Ellen Laan

Ellen Laan
Academisch Medisch Centrum Universiteit van Amsterdam | AMC · Department of Obstetrics & Gynecology

Professor

About

226
Publications
149,173
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9,507
Citations
Additional affiliations
January 2012 - present
January 2011 - present
Indiana University Bloomington
January 2009 - present
University of Missouri - St. Louis

Publications

Publications (226)
Article
Objectives To investigate associations between testosterone and patient reported sexual problems and need for sexual care in head and neck cancer patients at time of diagnosis and 6 months after treatment. Patients and methods Data and samples were used of 40 patients (20 men, 20 women) before and 6 months after treatment. Outcome measures were to...
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Objective Many healthcare professionals experience difficulties in discussing sexual health with their patients. The aim of this review was to synthesize results of studies on communication practices in interactions about sexual health in medical settings, to offer healthcare professionals suggestions on how to communicate about this topic. Method...
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Introduction Hypertonicity of the pelvic floor (PFH) is a disabling condition with urological, gynecological and gastrointestinal symptoms, sexual problems and chronic pelvic pain, impacting quality of life. Pelvic floor physical therapy (PFPT) is a first-line intervention, yet no systematic review on the efficacy of PFPT for the treatment of PFH h...
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Purpose: The aim of the present study is to investigate the prevalence of body image distress among head and neck cancer (HNC) patients after treatment and to examine its association with sociodemographic and clinical factors, health-related quality of life (HRQOL), HNC symptoms, sexuality, self-compassion, and psychological distress. Second, we a...
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Purpose The aim of this pretest–posttest study was to investigate the reach and effects of My Changed Body (MyCB), an expressive writing activity based on self-compassion, among head and neck cancer (HNC) survivors. Methods This pilot study had a pretest–posttest design. HNC survivors received an invitation to complete a baseline survey on body im...
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Introduction A recent randomized controlled trial (RCT) in patients with head and neck cancer (HNC) with psychological distress showed that a stepped care (SC) program targeting psychological distress compared with care as usual (CAU), is (cost)effective in reducing psychological distress. Aim The aim of the present study was to investigate whethe...
Article
Objective: To determine long-term outcomes of a randomized trial (BIOPEX) comparing biological mesh and primary perineal closure in rectal cancer patients following extralevator abdominoperineal resection (APR) and preoperative radiotherapy, with a primary focus on symptomatic perineal hernia. Summary background data: BIOPEX is the only randomiz...
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Women undergo important changes in sex hormones throughout their lifetime that can impact cardiovascular disease risk. Whereas the traditional cardiovascular risk factors dominate in older age, there are several female-specific risk factors and inflammatory risk variables that influence a woman’s risk at younger and middle age. Hypertensive pregnan...
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Background Traumatic sexual experiences can negatively affect sexual functioning and increase pelvic floor activity in women, especially when post-traumatic stress disorder (PTSD) is developed. However, little is known about the effect of other types of interpersonal and non-interpersonal, traumatic experiences on sexual function and pelvic floor o...
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Introduction Multidisciplinary management of women‐specific bleeding is important to preserve quality of life, healthy reproduction and social participation of women and girls with bleeding disorders (WBD). Aim To support appropriate multidisciplinary care for WBD in haemophilia treatment centres. Methods Two case examples are presented and manag...
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Introduction The prevalence of polycystic ovary syndrome (PCOS) is 10–15% in women of reproductive age. Its characteristics are (i) clinical or biochemical hyperandrogenism, (ii) oligomenorrhea or amenorrhea, and (iii) polycystic ovaries on ultrasound. PCOS is associated with lower quality of life, depression, anxiety, diabetes, and cardiovascular...
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Study question: Can we develop a web-based sex education programme (programme running in a web browser) that addresses the needs of subfertile couples who are advised expectant management for at least 6 months? Summary answer: The 'Pleasure & Pregnancy' programme addresses couples' needs, is likely to improve couples' sexual functioning, and is...
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Background Sexual complaints are a widespread problem around the globe. Ethnicity and culture play a vital role in sexual complaints, in terms of presentation, treatment, etiology, meaning, help-seeking behavior, and treatment preferences. Aim This study investigates whether there are differences in the type of sexual complaints among Dutch people...
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Introduction: Several studies demonstrated that genital arousal and enhanced positive affect toward neutral stimuli due to sexual conditioning did not extinguish during a brief extinction phase, but other studies showed contrasting results. Possible resistance to extinction of conditioned human sexual response has, however, not been studied using...
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Introduction Many subfertile couples are diagnosed with (relatively) unexplained subfertility and a good prognosis. National professional guidelines (eg, the Netherlands and UK) advise ‘expectant management (EM)’ for 6–12 months, in which no interaction with healthcare staff is offered. Underpowered studies indicate that face-to-face sex-counsellin...
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Background: Provoked Vulvodynia (PVD) is the most common cause of vulvar pain. General practitioners (GPs) are insufficiently familiar with it, causing a delay in many women receiving correct diagnosis and treatment. Besides patients factors, this delay can partly be explained by the reluctance of GPs to explore the sexual context of PVD and by th...
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Introduction Now that HIV infection has become a chronic disease, optimizing health status is an important goal of care for HIV-infected patients. Testosterone insufficiency (TI) can compromise health status, but little is known about the prevalence of TI and possible related factors in HIV-infected women. Aim To investigate the prevalence of TI a...
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Abstract Problems related to low sexual desire in women are common clinical complaints, and the aetiology is poorly understood. We investigated predictors of change in levels of sexual desire using a novel network approach, which assumes that mental disorders arise from direct interactions between symptoms. Using population-based data from 1,449 Fi...
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Background Obesity and infertility are associated with poorer sexual function. We have previously shown that a lifestyle intervention in women with obesity and infertility reduced weight and improved cardiometabolic health and quality of life, which may positively affect sexual function. We now report on sexual function 5 years after randomization....
Data
Research protocol as approved by the ethics committee. (PDF)
Data
Comparison of baseline characteristics of participants and non-participants. (DOCX)
Data
Comparison of women who had intercourse and women who did not had intercourse in past four weeks. (DOCX)
Data
Baseline and follow-up characteristics of all women who reported intercourse in past four weeks. (DOCX)
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We present the first systematic review and meta-analysis of sexual function in women with polycystic ovary syndrome (PCOS) compared with women without PCOS. Data on this topic are limited and often contradicting. Sexual function is influenced by endocrine, mental and social factors, which are often compromised in women with PCOS. The main outcome m...
Article
Background: Provoked vulvodynia (PVD) is a chronic vulvar pain condition affecting up to 8.3% of the female population. Despite many years of research, no clear cause for PVD has been identified. Several risk factors have been studied, including vulvovaginal candidiasis (VVC). However, to date, the role of Candida infections in PVD has remained un...
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Introduction: The aim of this prospective study was to investigate the course of sexual interest and enjoyment in relation to sociodemographic and clinical factors, health-related quality of life (HRQOL), and symptoms of psychological distress in head and neck cancer (HNC) patients treated with primary (chemo)radiotherapy. Methods: HNC patients...
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Objective: A literature analysis on the effects of female genital mutilation (FGM) on sexual and psychological well-being. Design: Narrative systematic review. Method: In March 2016 we performed a search for relevant literature in the Cochrane Library, Embase, PubMed, PsycINFO and CINAHL. Inclusion criteria were studies (a) of women who had un...
Article
Objectives: To evaluate the effect of combined oral contraceptives (OCs) on sexual function, either alone or together with DHEA. Study design: An exploratory randomized, double-blind, placebo-controlled, comparative, crossover study was conducted in 81 OC users. Subjects discontinued their OC for one cycle before being randomized for 10cycles to...
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Background: The differential role of psychological traits in the etiology and maintenance of female orgasm difficulties is yet to be consistently established. Aim: To investigate the contribution of different psychological trait features (personality, sexual inhibition and excitation, and sexual beliefs) to predict female orgasm and to assess th...
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Background: The gap between the relatively high prevalence of provoked vulvodynia (PVD) in the general population and the low incidence in primary care can partly be explained by physicians’ lack of knowledge about the assessment and management of PVD. Objectives: To recognize barriers and facilitators of GPs in the diagnostic process of women pres...
Article
Researchers have demonstrated that several dimensions of sexual functioning (e.g., sexual desire, arousal, orgasm) are associated with the sexual satisfaction of individuals in a committed mixed-sex (male–female) relationship. We extended this research by comparing a dyadic model that included both own (i.e., actor effect) and partner (i.e., partne...
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Background A recent Dutch study in general practice showed a clear relationship between the diagnosis of vulvovaginal candidiasis (VVC) and symptoms suggestive of provoked vulvodynia (PVD). PVD accounts for the largest group of vulvar pains, but is often not recognised by GPs. Aim To investigate whether diagnostic uncertainty about VVC in general...
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Background: Cognitive-affective factors contribute to female sexual dysfunctions, defined as clinically significant difficulties in the ability to respond sexually or to experience sexual pleasure. Automatic thoughts and affect presented during sexual activity are acknowledged as maintenance factors for these difficulties. However, there is a lack...
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Introduction: In dyspareunia-a somatically unexplained vulvovaginal pain associated with sexual intercourse-learned pain-related fear and inhibited sexual arousal are supposed to play a pivotal role. Based on research findings indicating that enhanced pain conditioning is involved in the etiology and maintenance of chronic pain, in the present stu...
Chapter
The recent views of sexual desire and sexual arousal are in line with an information processing model of sexual arousal. In this model, two information processing pathways are distinguished. The first pathway concerns, in particular, the automatic and unconscious processes, whereas the second pathway concerns attention and regulation. This chapter...
Chapter
Absent or reduced sexual desire and/or arousal is a prevalent and often distressing complaint. In general, women present this problem only when the gynecologist proactively inquires about possible sexual difficulties. Incentive motivation theories, the abundance of evidence that spontaneous sexual desire does not exist, and the knowledge that sexua...
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Introduction: Many women have doubts about the normality of the physical appearance of their vulvas. This study measured genital self-image in a convenience sample of college-educated women, and assessed whether exposure to pictures of natural vulvas influenced their genital self-image. Method: Forty-three women were either shown pictures of natura...
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In Reply We agree with Goldstein et al that it is a clinician’s task to diligently and routinely help patients to evaluate benefits, risks, and appropriateness of therapeutic options. When available, meta-analyses, not clinical opinion, should be the basis of such a risk and benefit analysis. Being clinicians as well as scientists, we know that red...
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Objective: To determine whether adding dehydroepiandrosterone (DHEA) to combined oral contraceptives (COCs) maintains physiological levels of free testosterone. Study design: A randomized, double-blind, placebo-controlled, two-way crossover study conducted in 81 healthy women (age range: 20-35 years; BMI range: 18-35 kg/m(2)) using oral contrace...
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This study examined whether lesbian and heterosexual women differ in the likelihood of experiencing an orgasm during partnered sexual activity, and whether that would possibly be related to differences in stimulation of the glans clitoris. Orgasm consistency was defined as the likelihood with which orgasm occurs during sexual activity. In an online...
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Introduction: Lichen sclerosus (LS) of the vulva can profoundly affect sexual interaction because of painful fissures and narrowing of the vaginal introitus. Successful surgical treatment is usually defined as restoration of (pain-free) penetrative sexual activity. Aims: To evaluate the impact of surgery on (dyadic) sexual functioning and pleasu...
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Rationale Dopamine (DA) plays a key role in reward-seeking behaviours. Accumulating evidence from animal and human studies suggests that human sexual reward learning may also depend on DA transmission. However, research on the role of DA in human sexual reward learning is completely lacking. Objectives To investigate whether DA antagonism attenuate...
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Importance In August 2015, the US Food and Drug Administration (FDA) approved flibanserin as a treatment for hypoactive sexual desire disorder (HSDD) in premenopausal women, despite concern about suboptimal risk-benefit trade-offs.Objective To conduct a systematic review and meta-analysis of randomized clinical trials assessing efficacy and safet...
Article
Background: The lifetime prevalence of women suffering from provoked vestibulodynia (PVD) is estimated to be approximately 15%. The etiology of PVD is not yet clear. Recent studies approach PVD as a chronic multifactorial sexual pain disorder. PVD is associated with pain syndromes, genital infections, and mental disorders, which are common disease...
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Introduction: Emotion regulation research has shown successful altering of unwanted aversive emotional reactions. Cognitive strategies can also downregulate expectations of reward arising from conditioned stimuli, including sexual stimuli. However, little is known about whether such strategies can also efficiently upregulate expectations of sexual...
Chapter
Pelvic floor overactivity is a multifaceted problem with medical, psychological, sexual, and relational sequelae. This chapter addresses the involvement of the pelvic floor muscles in sexual arousal and orgasm, as well as the relationship between pelvic floor overactivity and sexual problems in women, including persistent genital arousal disorder....
Article
Introduction: Women with lichen sclerosus (LS) may experience (superficial) dyspareunia or the inability to have vaginal intercourse due to painful fissures and narrowing of the vaginal introitus. A surgical procedure may contribute to the relief of these sexual pain problems. It is unknown what motives women have to undergo surgery in order to re...
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There were numerous missed opportunities at the October 2014 U.S. Food and Drug Administration (FDA) meeting on female sexual dysfunction (FSD). They included opportunities to hear from a diverse range of patients and to engage in evidence-based discussions of unmet medical needs, diagnostic instruments, trial end points, and inclusion criteria for...
Book
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The Gender and Health Knowledge Agenda summarises the gaps in our knowledge of gender and health, and serves as a basis for new research programming, including a future National Gender and Health knowledge programme. This publication is a translation of the Dutch Gender and Health Knowledge Agenda, and reflects the situation in the Netherlands (May...