39 ONSET OF FLIBANSERIN TREATMENT EFFECT IN POSTMENOPAUSAL WOMEN ASSESSED BY SUBDOMAIN SCORES OF THE FEMALE SEXUAL FUNCTION INDEX (FSFI) Simon, J 1 ; Shapiro, M 2 ; Larkin, L 3 ; Kim, N 4 ; Patel, S 5 ; Kingsberg, S 6 1 George Washington University School of Medicine and IntimMedicine Special- ists; 2 University of Toronto; 3 Lisa Larkin MD and Associates; 4 Institute for Sex- ual Medicine; 5 Sprout Pharmaceuticals, Inc.; 6 Case Western Reserve University School of Medicine Introduction: Flibanserin, a treatment for acquired, generalized hypoactive sexual desire disorder (HSDD), is approved in the US for use in certain pre- menopausal women and in Canada for use in both premenopausal and natu- rally postmenopausal women ≤60 years of age. Improvement in symptoms following initiation of flibanserin may take several weeks to emerge and it is important to set realistic expectations of treatment onset. Objective: The primary objective of this analysis was to evaluate the onset of flibanserin’s treatment effect in naturally postmenopausal women with HSDD across the 6 subdomains of the FSFI. Methods: A post-hoc analysis was conducted using FSFI data from a ran- domized, controlled, double-blind trial of flibanserin in naturally postmeno- pausal women with HSDD that included 895 postmenopausal women (flibanserin, n=432; placebo, n=463) who had at least one on-treatment effi- cacy assessment. The FSFI is a validated, 19-item self-report questionnaire comprising 6 subdomains of sexual functioning: desire, arousal, lubrication, orgasm, satisfaction, and pain. Each subdomain has a maximum score of 6 and higher scores indicate better sexual functioning. For each subdomain, change from baseline at each assessment visit (4, 8, 16, and 24 weeks) was calculated as the least squares mean difference. Comparisons between fliban- serin and placebo groups were performed using analysis of covariance. Results: Postmenopausal patients treated with flibanserin had significantly greater sexual desire and arousal scores than those treated with placebo at Week 4 and at every assessment timepoint thereafter (see figure). By Week 8, patients in the flibanserin group had significantly higher scores for all FSFI subdomains compared to the placebo group. This treatment effect was maintained at Week 24 for all subdomains except for pain. Conclusions: Results from this post-hoc analysis indicates that postmeno- pausal women treated with flibanserin experienced improved sexual function compared to those treated with placebo with regard to sexual desire, arousal, lubrication, orgasm and satisfaction. This improvement was maintained over the entire course of treatment. These findings are consistent with those from a previous FSFI post-hoc analysis of clinical trial data from premenopausal women and suggest that flibanserin treatment of postmenopausal women was associated with improvement of multiple aspects of sexual function in addition to sexual desire. Disclosure: Yes, this is sponsored by industry/sponsor: Sprout Pharmaceuti- cals, Inc. Clarification: Industry initiated, executed and funded study Any of the authors act as a consultant, employee or shareholder of an industry for: Sprout Pharmaceuticals, Inc. 40 FEMALE GENITALIA IN PORNOGRAPHY: THE SOURCE OF LABIAPLASTY TRENDS? Dubinskaya, A; Dallas, K; Eilber, K; Scott, V; Anger, J Cedars Sinai Medical Center Introduction: Trends in appearance of female genitalia has been influenced by social media, entertainment industry, and even politics. Cosmetic labia- plasty has increased by 39% over the last decade. Wide availability and acces- sibility of pornography is another source where women and men learn about the anticipated normal appearance of the genitals. Objective: The purpose of this review is to evaluate the current trends in appearance of female genitalia based on the most viewed pornography vid- eos. We hypothesized that pornography may influence such trends in labiaplasty. Methods: After panel of experts agreed on definitions and classifications of the different genital parts and beautification trends, we reviewed videos from the category “most viewed videos” on the most popular free pornography websites. We analyzed common representations of female genital appear- ance, including hair grooming (completely shaved, trimmed, natural), hyper- pigmentation (natural with hyperpigmented perianal and labial skin vs. bleached with equal hyperpigmentation throughout), appearance of labia majora (thickness, length), appearance of labia minora (presence and length compared to the labia majora), clitoral hood appearance (status post clitoral hood reduction), and width of the genital hiatus. Results: We reviewed the 25 most viewed videos from the five most popular free pornography websites. Among females and males, complete shaving of the pubic hair was the most common pattern, 56% (14) and 52% (13) respectively, followed by the trimmed pubic hair equally among both gen- ders 40% (10). Only 8% of videos demonstrated labia majora resembling pre-pubertal (surgically enhanced) appearance. 44% of women had labia minora larger than labia majora, 36% had them at equal length, and 16% showed no labia minora and were consistent with labiaplasty. 92% of videos demonstrated a normal appearing clitoral hood with no signs of surgical reduction. Bleaching or removal of natural hyperpigmentation was noted in 22nd Annual Fall Scientific Meeting of SMSNA S21 J Sex Med 2022;19:S1-S26 Downloaded from https://academic.oup.com/jsm/article/19/Supplement_1/S21/7013314 by guest on 02 February 2023