title: Sexual function among overweight and obese women with urinary incontinence in a randomized controlled trial of an intensive behavioral weight loss intervention.
abstract: OBJECTIVE
  We examined sexual function in overweight and obese women with urinary incontinence, and evaluated the effects of an intensive behavioral weight reduction intervention on sexual function in this population.
  
  
  METHODS
  A total of 338 overweight and obese women reporting 10 or more incontinence episodes weekly were randomized to an intensive behavioral change (226) or structured education program (112) for 6 months. Sexual function was assessed using self-administered questionnaires. Multivariate regression was used to examine factors associated with baseline and 6-month change in sexual function as well as intervention effects.
  
  
  RESULTS
  Two-thirds of participants (233) were sexually active at baseline but more than half (188) reported low desire and a quarter (91) were sexually dissatisfied. More than half of sexually active participants (123) reported problems with arousal, lubrication, orgasm or incontinence during sex. Compared to controls women in the intervention group demonstrated a borderline increase in frequency of sexual activity at 6 months (OR 1.34, 95% CI 0.99-1.81, p = 0.06) but no differences in satisfaction (OR 1.28, 95% CI 0.83-1.99, p = 0.26), desire (OR 1.12, 95% CI 0.79-1.61, p = 0.52) or problems (beta +/- SE 0.03 +/- 0.07, p = 0.68 for intervention effects on problems score). Neither clinical incontinence severity nor body mass index was independently associated with baseline or 6-month change in function (p >0.10 for all).
  
  
  CONCLUSIONS
  Sexual dysfunction is common in overweight and obese women with incontinence but the severity of this dysfunction may not be directly related to the severity of incontinence or obesity. An intensive 6-month behavioral weight reduction intervention did not significantly improve sexual function in this population relative to controls.
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, California, USA. ahuang@ucsfmed.org
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Huang
authors.forename: Anita L
authors.initials: AL
authors.lastname: Stewart
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Hernandez
authors.forename: Hui
authors.initials: H
authors.lastname: Shen
authors.forename: Leslee L
authors.initials: LL
authors.lastname: Subak
mesh_terms: D000328:Adult; D000367:Age Factors; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D016001:Confidence Intervals; D018752:Diet, Fat-Restricted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D016017:Odds Ratio; D050177:Overweight / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D010353:Patient Education as Topic / Q000379:methods; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000502:physiology; D020018:Sexual Dysfunctions, Psychological / Q000150:complications / Q000175:diagnosis*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000150:complications / Q000175:diagnosis*; D015431:Weight Loss