Diss. (sammanfattning) Linköping : Linköpings universitet, 2007. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 6 uppsatser.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2005. / Härtill 4 uppsatser.

<p>Objectives: This descriptive epidemiological dissertation aims to identify conditions of Swedish women’s sexual well-being. The focus is on the relationship between their idiosyncratically reported levels, during the last 12 months, of 5 sexual functions/dysfunctions per se and distressing and their socio-psychological situation, including aspects of their sexual history. Levels of sexual functions/dysfunctions are also related to levels of sexual satisfaction and to other aspects of life satisfaction.</p><p>Methods: Data on a randomized cross-sectional national sample of 1335 women aged 18-74 (59% of target sample) were gathered in 1996 using a combination of structured interviews and questionnaires/checklists. Analyses were performed for the total sample or for sub-samples aged 18-65 years. In 3 of the 4 dissertational articles, trichotomies of a 6-grade scale characterizing level of sexual dysfunctions into No/Mild/Manifest dysfunction were used.</p><p>Main results: Mild sexual dysfunctions were, generally, much more common than were manifest, and dysfunctional distress was considerably less common than were dysfunctions per se. All dysfunctions, and in particular orgasmic dysfunction, were closely associated with level of sexual well-being. Four factors independently pair-wise linking levels of dysfunctions per se with levels of distressful dysfunction were identified. These were Sexual interest/Desire, Genital function (lubrication and dyspareunia), Orgasm, Vaginismus. Three of these (not vaginismus) were powerful classificators of gross level of sexual well-being. Many of socio-demographic and socio-psychological contextual life-conditions were significantly associated with the different sexual functions/dysfunctions. However, the most prominent contextual variables were satisfaction with partner relationship and partner’s levels of sexual functions.</p><p>In conclusion, many different socio-psychological aspects must be taken into account to optimize treatment modalities and resources when dealing with women’s sexual dysfunction in order to secure a good level of sexual well-being.</p>

Objectives: This descriptive epidemiological dissertation aims to identify conditions of Swedish women’s sexual well-being. The focus is on the relationship between their idiosyncratically reported levels, during the last 12 months, of 5 sexual functions/dysfunctions per se and distressing and their socio-psychological situation, including aspects of their sexual history. Levels of sexual functions/dysfunctions are also related to levels of sexual satisfaction and to other aspects of life satisfaction. Methods: Data on a randomized cross-sectional national sample of 1335 women aged 18-74 (59% of target sample) were gathered in 1996 using a combination of structured interviews and questionnaires/checklists. Analyses were performed for the total sample or for sub-samples aged 18-65 years. In 3 of the 4 dissertational articles, trichotomies of a 6-grade scale characterizing level of sexual dysfunctions into No/Mild/Manifest dysfunction were used. Main results: Mild sexual dysfunctions were, generally, much more common than were manifest, and dysfunctional distress was considerably less common than were dysfunctions per se. All dysfunctions, and in particular orgasmic dysfunction, were closely associated with level of sexual well-being. Four factors independently pair-wise linking levels of dysfunctions per se with levels of distressful dysfunction were identified. These were Sexual interest/Desire, Genital function (lubrication and dyspareunia), Orgasm, Vaginismus. Three of these (not vaginismus) were powerful classificators of gross level of sexual well-being. Many of socio-demographic and socio-psychological contextual life-conditions were significantly associated with the different sexual functions/dysfunctions. However, the most prominent contextual variables were satisfaction with partner relationship and partner’s levels of sexual functions. In conclusion, many different socio-psychological aspects must be taken into account to optimize treatment modalities and resources when dealing with women’s sexual dysfunction in order to secure a good level of sexual well-being.

The aim of our investigation is to explore a sexual life, experience and attitudes of women who are divided into for groups, according to their ability to reach orgasm during partnered sexual activities. We try to identify possible differences between these groups in diverse sexual areas. We do not formulate any hypothesis, our research has an exploratory character. We used data from 905 women, who participated in a nationwide research, that aims to investigate changes in Czech population sexual behavior. The research is in progress since 1993 and it repeats every five years. Our sample originates from a data collection in 2008. The data collection (using anonymous questionnaire) was conducted by a specialized agency DEMA a.s. The data were processed using SPSS 16.0. Our results are following: The orgastic ability decreases with age. Widows, pensioners, and Roman Catholics rarely experience orgasm. Highly orgasmic women are of higher education. These women engaged into partnered sexual activities (such as necking, petting, sexual intercourse) earlier than the less orgasmic women did. The highly orgasmic women more masturbate. They also reported a higher number of sexual partners during their life, and they engage into a casual sex and diverse sexual practices more often. Furthermore, the highly...

Os objetivos do presente estudo foram: (1) avaliar a função sexual feminina e a presença de depressão e ansiedade; (2) verificar a associação entre disfunção sexual feminina (DSF), depressão e ansiedade e (3) identificar as variáveis relacionadas com os domínios: desejo, excitação, orgasmo e dor durante a relação sexual Participaram do estudo 110 pacientes saudáveis (idade: 18-61, média:38,5 anos) que aguardavam consulta ambulatorial de prevenção ginecológica no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). A avaliação foi realizada com questionários específicos desenvolvidos para a pesquisa, juntamente com o Quociente Sexual Feminino (QS-F), Inventário Beck de Depressão (BDI-II) e Inventário Beck de Ansiedade (BAI). A análise das respostas mostrou que do total da amostra, 36 (32,7%) mulheres apresentavam inibição de desejo; 16 (14,5%), problemas de excitação; 35 (31,8%), dificuldades de orgasmo; 31 (28,2%) queixavam-se de dor durante a relação; e 39 (35,5%) atingiram pontuação inferior a 60 no QS-F, indicando DSF em geral. Depressão e ansiedade acometeram 26 (23,6%) e 37 (33,6%) pacientes, respectivamente. Os dados também revelaram uma relação significante entre DSF, depressão e ansiedade, além de identificar fatores de risco para os domínios sexuais. Diminuição do desejo sexual foi associada à depressão, ansiedade, escolaridade, incômodo com próprio o corpo, masturbação e educação sexual; problemas de excitação foram ligados à depressão, ansiedade, idade, escolaridade, incômodo com o próprio corpo, medo relacionado a sexo e educação sexual; orgasmo foi impactado por depressão, ansiedade, escolaridade, incômodo com o próprio corpo, medo relacionado a sexo, vergonha durante o ato sexual, masturbação e educação sexual; queixas de dor durante a relação sexual foram associadas à depressão, renda, escolaridade e educação sexual; por fim, fatores relevantes para a presença de DSF em geral foram depressão, ansiedade, escolaridade, incômodo com o próprio corpo, medo relacionado ao sexo, vergonha durante o ato sexual e educação sexual. Modelos de regressão foram utilizados para identificar as variáveis mais significantes para cada domínio da atividade sexaul. Com efeito, desejo sexual é inibido pela presença de depressão; o nível de excitação é negativamente impactado por depressão e pelo aumento da idade; a capacidade de atingir o orgasmo é reduzida pela baixa escolaridade, pela ansiedade e por medos relacionados ao sexo; e tanto dor durante o intercurso quanto DSF em geral estão diretamente ligadas à baixa escolaridade e à depressão. Conclui-se que inúmeras variáveis interferem na resposta sexual feminina, sendo depressão e ansiedade especialmente nocivas à função sexual. Ademais, enquanto depressão é mais prejudicial nas primeiras fases da resposta sexual (desejo e excitação), ansiedade influencia principalmente a fase de orgasmo. / The present work proposes to (1) assess female sexual functioning, depression, and anxiety; (2) verify the association between female sexual dysfunction (FSD), depression, and anxiety; and (3) identify the variables associated with the sexual domains: desire, arousal, orgasm, and pain during intercourse. A group of 110 healthy women (age: 18-61, mean: 38.5 years) among those waiting for gynecological routine consultations at the Clinics Hospital of the Faculty of Medicine of the University of São Paulo (HCFMUSP) was randomly selected for this research. The patients were asked to fill questionnaires specifically developed for this work and validated instruments, such as the Female Sexual Quotient (FSQ), the Beck Depression Inventory (BDI-II), and the Beck Anxiety Inventory (BAI). The analysis of the responses show that 36 (32.7%) women present sexual desire inhibitions; 16 (14.5%) have arousal problems; 35 (31.8%) have orgasm difficulties; 31 (28.2%) report pain during intercourse; and 39 (35.5%) exhibit overall FSD. Depression and anxiety are present in 26 (23.6%) and 37 (33.6%) patients respectively. The data also reveal a significant relation between FSD, depression, and anxiety, in addition to identifying risk factors for the sexual domains. More specifically, sexual desire inhibition is associated to depression, anxiety, education level, body issues, masturbation, and sexual education; arousal is connected to depression, anxiety, age, education level, body issues, sex-related fears, and sexual education; orgasm difficulties is related to depression, anxiety, education level, body issues, sex-related fears, sex-related shame, masturbation, and sexual education; pain during intercourse is associated with depression, monetary income, education level, and sex education; and finally, the factors relevant to overall FSD are depression, anxiety, education level, body issues, sex-related fears, sex-related shame, and sexual education. Regression models were then used to identify the most significant variables for each domain, resulting in sexual desire being inhibited by the presence of depression; excitation levels being impaired by low education levels and the increase of age; ability to achieve orgasm being hindered by low education levels, anxiety, and sex-related fears; and pain during intercourse and overall FSD increasing with lower education levels and depression. In conclusion, numerous variables influence female sexual response, depression and anxiety being especially detrimental to sexual functioning. What is more, while depression is more harmful in the early stages of sexual response (desire and arousal), anxiety is the main influence on the orgasm phase

Os objetivos do presente estudo foram: (1) avaliar a função sexual feminina e a presença de depressão e ansiedade; (2) verificar a associação entre disfunção sexual feminina (DSF), depressão e ansiedade e (3) identificar as variáveis relacionadas com os domínios: desejo, excitação, orgasmo e dor durante a relação sexual Participaram do estudo 110 pacientes saudáveis (idade: 18-61, média:38,5 anos) que aguardavam consulta ambulatorial de prevenção ginecológica no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). A avaliação foi realizada com questionários específicos desenvolvidos para a pesquisa, juntamente com o Quociente Sexual Feminino (QS-F), Inventário Beck de Depressão (BDI-II) e Inventário Beck de Ansiedade (BAI). A análise das respostas mostrou que do total da amostra, 36 (32,7%) mulheres apresentavam inibição de desejo; 16 (14,5%), problemas de excitação; 35 (31,8%), dificuldades de orgasmo; 31 (28,2%) queixavam-se de dor durante a relação; e 39 (35,5%) atingiram pontuação inferior a 60 no QS-F, indicando DSF em geral. Depressão e ansiedade acometeram 26 (23,6%) e 37 (33,6%) pacientes, respectivamente. Os dados também revelaram uma relação significante entre DSF, depressão e ansiedade, além de identificar fatores de risco para os domínios sexuais. Diminuição do desejo sexual foi associada à depressão, ansiedade, escolaridade, incômodo com próprio o corpo, masturbação e educação sexual; problemas de excitação foram ligados à depressão, ansiedade, idade, escolaridade, incômodo com o próprio corpo, medo relacionado a sexo e educação sexual; orgasmo foi impactado por depressão, ansiedade, escolaridade, incômodo com o próprio corpo, medo relacionado a sexo, vergonha durante o ato sexual, masturbação e educação sexual; queixas de dor durante a relação sexual foram associadas à depressão, renda, escolaridade e educação sexual; por fim, fatores relevantes para a presença de DSF em geral foram depressão, ansiedade, escolaridade, incômodo com o próprio corpo, medo relacionado ao sexo, vergonha durante o ato sexual e educação sexual. Modelos de regressão foram utilizados para identificar as variáveis mais significantes para cada domínio da atividade sexaul. Com efeito, desejo sexual é inibido pela presença de depressão; o nível de excitação é negativamente impactado por depressão e pelo aumento da idade; a capacidade de atingir o orgasmo é reduzida pela baixa escolaridade, pela ansiedade e por medos relacionados ao sexo; e tanto dor durante o intercurso quanto DSF em geral estão diretamente ligadas à baixa escolaridade e à depressão. Conclui-se que inúmeras variáveis interferem na resposta sexual feminina, sendo depressão e ansiedade especialmente nocivas à função sexual. Ademais, enquanto depressão é mais prejudicial nas primeiras fases da resposta sexual (desejo e excitação), ansiedade influencia principalmente a fase de orgasmo. / The present work proposes to (1) assess female sexual functioning, depression, and anxiety; (2) verify the association between female sexual dysfunction (FSD), depression, and anxiety; and (3) identify the variables associated with the sexual domains: desire, arousal, orgasm, and pain during intercourse. A group of 110 healthy women (age: 18-61, mean: 38.5 years) among those waiting for gynecological routine consultations at the Clinics Hospital of the Faculty of Medicine of the University of São Paulo (HCFMUSP) was randomly selected for this research. The patients were asked to fill questionnaires specifically developed for this work and validated instruments, such as the Female Sexual Quotient (FSQ), the Beck Depression Inventory (BDI-II), and the Beck Anxiety Inventory (BAI). The analysis of the responses show that 36 (32.7%) women present sexual desire inhibitions; 16 (14.5%) have arousal problems; 35 (31.8%) have orgasm difficulties; 31 (28.2%) report pain during intercourse; and 39 (35.5%) exhibit overall FSD. Depression and anxiety are present in 26 (23.6%) and 37 (33.6%) patients respectively. The data also reveal a significant relation between FSD, depression, and anxiety, in addition to identifying risk factors for the sexual domains. More specifically, sexual desire inhibition is associated to depression, anxiety, education level, body issues, masturbation, and sexual education; arousal is connected to depression, anxiety, age, education level, body issues, sex-related fears, and sexual education; orgasm difficulties is related to depression, anxiety, education level, body issues, sex-related fears, sex-related shame, masturbation, and sexual education; pain during intercourse is associated with depression, monetary income, education level, and sex education; and finally, the factors relevant to overall FSD are depression, anxiety, education level, body issues, sex-related fears, sex-related shame, and sexual education. Regression models were then used to identify the most significant variables for each domain, resulting in sexual desire being inhibited by the presence of depression; excitation levels being impaired by low education levels and the increase of age; ability to achieve orgasm being hindered by low education levels, anxiety, and sex-related fears; and pain during intercourse and overall FSD increasing with lower education levels and depression. In conclusion, numerous variables influence female sexual response, depression and anxiety being especially detrimental to sexual functioning. What is more, while depression is more harmful in the early stages of sexual response (desire and arousal), anxiety is the main influence on the orgasm phase

INTRODUÇÃO: Estudos realizados com mulheres apontam para a importância de se fazer uma avaliação de ocorrência de abuso sexual infantil em pacientes com disfunções sexuais e dor pélvica crônica, pois o histórico de abuso aumenta o risco de apresentarem problemas sexuais na vida adulta. O Abuso sexual infantil é um fenômeno universal que atinge todas as idades, classes sociais e culturas. No Brasil é a segundo maior tipo de violência entre crianças de 0 a 9 anos. Diferentemente de mulheres, há poucos estudos relacionam a experiência de abuso sexual infantil e o desenvolvimento de queixas urológicas que afetem a função sexual masculina. OBJETIVO: Avaliar a relação entre a experiência de abuso sexual na infância e as queixas de dor pélvica crônica (DPC), disfunção erétil (DE) e/ou ejaculação precoce (EP). MÉTODO: Trata-se de um estudo cross-section. A amostra foi composta por oitenta homens, entre 30 e 59 anos, pacientes da Divisão de Clínica Urológica do Hospital das Clínicas, que apresentavam EP, DE e/ou DPC. Os dados foram coletados por um ano. O antecedente de abuso sexual na infância foi avaliado por meio do questionário de Childhood Sexual Experiences Questionnai, traduzido e testado para uso na pesquisa. Também foi avaliado o tipo de abuso, pessoas envolvidas, idade de inicio e tempo de duração do abuso, opção sexual, estado civil e fatores de risco (cardiopatia, hipertensão, diabetes e doenças psiquiáticas) para EP, DE e DPC. Na análise estatística o teste de Qui Quadrado foi utilizado para avaliar as variáveis categóricas e o GLM univariado para avaliar as variáveis contínuas, representadas por média ± desvio padrão. Os dados contínuos foram representados em frequência absoluta e percentual (%). RESULTADOS: A amostra se caracterizou por homens predominantemente heterossexuais e em união estável. A média de idade foi de 50,2 anos. O grupo com DE apresentou maior índice de diabetes comparado com os demais. Não houve diferença significativa entre os grupos em relação à hipertensão, cardiopatia e transtornos psiquiátricos. Não houve diferença entre os grupos quanta a prevalência de abuso. 10% do total da amostra relatam ter sofrido abuso com ou tentativa de penetração A média de idade do inicio do abuso foi de 9,6 anos. A maioria dos abusos durou mais de um ano sendo que em todos os episódios a pessoa envolvida era conhecida da criança. CONCLUSÃO: A alta prevalência de abuso sexual infantil na amostra revela um problema na notificação dos casos ocorridos com o gênero masculino, pelo estigma do abuso com meninos, conceito restrito de abuso (focados em casos graves), despreparo dos profissionais de saúde e educação em identificar os casos. A literatura indica maiores taxas de abuso com a população feminina, mesmo comparado com estes dados a prevalência de violência sexual infantil é maior nesta pesquisa, reforçando a hipótese de que o antecedente de violência sexual é um fator de risco para o desenvolvimento de problemas de saúde que afetam a sexualidade masculina / INTRODUCTION: Child sexual abuse is a universal phenomenon that affects all ages, social classes and cultures. In Brazil it is the second largest type of violence among children from 0 to 9 years old. Many studies point to the importance of evaluating the ocurrence of child sexual abuse in patients with sexual disfunctions and chronic pelvic pain, since the history of abuse increases the risc of presenting sexual problems in the adult life. Unlinke women, there are few studies that relate the experience of child sexual abuse and the development of utological complaints the affect male sexual function. OBJECTIVE: To evaluate the relationship of sexual abuse experience in childhood and chronic pelvic pain (CPP), erectile dysfunction (ED) and premature ejaculation (PE). METHOD: This is a cross sectional study. The sample consisted of eighty men, between 30 and 59 years old, patients of the Urological Clinic Dividion of the Hospital das Clínicas in São Paulo, Brazil. The patients presented chronic pelvic pain, erectile dysfunction and or premature ejaculation. Data were collected during one year. The history of childhood sexual abuse was assessed using the Childhood Sexual Experience Questionnaire, translated and tested for use in research. The type of abuse, people involved, age of onset and duration of abuse, sexual choice, marital status and risk factors (heart disease, hypertension, diabetes and psychiatric diseases) were also evaluated. Chi Square test was used to evaluate the categorical variables and univariate GLM to evaluate the continuous variables, represented by mean ± standard deviation. The continuous data were represented in absolute frequency and percentage (%). RESULTS: The sample was characterized by predominantly married and heterossexual men wich mean age of 50.2 years. The ED group presented a higher diabetes index compared to the CPP and PE groups. There were no statistical difference between groups in prevalence of abuse. The mean age at onset of abuse was 9.6 years. Most of the abuses lasted more than a year and in all episodes the person involved was known to the child. COCLUSION: The high prevalence of child sexual abuse in the sample reveals a problem in the notification of cases with the male gender. The stigma of child abuse, restricted concept of abuse (focused on serious cases), unprepared health professional in identify the cases. The literature indicates higher rates of abuse with the famale population. Even compared to these data, the prevalence of child sexual violence is higher in this research, reinforcing the hypothesis that the antecedente of sexual violence is a risk fator for the development of health problems which affect male sexuality

Introdução: No Brasil, como em outros países, obesidade e disfunção sexual são consideradas problemas de saúde pública pela alta prevalência e por estarem relacionadas com hipertensão arterial, diabetes, doenças cardiovasculares, transtornos depressivos, outras morbidades e prejuízos na qualidade de vida dos indivíduos. Em geral, há poucos estudos sobre resposta sexual, obesidade e qualidade de vida em mulheres, e, na maioria deles, as pesquisas são realizadas com pacientes portadoras de doenças crônicas. Objetivos: Avaliar a resposta sexual, as disfunções sexuais e a qualidade de vida de mulheres obesas sem outras morbidades associadas e com parceiros não portadores de disfunção sexual. Métodos: Foram selecionadas 37 mulheres obesas (IMC = 30-39,9 Kg/m2) sem outras morbidades, com idade acima de 18 anos, não menopausadas, com parceiro funcional e relacionamento estável. Os parceiros foram avaliados pelo questionário QS-M. Considerando critérios para exclusão de doenças, as pacientes foram submetidas aos seguintes exames laboratoriais: glicose, colesterol e frações, triglicérides, TSH, prolactina, testosterona total, SHBG e testosterona livre. Também foram avaliadas por entrevista clínica e, posteriormente, pelos questionários QS-F, IWQOL-Lite, BDI e HAM-A. Resultados: Das 37 pacientes, 4 (10,8%) foram consideradas disfuncionais (QSF 60) e 33 (89,2%) apresentaram desempenho sexual satisfatório (QS-F 60). Dentre as disfunções sexuais, a diminuição do desejo sexual e a disfunção do orgasmo comprometeram 100% das pacientes; a disfunção de excitação 75%, o vaginismo 50% e a dispareunia 25%. Não houve correlação estatisticamente significativa entre o IMC e o QS-F (r=-0,12; p=0,470). O IWQOL-Lite total, com escore máximo de 155 pontos, variou de 31 a 116 pontos, com mediana de 60,0 pontos. Houve correlação estatisticamente significativa entre o QS-F e os domínios do IWQOL-Lite vida sexual, trabalho e o total. Verificou-se correlação estatisticamente significativa entre o IMC e a QV (r=-0,41; p=0,012). Ocorreu correlação negativa e estatisticamente significativa entre o QSF e o BDI (r= -0,37; p= 0,025), e o HAM-A (r=-0,39; p=0,016). Conclusões: Mulheres obesas sem outras morbidades mostraram um desempenho sexual satisfatório, e não houve correlação entre a obesidade e a presença de disfunção sexual. O melhor desempenho sexual foi associado com a melhor qualidade de vida. Quanto mais obesas, pior a qualidade de vida das pacientes. Quanto melhor o desempenho sexual, menor a possibilidade de depressão e ansiedade / Introduction: In Brazil, as in other countries, obesity and sexual dysfunction are considered public health problems because of their high prevalence and association with high blood pressure, diabetes, cardiovascular disease, depressive disorders, other morbidities, and impaired patient quality of life (QoL). In general, there are few studies on sexual response, obesity, and QoL in women, and in most of these studies, assessments are conducted with patients with chronic diseases. Aims: To assess sexual response, sexual dysfunction, and QoL of obese women without other associated morbidities and partners without sexual dysfunction. Methods: We selected 37 non-menopausal, obese women (body mass index [BMI] = 30-39.9 Kg/m2) without comorbidities, aged > 18 years, with functional partners and stable relationship. The partners were assessed by the SQ-M. Considering the disease exclusion criteria, the patients underwent the following laboratory tests: glucose, cholesterol, high-density lipoprotein, triglycerides, thyroid-stimulating hormone, prolactin, total testosterone, sex hormone-binding globulin, and free testosterone. They were also assessed in a clinical interview and subsequently, by the Sexual Quotient-Female Version (SQ-F), Impact of Weight on the Quality of Life (IWQOL)-Lite, Beck Depression Inventory (BDI), and Hamilton Anxiety Rating Scale (HAM-A) questionnaires. Results: Of the 37 patients, 4 (10.8%) were considered to have sexual dysfunction (SQ-F60), and 33 (89.2%) had satisfactory sexual performance (SQ-F60). Among those with sexual dysfunction, all patients experienced decreased sexual desire and orgasm dysfunction, 75% experienced arousal dysfunction, 50 % experienced vaginismus, and 25 % experienced dyspareunia. No statistically significant correlation was noted between BMI and SQF (r= -0.12; p = 0.470). The total IWQOL-Lite, with a maximum score of 155 points, ranged from 31 to 116 points, with a median of 60.0 points. A statistically significant correlation was observed between the sex life, work, and total domains of the SQ-F and IWQOL-Lite questionnaires, and between BMI and QoL (r = -0.41; p = 0.012). A statistically significant negative correlation was noted between the SQ-F and BDI (r = -0.37, p = 0.025) and HAM-A (r = -0.39, p = 0.016) results. Conclusions: Obese women without comorbidities showed satisfactory sexual performance; no correlation was found between obesity and sexual dysfunction. The best sexual performance was associated with a better QoL. Increase in obesity was associated with a deteriorated QoL of patients. Superior sexual performance was found to be associated with a low possibility of depression and anxiety