{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:04:38Z","timestamp":1789495478275,"version":"build-2803163510"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate sexual dysfunction as a clinically relevant but under-recognized manifestation of disease burden in women with COPD and to identify its clinical and psychological determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>In this cross-sectional study, 100 consecutive women with stable COPD (mean age 57\u2009\u00b1\u20097 years) attending an outpatient chest clinic were enrolled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Participants underwent pulmonary function testing and completed the COPD Assessment Test (CAT), Modified Medical Research Council (mMRC) scale, Beck Depression Inventory, Short Form-36 (SF-36), Functional Assessment of Chronic Illness Therapy\u2013Fatigue (FACIT-FS), and Female Sexual Function Index (FSFI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sexual dysfunction (FSFI \u226426.55) was more prevalent in patients with greater disease burden, particularly those in GOLD stage E, and was associated with significantly higher fatigue and depressive symptoms. FSFI scores showed a positive correlation with FACIT-FS and quality-of-life domains, and a negative correlation with depression scores (all p\u2009&lt;\u20090.05). In multivariable analysis, fatigue was positively associated with FSFI scores, whereas depression and body mass index were negatively associated. Patients with more severe disease (GOLD E), comorbidities, and dyspnea during intercourse had lower FSFI scores, while those receiving triple therapy demonstrated higher scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sexual dysfunction was associated with greater symptom burden in women with COPD and was closely related to fatigue and depression. Assessment of sexual function may contribute to a more comprehensive evaluation of disease burden in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0357921","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:31:32Z","timestamp":1789493492000},"page":"e0357921","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between sexual dysfunction and symptom burden in women with Chronic Obstructive Pulmonary Disease"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8345-4539","authenticated-orcid":true,"given":"M\u00fcfide Arzu","family":"\u00d6zkarafak\u0131l\u0131","sequence":"first","affiliation":[{"name":"\u015ei\u015fli Hamidiye Etfal Training and Research Hospital, University of Health Sciences","place":["Istanbul, Turkey"],"department":["Department of Chest Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cemil","family":"Kutsal","sequence":"additional","affiliation":[{"name":"\u015ei\u015fli Hamidiye Etfal Training and Research Hospital, University of Health Sciences","place":["Istanbul, Turkey"],"department":["Department of Urology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihat","family":"T\u00fcrkmen","sequence":"additional","affiliation":[{"name":"\u015ei\u015fli Hamidiye Etfal Training and Research Hospital, University of Health Sciences","place":["Istanbul, Turkey"],"department":["Department of Urology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatice","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"\u015ei\u015fli Hamidiye Etfal Training and Research Hospital, University of Health Sciences","place":["Istanbul, Turkey"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"pone.0357921.ref001","volume-title":"Global Strategy for Prevention, Diagnosis and Management of COPD: 2024 Report","author":"Global Initiative for Chronic Obstructive Lung Disease (GOLD)","year":"2024"},{"key":"pone.0357921.ref002","unstructured":"World Health Organization. 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