TUBITAK project # 113S193.
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Surgical Resolution of Dyspareunia after Traumatic Pelvic Injury (#046)

S.M. Kim

046
Surgical Resolution of Dyspareunia after Traumatic Pelvic Injury
Kim, SM1; Lee, YS 1
1: Dae Jeon St Mary's Hospital, The Catholic University of Korea, College of Medicine, Korea, South

As the more of patients with traumatic pelvic injuries survive, the more patient population demand for optimal quality of life, including treatment of sexual dysfunction, even after the most severe injuries. We present the case of a 31-year-old woman who suffered from dyspareunia after severe pelvic injury. After multi-department cooperation, including the excision of a disunited fragment of pelvic bone and an adhesion band at the vaginal wall, dyspareunia was considerably resolved and the patient recovered sexual function. In cases of severe pelvic injury, physicians used to be satisfied with patient's survival alone and tend to regard sexual dysfunction as a trivial outcome. Many cases of sexual dysfunction resulting from traumatic pelvic injury, such as dyspareunia, could be improved by planned surgical interventions.

Disclosure:
Work supported by industry: no.
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The EIS Model: A Mixed Methods Research Study of a Multidisciplinary Sex Therapy Treatment (#047)

J. Konzen

047
The EIS Model: A Mixed Methods Research Study of a Multidisciplinary Sex Therapy Treatment
Konzen, J1
1: Alliant International University, USA

Marital and sexual satisfaction have a significant role in overall well-being and mental health. When a married couple is not experiencing a satisfying sexual relationship, partners tend to be less satisfied in their overall relationship. There is a paucity of controlled outcome studies researching effectiveness of sex therapy interventions. This study utilized a convergent parallel mixed method approach that evaluated the effectiveness of a manualized sex therapy approach. The research involved: (a) correlational analyses of quantitative data related to primary tenets of the model, (b) a randomized controlled trial using the EIS manual, and (c) qualitative analysis of participants' perceptions of intimacy and their experiences of change in therapy. Participants were heterosexual, married, Christian couples who were between 30-64 years old, 70% Caucasian, 22% Latino/Hispanic, 5% Black/African American, and 3% Asian. Pre-treatment correlational analysis revealed an association between negative psychosexual events during development and a lower sexual self-schema for women. Thirteen couples were randomly assigned to the treatment group and received between 12 and 24 weeks of treatment, and 16 couples were assigned to the waitlist group. A treatment-as-received repeated measures of analysis showed significantly greater improvement for treatment couples in sexual and marital satisfaction, marital intimacy, and verbal sexual intimacy for men and women, and sexual function for women. Results provide initial support for the theory and interventions of the EIS model. For post-treatment differences between treatment and control groups, treatment effect sizes were large for sexual and marital satisfaction, marital intimacy, and verbal intimacy for both men and women, and for sexual functioning for women, ranging from .89 to 2.13. Treatment effect sizes for all outcome variables pre-post for the treatment group were also large, ranging from .82 to 2.37, p < .05 to p < .001, with the exception of sexual functioning for men. Content analysis of qualitative open-ended questions enriched and supported quantitative findings.

Disclosure:
Work supported by industry: no.
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Sexual Desire, It's Complicated: Results from Bi, Lesbian, and Straight Women (#048)

K. Mark

048
Sexual Desire, It's Complicated: Results from Bi, Lesbian, and Straight Women
Mark, K1
1: University of Kentucky, USA

Objectives: Sexual desire is often defined as a motivational state where a combination of forces bring us toward and away from sexual behavior. Low sexual desire is the most common sexual complaint reported by women, and sexual desire and desire discrepancy have become more frequently studied in part due to the potential for pharmaceutical intervention. However, sexual desire is not fully understood in sexually diverse populations. The current study aimed to answer the following research questions: 1) Are there significant differences in women's level of dyadic, solitary, and overall sexual desire in diverse sexual identity groups? 2) Is desire discrepancy experienced differently between women of diverse sexual identity groups? and 3) What are the contextual factors contributing to changes in sexual desire and desire discrepancy in women of diverse sexual identity groups?
Material and Method: Quantitative data were collected from 685 women (150 bi-identified, 74 lesbian-identified, and 407 straight-identified) through an online survey on sexual desire and sexual desire discrepancy. Women were an average age of 32 and 80.8% were in a romantic relationship at the time of data collection. Qualitative data were collected in the form of face-to-face semi-structured interviews from 26 women (9 bi-identified, 8 lesbian-identified, and 9 straight-identified) to contextualize the quantitative findings. Women were an average age of 29 and 89% were in a romantic relationship at the time of data collection.
Results: Quantitative findings indicated that levels of sexual desire were significantly different among different identity groups, such that bisexual-identified women scored significantly higher on solitary, dyadic, and overall desire than gay- and straight-identified women. Desire discrepancy was a universal experience that did not significantly differ between women of different identity groups. Qualitative findings provided context around the cultural influence on sexual desire in the different orientation groups. Bisexual- and lesbian-identified women expressed vastly different reasons for ebbs and flows of sexual desire than straight-identified women.
Conclusions: Sexual desire is multifaceted and women of diverse sexual identities may experience sexual desire in a different way than straight-identified women. Future research on the utility of this perspective of sexual desire and implications for clinicians working with women struggling with low sexual desire in their relationships will be discussed.

Disclosure:
Work supported by industry: no.
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Oral Supplementation with Stronvivo Improves Male Erectile Function and Female Sexual Desire (#049)

J. Vascoe

049
Oral Supplementation with Stronvivo Improves Male Erectile Function and Female Sexual Desire
Vascoe, J1; Merrill, R1; Vieira, K2
1: Abbey Research Ltd., USA; 2: The Med Writers, USA

Objective(s): Stronvivo is an Informed Choice certified nutritional supplement, comprised of USP-verified, pharmaceutical grade ingredients, designed to improve the health of the endothelium, stimulate the production of nitric oxide, improve circulation, boost energy and inhibit platelet aggregation and adherence. Given that these processes play an integral role in sexual function, it was hypothesized that Stronvivo would have additional beneficial effects in this area. The current study was an open-label trial exploring the effect of Stronvivo supplementation on various subjective ratings of sexual functioning.
Material(s) and Method(s):The sample included 60 adults (m/f 51/9), ages 30-84, BMI 21-56. Patients were administered 6 capsules of Stronvivo daily for 90 days, which equated to a total daily intake of: 2,000mg of L-arginine, 1,000mg of L-citrulline, 1,000mg of L-carnitine, 30mg of zinc, and 400mg of magnesium. Patients were assessed at four time points: baseline (prior to supplementation with Stronvivo), 30-day follow-up, 60-day follow-up and 90-day follow-up. Measures included: FSFI, IIEF, ADAM and PHQ-9.
Result(s): Mean scores on the subscales of the FSFI, (i.e., Desire, Arousal, Lubrication, Orgasm, Satisfaction, Pain) demonstrated linear improvement. Mean full-scale FSFI scores were as follows: baselineM=20.84; 30-day M=24.77; 60-day M= 25.39; and 90-day M=29.33 with the biggest improvements shown in the domains of Desire (1.94), Arousal (1.47), Orgasm (1.42) and Lubrication (1.26). For males, significant improvement was noted in terms of IIEF total scores from baseline (M=43.65) to 60 days (M=52.40). Ratings of erectile dysfunction improved from baseline to 60 days and ratings of sexual desire improved from baseline to all other time points. On the ADAM, over half the sample meeting criteria for androgen deficiency at baseline no longer met criteria after 30 days (n=22; 51%). Finally, significant improvement in depressive symptoms (PHQ-9) was noted for males after 30 days and for females after 60 days.
Conclusion(s): Though results must be interpreted with caution, females reported improvements in all areas of sexual functioning, as well as significant improvements in subjective mood while taking Stronvivo. Males reported improved erectile function and sexual desire following initiation of Stronvivo. Further, taking Stronvivo for a month led to reduced symptoms of androgen deficiency and significant improvements in subjective mood.

Disclosure:
Work supported by industry: yes, by Abbey Research Ltd. (industry initiated, executed and funded study). The presenter or any of the authors act as a consultant, employee (part of full time) or shareholder of an industry.

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Assessing for Female Sexual Dysfunction: Is Empathy Required for OB-Gynecologists? (#050)

J. Newman

050
Assessing for Female Sexual Dysfunction: Is Empathy Required for OB-Gynecologists?
Newman, J1; Curlin, F2; Lindau, S3; Rowen, T1
1: UCSF, USA; 2: Duke, USA; 3: University of Chicago, USA

Objectives: Up to 12% of American women undergo female sexual dysfunction that causes personal distress, and often, desire medical counseling on this subject.  Obstetricians and gynecologists, as providers trained in women's reproductive health, should be well-prepared to address this need. However, in a survey completed in over 1800 practicing OB-Gynecologists, only about 40% routinely brought up this subject. In a study looking at predictors of discussing issues of sexual health is male patient, the largest predictor of provider patient communication on this subject was having training in communication skills. No such study has been performed relating to women's sexual health The objective of this data analysis was to look particularly at the ratings of empathy to assess whether this had an impact on providers discussions with female patients regarding sexual dysfunction and sexual satisfaction.
Materials and Methods: The data were obtained from OB-GYNs Approaches to Sexual and Reproductive Health Care: A National Survey that was mailed to a stratified random sample of 1800 practicing OB-Gyns through a sample from the American Medical Association's Physician Masterfile. In this study, the physicians were asked about their self-perceived empathy and how empathetic their colleagues, particularly nurses, or their own patient population would rate them. The providers were also asked about how often they asked about sexual dysfunction and sexual satisfaction. A chi-square analysis was then used to compare their self-perceived empathy ratings with their assessment of sexual dysfunction and satisfaction.
Results: Using cross tabulations, physicians who were rated above average on empathy scores were significantly more likely to assess for sexual dysfunction, in a routine or sometimes manner,(84 vs 72%, p= 0.0033) and satisfaction (74 vs 60%, P: 0.0001) when rated by their colleagues. Similar findings were notable for self perceived empathy ratings of their own empathy and how they perceived patient's viewed them.
Conclusions: In this large survey, empathy was found to be a strong predictor of whether physicians engaged in counseling regarding sexual dysfunction as well as sexual satisfaction. As sexual function is an important part of female health and well-being. perhaps further training of OB-Gyn residents in empathy and communication skills overall would improve patient counseling on sexual dysfunction as well as sexual satisfaction.

Disclosure:
Work supported by industry: no.
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Audit on Informed Consent for Intrauterine Contraception (#051)

R. Patel

051
Audit on Informed Consent for Intrauterine Contraception
Patel, R1; Choudry, B2
1: University of Manchester, United Kingdom; 2: Walkden Medical Centre, United Kingdom

Aims: Looking at whether patients are adequately informed about insertion of intrauterine contraception at Walkden Medical Centre. Particularly focussing on ensuring that the clinicians tell specific information to the patients set out in The Faculty of Sexual and Reproductive Healthcare's Guidelines and NICE Long-acting reversible contraception guidelines. After all this information, the patients have sufficient information to give informed consent for the procedure.
Methodology: An EMIS search was completed for all patients who had any intrauterine device (IUD) in the past year. Their consultation notes were examined to find information that had been recorded by the clinician as proof they have adequately informed the patient about the IUD. The information included in the notes was then crosschecked against the information that NICE recommends should be conveyed and recorded in a table.
Results: 51 patients were identified in total. The consultation records show the following; 100% of patients had a 'chaperone offered', 'gynaecological exam' and given a 'follow-up appointment' (65% attendance rate). 98% of patients had been told to 'check threads'. 93% of patients had 'fertility advice' and 91% had 'procedural information'. 70% of patients had been told the 'effect on their periods'. 56% had an STI check and 47% had been told about the 'failure rate', 'risks and side effects'. Only 19% had been told about when to seek medical attention and 2% patients had been told the duration time of the IUD. 0% of patients were told about the method of action of the IUD and no contraindications were checked.
Conclusions: The results were mixed with some categories being recorded more than other. It may be the case that the patient was informed about the procedure verbally but not recorded in the consultation notes, which could explain some of the poor results.
Recommendations: Present findings to practice to raise awareness of the findings. Implement a consent form that can be printed off, completed by the patient, which contains all the relevant information and the scanned back into the EMIS database.

Disclosure:
Work supported by industry: no.
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Sexual Abuse History and Intimate Relationship Conflict: The Role of Sexual Shame (#052)

A. Proctor

052
Sexual Abuse History and Intimate Relationship Conflict: The Role of Sexual Shame
Proctor, A1; Sherrill, B1; Pulverman, C1; Meston, C1
1: University of Texas, USA

The negative effects of sexual abuse on later sexual and relational well-being have been well documented (Noll et al., 2003; Rumstein-McKean & Hunsley, 2001). Less known are the mechanisms by which sexual abuse negatively impacts relational intimacy. One potential mediator of this relationship is shame. Shame influences the social and emotional adjustment of sexual abuse survivors (Negrao, Bonanno, Noll, Putnam, & Trickett, 2005). Shame is best understood as an individual's intense disappointment concerning the self (Ferguson, 2005). Researchers have identified the need for domain-specific types of shame to apply to different aspects of the self (Rizvi, 2010). Sexual shame is classified as a negative reflection on the self with specific negative feelings about sexual thoughts, experiences, or behaviors (Kyle, 2013). To date, no study has examined the role of sexual shame in relational dysfunction among sexual abuse survivors.
Sexual shame was examined as a potential mechanism underlying the relationship between sexual abuse status and relationship conflict using a mediation model. Sexual abuse was defined as any form of unwanted sexual contact at any age. Men (n = 89) and women (n = 245) from a college student sample completed online surveys on abuse history, sexual shame, and frequency of intimate relationship conflict.
Results showed that history of abuse predicted greater relationship conflict (b = -.123, t(348) = -2.30, p =.022), with sexual shame significantly mediating this relationship (z = -3.85, p <.001). Sexual shame was an even better predictor of relationship conflict than abuse status b = .291, t(348) = 5.665, p <.001.
Results highlight the importance of specifically addressing sexual shame in therapeutic interventions with survivors of sexual abuse reporting relationship conflict. Therapy could help ameliorate the negative effects of sexual abuse on relational intimacy by providing a healthy and objective perspective on sexual shame.

Disclosure:
Work supported by industry: no. The presenter or any of the authors act as a consultant, employee (part time or full time) or shareholder of an industry.
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Prevalence of Dyspareunia in Female Urology Clinic-Characteristics of Dyspareunia Patients (#053)

Y. Sekiguchi

053
Prevalence of Dyspareunia in Female Urology Clinic-Characteristics of Dyspareunia Patients
Sekiguchi, Y1; Maeda, Y 1; Azekoshi, Y1; Kinjo, M1; Fujisaki, A1; Nakamura, R1; Yao, M2
1: Womens Clinic LUNA Group, LUNA Pelvic Floor Total Support Clinic, Japan; 2: Department of Urology, Yokohama City University Graduate School of Medicine

Background: Integra theory 1) which is the development basis of TVT by P.P.Petros referred pelvic floor disorders were one of causes of dyspareunia. Pelvic floor disorders consist of stress urinary incontinence, overactive bladder and pelvic organ prolapse which are treated in female urology clinic. We conducted a study of the prevalence of dyspareunia in female urology clinic for researching the relation between pelvic floor disorders and dyspareunia.
Participants & Intervention: 747 patients visited first between Aug. 2013 and Jan. 2014 to our clinic. They took the questionnaire included dyspareunia, chronic pelvic pain and lower urinary symptoms.
Results: There were 105 patients (14%) had dyspareunia. The average age of dyspareunia patients was 45.5 ± 14.3 (max.72, min.19). The diagnosis of patients were chronic pelvic pain syndrome/ interstitial cystitis 37 (35.2%), urinary incontinence 15 (14.3%), acute cystitis 14 (13.3%), overactive bladder 12 (11.4%), pelvic organ prolapse 11 (10.5%), female sexual dysfunction 10 (9.5%), hematuria 3 (2.9%), nocturnal enuresis 2 (1.9%) and urinary calculi 1 (1%). Therefore pelvic floor disorders held 36.2% of dyspareunia. Additionally people complained of back pain were 26 (24.8%), people complained of abdominal pain were 40 (38.1%) and people complained of pain in the vulva were 49 (46.7%). The rates of nullipara were 52.8% of chronic pelvic pain syndrome/ interstitial cystitis and 29.7% of pelvic floor disorders, There were significant statistically differences between them. (p<0.05) And the rates of complaining abdominal pain were 55.6% of chronic pelvic pain syndrome/ interstitial cystitis and 35.1% of pelvic floor disorders, There were also significant statistically differences between them. (p<0.05)
Conclusion: 14% of dyspareunia in our study is same as the prevalence of dyspareunia in Europe and USA2) It suggested that there were many potential patients with female sexual dysfunction in Japan. The probability of pelvic floor disorder in dyspareunia patients is equivalent that of chronic pelvic pain syndrome/interstitial cystitis. Therefore the dyspareunia related to pelvic floor disorders can be treated by pelvic floor rehabilitation and pelvic floor operation

Disclosure:
Work supported by industry: no.
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The Relationship between Disclosure of Virginity Status and Dysfunctional Sexual Beliefs (#054)

K. Sligar

054
The Relationship between Disclosure of Virginity Status and Dysfunctional Sexual Beliefs
Sligar, K1; Belfy, A1; Barnett, M1
1: University of North Texas, USA

Disclosure of virginity status refers to an individual's revelation of their status as a virgin or non-virgin, based on their subjective definition of virginity. Feminist Theory contends that the sexual double standard along with sexual labeling negatively impact women's sexual experiences and expression of those experiences (Holland et al., 1996). This study investigated the relationship between disclosure of virginity status, gender, and dysfunctional sexual beliefs. College students (N = 986) were administered the Sexual Dysfunctional Beliefs Questionnaire and the newly-developed Disclosure of Virginity Status Scale. No significant differences by gender were found in disclosure of virginity status. Among women, disclosure of virginity status negatively associated with several sexual dysfunctional beliefs, including: sexual conservatism (r = -.121, p = .001), sexual desire/pleasure as a sin (r = -.143, p < .001), age-related beliefs (r = -.129, p = .001), body image beliefs (r = -.157, p < .001), and affection primary (r = -.153, p < .001). There was no association found between motherhood primacy and disclosure. Among men, there was no relationship found between disclosure of virginity status and sexual dysfunctional beliefs. These findings may indicate that disclosure of virginity status among younger women reflects a rejection of the sexual double standard, and thus serves to buffer against dysfunctional sexual beliefs. Future research could incorporate variables such as gender role conformity and explore whether it mediates the relationship between dependent variables and dysfunctional sexual beliefs.

Disclosure:
Work supported by industry: no.
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A Mindfulness Based Therapeutic Perspective to Sexual Dysfunction/Healthy Sexual Functioning in Women: Clinical Mental Health DSM-5 Implications (#055)

A. Stepensky

055
A Mindfulness Based Therapeutic Perspective to Sexual Dysfunction/Healthy Sexual Functioning in Women: Clinical Mental Health DSM-5 Implications
Stepensky, A1; Johnson, R1
1: University of San Diego, USA

The complexity of the clinical problems stemming from sexual dysfunction (e.g., anxiety and depression) is best reflected in the diversity found in the psychological treatment literature. The exacerbation of this problem is due in large part to a failure to address underlying factors of female sexuality. Despite the prevalence of female sexual distress, there is no one recognized treatment. For example, some women seek professional help for a variety of medically based sexual symptomatology. The symptoms may include arousal and genital pain. Other patients experience symptoms that reflect a disconnection between self-reported feelings of arousal, pleasure, and the body's physiologic response. From a clinical mental health perspective, Mindfulness is an empirically based approach that aims to cultivate a state of present-moment, non-judgmental awareness of the mind and body. Mindfulness skills have been incorporated into both individual and group treatment programs (e.g. Mindfulness Based Stress Reduction). The approach has been found to be effective for significantly improving several domains of sexual response while decreasing sex-related distress. As a result, this approach may be proven useful in addressing the sexual distress symptoms often reported by women and viewed as sexual distress in women. The proposed poster session examines the clinical research literature on the effect of mindfulness for three categories of known to be barriers to healthy sexual functioning for women. This poster also provides information on attention, self-judgment, and associated clinical diagnostic symptoms that may have DSM-5 relevance.

Disclosure:
Work supported by industry: no.
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Age Trends in Sexual Behaviour and Satisfaction in Finnish Heterosexual Women (#056)

M. Sundstedt

056
Age Trends in Sexual Behaviour and Satisfaction in Finnish Heterosexual Women
Sundstedt, M1; …sterman, K1; Bjšrkqvist, K1
1: bo Akademi University, Finland

The present study examined onset and frequencies of sexual activities, sexual satisfaction, and amount of love and equality in the relationship, among a sample of women in Finland. 1,044 heterosexual women between 18 and 65 years of age filled in an online questionnaire. Of the respondents, 80.6 % had a partner.
Frequencies for different sexual activities for women with and without a partner are presented. Significant variation due to age regarding sexual satisfaction, love and equality in the relationship, and sexual pleasure and orgasm were found. Women in their forties experienced more sexual pleasure and were more satisfied with their ability to reach orgasm than women in their twenties. Scores of love and equality were low for women in their forties. It was found that respondents born in the 80s had experienced their first orgasm significantly earlier than all other age groups. The age group born in the 70s stood out as late beginners of sexual activity: they had not had their first sexual relationship any earlier than those born in the 60s. Results showed that the oldest respondents in the study, born in the late 1940s, had experienced their first kiss, first intercourse, and first orgasm during intercourse at a significantly older age compared to the respondents born later.
A clear decreasing trend was found for the age of the first intercourse and first orgasm during intercourse. Regarding age at first sexual relationship and first kiss, however, no clear trends were found.

Disclosure:
Work supported by industry: no.
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Oral Contraceptive Use and Overall Relationship Satisfaction: Is There a Link? (#057)

T.C. Taggart

057
Oral Contraceptive Use and Overall Relationship Satisfaction: Is There a Link?
Taggart, TC1; Hammett, JF1; Ulloa, EC1
1: San Diego State University, USA

A high proportion of women today take oral contraceptive pills (OCPs). In addition to preventing pregnancy, many women take OCPs for non-contraceptive benefits, such as alleviating severe cramping, endometriosis, and excessive menstrual bleeding; getting rid of severe and persistent acne; normalizing irregular cycles, and mitigating symptoms of premenstrual dysphoric disorder (PMDD) and PMS (Dawood, 2006; Jones, 2011). Interestingly, because hormones can be linked to mood, researchers are beginning to explore what role OCPs may play in mental health. Approximately 17% of women experience major depression during their lifetime, coincidentally, incidence is highest during the reproductive years (Hasin, Goodwin, Stinson, & Grant, 2005), and many more experience depressive symptoms that do not warrant a clinical diagnosis but still by may be disabling (Rushton, Forcier, & Schectman, 2002; Wight, Sepulveda, & Aneshensel, 2004). Relatively little research has focused on OCPs and mental health outcomes until recently. One recent study utilized a national longitudinal dataset and reported an association of OCP use with reduced levels of depressive symptoms (Keyes et al., 2013). Since the dataset used by Keyes was archival, there were many notable limitations. While they controlled for many factors, other potentially confounding variables could not be ruled out due to the study's design. Specific hormone levels contained in the OCPs were not documented, and, thus, were unable to be assessed. Despite the limitations, the results indeed warrant further exploration of the topic. We would like to not only replicate, but also extend the findings from Keyes' study. Specifically, we would like to assess for the dosing levels of synthetic estrogen and progestin contained in OCPs in order to assess a potential dose-response or threshold. Further, we would like to include variables that Keyes' study was unable to assess for use as covariates or potential moderators (i.e. sexual orientation, overall relationship satisfaction, sexual satisfaction, mood changes, concurrent medications being taken, previous clinical diagnoses of depression, experiences of sexual trauma and/or intimate partner violence). It is hypothesized that once hormone levels are being regulated due to OCPs, individuals may experience less mood swings and thereby may enjoy more relationship satisfaction with their partners. In order to properly assess this, we would like to control for as many potential confounding variables as possible, which is why we are asking about sensitive topics such as intimate partner violence and past sexual abuse history, as it is well documented that these factors have long-term effects in many areas, but especially in interpersonal relationships (Alexander & Lupfer, 1987; Browne & Finkelhor, 1986; DiLillo, 2001; Finkelhor, Hotaling, Lewis, & Smith, 1989; Testa, VanZile-Tamsen, & Livingston, 2005). Participants will be recruited using Amazon Mechanical Turk, a crowdsourcing Internet marketplace, which touts a more demographically diverse sample than typical college samples with high quality, reliable data (see Buhrmester, Kwang, & Gosling, 2011). Participants will consist of 300 women between the ages of 18 and 32, who are currently in a relationship and are not pregnant. Results will be presented at the conference. Funded by SDSU Research Grant.

Disclosure:
Work supported by industry: no.
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Pattern of Seminal Fluid Analysis among Infertile Couples Presenting at a Tertiary Hospital in a Semi-Urban Setting of North-West Nigeria (#058)

E. Ugwa

058
Pattern of Seminal Fluid Analysis among Infertile Couples Presenting at a Tertiary Hospital in a Semi-Urban Setting of North-West Nigeria
Ugwa, E1; Ashimi, A2; Abubakar, M2; Attah, R3
1: Nigeria; 2: Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria; 3: Aminu Kano Teaching Hospital, Kano, Nigeria

Objective: The present study was undertaken to review the seminal fluid analysis (SFA) of male partners of couples presenting with inability to conceive at a gynaecological clinic using World Health Organization (2010) criteria and to identify the correlation between poor semen quality and age.
Materials and Method: This was a retrospective study done at the Federal Medical Centre, Birnin Kudu, Nigeria located in a semi-urban setting. The sample size was 63. Ethical clearance was obtained. Patients' case records and laboratory registers were retrieved to review the reports of SFA. Data was analyzed by using SPSS Version 16. Descriptive statistics was used. Association between age and semen parameters was determined using Pearson's coefficient of correlations and chi-square test and p<0.05 was considered statistically significant.
Results: Only 63 of 308 male partners presented for seminal fluid analysis. This is 20.5% of the couples. After analysis, 52.38% were normospermic, while 26.98% and 20.64% were azoospermic and oligospermic respectively. Asthenospermia was the commonest motility/morphology abnormality occurring in 60.3%. The volume, motility, morphology and pH showed weak correlations with age.
Conclusion: Male partners are significant contributors to the infertile couple problems in this study; therefore awareness is needed in order to engage more males in evaluation and treatment of infertility.

Table1. Age distribution


Table2. Distribution of Sperm count


Table 3. Semen profile and age-related correlation


Disclosure:
Work supported by industry: no.
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Risk Factors for Sexual Dysfunction among Women Seeking Infertility Treatment (#059)

W.D. Winkelman

059
Risk Factors for Sexual Dysfunction among Women Seeking Infertility Treatment
Winkelman, WD1; Smith, JF1; Katz, P1; Rowen, TS1
1: University of California San Francisco, USA

Objectives: To assess the demographic characteristics associated with sexual dysfunction among infertile women
Materials and Methods: Cross-sectional analysis of 383 women from eight reproductive endocrinology clinics. Participants received an extensive questionnaire and face-to-face and telephone interviews. Basic demographic information and medical histories were obtained from all participants. Questions about sexual impact were originally taken from the Fertility Problem Inventory and included items about level of sexual enjoyment, perceived attractiveness to partner, inability to have sex because of fertility problems and persistent thoughts about having a child during intercourse. Total potential scores ranged from 0 to 100 and higher scores represent greater sexual dysfunction.
Results: Among 383 respondents, 23.2% were married one year or less. Most participants (75.5%) reported having no prior children. The average sexual impact score was 38 with a range from 0 to 90 and standard deviation of 20. Among couples seeking treatment for infertility, females reported greater sexual dysfunction (mean=39, SD=20) when compared to males (mean=25, SD=18). Respondents who were 20 to 35 years old experienced significantly more sexual dysfunction than respondents more than 45 years old, (mean of 39, CI 36-42 and mean of 23, CI 9-39 respectively, p=0.01). Among female respondents, total length of infertility, years of marriage, parity and religion were not associated with increased sexual dysfunction.
Conclusions: Among women seeking infertility treatment there are high levels of sexual dysfunction. In couples suffering from infertility, women have significantly higher rates of sexual dysfunction when compared to men. There is significantly more sexual dysfunction among younger women suggesting that infertility impacts patient's lives differently throughout the reproductive years.

Disclosure:
Work supported by industry: no.
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Evaluation of NEOGYN® Feminine Soothing Cream in Treating Female Sexual Function in Postmenopausal Women with Chronic Vulvar Pain and Discomfort (#060)

Susan Kellogg-Spadt, PhD, CRNP, IF

060
Evaluation of NEOGYN® Feminine Soothing Cream in Treating Female Sexual Function in Postmenopausal Women with Chronic Vulvar Pain and Discomfort
Kellogg-Spadt, S1; Carlow, JJ2; Haines, M3; Krychman, ML4
1: Center for Pelvic Medicine, Byrn Mawr Pa and Dept. Obgyn, Drexel University College Medicine Philadelphia, PA; 2: Discovery Statistics, San Clemente, CA; 3: Neogyn, Inc., Jersey City, NJ; 4: Southern California Center for Health & Survivorship Medicine, Newport Beach, CA

Objective: The menopausal process is a natural progression for women. In addition to exacerbation of vasomotor symptoms, vaginal and vulvar dryness, pruritis, and atrophy of the vulvar skin, postmenopausal women often experience painful intercourse (dyspareunia) and gradual decline of sexual interest. The aim of this study was to evaluate the effect of Neogyn®, a feminine vulvar soothing cream, in relieving chronic mild-to-moderate outer genital discomfort or pain in otherwise healthy, postmenopausal women. Neogyn® is a cellular lysate cream that is hormone, fragrance and paraben free. It is a proprietary blend of proteins and interleukins specifically formulated by Swiss scientists. The study was also designed to evaluate the hypothesis that chronic vulvar pain and discomfort are highly associated with patient reported sexual dysfunction and dissatisfaction.
Design: Convenience sampling was used at two geographically diverse clinical institutions to enrol 24 postmenopausal women in this single-group, open label, pre- post-test study design. At the time of screening, all subjected reported vulvar and intercourse related pain and discomfort. The patients were consented, examined and screened to ensure qualification. The subjects were not on any other treatments for vulvar pain or discomfort. Subjects were educated with anatomical pictures on where to and how to apply 0.25-0.30g of the study product to their outer genital areas once daily or as much as clinically indicated for 12 weeks. Assessments at baseline and 12 weeks consisted of an 11-pt numeric rating scale of discomfort, the Female Sexual Dysfunction Index (FSFI), and the McGill Genital Pain Questionnaire. Global assessments of the treatment were also made at 4 and 8 weeks.
Results: Twenty-four predominantly (93%) white postmenopausal women ages ranging from 53-80 (average 62.4 ± 7.7) were enrolled between June and November 2013. With a response range of 0 for no discomfort and 10 the worse possible discomfort; the average vulvar discomfort score was 6.2 ± 1.8 at baseline and 2.7 ± 2.5 at 12 weeks representing a 56% improvement in outer genital discomfort (p <0.0001). Utilizing the McGill Genital Pain Questionnaire, 3 (12.5%) subjects reported none-mild pain at baseline in contrast to 13 (56%) subjects reporting none-mild pain at 12 weeks (p < 0.05). The total FSFI score significantly improved from 14.2 ± 7.6 at baseline to 21.4 ± 8.4 at 12 weeks (p = 0.006). When comparing the baseline and 12-week FSFI domain average scores, there was also a 77% improvement in the Pain domain (p = 0.029), a 46% improvement in the Arousal domain (p = 0.016), and a 30% improvement in the Satisfaction domain (p = 0.082). Based on the global assessments of the treatment, the study product was well tolerated by the majority of the subjects with 83.3% of the subjects at 4 weeks and 86.4% of the subjects at 12 weeks reporting they were satisfied with the treatment. Overall at the final 12-week evaluation, 14/23 (60.9%) subjects reported that their level of discomfort had improved, 13/23 (56.6%) reported that the quality of their sex life had improved, and 18/23 (78.3%) experienced a meaningful benefit from the study cream.
Conclusion: Vulvar pain and discomfort can have a significant impact on a woman’s quality of life. It is apparent that the study product, Neogyn® Soothing Cream, can relieve vulvar pain and discomfort and henceforth improve sexual well being in many postmenopausal women. Neogyn® is a novel non-hormonal vulvar product that should be added to the treatment paradigm options for outer genital discomfort.

Disclosure:
Work supported by industry: yes, by Neogyn, Inc..

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