Background and Aim:

Chronic pelvic floor pain syndrome (CPPS) is the most common urological condition in men under 50, but men's lived experiences with CPPS are under-researched. This study explores how men with CPPS perceive their sexual and general health, and which healthcare and environmental factors support coping and recovery.

Method:

Sixteen men (age 30 to 57) with current or previous CPPS participated in semi-structured interviews. The interviews were analyzed thematically.

Results:

Four main themes were generated: (1) Dealing with a diffuse diagnosis, (2) Sex life that has taken a turn for the worse, (3) Things men prefer not to talk about, and (4) Favorable factors for recovery. Most reported dissatisfaction with care, lack of effective treatments, and poor mental health including suicidal thoughts, which were rarely discussed with healthcare providers. Sexual problems were common. Helpful interventions included physiotherapy, PDE-5 inhibitors, and support from a partner.

Conclusion and Implications:

Knowledge about CPPS remains limited. Shame and fear can hinder open dialogue. Increased awareness and a holistic approach in healthcare are needed, especially regarding sexual and mental health.

Research shows that young adults with intellectual disabilities struggle to understand the social codes embedded in sexual situations. This may lead to an incomprehension of sexual consent, or when consenting to sex may lead to abuse. This qualitative study aimed to gain an in-depth understanding of sexual experiences and perceptions about sexual consent among Swedish young adults with intellectual disabilities. The data comprise 22 semi-structured interviews with young adults aged 18-35 with intellectual disabilities, thematically analyzed using sexual script theory as a theoretical framework. Four themes emerged from the analysis: Setting the sexual scene, Sexual self-awareness, Sexual communication and the necessity of clarification and Striving for a balance. The results show that the participants had a variety of sexual experiences and challenges associated with sexual consent, but also an agency that favors sexual situations. Further research is necessary to understand the complexities of sexual consent in this population.

Background Pandemics are linked with declining birth rates, but little is known about how the COVID-19 pandemic has influenced childbearing decisions. We aimed to investigate the associations between the COVID-19 pandemic and reproductive decisions, specifically to identify potential changes in the frequency of deliveries and induced abortions in Sk & aring;ne, Sweden.Methods Using the Sk & aring;ne Healthcare Register, we identified women aged 15-45 years who had at least one pregnancy-related care visit registered between 1 January 2013 and 11 November 11 2021. Deliveries and induced abortions were identified, and changes in weekly delivery and abortion counts were assessed using an interrupted time series design. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated from a Poisson regression model.Results During the study period we identified 129 131 deliveries and 38 591 abortions. Compared with the counterfactual (exposed interval assuming COVID-19 had not occurred), pandemic exposure was associated with fewer deliveries (RR 0.93; 95% CI 0.89 to 0.98). For abortions, pandemic exposure appeared to be associated with fewer abortions (RR 0.95; 95% CI 0.90 to 1.00); however, age-related differences were found. Among women aged 25 years and over, pandemic exposure was more strongly associated with fewer abortions. Contrastingly, among women aged under 25 years, abortions appeared to increase.Conclusions The COVID-19 pandemic seemed to have contributed to a decline in births in Southern Sweden. During the same period, abortions declined in women in the older age range, but contrastingly increased among younger women.

PURPOSE: This study explores women's experiences of a novel prehabilitation intervention, integrating early vaginal dilator therapy before and during pelvic radiotherapy.

METHODS: This qualitative study included sixteen women scheduled for pelvic radiotherapy. All participants received a pre-treatment intervention with individualized information and support to start vaginal dilator therapy prior to radiotherapy. Semi-structured interviews were conducted with all sixteen women before or during treatment. Of these, ten also participated in follow-up interviews after radiotherapy. Data were analyzed using reflexive thematic analysis.

RESULTS: Four themes were constructed reflecting women's experiences of the new prehabilitation intervention: (1) Regaining control while facing the unknown, (2) Navigating identity, (3) Conceptualizing vaginal and sexual health, and (4) Building trust. Women found that vaginal dilator therapy during prehabilitation enabled a sense of control and readiness for upcoming sexual and vaginal health concerns. The early support was perceived as timely, acceptable, and empowering, regardless of women's initial motivation to engage. None of the women preferred to only receive the information after treatment, reflecting the value of proactive care.

CONCLUSION: Integrating vaginal dilator therapy into prehabilitation may enhance preparedness, promote self-care, and reduce distress during pelvic radiotherapy. Further research is needed to confirm benefits and tailor support to individual needs.

Sexual health concerns, experiences of violence, and risk-taking behaviors significantly impact various aspects of life, leading to adverse health outcomes. Unfortunately, few patients disclose these problems to healthcare providers (HCPs) due to shame and fear. While HCPs recognize the importance of addressing sexual and reproductive health related issues, time constraints, lack of knowledge, and fear of embarrassing patients often hinder thorough investigation. SEXIT (SEXual health Identification Tool) was developed to facilitate and initiate conversations about sexual health, experiences of violence, and risk-taking behaviors between youths aged 13–24 and HCPs. However, no comparable methods exist for adults. This study aimed to explore which questions professionals believe HCPs should ask adult patients. Using a Delphi methodology, 19 academic and/or clinical experts participated in two online questionnaire rounds and a web meeting. The panel identified 25 highly relevant questions covering diverse areas (e.g., sexual and gender identity, sexual satisfaction, experiences of violence, and substance use). These questions may empower adult patients to disclose sexual health concerns, enabling HCPs to comprehensively address these issues during medical history assessments. The identified questions have been incorporated into the development of the SEXIT Adult questionnaire.

Objectives: Few patients voluntarily disclose problems with sexual health, experiences of violence, and risk-taking behaviors to their health care providers. Despite health care providers being aware of the importance of these topics, few regularly address these areas in outpatient settings. This is often due to a lack of knowledge about sexual health among providers and a fear of embarrassing patients by asking questions that might be perceived as private or intrusive.To address these challenges, the SEXual health Identification Tool (SEXIT) was developed. Initially designed to identify sexual ill health, experiences of violence, and risk-taking behaviors among youth through a structured questionnaire and follow-up conversation, SEXIT has proven effective in these demographics. However, there is an absence of comparable methods tailored for adult populations.

Methods: This study aimed to identify the specific questions that health care providers should ask concerning sexual health, experiences of violence, and risk-taking behaviors in adult outpatient settings. Utilizing a modified Delphi methodology, a panel of 19 experts from clinical and academic fields was recruited.

Results: In the end, 25 questions were identified as highly relevant. These questions cover topics including sexual and gender identity, sexual satisfaction, experiences of violence, and substance use.The findings from this study provide a deeper understanding of the pertinent questions that should be integrated into medical history taking to address sexual health, experiences of violence, and risk-taking behaviors. By incorporating these questions, health care providers can bridge the knowledge gaps commonly experienced in the Sexual and Reproductive Health and Rights (SRHR) field. Moreover, this approach can remove the barriers that patients face when attempting to discuss these sensitive issues.

Conclusions: The questions identified have been included in the development of the first version of the SEXIT Adult questionnaire. This tool, along with the accompanying guidance for health care providers, is currently undergoing clinical evaluation. The implementation of SEXIT Adult holds promise for enhancing the identification and management of sexual health issues, experiences of violence, and risk-taking behaviors in adult outpatient settings, ultimately contributing to improved patient well-being.

Conflicts of Interest: There are no potential conflicts of interests.

Summary: Research shows that young adults with intellectual disabilities are eager to engage in conversations about sexuality and intimacy, but the nuances of these discussions from their own perspective remain unexplored. This study aims to understand the challenges, facilitators, and dynamics that influence these young adults' engagement in conversations about sexuality and intimacy with family, friends, and support networks. The data comprise 22 qualitative interviews with Swedish young adults aged 18-35 with intellectual disabilities.

Findings: Thematic analysis revealed four themes: (1) Sharing is caring-motivating and initiating conversations about sexuality and intimacy; (2) Safe spaces-facilitators of sexual and intimate communication; (3) Being overlooked and feeling unheard; and (4) Overprotection and self-blame. The findings show that young adults with intellectual disabilities encounter additional challenges when engaging in conversations about sexual or intimate matters with their broader support networks. Trust plays a pivotal role in determining with whom they choose to have conversations about these topics, and societal norms can impede the occurrence of crucial conversations. In the discussion, the findings are explored further guided by Ken Plummer's theoretical framework, which outlines four levels in the process of producing and consuming socially constructed sexual narratives.

Applications: These insights are vital for enhancing social work practices, informing policy development, and guiding the creation of supportive interventions that foster inclusive environments. By recognizing and addressing these barriers, professionals can better support the sexual health and well-being of young adults with intellectual disabilities, promoting their agency and self-determination in intimate matters.