Pub Date : 2026-01-01DOI: 10.1016/j.jmig.2025.08.002
Helen Y. Zhang MD , Alexis A. Dieter MD
{"title":"Vulvar Health, Disease, and Sexual Function: A Comprehensive Review for the Minimally Invasive Gynecologist","authors":"Helen Y. Zhang MD , Alexis A. Dieter MD","doi":"10.1016/j.jmig.2025.08.002","DOIUrl":"10.1016/j.jmig.2025.08.002","url":null,"abstract":"","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 1","pages":"Pages 110-116"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jmig.2025.12.035
Renan Orellana-Walden, Lisbell Estrada Apablaza, Manuel E Cortes
Surgery is chosen over pharmacological treatment, probably due to the limitations of medical therapy, pregnancy, the preferences of patients and physicians, and the psychological perception of a more definitive symptom relief. Novel advances in endometriosis-designed drugs might balance risks, benefits, and patient goals, leading to safer treatment.
{"title":"Regarding \"Trends in endometriosis Management: a 10 year US Claims Analysis\".","authors":"Renan Orellana-Walden, Lisbell Estrada Apablaza, Manuel E Cortes","doi":"10.1016/j.jmig.2025.12.035","DOIUrl":"https://doi.org/10.1016/j.jmig.2025.12.035","url":null,"abstract":"<p><p>Surgery is chosen over pharmacological treatment, probably due to the limitations of medical therapy, pregnancy, the preferences of patients and physicians, and the psychological perception of a more definitive symptom relief. Novel advances in endometriosis-designed drugs might balance risks, benefits, and patient goals, leading to safer treatment.</p>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jmig.2025.10.007
Gaelle Massoud MD, Sadie Wenger BS, Sarah T. Cigna MD, MS
Sexual health is a fundamental component of a person’s overall well-being, and sexual dysfunction can often be a symptom of an underlying medical condition. These factors can be critical for optimizing pre-, peri-, and postoperative care in a gynecologic surgery practice. Sexual function remains underemphasized in both medical education and clinical practice, particularly for women and people assigned female at birth. As a result, only a small proportion of providers feel equipped to routinely address sexual problems with their patients, despite the vast majority recognizing sexual health as essential to patient care. A careful review of articles addressing sexual health history taking was performed in PubMed. Two evidence-based, inclusive approaches are described by the Centers for Disease Control and Prevention and the International Society for the Study of Women’s Sexual Health. Because sexual health is often overlooked and undervalued, particularly for women and people assigned female at birth, it is imperative that gynecologic surgeons are on the forefront of identifying sexual dysfunction and also prioritizing sexual function in planning for surgery.
{"title":"Sexual Health History: Addressing a Commonly Neglected Health Indicator in Gynecologic Surgery","authors":"Gaelle Massoud MD, Sadie Wenger BS, Sarah T. Cigna MD, MS","doi":"10.1016/j.jmig.2025.10.007","DOIUrl":"10.1016/j.jmig.2025.10.007","url":null,"abstract":"<div><div>Sexual health is a fundamental component of a person’s overall well-being, and sexual dysfunction can often be a symptom of an underlying medical condition. These factors can be critical for optimizing pre-, peri-, and postoperative care in a gynecologic surgery practice. Sexual function remains underemphasized in both medical education and clinical practice, particularly for women and people assigned female at birth. As a result, only a small proportion of providers feel equipped to routinely address sexual problems with their patients, despite the vast majority recognizing sexual health as essential to patient care. A careful review of articles addressing sexual health history taking was performed in PubMed. Two evidence-based, inclusive approaches are described by the Centers for Disease Control and Prevention and the International Society for the Study of Women’s Sexual Health. Because sexual health is often overlooked and undervalued, particularly for women and people assigned female at birth, it is imperative that gynecologic surgeons are on the forefront of identifying sexual dysfunction and also prioritizing sexual function in planning for surgery.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 1","pages":"Pages 117-125"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jmig.2025.08.001
Danielle D. Antosh MD , Hunter McSpedden MD
Study Objective
Pelvic organ prolapse (POP) can negatively affect body image and sexual function in women. The objective of this review is to describe changes to sexual function, dyspareunia, and other sexual function domains after POP surgery.
Design
This narrative review will describe prior systematic review results on this topic with a search through January 2025 on how POP surgery affects other domains of sexual function, such as sexual desire, arousal, satisfaction, lubrication, and orgasm.
Results
Both the systematic review and more recent trials show an improvement or similar scores in overall sexual function after POP surgery. These improvements in sexual function persisted when measured 5 years postoperatively. A total of 50% to 74% of women have resolution of dyspareunia after surgery, and de novo dyspareunia ranges from 0% to 9% with the exception of posterior repairs. De novo dyspareunia after posterior repair is approximately 14%, based on limited data. Sexual desire, arousal, and satisfaction usually improve after POP surgery, whereas the effect on orgasm and lubrication is limited or conflicting.
Conclusion
Sexual function either improves or remains unchanged after surgical repairs for prolapse. Dyspareunia rates decrease after all types of POP surgery, whereas the risk of de novo dyspareunia remains low. Domains of sexual desire, arousal, and satisfaction also tend to improve after prolapse repair.
{"title":"Sexual Function Following Surgical Approaches for Pelvic Organ Prolapse","authors":"Danielle D. Antosh MD , Hunter McSpedden MD","doi":"10.1016/j.jmig.2025.08.001","DOIUrl":"10.1016/j.jmig.2025.08.001","url":null,"abstract":"<div><h3>Study Objective</h3><div>Pelvic organ prolapse (POP) can negatively affect body image and sexual function in women. The objective of this review is to describe changes to sexual function, dyspareunia, and other sexual function domains after POP surgery.</div></div><div><h3>Design</h3><div>This narrative review will describe prior systematic review results on this topic with a search through January 2025 on how POP surgery affects other domains of sexual function, such as sexual desire, arousal, satisfaction, lubrication, and orgasm.</div></div><div><h3>Results</h3><div>Both the systematic review and more recent trials show an improvement or similar scores in overall sexual function after POP surgery. These improvements in sexual function persisted when measured 5 years postoperatively. A total of 50% to 74% of women have resolution of dyspareunia after surgery, and de novo dyspareunia ranges from 0% to 9% with the exception of posterior repairs. De novo dyspareunia after posterior repair is approximately 14%, based on limited data. Sexual desire, arousal, and satisfaction usually improve after POP surgery, whereas the effect on orgasm and lubrication is limited or conflicting.</div></div><div><h3>Conclusion</h3><div>Sexual function either improves or remains unchanged after surgical repairs for prolapse. Dyspareunia rates decrease after all types of POP surgery, whereas the risk of de novo dyspareunia remains low. Domains of sexual desire, arousal, and satisfaction also tend to improve after prolapse repair.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 1","pages":"Pages 74-80"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jmig.2025.08.022
Erryn E. Tappy MD, MPH , Marlene M. Corton MD, MSCS
Background
Numerous anatomic structures are thought to contribute to female sexual arousal and orgasm. Among these, the clitoris is perhaps the most widely emphasized, followed by other critical structures within the vulva and vagina.
Findings
Details of gross anatomy, histology, and the neurovascular supply of vulvar structures, including the mons pubis, labia majora, labia minora, vaginal vestibule, clitoris, and vestibular bulbs, as well as the vagina, are reviewed.
Conclusions
Structures of the vulva and vagina each have unique properties that contribute to sexual arousal, pleasure, and orgasm. Knowledge of female sexual anatomy empowers female health providers to educate patients about sexual health and treat conditions of sexual dysfunction.
{"title":"Anatomy of Sex: A Review of Critical Structures Within the Vulva and Vagina","authors":"Erryn E. Tappy MD, MPH , Marlene M. Corton MD, MSCS","doi":"10.1016/j.jmig.2025.08.022","DOIUrl":"10.1016/j.jmig.2025.08.022","url":null,"abstract":"<div><h3>Background</h3><div>Numerous anatomic structures are thought to contribute to female sexual arousal and orgasm. Among these, the clitoris is perhaps the most widely emphasized, followed by other critical structures within the vulva and vagina.</div></div><div><h3>Findings</h3><div>Details of gross anatomy, histology, and the neurovascular supply of vulvar structures, including the mons pubis, labia majora, labia minora, vaginal vestibule, clitoris, and vestibular bulbs, as well as the vagina, are reviewed.</div></div><div><h3>Conclusions</h3><div>Structures of the vulva and vagina each have unique properties that contribute to sexual arousal, pleasure, and orgasm. Knowledge of female sexual anatomy empowers female health providers to educate patients about sexual health and treat conditions of sexual dysfunction.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 1","pages":"Pages 3-9"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jmig.2025.05.010
Chensi Ouyang MD , Alexander Wang MD , Morgan Briggs MD , Grace Maszy BS , Hannah Lewis DO , Isabel Green MD, MEHP , Meryl Alappattu DPT, PhD , Georgine Lamvu MD, MPH
Objective
One primary concern among patients undergoing minimally invasive hysterectomy (MIH) is postsurgical sexual function. Conflicting evidence exists due to variability in the sexual function measures, the menopause status of patients, and the inclusion of data from laparotomies. The purpose of this systematic review and meta-analysis was to evaluate the effects of MIH on sexual function in premenopausal women while accounting for these confounders.
Data Sources
Data search was conducted in PubMed, Google Scholar, Cochrane Central Register of Controlled Trials, Scopus, Science Direct, ProQuest, and EBSCO from inception to December 31, 2024.
Methods
The initial search yielded 1124 papers, and 8 studies met eligibility criteria. Eligibility criteria included reporting on sexual function using the Female Sexual Function Index (FSFI), MIH for benign and nonurogynecological conditions, and a study population of premenopausal women. MIH routes included laparoscopic and vaginal surgeries. The primary outcome of interest was a change in the total FSFI score and domains pre- and postsurgery.
Tabulation, Integration, and Results
Meta-analysis was performed for each outcome using Cochrane Review Manager 5. Mean differences and 95% confidence intervals (CI) were calculated using pre- and postsurgery FSFI scores. The mean difference between pre- and posthysterectomy FSFI scores showed a small statistically significant improvement in sexual function after surgery: −1.54 (CI −2.83, −0.25). There were small statistically significant improvements in sexual function in the domains of desire (−0.75, CI −1.34, −0.17), arousal (−0.85, CI −1.46, −0.25), orgasm (−0.46, CI −0.81, −0.12), and satisfaction (−0.69, CI −1.20, −0.18). There were no statistically significant changes in the domains of lubrication and pain. The level of evidence is low, with moderate heterogeneity and risk of bias.
Conclusion
After hysterectomy with ovarian preservation, premenopausal women report small, yet statistically significant, improvement in overall sexual function, which is not likely clinically significant.
{"title":"Changes in Sexual Function After Minimally Invasive Hysterectomy in Reproductive-Aged Women: A Systematic Review and Meta-Analysis","authors":"Chensi Ouyang MD , Alexander Wang MD , Morgan Briggs MD , Grace Maszy BS , Hannah Lewis DO , Isabel Green MD, MEHP , Meryl Alappattu DPT, PhD , Georgine Lamvu MD, MPH","doi":"10.1016/j.jmig.2025.05.010","DOIUrl":"10.1016/j.jmig.2025.05.010","url":null,"abstract":"<div><h3>Objective</h3><div>One primary concern among patients undergoing minimally invasive hysterectomy (MIH) is postsurgical sexual function. Conflicting evidence exists due to variability in the sexual function measures, the menopause status of patients, and the inclusion of data from laparotomies. The purpose of this systematic review and meta-analysis was to evaluate the effects of MIH on sexual function in premenopausal women while accounting for these confounders.</div></div><div><h3>Data Sources</h3><div>Data search was conducted in PubMed, Google Scholar, Cochrane Central Register of Controlled Trials, Scopus, Science Direct, ProQuest, and EBSCO from inception to December 31, 2024.</div></div><div><h3>Methods</h3><div>The initial search yielded 1124 papers, and 8 studies met eligibility criteria. Eligibility criteria included reporting on sexual function using the Female Sexual Function Index (FSFI), MIH for benign and nonurogynecological conditions, and a study population of premenopausal women. MIH routes included laparoscopic and vaginal surgeries. The primary outcome of interest was a change in the total FSFI score and domains pre- and postsurgery.</div></div><div><h3>Tabulation, Integration, and Results</h3><div>Meta-analysis was performed for each outcome using Cochrane Review Manager 5. Mean differences and 95% confidence intervals (CI) were calculated using pre- and postsurgery FSFI scores. The mean difference between pre- and posthysterectomy FSFI scores showed a small statistically significant improvement in sexual function after surgery: −1.54 (CI −2.83, −0.25). There were small statistically significant improvements in sexual function in the domains of desire (−0.75, CI −1.34, −0.17), arousal (−0.85, CI −1.46, −0.25), orgasm (−0.46, CI −0.81, −0.12), and satisfaction (−0.69, CI −1.20, −0.18). There were no statistically significant changes in the domains of lubrication and pain. The level of evidence is low, with moderate heterogeneity and risk of bias.</div></div><div><h3>Conclusion</h3><div>After hysterectomy with ovarian preservation, premenopausal women report small, yet statistically significant, improvement in overall sexual function, which is not likely clinically significant.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 1","pages":"Pages 65-73"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jmig.2025.05.016
Jon F. Pennycuff MD, MSPH
More than half of women report using vaginal lubricants during their lifetime. Despite such ubiquitous use, most healthcare providers do not ask about their use, and they may not feel comfortable counseling a patient about how to choose the best product. The purpose of this review is to explain the difference between various vaginal products, address the factors that affect the efficacy of vaginal products, and provide evidence on the use of these products for masturbation and the use of sex toys, penile-vaginal intercourse, anal intercourse, and for couples seeking to become pregnant.
{"title":"The Osmolality of Sex—the Science of Vaginal Moisturizers and Lubricants","authors":"Jon F. Pennycuff MD, MSPH","doi":"10.1016/j.jmig.2025.05.016","DOIUrl":"10.1016/j.jmig.2025.05.016","url":null,"abstract":"<div><div>More than half of women report using vaginal lubricants during their lifetime. Despite such ubiquitous use, most healthcare providers do not ask about their use, and they may not feel comfortable counseling a patient about how to choose the best product. The purpose of this review is to explain the difference between various vaginal products, address the factors that affect the efficacy of vaginal products, and provide evidence on the use of these products for masturbation and the use of sex toys, penile-vaginal intercourse, anal intercourse, and for couples seeking to become pregnant.</div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 1","pages":"Pages 94-99"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.jmig.2025.04.013
Molly K. Irvin BA , Madison Ellis BS , Tierney K. Lorenz PhD
Despite representing a growing percentage of the global population, queer patients (i.e., lesbian, gay, bisexual, transgender, intersex, and/or asexual; LGBTQIA+) continue to experience significant disparities in gynecologic healthcare. Common barriers to inclusive care include discriminatory healthcare experiences, difficulty finding identity-affirming providers, and systemic lack of competency in addressing queer-specific medical needs. Such barriers arise out of heteronormative assumptions, limited provider training, and insufficient understanding of diverse sexual and gender identities. This narrative review examines gynecologic care considerations for lesbian, gay, bisexual/pansexual, asexual, intersex, and transgender patients. We review research documenting how queer patients delay or avoid healthcare due to fear of judgment, discrimination, and inadequate provider understanding. Our review highlights unique healthcare needs across different queer identities, including inclusive and culturally-sensitive sexual health screening that includes (but is not centered solely on) queer-specific sexual practices; considerations for transgender patients undergoing gender-affirming care; and incorporating intersectionality into assessment, treatment planning, and delivery. Finally, we make direct recommendations for caring for queer patients, including developing inclusive intake processes; training healthcare teams in affirming, non-discriminatory practices; using gender-neutral language; recognizing the diversity of sexual and gender identities; and addressing minority stress and its impacts on health.
{"title":"Caring for the LGBTQIA+ Patient: A Best-Practices Primer on Language, Sexual Function Considerations, and Health Disparities in Gynecologic Care","authors":"Molly K. Irvin BA , Madison Ellis BS , Tierney K. Lorenz PhD","doi":"10.1016/j.jmig.2025.04.013","DOIUrl":"10.1016/j.jmig.2025.04.013","url":null,"abstract":"<div><div>Despite representing a growing percentage of the global population, queer patients (i.e., lesbian, gay, bisexual, transgender, intersex, and/or asexual; LGBTQIA+) continue to experience significant disparities in gynecologic healthcare. Common barriers to inclusive care include discriminatory healthcare experiences, difficulty finding identity-affirming providers, and systemic lack of competency in addressing queer-specific medical needs. Such barriers arise out of heteronormative assumptions, limited provider training, and insufficient understanding of diverse sexual and gender identities. This narrative review examines gynecologic care<span> considerations for lesbian, gay, bisexual/pansexual, asexual, intersex, and transgender patients. We review research documenting how queer patients delay or avoid healthcare due to fear of judgment, discrimination, and inadequate provider understanding. Our review highlights unique healthcare needs across different queer identities, including inclusive and culturally-sensitive sexual health screening that includes (but is not centered solely on) queer-specific sexual practices; considerations for transgender patients undergoing gender-affirming care; and incorporating intersectionality into assessment, treatment planning, and delivery. Finally, we make direct recommendations for caring for queer patients, including developing inclusive intake processes; training healthcare teams in affirming, non-discriminatory practices; using gender-neutral language; recognizing the diversity of sexual and gender identities; and addressing minority stress and its impacts on health.</span></div></div>","PeriodicalId":16397,"journal":{"name":"Journal of minimally invasive gynecology","volume":"33 1","pages":"Pages 126-136"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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