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Sample records for antipsychotic-induced sexual dysfunction

  1. Strategies for the treatment of antipsychotic-induced sexual dysfunction and/or hyperprolactinemia among patients of the schizophrenia spectrum: a review.

    PubMed

    Nunes, Luciana Vargas Alves; Moreira, Hugo Cogo; Razzouk, Denise; Nunes, Sandra Odebrecht Vargas; Mari, Jair De Jesus

    2012-01-01

    There is limited evidence for the management of sexual dysfunction and/or hyperprolactinemia resulting from use of antipsychotics in patients with schizophrenia and spectrum. The aim of this study was to review and describe the strategies for the treatment of antipsychotic-induced sexual dysfunctions and/or hyperprolactinemia. The research was carried out through Medline/PubMed, Cochrane, Lilacs, Embase, and PsycINFO, and it included open labels or randomized clinical trials. The authors found 31 studies: 25 open-label noncontrolled studies and 6 randomized controlled clinical trials. The randomized, double-blind controlled studies that were conducted with adjunctive treatment that showed improvement of sexual dysfunction and/or decrease of prolactin levels were sildenafil and aripiprazole. The medication selegiline and cyproheptadine did not improve sexual function. The switch to quetiapine was demonstrated in 2 randomized controlled studies: 1 showed improvement in the primary outcome and the other did not. This reviewed data have suggested that further well-designed randomized controlled trials are needed to provide evidence for the effects of different strategies to manage sexual dysfunction and/or hyperprolactinaemia resulting from antipsychotics. These trials are necessary in order to have a better compliance and reduce the distress among patients with schizophrenia.

  2. Sexual Dysfunction in Women

    MedlinePlus

    ... pressure), excessive alcohol use or vaginal infections can cause sexual problems. Depression, relationship problems or abuse (current or past abuse) can also cause sexual dysfunction.You may have less sexual desire ...

  3. Sexual Dysfunction in Women

    PubMed Central

    Brown, Pamela

    1989-01-01

    Sexual dysfunction takes place in the context of women's lives and affects their sexuality and self-esteem. Awareness of these influences are vital to the management of the dysfunction and the promotion of positive sexuality. The family physician's contribution to both the prevention and management of sexual concerns includes an awareness of societal influences and facilitation of a woman's sense of her own power and control over her life. PMID:21248971

  4. Burden of Sexual Dysfunction.

    PubMed

    Balon, Richard

    2017-01-02

    Similar to the burden of other diseases, the burden of sexual dysfunction has not been systematically studied. However, there is growing evidence of various burdens (e.g., economic, symptomatic, humanistic) among patients suffering from sexual dysfunctions. The burden of sexual dysfunction has been studied a bit more often in men, namely the burden of erectile dysfunction (ED), premature ejaculation (PE) and testosterone deficiency syndrome (TDS). Erectile dysfunction is frequently associated with chronic conditions such as cardiovascular disease, diabetes, and depression. These conditions could go undiagnosed, and ED could be a marker of those diseases. The only available report from the United Kingdom estimated the total economic burden of ED at £53 million annually in terms of direct costs and lost productivity. The burden of PE includes significant psychological distress: anxiety, depression, lack of sexual confidence, poor self-esteem, impaired quality of life, and interpersonal difficulties. Some suggest that increase in female sexual dysfunction is associated with partner's PE, in addition to significant interpersonal difficulties. The burden of TDS includes depression, sexual dysfunction, mild cognitive impairment, and osteoporosis. One UK estimate of the economic burden of female sexual dysfunctions demonstrated that the average cost per patient was higher than the per annum cost of ED. There are no data on burden of paraphilic disorders. The burden of sexual dysfunctions is underappreciated and not well studied, yet it is significant for both the patients and the society.

  5. The Facts About Sexual (Dys)function in Schizophrenia: An Overview of Clinically Relevant Findings

    PubMed Central

    de Boer, Marrit K.; Castelein, Stynke; Wiersma, Durk; Schoevers, Robert A.; Knegtering, Henderikus

    2015-01-01

    A limited number of studies have evaluated sexual functioning in patients with schizophrenia. Most patients show an interest in sex that differs little from the general population. By contrast, psychiatric symptoms, institutionalization, and psychotropic medication contribute to frequently occurring impairments in sexual functioning. Women with schizophrenia have a better social outcome, longer lasting (sexual) relationships, and more offspring than men with schizophrenia. Still, in both sexes social and interpersonal impairments limit the development of stable sexual relationships. Although patients consider sexual problems to be highly relevant, patients and clinicians not easily discuss these spontaneously, leading to an underestimation of their prevalence and contributing to decreased adherence to treatment. Studies using structured interviews or questionnaires result in many more patients reporting sexual dysfunctions. Although sexual functioning can be impaired by different factors, the use of antipsychotic medication seems to be an important factor. A comparison of different antipsychotics showed high frequencies of sexual dysfunction for risperidone and classical antipsychotics, and lower frequencies for clozapine, olanzapine, quetiapine, and aripiprazole. Postsynaptic dopamine antagonism, prolactin elevation, and α1-receptor blockade may be the most relevant factors in the pathogenesis of antipsychotic-induced sexual dysfunction. Psychosocial strategies to treat antipsychotic-induced sexual dysfunction include psychoeducation and relationship counseling. Pharmacological strategies include lowering the dose or switching to a prolactin sparing antipsychotic. Also, the addition of a dopamine agonist, aripiprazole, or a phosphodiesterase-5 inhibitor has shown some promising results, but evidence is currently scarce. PMID:25721311

  6. Prevalence of Sexual Dysfunctions

    PubMed Central

    Simons, Jeffrey; Carey, Michael P.

    2008-01-01

    Ten years of research that has provided data regarding the prevalence of sexual dysfunctions is reviewed. A thorough review of the literature identified 52 studies that have been published in the 10 years since an earlier review by Spector and Carey (1990). Community samples indicate a current prevalence of 0 - 3% for male orgasmic disorder, 0 - 5% for erectile disorder, and 0 - 3% for male hypoactive sexual desire disorder. Pooling current and 1-year figures provides community prevalence estimates of 7 - 10% for female orgasmic disorder and 4 - 5% for premature ejaculation. Stable community estimates of the current prevalence for the other sexual dysfunctions remain unavailable. Prevalence estimates obtained from primary care and sexuality clinic samples are characteristically higher. Although a relatively large number of studies have been conducted since Spector and Carey’s (1990) review, the lack of methodological rigor of many studies limits the confidence that can be placed in these findings. PMID:11329727

  7. Managing female sexual dysfunction.

    PubMed

    Buster, John E

    2013-10-01

    Female sexual dysfunctions (FSDs) range from short-term aggravations to major emotional disturbances adversely affecting family and workplace. This review highlights diagnosis and management of the four most widely diagnosed FSDs. It initially focuses on hypoactive sexual desire disorder (HSDD) as a driving force at the heart of all other FSDs; nothing happens without sexual desire. Successful resolution of HSDD frequently facilitates resolution of other disorders. Central to understanding HSDD is the impact of aging female sexual endocrinology and its effect on both prevalence and expression patterns of FSD. Advances in this field have enabled introduction of some the most effective treatments yet described for HSDD. Sexual arousal disorder, though commonly affected by the same factors as HSDD, is heavily associated with psychotropic drugs and mood elevators. Orgasmic disorder is frequently the downstream result of other sexual dysfunctions, particularly HSDD, or the result of a major psychosexual trauma. Successful management of the underlying disorder often resolves orgasmic disorder. Sexual pain disorder is frequently the result of a gynecologic disorder, such as endometriosis, that can be substantially managed through successful treatment of that disorder. This article ends with the article's most important note: how to initiate the conversation. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Female sexual dysfunction: Assessment.

    PubMed

    Sharma, J B; Kalra, Bharti

    2016-05-01

    Female sexual dysfunction (FSD) is a common complex clinical condition, with multiple etiologies, association and pathophysiologic correlations. This review includes the definition, etiology, and diagnosis of FSD. It calls for a bio psychosocial approach to FSD management, which incorporates, but is not limited to, only the psychological aspects of FSD.

  9. [Female sexual dysfunction].

    PubMed

    Luria, Mijal

    2009-09-01

    Female sexual problems are common, frequently overlooked and have a significant impact on the lives of women. Research in the last decade has brought to the understanding and recognition of a number of standpoints, mainly the broad range of normative function. In 2003, the American Urological Association Foundation convened an international committee of experts in the field of women's sexuality, to reconsider the existing definitions of women's sexual dysfunction. Based on the circular response cycle developed by Basson, the group emphasized motivations that might move a woman from being sexually "neutral" to making a decision to be sexual with her partner, as a normative alternative to the need for spontaneous sexual desire as the trigger for sexual behavior. Etiology may stem from medical as well as psychological factors, thus assessment must include a complete evaluation. Treatment includes psycho-education, improvement of interpersonal communication, cognitive behavioral treatment and elucidation and treatment of medical problems, if necessary. Several pharmacological treatments are under investigation, with modest results and uncertainties about their long term safety. This review presents the female sexual response as it is understood today and the current diagnostic and therapeutic understandings and directions.

  10. Sexual dysfunction with antihypertensive drugs.

    PubMed

    Prisant, L M; Carr, A A; Bottini, P B; Solursh, D S; Solursh, L P

    1994-04-11

    The relationship of antihypertensive drugs have a long history of association with sexual dysfunction; however, this relationship is poorly documented. There appears to be a higher rate of sexual dysfunction in untreated hypertensive men compared with normotensive men. Sexual dysfunction increases with age and is associated with physical and emotional symptoms. There are few studies assessing sexual dysfunction with female and African-American hypertensive patients. Sexual dysfunction is associated with impairment of quality of life and noncompliance. Since group data may hide individual drug effects, baseline data should be collected on all patients before initiating therapy with any antihypertensive agent. Although questionnaires may not provide objective information on sexual dysfunction, the response rate to direct questioning may be less than the response rate on a questionnaire and may be affected by the gender or race of the interviewer. Research protocols using a double-blind, placebo-controlled design should assess sexual dysfunction in men and women in a standardized fashion.

  11. Sexual dysfunction in diabetes.

    PubMed

    Tamás, Várkonyi; Kempler, Peter

    2014-01-01

    We aimed to summarize the etiology, clinical characteristics, diagnosis, and possible treatment options of sexual dysfunction in diabetic patients of both sexes. Details of dysfunction in diabetic women are less conclusive than in men due to the lack of standardized evaluation of sexual function in women. Male sexual dysfunction is a common complication of diabetes, including abnormalities of orgasmic/ejaculatory function and desire/libido in addition to penile erection. The prevalence of erectile dysfunction (ED) among diabetic men varies from 35% to 75%. Diabetes-induced ED has a multifactorial etiology including metabolic, neurologic, vascular, hormonal, and psychological components. ED should be regarded as the first sign of cardiovascular disease because it can be present before development of symptomatic coronary artery disease, as larger coronary vessels better tolerate the same amount of plaque compared to smaller penile arteries. The diagnosis of ED is based on validated questionnaires and determination of functional and organic abnormalities. First-, second- and third-line therapy may be applied. Phosphodiesterase-5 (PDE-5) inhibitor treatment from the first-line options leads to smooth muscle relaxation in the corpus cavernosum and enhancement in blood flow, resulting in erection during sexual stimulus. The use of PDE-5 inhibitors in the presence of oral nitrates is strictly contraindicated in diabetic men, as in nondiabetic subjects. All PDE-5 inhibitors have been evaluated for ED in diabetic patients with convincing efficacy data. Second-line therapy includes intracavernosal, trans- or intraurethral administration of vasoactive drugs or application of a vacuum device. Third-line therapies are the implantation of penile prosthesis and penile revascularization.

  12. Sexual Dysfunction After Urethroplasty.

    PubMed

    Dogra, Prem Nath; Singh, Prabhjot; Nayyar, Rishi; Yadav, Siddharth

    2017-02-01

    Posturethroplasty sexual dysfunction (SD) is multifactorial and its true incidence is unknown. Even with the current evidence suggesting that it is uncommon, de novo SD causes dissatisfaction even after a successful surgery. Posterior urethroplasty carries the highest chance of SD, mostly attributable to the pelvic fracture itself rather than the urethroplasty. With anterior urethroplasty, transecting bulbar urethroplasty leads to greater SD compared with penile or nontransecting bulbar urethroplasty. Most patients with posturethroplasty SD recover within 6 months after surgery.

  13. [Sexual dysfunction in torture victims].

    PubMed

    Theilade, Lotte D Arlø

    2002-10-07

    Sexual dysfunction is seen in up to 51% of torture victims. The torture victim seldom reports anything about having been tortured but often consults the health care system because of a somatic problem which may seem unrelated to torture. Therefore, it is important that doctors are aware of the possible correlation. Symptoms and findings may be both physical and psychical. The torture may be both sexual and non-sexual as well as physical and non-physical. Social, cultural and individual factors also influence the development of sexual dysfunction in a torture victim. The factors that cause sexual dysfunction and the identification of any direct causal relations are discussed. There are indications that sexual torture has a greater impact on the development of sexual dysfunction than other types of torture and it seems that sexual dysfunction is a result of many factors.

  14. Psychotropics and sexual dysfunction

    PubMed Central

    Bella, Anthony J.

    2013-01-01

    Introduction Sexual dysfunction (SD) is common in patients taking antipsychotics, and is the most bothersome symptom and adverse drug effect compromising treatment compliance. Mechanisms involved in psychotropics–induced SD are either largely unknown or poorly understood. The aim of this review is to present an updated analysis of SD associated with the use of psychotropic drugs in psychiatric patients. Results Contemporary evidence from available studies demonstrates that SD rates are drug–related rather than drug–class specific, and that these rates vary widely. Mechanisms involved in psychotropics–induced SD are either largely unknown or poorly understood. Our understanding of psychotropics–induced SD is limited by the inability to differentiate whether these effects are really drug–induced or due to different inclusion criteria. Conclusions Rigorous research, basic and clinical, is needed to understand the exact incidence, severity and mechanisms involved in the development of SD induced by various psychotropic treatment regimens. PMID:24757547

  15. Sexual dysfunction in infertile women

    PubMed Central

    Zare, Zahra; Amirian, Malihe; Golmakani, Nahid; Mazlom, Reza; Laal Ahangar, Mojtaba

    2016-01-01

    Background: Sexual problems have different effects on the life of people by influencing their interpersonal and marital relationships and satisfaction. Relationship between sexual dysfunctions and infertility can be mutual. Sexual dysfunction may cause difficulty conceiving but also attempts to conceive, may cause sexual dysfunction. Objective: This paper compares sexual dysfunction in fertile and infertile women. Materials and Methods: In this cross-sectional study, 110 infertile couples referring to Montasarieh Infertility Clinic and 110 fertile couples referring to five healthcare centers in Mashhad were selected by class cluster sampling method. Data collection tools included demographic questionnaire and Glombok-Rust Inventory of Sexual Satisfaction. Data were analyzed through descriptive and analytical statistical methods by SPSS. Results: There was no significant difference in total score of sexual problems and other dimensions of sexual problems (except infrequency) in fertile 28.9 (15.5) and infertile 29.0 (15.4) women. Fertile women had more infrequency than infertile women (p=0.002). Conclusion: There was no significant difference between fertile and infertile women in terms of sexual problems. Paying attention to sexual aspects of infertility and presence of programs for training of sexual skills seems necessary for couples. PMID:27200422

  16. [Sexual dysfunctions in selected endocrinopathies].

    PubMed

    Skrzypulec, Violetta; Nowosielski, Krzysztof; Drosdzol, Agnieszka; Kowalaczyk, Robert

    2005-01-01

    According to the socio-sexological reports approximately 40-45% of women and up to 30% of males may suffer from different sexual dysfunctions. The prevalence of those disorders is gradually increasing with age. Multiply numbers of endocrinopathies may influence the human sexual life. In diabetic patients all phases of the sexual responses cycle, especially orgasm, might be affected. Women diagnosed with PCOS have decreased adaptation to the sexual life, low self-esteem and perception of self sexual attractiveness. The intimacy of infertile couples has not been well described and the characteristic of particular dysfunction in sex life has not been established yet. Interdisciplinary approach, understood as treatment of the endocrinopathy accompanied with psychological and sexological counseling, seems to be the fundamental issue in the therapy of sexual dysfunctions in patients with endocrinological disorders.

  17. Effect of Adjunctive Aripiprazole on Sexual Dysfunction in Schizophrenia: A Preliminary Open-Label Study.

    PubMed

    Fujioi, J; Iwamoto, K; Banno, M; Kikuchi, T; Aleksic, B; Ozaki, N

    2017-03-01

    Introduction: Although adjunctive aripiprazole improves hyperprolactinemia, sufficient evidence for its effects on sexual dysfunction has not been obtained. We assessed the usefulness of adjunctive aripiprazole for schizophrenia with sexual dysfunction. Methods: 22 Japanese schizophrenia patients with antipsychotic-induced hyperprolactinemia and sexual dysfunction were enrolled, and 19 of them completed the study. Aripiprazole was administrated in a flexible titration schedule to participants according to the judgment of each doctor, and patients were followed for 24 weeks. Serum prolactin, Clinical Global Impression Scales-Severity (CGI-S), and Nagoya Sexual Function Questionnaire (NSFQ) were measured at baseline and at 4, 8, 12, and 24 weeks. Results: Prolactin at week 4 and later was significantly lower than that at baseline. Compared to baseline, we observed a significant improvement in total sexual dysfunction as measured by NSFQ at week 8 and later. In males, erectile dysfunction was significantly reduced at week 24. In females, menstrual irregularity and galactorrhea were significantly reduced at week 24. CGI-S did not significantly change. Discussion: Although the small sample size is a limitation in this study, adjunctive aripiprazole may be useful treatment for sexual dysfunction including hyperprolactinemia in schizophrenia.

  18. [Male sexual dysfunctions and homosexuality].

    PubMed

    Leuillet, P; Cour, F; Droupy, S

    2013-07-01

    The homosexuality, which expresses itself through a varied and complex behavior that those whom are shared by the heterosexual majority, is not that a simple sexual behavior, obvious or not, but a whole set of attitudes, affects, preferences, values, lifestyle which concern profoundly the individual, as the heterosexuality. A review of the literature using PubMed database has been performed to select 38 articles. Among sexual difficulties met by the gays, erectile dysfunction and hypoactive sexual desire are the more frequent. Concerning the ejaculation disorders observed in the gay population, premature ejaculation is rather rare in comparison with heterosexual men; however delayed ejaculation or anejaculation are more frequent. Painful sexual disorders in particular anodyspareunia are also reported. Sexual disorder management must follows the classic rules but it is necessary to be aware how to approach the specific questions affecting the homosexual persons. Still the homosexual person has to find a competent therapist, "opened" to the sexual problem of the homosexuals, with the aim of a care privileging the efficiency to efficacy in the respect for the truth of the homosexual person. The homosexuality is the only one of the "unusual" sexual conducts to possibly concern the daily medical practice due to is prevalence. The management of sexual dysfunctions must privilege the "meeting" in a quest of sense in front of any sexual symptom, whatever the individual sexual orientation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. Flibanserin for female sexual dysfunction.

    PubMed

    Reviriego, C

    2014-08-01

    Hypoactive sexual desire disorder (HSDD) is the most commonly described form of female sexual dysfunction. There is currently no pharmacological therapy approved to treat HSDD, and therefore, there is an unmet medical need for the development of efficacious treatment alternatives. Flibanserin is a novel, non-hormonal drug for the treatment of HSDD in pre- and postmenopausal women, although the application submitted to the U.S. Food and Drug Administration by Sprout Pharmaceuticals is only for premenopausal women. Flibanserin works by correcting an imbalance of the levels of the neurotransmitters that affect sexual desire. More specifically, flibanserin increases dopamine and norepinephrine, both responsible for sexual excitement, and decreases serotonin, responsible for sexual inhibition. Clinically, flibanserin has exhibited some encouraging results in terms of its ability to increase the frequency of satisfying sexual events, and the intensity of sexual desire. However, adverse events such as dizziness, nausea, fatigue and somnolence, typical of a centrally acting drug, are also frequently related to flibanserin treatment.

  20. Male sexual dysfunction in Asia.

    PubMed

    Ho, Christopher Ck; Singam, Praveen; Hong, Goh Eng; Zainuddin, Zulkifli Md

    2011-07-01

    Sex has always been a taboo subject in Asian society. However, over the past few years, awareness in the field of men's sexual health has improved, and interest in sexual health research has recently increased. The epidemiology and prevalence of erectile dysfunction, hypogonadism and premature ejaculation in Asia are similar in the West. However, several issues are specific to Asian males, including culture and beliefs, awareness, compliance and the availability of traditional/complementary medicine. In Asia, sexual medicine is still in its infancy, and a concerted effort from the government, relevant societies, physicians and the media is required to propel sexual medicine to the forefront of health care.

  1. Drug addiction and sexual dysfunction.

    PubMed

    Zaazaa, Adham; Bella, Anthony J; Shamloul, Rany

    2013-09-01

    This article attempts to review the most current and the well-established facts concerning drug addiction and sexual dysfunction. Surprisingly, even though alcohol is prevalent in many societies with many myths surrounding its sexual-enhancing effects, current scientific research cannot provide a solid conclusion on its effect on sexual function. Unfortunately, the same concept applies to tobacco smoking; however, most of the current knowledge tends to support the notion that it, indeed, can negatively affect sexual function. Similar ambiguities also prevail with substances of abuse.

  2. Male sexual dysfunction in Asia

    PubMed Central

    Ho, Christopher CK; Singam, Praveen; Hong, Goh Eng; Zainuddin, Zulkifli Md

    2011-01-01

    Sex has always been a taboo subject in Asian society. However, over the past few years, awareness in the field of men's sexual health has improved, and interest in sexual health research has recently increased. The epidemiology and prevalence of erectile dysfunction, hypogonadism and premature ejaculation in Asia are similar in the West. However, several issues are specific to Asian males, including culture and beliefs, awareness, compliance and the availability of traditional/complementary medicine. In Asia, sexual medicine is still in its infancy, and a concerted effort from the government, relevant societies, physicians and the media is required to propel sexual medicine to the forefront of health care. PMID:21643001

  3. Comparing the Effectiveness and Safety of the Addition of and Switching to Aripiprazole for Resolving Antipsychotic-Induced Hyperprolactinemia: A Multicenter, Open-Label, Prospective Study.

    PubMed

    Yoon, Hui Woo; Lee, Jung Suk; Park, Sang Jin; Lee, Seon-Koo; Choi, Won-Jung; Kim, Tae Yong; Hong, Chang Hyung; Seok, Jeong-Ho; Park, Il-Ho; Son, Sang Joon; Roh, Daeyoung; Kim, Bo-Ra; Lee, Byung Ook

    Hyperprolactinemia is an important but often overlooked adverse effect of antipsychotics. Several studies have shown that switching to or adding aripiprazole normalizes antipsychotic-induced hyperprolactinemia. However, no study has directly compared the effectiveness and safety of the 2 strategies. A total of 52 patients with antipsychotic-induced hyperprolactinemia were recruited. Aripiprazole was administered to patients with mild hyperprolactinemia (serum prolactin level < 50 ng/mL). Patients with severe hyperprolactinemia (serum prolactin level > 50 ng/mL) were randomized to an aripiprazole-addition group (adding aripiprazole to previous antipsychotics) or a switching group (switching previous antipsychotics to aripiprazole). Serum prolactin level, menstrual disturbances, sexual dysfunction, psychopathologies, and quality of life were measured at weeks 0, 1, 2, 4, 6, and 8. Both the addition and switching groups showed significantly reduced serum prolactin level and menstrual disturbances and improved sexual dysfunction. In patients with severe hyperprolactinemia, the numbers of patients with hyperprolactinemia and menstrual disturbance in the switching group were significantly lower than those in the addition group at week 8. Both the addition and switching strategies were effective in resolving antipsychotic-induced hyperprolactinemia and hyperprolactinemia-related adverse events, including menstrual disturbances and sexual dysfunction. In addition, these findings suggest that switching to aripiprazole may be more effective than addition of aripiprazole for normalizing hyperprolactinemia and improving hyperprolactinemia-related adverse events in patients with schizophrenia.

  4. Attention bias for sexual words in female sexual dysfunction.

    PubMed

    Beard, Courtney; Amir, Nader

    2010-01-01

    Cognitive models suggest that attention processes maintain sexual dysfunction. However, few published studies have examined attention bias, and even fewer have studied female participants with sexual dysfunction. Using the Female Sexual Function Index, the authors classified undergraduates as experiencing sexual dysfunction (n = 28) or not (n = 28). The authors assessed whether participants showed attention bias for sexual words using a modified dot-probe task. As expected, female participants with sexual dysfunction showed an attention bias to sexual words, whereas control participants did not. The authors discuss implications for models of sexual dysfunction and clinical intervention.

  5. [Female sexual dysfunction].

    PubMed

    Bitzer, Johannes; Alder, Judith

    2010-03-01

    Sexual medicine has become an integrated part of womens' health care. Physicians need therefore communication skills to talk about sexuality with their female patients and a knowledge about models of human sexuality, about classification systems, and diagnostic and therapeutic concepts and processes. The diagnostic reaches from a clear description of the sexual problem to an exploration of the conditioning factors. These can be differentiated into biological factors, intraindividual and interpersonal psychological factors and sociocultural factors. These factors can become effective as predisposing, precipitating and maintaining factors. The therapeutic process is based on several steps. The basic step consists in psychoeducation and basic counselling. Therapy usually includes the combination of pharmacologic intervention (hormones, PDE5) and specific psychotherapeutic techniques (sensate focus, cognitive techniques, couple counselling).

  6. Hypnotic metaphor and sexual dysfunction.

    PubMed

    Gilmore, L G

    1987-01-01

    Although hypnosis can be very effective in alleviating sexual problems, few sex therapists use hypnotic methods. This paper seeks to encourage a greater use of hypnosis among clinicians by presenting: a description of the new hypnosis exemplified in the work of Milton H. Erickson; an explanation of one of Erickson's most important and innovative methods, the use of multiple embedded metaphors; and case histories illustrating the application of hypnotic approaches to sexual dysfunction.

  7. Pathophysiology of diabetic sexual dysfunction.

    PubMed

    Morano, S

    2003-01-01

    Sexual dysfunction is common in patients with diabetes mellitus. Vascular, neurological and hormonal alterations are involved in this complication. Many studies showed altered endothelium-dependent and neurogenic relaxations in corpus cavernosum from diabetic patients with erectile dysfunction (ED). This finding has been associated with a lack of nitric oxyde (NO) production and a significant increase in NO synthase (NOS) binding sites in penile tissues, induced by diabetes. Advanced glycation endproducts (AGEs) concur to diabetic vascular complications by quenching NO activity and by increasing the expression of mediators of vascular damage such as vascular endothelial growth factor (VEGF), possessing permeabilizing and neoangiogenic effects, and endothelin-1 (ET-1), with vaso-constricting and mitogenic action. Moreover, the differential gene expression for various growth factors in penile tissues may be involved in the pathophysiology of ED associated with diabetes. Neuropathy is also likely to be an important cause of diabetic ED: morphological alterations of autonomic nerve fibers in cavernosal tissue of patients with diabetic ED have been demonstrated. Finally, androgens enhance nNOS gene expression in the penile corpus cavernosum of rats, suggesting that they play a role in maintaining NOS activity. However, sexual dysfunctions in women with diabetes has received less attention in clinical research. Several studies suggest an increased prevalence of deficient vaginal lubrication, making sexual intercourse unpleasant. Sexual dysfunction is associated with lower overall quality of marital relation and more depressive symptoms in diabetic women.

  8. Sexual dysfunction among youth: an overlooked sexual health concern.

    PubMed

    Moreau, Caroline; Kågesten, Anna E; Blum, Robert Wm

    2016-11-18

    There is growing recognition that youth sexual health entails a broad range of physical, emotional and psychosocial responses to sexual interactions, yet little is known about sexual dysfunctions and well being in youth populations. This study explored sexual dysfunctions among youth and its associations with other domains of sexual health. Sexual dysfunctions were defined as: problems related to orgasm, pain during intercourse, lack of sexual desire or sexual pleasure. Data were drawn from the 2010 French national sexual and reproductive health survey comprising a random sample of 2309 respondents aged 15-24 years. The current analysis included 842 females and 642 males who had sexual intercourse in the last 12 months. Chi square tests were used to test for differences in sexual dysfunctions by sex and explore associations with other domains of sexual health. Half of females (48%) reported at least one sexual dysfunction versus 23% of males. However, over half (57%) of youth reporting at least one dysfunction did not consider this to hinder their sexuality. Altogether, 31% of females cited at least one sexual dysfunction hindering their sexuality-more than three times the 9% of males. Sexual dysfunction was strongly and inversely related to sexual satisfaction for both males and females and additionally to a recent diagnosis of STI or unintended pregnancy for females. Sexual dysfunctions hindering sexuality were also correlated with a history of unintended pregnancy among males. While most youth in France enjoy a satisfying sexual life, sexual dysfunction is common, especially among females. Public health programs and clinicians should screen for and address sexual dysfunction, which substantially reduce youth sexual wellbeing.

  9. On the Etiology of Sexual Dysfunction

    ERIC Educational Resources Information Center

    Apfelbaum, Bernard

    1977-01-01

    Lack of consideration of the sexually functional population has led to misconceptions about causes of sexual dysfunction functioning. Automatic functioning can mask effects of pathogenic influences on sexuality, making these effects appear random, confounding etiological issues and creating the belief that causes of sexual dysfunction and disorder…

  10. On the Etiology of Sexual Dysfunction

    ERIC Educational Resources Information Center

    Apfelbaum, Bernard

    1977-01-01

    Lack of consideration of the sexually functional population has led to misconceptions about causes of sexual dysfunction functioning. Automatic functioning can mask effects of pathogenic influences on sexuality, making these effects appear random, confounding etiological issues and creating the belief that causes of sexual dysfunction and disorder…

  11. [Antipsychotic-induced tardive syndromes].

    PubMed

    Fleischhacker, W Wolfgang; Hofer, Alex; Jagsch, Christian; Pirker, Walter; Psota, Georg; Rittmannsberger, Hans; Seppi, Klaus

    2016-09-01

    Tardive dyskinesia (TD) remains a relevant clinical problem despite the increasing use of new-generation antipsychotics. Antipsychotic-induced tardive syndromes are difficult to treat and have a low tendency of remission. Therefore, prophylaxis is of utmost importance, with the responsible use of antipsychotics as a prime desideratum. With respect to managing tardive dyskinesia, discontinuing the antipsychotic, if possible, albeit not backed up by unequivocal evidence, is still the main recommendation. If this is not possible, the switch to an antipsychotic with a lower TD risk is the next-preferred option. Other symptomatic treatments have been explored, but clinical trials have provided inhomogeneous results and only very few compounds are approved for the treatment of tardive dyskinesia. This manuscript summarizes the current evidence with respect to the phenomenology, course, prevention and treatment of tardive syndromes.

  12. Pharmacotherapy of Sexual Dysfunctions : Current Status

    PubMed Central

    Avasthi, Ajith; Biswas, Parthasarathy

    2004-01-01

    The sexual dysfunctions are one of the most prevalent conditions. Sexual dysfunctions can have profound effect on the psychological well-being of an individual and the psychosexual relationship of a couple. Management of the sexual dysfunction should be preceded by an accurate diagnosis reached after a complete medical and sexual history and physical examination. Current focus of researchers has been on understanding the pathophysiology of erectile dysfunction, premature ejaculation and other sexual dysfunctions that can help in developing newer pharmacological cures for these conditions. Recently, a number of clinical trials have studied the potential effectiveness of the phosphodiesterase (PDE)-5 inhibitor sildenafil in the treatment of Erectile Dysfunction (ED) and Premature Ejaculation (PME). The introduction of PDE-5 inhibitors like sildenafil, vardenafil and tadalafil has revolutionized the treatment of sexual dysfunctions. This review focuses on the recent pharmacological advances in the treatment of common sexual dysfunctions like ED and PME with special focus on the role of PDE-5 inhibitors. Also discussed is the pharmacological treatment of other less prevalent and recognized disorders like female sexual dysfunction, drug induced sexual dysfunction etc. PMID:21224902

  13. Frequency of sexual dysfunction in patients with a psychotic disorder receiving antipsychotics.

    PubMed

    Montejo, Angel L; Majadas, Susana; Rico-Villademoros, Fernando; Llorca, Ginés; De La Gándara, Jesús; Franco, Manuel; Martín-Carrasco, Manuel; Aguera, Luis; Prieto, Nieves

    2010-10-01

    Although it is a troublesome side effect, information on antipsychotic-induced sexual dysfunction is limited. To evaluate the frequency of sexual dysfunction and its impact on treatment adherence in patients with a psychotic disorder treated with various antipsychotics under routine clinical conditions. Subjects included were sexually active male and female patients 18 years of age or older with a diagnosis of schizophrenia, schizophreniform disorder, schizoaffective disorder, or other psychotic disorder. This was a multicenter, cross-sectional, and naturalistic study conducted by 18 investigators. In addition to sexual functioning, we recorded demographic data, psychiatric diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), and medication history. Pyschotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SalSex). All the analyses were performed in the 243 evaluable patients. Most patients were males (71%), and the most common diagnosis was schizophrenia (71%). Overall, 46% of the patients exhibited sexual dysfunction according to the assessment with the SalSex (50% of the males and 37% of the females). Only 37% of the patients with sexual dysfuntion spontaneously reported it. Among the patients exhibiting sexual dysfunction, 32% reported to have poor tolerance to the disturbance. With the exception of conventionals depot, which had a very important and greater effect on females' sexual funtioning, the severity and tolerance of sexual dysfunction were worse in males than in females regardless of the antipsychotic studied. In the univariate logistic regression analysis, using olanzapine as a reference category, risperidone (odds ratio [OR] 7.45, 95% confidence interval [CI] 3.73-14.89) and conventionals, depot (OR 4.57, 95% CI 1.72-12.13) and nondepot (OR 4.92, 95% CI 1.43-16.93), showed a significant increased risk of sexual dysfunction. Our results show that sexual dysfunction is very common in patients receiving

  14. Diabetes and sexual dysfunction: current perspectives

    PubMed Central

    Maiorino, Maria Ida; Bellastella, Giuseppe; Esposito, Katherine

    2014-01-01

    Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress – all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes. PMID:24623985

  15. Marital sexual dysfunction:introductory concepts.

    PubMed

    Levine, S B

    1976-04-01

    The concepts presented in this overview of marital sexual dysfunction are derived from increasing clinical experience with couples who seek help for their sexual problems. These couples, in marked contrast to couples with good sexual functioning, usually report a steady state of emotional dissatisfaction and minimal physical pleasure from sex. The affectual and behavioral consequences of persistent dysfunction are reviewed. Sexual therapy is discussed in terms of its two elements, sensate focus and psychotherapy. The various tastks which the sexual therapist may have to accomplish with individual couples are described. Consideration is given to the specific hypothese usually offered as explanation for sexual dysfunction-i.e., organic factors, varying degrees of relationship failure, poor communication, sexual ignorance, performance anxiety, and intrapsychic residua of past experience. A protocol for the screening physician to use in the formulation of a reasonable clinical plan for dysfunctional couples is included.

  16. Sexual dysfunction within an adult developmental perspective.

    PubMed

    Fagan, P J; Meyer, J K; Schmidt, C W

    1986-01-01

    The focus of this paper is on the adult who has adequately mastered the oedipal stage of psychosexual development and who presents with a sexual dysfunction. Drawing on the developmental sequence of Erik Erikson, the authors suggest that failure to address adequately an adult psychosocial crisis may result in sexual dysfunction. There may be both adult developmental deficits and regression to adolescent and adult stages previously negotiated. Both may be symptomatically represented by sexual dysfunction. The authors urge that the sexual and marital problems be evaluated within an adult developmental framework and that the therapy address the psychosocial issues which are appropriate to the developmental stage of the patient.

  17. Female sexual dysfunction: definition, classification, and debates.

    PubMed

    Chen, Ching-Hui; Lin, Yen-Chin; Chiu, Li-Hsuan; Chu, Yuan-Hsiang; Ruan, Fang-Fu; Liu, Wei-Min; Wang, Peng-Hui

    2013-03-01

    Sexual dysfunction refers to difficulties that occur during the sexual response cycle that prevent the individual from experiencing satisfaction from sexual activity. It is relatively difficult to estimate the prevalence of female sexual dysfunction (FSD), because the definition and diagnostic criteria are still controversial and under development. These difficulties reveal our insufficient understanding of the basis of FSD. This review was conducted in an effort to deal with this complicated clinical issue, by examining the most updated clinical criteria of FSD under the context of a redefined female sexual response model.

  18. Antidepressant-Induced Female Sexual Dysfunction.

    PubMed

    Lorenz, Tierney; Rullo, Jordan; Faubion, Stephanie

    2016-09-01

    Because 1 in 6 women in the United States takes antidepressants and a substantial proportion of patients report some disturbance of sexual function while taking these medications, it is a near certainty that the practicing clinician will need to know how to assess and manage antidepressant-related female sexual dysfunction. Adverse sexual effects can be complex because there are several potentially overlapping etiologies, including sexual dysfunction associated with the underlying mood disorder. As such, careful assessment of sexual function at the premedication visit followed by monitoring at subsequent visits is critical. Treatment of adverse sexual effects can be pharmacological (dose reduction, drug discontinuation or switching, augmentation, or using medications with lower adverse effect profiles), behavioral (exercising before sexual activity, scheduling sexual activity, vibratory stimulation, psychotherapy), complementary and integrative (acupuncture, nutraceuticals), or some combination of these modalities. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  19. [Behavioral approach to sexual dysfunctions].

    PubMed

    Gellman, C

    1983-01-01

    The basic principles of those behaviourist approaches are: - Treatment of the couple, no matter which partner is apparently "responsible" for the sexual problem, and mutual involvement of both partners. - Sexual information and education regarding the cycle of sexual response, anatomy, biology, and sexual techniques. - Changing negative attitudes vis-à-vis sexuality. - Elimination of sexual anxieties. - Improvement of verbal and corporal communication within the couple. - Learning to know oneself and others better--Initiation to psychological attention and observation.

  20. [Female sexual dysfunction: Drug treatment options].

    PubMed

    Alcántara Montero, A; Sánchez Carnerero, C I

    2016-01-01

    Many women will likely experience a sexual problem in their lifetime. Female sexual dysfunction is a broad term used to describe 3 categories of disorders of a multifactorial nature. Effective, but limited pharmacotherapeutic options exist to address female sexual dysfunction. The FDA recently approved the first agent for treatment of hypoactive sexual desire disorder in pre-menopausal women. Off-label use of hormonal therapies, particularly oestrogen and testosterone, are the most widely employed for female sexual dysfunction, particularly in post-menopausal women. Other drugs currently under investigation include phosphodiesterase inhibitors and agents that modulate dopamine or melanocortin receptors. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Major depressive disorder, antidepressants, and sexual dysfunction.

    PubMed

    Clayton, Anita H; Montejo, Angel L

    2006-01-01

    Sexual dysfunction is a common problem with a number of causes, including psychosocial factors, general medical illness, psychiatric disorders, and psychotropic and nonpsychiatric medications. It is especially prevalent among patients with poor emotional health and has been strongly associated with antidepressant medications. Selective serotonin reuptake inhibitors (SSRIs) in particular have demonstrated a higher incidence of sexual dysfunction than other antidepressants that work through different mechanisms of action. Further supporting the relationship between sexual dysfunction and antidepressant mechanism of action, data from a number of studies indicate that bupropion, nefazodone, and mirtazapine alleviate symptoms of sexual dysfunction and are as effective as SSRIs at controlling depressive symptoms. Although a number of strategies besides drug substitution have been utilized to help manage antidepressant-induced sexual dysfunction, many patients remain suboptimally treated; as many as 42% of patients were found to passively wait for spontaneous remission. The addition of antidotal therapy has been proven to be among the effective management strategies for sexual dysfunction. However, due to a lack of systematic data, additional studies are warranted to further investigate these findings.

  2. [Sex therapy for male sexual dysfunction].

    PubMed

    Rösing, D; Klebingat, K-J; Beier, K M

    2006-08-01

    A high prevalence and incidence of sexual dysfunctions as well as the availability of orally effective medications cause a rising interest in professional help. In diagnosing and treating sexual disorders, a holistic, biopsychosocial understanding of sexuality and a thorough analysis of the specific needs of the couple are of the utmost importance. Furthermore, the typical physician-patient relationship has to be transformed into a physician-couple relationship wherever possible. Sex therapy, then, focuses on the universal psychosocial fundamental needs and their relevance for the complaints of the couple. In this way the main focus of attention is shifted from the sexual dysfunction to the communicative meaning of sexuality within the relationship and to the quality of the partnership as a whole. Thus the sexual problem is put into a new perspective and sexual functions are relieved from the pressure of performance anxiety. Simultaneously intimacy and mutual satisfaction are promoted. The possibility of obtaining an additional qualification in sexual medicine (since 1997 in postgraduate, curricular trainings) is offering new opportunities for urologists to integrate aspects of sexual medicine into their clinical practice and thus to propose a more extensive form of therapy to their patients. This paper reflects the process of this integration, illustrating it with respective case reports; it stresses the necessity of a holistic approach to the treatment of sexual dysfunctions, also in regard to the economic advantages of a biopsychosocially oriented sex therapy.

  3. Male Pseudoheterosexuality and Minimal Sexual Dysfunction

    ERIC Educational Resources Information Center

    Gutstadt, Joseph P.

    1976-01-01

    There is often a correlation between "pseudoheterosexuality" and minor sexual dysfunction. Insight alone is not sufficient to provide relief, but when the patient can be helped to a comfortable acceptance of his homosexual feelings as a normal and healthy facet of his personality, very often the dysfunction is relieved. (Author)

  4. Sexual dysfunction in inflammatory bowel disease.

    PubMed

    Ghazi, Leyla J; Patil, Seema A; Cross, Raymond K

    2015-04-01

    Sexual health is a broad term that encompasses a variety of functions including sexual thoughts, desire, arousal, intercourse, orgasm, and the impact of body image. Sexual dysfunction in individuals with inflammatory bowel disease is multifactorial including the impact of psychosocial factors, disease activity, medical therapies, surgical interventions, body image perceptions and changes, hypogonadism, and pelvic floor disorders. Providers caring for patients with inflammatory bowel disease should be cognizant of these concerns and develop management plans and techniques for earlier diagnosis and treatment.

  5. Sex therapy for female sexual dysfunction

    PubMed Central

    2013-01-01

    Introduction About 45% of women suffer from some form of sexual dysfunction. Despite its high prevalence, there are few studies that have systematically evaluated sex therapy in comparison with other interventions. Objective Review randomized clinical trials that present psychotherapeutic interventions for female sexual dysfunctions. Method Through a search in three databases (Medline, Web of Science and PsycInfo), 1419 references were found. After an analysis of the abstracts, twenty-seven articles met the inclusion criteria and composed this review. Results Sex therapy, as proposed by Masters and Johnson and Heiman and LoPiccolo, is still the most commonly used form of therapy for sexual dysfunctions; although it has shown results, the results do not consistently support that this is the best alternative in the treatment of sexual dysfunctions. Conclusion There is a lack of systematic study of many female sexual dysfunctions. Orgasmic disorder and sexual pain (vaginismus and dyspaurenia) are the most extensively studied disorders and those in which sex therapy seems to have better outcomes. PMID:24066697

  6. Sexual medicine in family practice. Part 2: Treating sexual dysfunction.

    PubMed Central

    Holzapfel, S.

    1993-01-01

    Sexual problems can be caused by organic or psychological factors, or a combination of the two. Deciding which leads to an appropriate management plan. This paper describes the current status of treatments for common sexual dysfunctions seen in family practice. PMID:8471907

  7. Antipsychotic-induced hyperprolactinaemia: mechanisms, clinical features and management.

    PubMed

    Haddad, Peter M; Wieck, Angelika

    2004-01-01

    Hyperprolactinaemia is an important but neglected adverse effect of antipsychotic medication. It occurs frequently with conventional antipsychotics and some atypical antipsychotics (risperidone and amisulpride) but is rare with other atypical antipsychotics (aripiprazole, clozapine, olanzapine, quetiapine, ziprasidone). For this reason the terms 'prolactin-sparing' and 'prolactin-raising' are more useful than 'atypical' and 'conventional' when considering the effect of antipsychotic drugs on serum prolactin. During antipsychotic treatment prolactin levels can rise 10-fold or more above pretreatment values. In a recent study approximately 60% of women and 40% of men treated with a prolactin-raising antipsychotic had a prolactin level above the upper limit of the normal range. The distinction between asymptomatic and symptomatic hyperprolactinaemia is important but is often not made in the literature. Some symptoms of hyperprolactinaemia result from a direct effect of prolactin on target tissues but others result from hypogonadism caused by prolactin disrupting the normal functioning of the hypothalamic-pituitary-gonadal axis. Symptoms of hyperprolactinaemia include gynaecomastia, galactorrhoea, sexual dysfunction, infertility, oligomenorrhoea and amenorrhoea. These symptoms are little researched in psychiatric patients. Existing data suggest that they are common but that clinicians underestimate their prevalence. For example, well conducted studies of women treated with conventional antipsychotics have reported prevalence rates of approximately 45% for oligomenorrhoea/amenorrhoea and 19% for galactorrhoea. An illness-related under-function of the hypothalamic-pituitary-gonadal axis in female patients with schizophrenia may also contribute to menstrual irregularities. Long-term consequences of antipsychotic-related hypogonadism require further research but are likely and include premature bone loss in men and women. There are conflicting data on whether

  8. Pelvic floor dysfunction: women's sexual concerns unraveled.

    PubMed

    Roos, Anne-Marie; Thakar, Ranee; Sultan, Abdul H; Burger, Curt W; Paulus, Aggie T G

    2014-03-01

    Sexual function of women suffering from pelvic organ prolapse (POP) and/or urinary incontinence (UI) is adversely affected. However, our current understanding of the exact relationship between female sexual dysfunction and POP and/or UI is incomplete. A qualitative study can improve our understanding by describing what women themselves perceive as the real problem. To gain a more in-depth understanding of the impact of POP and/or UI on the different categories of female sexual dysfunction by way of a qualitative study. Qualitative semistructured interviews were conducted in 37 women scheduled for pelvic floor surgery, and one was excluded from analysis due to incomplete recordings. The impact of POP and/or UI on female sexual function. Only 17% of women were completely positive about their sex life. Both POP and UI had a negative effect on body image. Women with POP had a negative image of their vagina, which caused them to be insecure about their partner's sexual experience, while women with UI were embarrassed about their incontinence and pad use, and feared smelling of urine. Worries about the presence of POP during sexual activity, discomfort from POP, and reduced genital sensations were the most important reasons for decreased desire, arousal, and difficulty reaching an orgasm in women with POP. Fear of incontinence during intercourse affected desire, arousal, and orgasm and could be a cause for dyspareunia in women with UI. Desire was divided into two main elements: "drive" and "motivation." Although "drive," i.e., spontaneous sexual interest, was not commonly affected by POP and/or UI, a decrease in "motivation" or the willingness to engage in sexual activity was the most common sexual dysfunction mentioned. Body image plays a key role in the sexual functioning of women with POP and/or UI with the biggest impact on women's "motivation." © 2013 International Society for Sexual Medicine.

  9. Sexual Dysfunction before and after Cardiac Rehabilitation.

    PubMed

    Schumann, Jörg; Zellweger, Michael J; Di Valentino, Marcello; Piazzalonga, Simone; Hoffmann, Andreas

    2010-01-01

    Background. The aim of this study was to assess sexual function before and after cardiac rehabilitation in relation to medical variables. Methods. Analysis of patients participating in a 12-week exercise-based outpatient cardiac rehabilitation program (OCR) between April 1999 and December 2007. Exercise capacity (ExC) and quality of life including sexual function were assessed before and after OCR. Results. Complete data were available in 896 male patients. No sexual activity at all was indicated by 23.1% at baseline and 21.8% after OCR, no problems with sexual activity by 40.8% at baseline and 38.6% after OCR. Patients showed an increase in specific problems (erectile dysfunction and lack of orgasm) from 18% to 23% (P < .0001) during OCR. We found the following independent positive and negative predictors of sexual problems after OCR: hyperlipidemia, age, CABG, baseline ExC and improvement of ExC, subjective physical and mental capacity, and sense of affiliation. Conclusions. Sexual dysfunction is present in over half of the patients undergoing OCR with no overall improvement during OCR. Age, CABG, low exercise capacity are independent predictors of sexual dysfunction after OCR.

  10. The Relationship between Childhood Sexual Abuse and Adult Male Sexual Dysfunction.

    ERIC Educational Resources Information Center

    Sarwer, David B.; And Others

    1997-01-01

    A study of 359 men who sought sexual dysfunction treatment found that childhood sexual abuse did not predict sexual dysfunction in the men. Unemployment was the only significant predictor of male sexual dysfunction. Differences between the sexual abuse experiences of the male victims compared to female victims (n=73) are discussed. (Author/CR)

  11. The Relationship between Childhood Sexual Abuse and Adult Male Sexual Dysfunction.

    ERIC Educational Resources Information Center

    Sarwer, David B.; And Others

    1997-01-01

    A study of 359 men who sought sexual dysfunction treatment found that childhood sexual abuse did not predict sexual dysfunction in the men. Unemployment was the only significant predictor of male sexual dysfunction. Differences between the sexual abuse experiences of the male victims compared to female victims (n=73) are discussed. (Author/CR)

  12. Male Sexual Dysfunction and Chronic Kidney Disease

    PubMed Central

    Edey, Matthew M.

    2017-01-01

    Male sexual dysfunction is common in chronic kidney disease (CKD), particularly in end-stage renal disease. Historically, this cause of considerable morbidity has been under-reported and under-recognized. The ideal approach to diagnosis and management remains unclear due to a paucity of good quality data, but an understanding of the pathophysiology is necessary in order to address the burden of this important complication of CKD. This paper will review the endocrine dysfunction that occurs in renal disease, particularly the hypothalamic–pituitary–gonadal axis, discuss the causes of erectile dysfunction, infertility, and altered body image and libido in these patients and suggest appropriate treatment interventions. PMID:28382300

  13. Endocrine aspects of male sexual dysfunctions.

    PubMed

    Buvat, Jacques; Maggi, Mario; Gooren, Louis; Guay, Andre T; Kaufman, Joel; Morgentaler, Abraham; Schulman, Claude; Tan, Hui Meng; Torres, Luiz Otavio; Yassin, Aksam; Zitzmann, Michael

    2010-04-01

    Endocrine disorders may adversely affect men's sexual function. To provide recommendations based on best evidence for diagnosis and treatment of endocrine-related male sexual dysfunctions. The Endocrine Aspects of Male Sexual Dysfunctions Committee, including 11 members from eight countries and four continents, collaborated with the Endocrine subcommittee of the Standards Committee of the International Society for Sexual Medicine. Medical literature was reviewed in detail, followed by extensive internal committee discussion over 2 years, then public presentation and discussion with the other experts before finalizing the report. Recommendations based on grading of evidence-base medical literature and interactive discussion. From animal studies, it is derived that testosterone modulates mechanisms involved in erectile machinery, including expression of enzymes that both initiate and terminate erection. In addition, testosterone is essential for sexual motivation. Whether these findings could be extrapolated to human erections is unclear. Testosterone plays a broad role in men's overall health. Recent studies have established strong associations between low testosterone and metabolic and cardiovascular imbalances. In some studies, low testosterone decreased longevity; however, longitudinal studies do not support the predictive value of low testosterone for further cardiovascular events. The article proposes a standardized process for diagnosis and treatment of endocrine-related male sexual dysfunctions, updating the knowledge on testosterone and prostate safety. There is no compelling evidence that testosterone treatment causes prostate cancer or its progression in men without severe testosterone deficiency (TD). The possible roles of prolactin and thyroid hormones are also examined. Men with erectile dysfunction, hypoactive sexual desire and retarded ejaculation, as well as those with visceral obesity and metabolic diseases, should be screened for TD and treated

  14. [Effectiveness of trazodone in the treatment of sexual dysfunctions].

    PubMed

    Gałecki, Piotr; Florkowski, Antoni

    2010-07-01

    Sexual dysfunctions may be main cause of social disability. The knowledge of the rates of occurrence of sexual dysfunctions in the general population and the primary risk factors for these conditions is very important to assist in assessing the risk and planning treatment. Sexual dysfunctions are highly prevalent in our society worldwide, and that the occurrence of sexual dysfunctions increases directly with age for both men and women. Specific medical conditions and health behaviors represent major risk factors for sexual disorders. Trazodone is sedative antidepressant drug, which is effective, safe, fast acting, with a few side effects, with proved efficiency in the treatment of sexual dysfunction.

  15. AB271. Sexual dysfunction in chronic prostatitis

    PubMed Central

    Cho, In-Rae

    2016-01-01

    Chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS), or NIH category III prostatitis, is a clinical syndrome characterized by genital/ pelvic pain and lower urinary tract symptoms in the absence of urinary tract infection. CPPS is the most common prostatic disease in men younger than 50 years of age and the third most common in men older than 50 years of age. CP/CPPS is a complex entity with unclear etiology. Many articles reported that the high percentage of patients with CP/CPPS had sexual dysfunction. The most common symptoms of sexual dysfunction in chronic prostatitis patients are erectile dysfunction (ED), painful ejaculation and premature ejaculation. So we will discuss about ED and ejaculation problems in CP/CPPS patients.

  16. Sexual dysfunction in obese and overweight women.

    PubMed

    Yaylali, G F; Tekekoglu, S; Akin, F

    2010-01-01

    Both overweight and obesity have been identified as risk factors for sexual dysfunction in men, but the relationship between sexual function and amount of body fat in females is still obscure. There are few reported studies in women assessing the relationship between female sexual function index (FSFI) and body weight. The aim of this study was to identify the frequency of female sexual dysfunction (FSD) among obese and overweight women. A total of 45 obese and overweight and 30 age-matched voluntary healthy women serving as a control group were evaluated by a detailed medical and sexual history, including the FSFI questionnaire. Serum prolactin, cortisol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone-SO(4) (DHEA-S), testosterone, estradiol and sex hormone-binding globulin (SHBG) levels were measured. No significant difference was observed between controls and patients in terms of the FSH, LH, estradiol, free thyroxine and thyrotropin (TSH), testosterone and DHEA-S levels. The comparison of total FSFI scores between patients and controls showed no significant difference (P=0.74). As the FSFI score of sexual dysfunction. The mean total FSFI score was 22.1+/-4.3 for obese patients and 23.1+/-3.7 for healthy women. FSFI scores were not correlated with any of the anthropometric measurements (body mass index (BMI), waist-to-hip ratio (WHR) and fat percent). The levels of total testosterone and DHEA-S were not correlated with total FSFI scores. We found a significant negative correlation between BMI and orgasm (P=0.007, r=-0.413). Satisfaction was also negatively correlated with BMI (P=0.05, r=-0.305) and weight (P=0.03, r=-0.326). Testosterone levels were negatively correlated with only satisfaction domain scores of FSFI (P=0.01, r=-0.385). We found that 86% of obese women and 83% of controls had sexual dysfunction. Although obesity does not

  17. [How Does Lower Urinary Tract Dysfunction Affekt Female Sexuality?].

    PubMed

    Anding, R; Kirschner-Hermanns, R; Rantell, A; Wiedemann, A

    2016-08-01

    With increasing age many women suffer from lower urinary tract dysfunction (LUTD) and female sexual dysfunction. An increasing body of evidence supports an association between the 2 conditions. Especially women with urodynamically proved detrusor hyperactivity suffer from sexual dysfunction and there is some evidence that in patients with stress incontinence sexual health improves after successful surgery.

  18. PTSD and Sexual Dysfunction in Men and Women.

    PubMed

    Yehuda, Rachel; Lehrner, Amy; Rosenbaum, Talli Y

    2015-05-01

    Difficulties in sexual desire and function often occur in persons with posttraumatic stress disorder (PTSD), but many questions remain regarding the mechanisms underlying the occurrence of sexual problems in PTSD. The aim of this review was to present a model of sexual dysfunction in PTSD underpinned by an inability to regulate and redirect the physiological arousal needed for healthy sexual function away from aversive hyperarousal and intrusive memories. A literature review pertaining to PTSD and sexual function was conducted. Evidence for the comorbidity of sexual dysfunction and PTSD is presented, and biological and psychological mechanisms that may underlie this co-occurrence are proposed. This manuscript presents evidence of sexual dysfunction in conjunction with PTSD, and of the neurobiology and neuroendocrinology of PTSD and sexual function. Sexual dysfunction following trauma exposure may be mediated by PTSD-related biological, cognitive, and affective processes. The treatment of PTSD must include attention to sexual dysfunction and vice versa. © 2015 International Society for Sexual Medicine.

  19. Sexual dysfunction in women with ESRD requiring hemodialysis.

    PubMed

    Strippoli, Giovanni F M; Vecchio, Mariacristina; Palmer, Suetonia; De Berardis, Giorgia; Craig, Jonathan; Lucisano, Giuseppe; Johnson, David; Pellegrini, Fabio; Nicolucci, Antonio; Sciancalepore, Michela; Saglimbene, Valeria; Gargano, Letizia; Bonifati, Carmen; Ruospo, Marinella; Navaneethan, Sankar D; Montinaro, Vincenzo; Stroumza, Paul; Zsom, Marianna; Torok, Mariatta; Celia, Eduardo; Gelfman, Ruben; Bednarek-Skublewska, Anna; Dulawa, Jan; Graziano, Giusi; Gentile, Giorgio; Ferrari, Juan Nin; Santoro, Antonio; Zucchelli, Annalisa; Triolo, Giorgio; Maffei, Stefano; Hegbrant, Jörgen; Wollheim, Charlotta; De Cosmo, Salvatore; Manfreda, Valeria M

    2012-06-01

    The few existing studies of sexual dysfunction in women on hemodialysis are limited by small sample size. This large, cross-sectional study evaluated the prevalence and correlates of female sexual dysfunction in advanced kidney disease. DESIGN, SETTING, PARTICIPANTS, METHODS: A total of 1472 women with ESRD undergoing hemodialysis were recruited to a multinational, cross-sectional study conducted within a collaborative dialysis network in Europe and South America. Sexual dysfunction was identified by the Female Sexual Function Index. Correlates of self-reported sexual dysfunction were identified by regression analyses. Of the 1472 women, 659 completed questionnaires (45%). More than half (362 of 659 [55%]) lived with a partner, and 232 of 659 (35%) reported being sexually active. Of these 659 respondents, 555 (84%) reported sexual dysfunction. Women with a partner (282 of 362 [78%]) were less likely to report sexual dysfunction than those without a partner (273 of 297 [92%]) (P<0.001). Sexual dysfunction was independently associated with age, depressive symptoms, less education, menopause, diabetes, and diuretic therapy. Nearly all women who were not wait-listed for a kidney transplant and were living without a partner (249 of 260 [96%]) reported sexual dysfunction. More than half (128 of 232 [55%]) of sexually active women reported sexual dysfunction, associated with age, depressive symptoms, menopause, low serum albumin, and diuretic therapy. This descriptive study suggests most women on hemodialysis experience sexual problems. Additional research on the relevance of sexual dysfunction to symptom burden and quality of life in these women is needed.

  20. Future Targets for Female Sexual Dysfunction.

    PubMed

    Farmer, Melissa; Yoon, Hana; Goldstein, Irwin

    2016-08-01

    Female sexual function reflects a dynamic interplay of central and peripheral nervous, vascular, and endocrine systems. The primary challenge in the development of novel treatments for female sexual dysfunction is the identification and targeted modulation of excitatory sexual circuits using pharmacologic treatments that facilitate the synthesis, release, and/or receptor binding of neurochemicals, peptides, and hormones that promote female sexual function. To develop an evidence-based state-of-the-art consensus report that critically integrates current knowledge of the therapeutic potential for known molecular and cellular targets to facilitate the physiologic processes underlying female sexual function. State-of-the-art review representing the opinions of international experts developed in a consensus process during a 1-year period. Expert opinion was established by grading the evidence-based medical literature, intensive internal committee discussion, public presentation, and debate. Scientific investigation is urgently needed to expand knowledge and foster development of future treatments that maintain genital tissue integrity, enhance genital physiologic responsiveness, and optimize positive subjective appraisal of internal and external sexual cues. This article critically condenses the current knowledge of therapeutic manipulation of molecular and cellular targets within biological systems responsible for female sexual physiologic function. Future treatment targets include pharmacologic modulation of emotional learning circuits, restoration of normal tactile sensation, growth factor therapy, gene therapy, stem cell-based therapies, and regenerative medicine. Concurrent use of centrally and peripherally acting therapies could optimize treatment response. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  1. Sexual dysfunction in Klinefelter's syndrome patients.

    PubMed

    El Bardisi, H; Majzoub, A; Al Said, S; Alnawasra, H; Dabbous, Z; Arafa, M

    2016-09-23

    Klinefelter's syndrome (KS) is the most common chromosomal abnormality in men with infertility and hypogonadism. Although its influence on fertility has been extensively investigated, very few studies assessed the sexual function of patients with KS. Our aim was to assess the prevalence of sexual dysfunction in patients with KS and investigate possible aetiological factors for reported findings. Medical records of 53 patients with KS were retrospectively reviewed and compared to 75 age-matched control subjects who were prospectively recruited. Sexual history was evaluated through utilisation of international index of erectile function-5 and Arabic index for premature ejaculation questionnaires. Sexual desire was reported subjectively by patients or controls. The incidence of erectile dysfunction and premature ejaculation in patients with KS was 18.9% and 22.6% respectively. Compared to age-matched controls, patients with KS had significantly lower incidence of PE. However, there was no statistically significant difference between both groups regarding erectile function. Libido was significantly lower in patients with KS than normal controls (54.7% vs. 17.3%, p = 0.001). Klinefelter's syndrome is a condition that has a variable presentation. Despite having a higher likelihood of reduced sexual desire, patients may have normal erectile function comparable to age-matched individuals. They tend to have a lower incidence of premature ejaculation.

  2. Sexual Dysfunction in Women: A Practical Approach.

    PubMed

    Faubion, Stephanie S; Rullo, Jordan E

    2015-08-15

    Sexual dysfunction in women is a common and often distressing problem that has a negative impact on quality of life and medication compliance. The problem is often multifactorial, necessitating a multidisciplinary evaluation and treatment approach that addresses biological, psychological, sociocultural, and relational factors. Criteria for sexual interest/arousal disorder require the presence of at least three specific symptoms lasting for at least six months. Lifelong anorgasmia may suggest the patient is unfamiliar or uncomfortable with self-stimulation or sexual communication with her partner. Delayed or less intense orgasms may be a natural process of aging due to decreased genital blood flow and dulled genital sensations. Genito-pelvic pain/penetration disorder includes fear or anxiety, marked tightening or tensing of the abdominal and pelvic muscles, or actual pain associated with attempts toward vaginal penetration that is persistent or recurrent for at least six months. Treatment depends on the etiology. Estrogen is effective for the treatment of dyspareunia associated with genitourinary syndrome of menopause. Testosterone, with and without concomitant use of estrogen, is associated with improvements in sexual functioning in naturally and surgically menopausal women, although data on long-term risks and benefits are lacking. Bupropion has been shown to improve the adverse sexual effects associated with antidepressant use; however, data are limited. Psychotherapy or sex therapy is useful for management of the psychological, relational, and sociocultural factors impacting a woman's sexual function. Clinicians can address many of these issues in addition to providing education and validating women's sexual health concerns.

  3. Testosterone patches for female sexual dysfunction.

    PubMed

    2009-03-01

    There is some suggestion of a link between sexual dysfunction in postmenopausal women and low circulating concentrations of testosterone.1 This underlies the development of a new transdermal testosterone patch (black triangle down Intrinsa - Procter & Gamble) that has recently been licensed in the UK for the treatment of women who have hypoactive sexual desire disorder (HSDD) following a menopause induced by surgery (i.e. bilateral salpingooophorectomy and hysterectomy) and who are receiving concomitant oestrogen replacement therapy.2 Here we discuss the diagnosis of HSDD, as well as the evidence for using transdermal testosterone patches in women in whom this diagnosis is made.

  4. Female sexual dysfunction: anatomy, physiology, evaluation and treatment options.

    PubMed

    Berman, J R; Berman, L A; Werbin, T J; Goldstein, I

    1999-11-01

    It has been estimated that up to 76% of women, depending upon their age, have complaints of sexual dysfunction, including decreased libido, vaginal dryness, pain with intercourse, decreased genital sensation and difficulty or inability to achieve orgasm. Female sexual dysfunction is a significant problem that affects the quality of life of many women. This review addresses the etiologies and incidence of female sexual complaints, as well as new findings in the evaluation and treatment of female sexual dysfunction.

  5. Sexual dysfunction in chronic renal failure.

    PubMed

    Soffer, O

    1980-12-01

    Sexual dysfunction in end-stage renal disease is a troublesome, multifactorial disorder. Abnormality of the hypothalamo-pituitary-gonadal axis is but one of the causes leading to the impotence and infertility commonly encountered in chronic renal failure. Short of kidney transplantation, no therapy is available. Though infertility is the rule in end-stage renal disease, successful fatherhood and deliveries have occurred on rare occasions.

  6. Sexual dysfunction in women with epilepsy

    PubMed Central

    Karan, Vivek; Harsha, S.; Keshava, B. S.; Pradeep, R.; Sathyanarayana Rao, T. S.; Andrade, Chittaranjan

    2015-01-01

    Background: Sexual functioning and variables that influence sexual functioning have not been studied in Indian women with epilepsy. Materials and Methods: In a pilot study, female (age, 18–45 years) outpatients with epilepsy who were in a stable sexual relationship for at least 1-year were screened using the mini international neuropsychiatric interview. Those without anxiety or depressive disorders (n = 60) were studied using the female sexual function index (FSFI; higher scores indicate better functioning). Findings were compared with age- and sex- matched sample of healthy control women drawn from the same sociodemographic population. Results: Women with epilepsy had significantly poorer sexual functioning on all FSFI subscales (desire, arousal, lubrication, orgasm, satisfaction, pain), as well as on the total scale scores, and >70% of these women were rated as dysfunctional on individual FSFI subscales and on the total scale. In multivariate analysis, use of clobazam and phenobarbitone, and longer time after the last seizure were each associated with significantly higher FSFI scores; and longer duration of epilepsy was associated with significantly lower FSFI scores. Conclusion: There is a substantial impairment of sexual functioning in women with epilepsy. This study demonstrates the need for increased awareness of the problem, better case identification, and improved seizure control. PMID:26600586

  7. Association of major depression with sexual dysfunction in men.

    PubMed

    Fabre, Louis F; Clayton, Anita H; Smith, Louis C; Goldstein, Irwin M; Derogatis, Leonard R

    2013-01-01

    The effect of type and severity of depression on sexual functioning was examined before treatment in 591 men with Major Depression (MDD) or Atypical Depression, as determined by percentage of subjects meeting Diagnostic and Statistical Manual, 4th Edition (DSM-IV) sexual dysfunction criteria (A and B only), and percentage with Derogatis Inventory of Sexual Function (DISF) scores greater than 1 standard deviation below normal. Sexual dysfunction rates were higher for MDD than for Atypical Depression. Depression affected DISF domains differently: orgasm was most impaired, whereas sexual desire was preserved. More severe depression resulted in greater sexual dysfunction.

  8. Male sexual dysfunction and quality of life in schizophrenia.

    PubMed

    Olfson, Mark; Uttaro, Thomas; Carson, William H; Tafesse, Eskinder

    2005-03-01

    To describe the prevalence and clinical correlates of sexual dysfunction in a sample of adult male outpatients with schizophrenia treated with olanzapine, risperidone, quetiapine, or haloperidol, focusing on associations between sexual dysfunction and patient-perceived quality of life. Sexual dysfunction was assessed in 139 outpatients with DSM-IV schizophrenia who were receiving olanzapine, risperidone, quetiapine, or haloperidol, but no other medications associated with sexual side effects. Structured assessments were made of psychiatric symptoms, quality of life, and relationships. Sexual dysfunction occurred in 45.3% of patients. Patients with and without sexual dysfunction did not significantly differ with respect to severity of psychiatric symptoms. However, as compared with patients without sexual dysfunction, patients with sexual dysfunction reported significantly lower ratings on global quality of life (t = 2.4, df = 136, p = .02) and the level of enjoyment in their life (t = 2.5, df = 136, p = .01). Patients with sexual dysfunction were significantly less likely than those without sexual dysfunction to report having a romantic partner (17.5% vs. 43.4%; chi(2) = 10.7, df = 1, p = .001), though they were not significantly less likely to report difficulty making friends (27.0% vs. 32.9%; chi(2) = 0.57, df = 1, p = .45). Among patients with romantic partners, those with sexual dysfunction reported significantly poorer quality of their relationships (t = 2.3, df = 42, p = .02) and were less likely to talk to their partner about their illness (t = 2.0, df = 42, p = .047). Sexual dysfunction is common in men with schizophrenia who are treated with olanzapine, risperidone, quetiapine, or haloperidol and is associated with diminished quality of life, decreased occurrence of romantic relationships, and reduced intimacy when relationships are established. High prevalence and substantial interference with quality of life combine to make sexual dysfunction an

  9. Effect of normative masculinity on males' dysfunctional sexual beliefs, sexual attitudes, and perceptions of sexual functioning.

    PubMed

    Clarke, Michael J; Marks, Anthony D G; Lykins, Amy D

    2015-01-01

    Male sexual dysfunction is a prevalent and distressing condition, which may be exacerbated by the sufferer's perceptions of masculinity and normative sexual behavior. This study sought to investigate the effect of social context on males' beliefs regarding sexual behavior. The research examined the effect of male role modeling and masculine cues on males' dysfunctional sexual beliefs, sexual attitudes, and self-perceptions of sexual functioning. A sample of 140 male participants, with a mean age of 29 years, was exposed to pictorial and verbal cues that presented different versions of male behavior across three conditions. Results indicated that males exposed to models and cues of traditional masculinity showed significantly increased levels of dysfunctional sexual beliefs and traditional sexual attitudes relative to males exposed to models of modern masculinity. Results also indicated that males exposed to traditional masculine stimuli reported lower levels of sexual inhibition due to fear of performance failure than males exposed to models of modern masculinity. The potential role of social context is discussed in the development and maintenance of male sexual dysfunction and its implications for treatment.

  10. Sexual dysfunction in cancer patients: a review.

    PubMed

    Cakar, B; Karaca, B; Uslu, R

    2013-01-01

    Cancer is a life-threatening disease despite the advanced therapeutic strategies now available. A common problem is that physicians and patients tend to concentrate on intensive medical treatment options and underestimate the treatment-related adverse effects. In this review, we summarize one of these adverse effects in cancer patients; sexual dysfunction (SD). In addition, current therapeutic choices with optimal doses and patient selection strategies are defined. All patients should be informed about problems associated with therapy-related SD and must be guided toward the most appropriate therapeutic options before starting treatment.

  11. Management of sexual dysfunctions in women.

    PubMed

    Ghizzani, A; Razzi, S; Fava, A; Sartini, A; Picucci, K; Petraglia, F

    2003-01-01

    The deeper understanding of female physiology changed the perspective used to evaluate sexual difficulties. Systems like: vascular, neurological, biochemical, and endocrine are investigated as their modifications for aging or medical conditions may alter the sexual responsivity of women. New data imply that pharmacological interventions may become suitable for women. Gonadal steroids influence mood, wellbeing, and genital physiology but evidence of actions is controversial. Hormone imbalance provokes symptoms that may also derive from other conditions. Clinicians must exclude dismetabolism, depression and family crisis before diagnosing gonadal problems. The female androgen insufficiency syndrome was defined in July 2001 as altered mood, memory and wellbeing, and loss of desire. Estrogen maintains wellbeing and healthy genitals, influencing mood and sexuality. Progesterone provokes tension and nervousness, causing premenstrual syndrome. Hormone replacement is indicated in the treatment of endocrine deficiency. In research projects women receiving one preparation containing androgen reported improvement of mood, and arousal. Sildenafil cures approximately 25% of sexually dysfunctional, menopausal patients; being more effective with hormone replacement therapy (HRT) and consistently active against the block of antidepressants on orgasm. Added to psychiatric regimens, sildenafil ameliorates excitement. Sex therapy helps patients change behavior, overcome anger, communicate needs and redefine sex. We strongly believe that such crucial aspects must be addressed in therapy, even when the etiology is organic.

  12. Psychological and interpersonal dimensions of sexual function and dysfunction.

    PubMed

    McCabe, Marita; Althof, Stanley E; Assalian, Pierre; Chevret-Measson, Marie; Leiblum, Sandra R; Simonelli, Chiara; Wylie, Kevan

    2010-01-01

    There are limited outcome data on the etiology and efficacy of psychological interventions for male and female sexual dysfunction as well as the role of innovative combined treatment paradigms. This study aimed to highlight the salient psychological and interpersonal issues contributing to sexual health and dysfunction, to offer an etiological model for understanding the evolution and maintenance of sexual symptoms, and to offer recommendations for clinical management and research. This study reviewed the current literature on the psychological and interpersonal issues contributing to male and female sexual dysfunction. This study provides expert opinion based on a comprehensive review of the medical and psychological literature, widespread internal committee discussion, public presentation, and debate. Medical and psychological therapies for sexual dysfunctions should address the intricate biopsychosocial influences of the patient, the partner, and the couple. The biopsychosocial model provides an integrated paradigm for understanding and treating sexual dysfunction. There is need for collaboration between healthcare practitioners from different disciplines in the evaluation, treatment, and education issues surrounding sexual dysfunction. In many cases, neither psychotherapy alone nor medical intervention alone is sufficient for the lasting resolution of sexual problems. The assessment of male, female, and couples' sexual dysfunction should ideally include inquiry about predisposing, precipitating, maintaining, and contextual factors. Research is needed to identify efficacious combined and/or integrated treatments for sexual dysfunction.

  13. Creating a game for sexuality and aging: the Sexual Dysfunction Trivia game.

    PubMed

    Skinner, K D

    2000-01-01

    Older adults often present with signs and symptoms of sexual dysfunction, and nurses must possess the necessary knowledge to address this issue. Therefore, The Sexual Dysfunction Trivia Game was designed to educate staff nurses about sexual dysfunction and the aging process. A pilot test was conducted. Five staff nurses played The Sexual Dysfunction Trivia Game. Each nurse completed a pretest before playing the game and a posttest after playing the game. After playing the board game, the nurses were more knowledgeable about what the physical examination includes, what the laboratory tests are, and what the treatment options are for sexual dysfunction. Based on the pretest and posttest findings, The Sexual Dysfunction Trivia Game appears to be an effective teaching tool to educate staff nurses about sexual dysfunction in the older adult. However, more studies are needed to measure its effectiveness.

  14. Diagnosis and treatment of male sexual dysfunction.

    PubMed

    LoPiccolo, J

    1985-01-01

    This paper presents a critical review of recent work on diagnosis and treatment of male sexual dysfunction. One recent advance has been a focus on low sexual desire in males. Hormonal disorders are relatively uncommon in such men, with family-of-origin and couple-dynamic issues usually cited in the clinical literature as major etiologic factors. Recent work on erectile failure has focused on differential diagnosis of physiological and psychological factors in erectile failure. To date, no simple differential diagnostic procedure has been identified, and a complex and expensive multidimensional evaluation is required for accurate diagnosis. Treatment for premature ejaculation continues to be very effective, but an understanding of the mechanism underlying treatment effectiveness has remained elusive. The cause of inhibited ejaculation also continues to be unclear, although medication side effects have been recognized as a common contributing factor. Across all the male dysfunctions, clinical reports have outweighed empirical studies in the recent literature. Heterogeneity of patient groups, lack of objective outcome measures, lack of control groups, and other basic methodological problems, continue to plague this area of research.

  15. An update on sexual function and dysfunction in women.

    PubMed

    Khajehei, Marjan; Doherty, Maryanne; Tilley, P J Matt

    2015-06-01

    Sexual function of women can be affected by many factors resulting in female sexual dysfunction (FSD). Sexual dysfunction is a common problem among women of all ages and has negative effects not only on their quality of lives but also on the sexual function and quality of life of their partners. It can also affect mental health of the entire family and society. Regarding the multidimensional nature of female sexual dysfunction and considering its consequences, this condition needs to be recognised in its early stages in order to prevent future consequences and impacts. This article discusses biopsychosocial aspect of female sexual function, classifications and risk factors of female sexual dysfunction and investigates current approaches to identify and treat this problem.

  16. Arriving at the diagnosis of female sexual dysfunction.

    PubMed

    Latif, Erin Z; Diamond, Michael P

    2013-10-01

    Female sexual dysfunctions include a group of sexual complaints and disorders affecting women of all ages, and stemming from a heterogeneous array of etiologies and contributing factors. The classification system for sexual dysfunctions in the woman has evolved from a linear categorization of sexual desire, arousal, orgasm, and pain disorders to one that is more complex and overlapping. Personal distress is a key factor in defining a sexual problem as a dysfunction. The recently released Diagnostic and Statistical Manual of Mental Disorders, edition 5, collapses former definitions of female sexual disorders and moves away from the older linear model of diagnostic categories. Physicians should be open to discussing sexual problems with women, and may make use of validated questionnaires in the office setting. Evaluation tools available for assessing sexual function in the woman are in use in the research setting, as are physiological measures of assessment. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Assessment of sexual dysfunction in patients with benign prostatic hyperplasia.

    PubMed

    Rosen, Raymond C

    2006-04-01

    Sexual dysfunction is a highly prevalent condition in ageing men that considerably affects their quality of life, although it is a frequently neglected aspect of healthcare. The main predictors of sexual dysfunction are age and cardiovascular comorbidities such as hypertension, heart disease, hypercholesterolaemia and diabetes. Recently, the severity of lower urinary tract symptoms (LUTS) has also been identified as a crucial risk factor for sexual dysfunction, independent of age and comorbidities. Despite the increased prevalence of sexual dysfunction with age, health-related problems and psychological factors, there is evidence that many older men remain sexually active. Currently available self-administered questionnaires assessing male sexual dysfunction focus almost exclusively on erectile function. There is evidence from recent large-scale epidemiological studies that ejaculatory dysfunction (EjD) is almost as prevalent as erectile dysfunction (ED), affecting nearly half of men aged > or = 50 years. Other domains such as orgasm, desire, and satisfaction with sex life are important and should be considered. There is thus a need to develop and validate more comprehensive and multidimensional instruments for assessing sexual dysfunction in ageing men. A new instrument, the Male Sexual Health Questionnaire (MSHQ), was developed and validated to assess these specific aspects of male sexual dysfunction . It consists of a 25-item self-administered questionnaire including three core domains (erection, ejaculation, satisfaction with sex life) and additional items related to sexual activity, desire and bother related to sexual dysfunction. The MSHQ scale has excellent psychometric properties and is well suited for use in clinical and research settings. A short form of the MSHQ scale is currently under development.

  18. Sexual dysfunction in veterans with post-traumatic stress disorder.

    PubMed

    Tran, Jana K; Dunckel, Gina; Teng, Ellen J

    2015-04-01

    Veterans with post-traumatic stress disorder (PTSD) experience high rates of sexual dysfunction. However, the topic of sexual dysfunction is often overlooked clinically and underexamined in the PTSD research literature. Clinician assessment and treatment of sexual dysfunction are particularly important for Veterans, who are at increased risk of exposure to trauma. Review the literature regarding sexual dysfunction among Veterans with PTSD. Review of the literature. Sexual dysfunction, including erectile difficulties in males and vaginal pain in females, is common among Veterans with PTSD. Several underlying mechanisms may account for the overlap between PTSD and sexual dysfunction. Certain barriers may contribute to the reluctance of providers in addressing problems of sexual dysfunction in Veterans with PTSD. With the high likelihood of sexual dysfunction among Veterans with PTSD, it is important to consider the integration of treatment strategies. Efforts to further the research on this important topic are needed. Published 2015. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

  19. [Characteristic and treatment of sexual dysfunctions in depression (part I)].

    PubMed

    Gałecki, Piotr; Florkowski, Antoni; Depko, Andrzej; Woźniak, Aneta; Talarowska, Monika

    2011-09-01

    Sexual dysfunction in patients diagnosed with depressive disorders affect all phases of sexual response: a decline in libido, erectile dysfunction, ejaculation disorders in men and orgasm and menstruation in women. It is estimated that are present in approximately 70% of patients, affecting 23-50% of men suffering from depression and 33-90% of women. The most common symptoms include disorders of sexual arousal in women (usually in the form of excessive vaginal dryness), erectile dysfunction in men and affects both sexes abnormal orgasm (anorgasmia or delayed). Sexual dysfunction is treated as a potential side effect of antidepressant therapy. These drugs can exacerbate the symptoms of primary sexual dysfunction, and induce it in those patients who were not present before treatment. Symptoms of sexual dysfunction reduces quality of life, self-esteem, mood, and negatively affect the relationship with your partner. Most currently used antidepressants in the world leads to the occurrence of sexual dysfunction. These include monoamine oxidase inhibitors, tricyclic antidepressants, serotonin reuptake inhibitors, serotonin reuptake inhibitors and norepinephrine, and a new generation of antidepressants. SSRIs are considered to be preparations for the largest iatrogenic effect. Sexual dysfunction resulting from treatment with antidepressant among the most serious reasons for discontinuation by the patients.

  20. Antipsychotic Induced Symptomatic Hyperprolactinemia: Are Dopamine Agonists Safe?

    PubMed

    Lertxundi, Unax; Domingo-Echaburu, Saioa; Peral, Javier; García, Montserrat

    2011-09-15

    Published literature shows that dopamine agonists can reverse antipsychotic-induced hyperprolactinemia without worsening psychotic symptoms in the majority of schizophrenic patients. However, psychiatrists have been reluctant to use drugs with dopaminergic properties for fear of exacerbating psychiatric symptoms. There are reported cases of psychosis worsening published for both cabergoline and bromocriptine. Cabergoline has proven to be more effective and safe when used to treat hyperprolactinemia, but whether cabergoline is also safer than bromocriptine in antipsychotic induced hyperprolactinemia remains unproven.

  1. Antipsychotic Induced Symptomatic Hyperprolactinemia: Are Dopamine Agonists Safe?

    PubMed Central

    Lertxundi, Unax; Domingo-Echaburu, Saioa; Peral, Javier; García, Montserrat

    2011-01-01

    Published literature shows that dopamine agonists can reverse antipsychotic-induced hyperprolactinemia without worsening psychotic symptoms in the majority of schizophrenic patients. However, psychiatrists have been reluctant to use drugs with dopaminergic properties for fear of exacerbating psychiatric symptoms. There are reported cases of psychosis worsening published for both cabergoline and bromocriptine. Cabergoline has proven to be more effective and safe when used to treat hyperprolactinemia, but whether cabergoline is also safer than bromocriptine in antipsychotic induced hyperprolactinemia remains unproven. PMID:27738363

  2. Lithium and sexual dysfunction: an under-researched area.

    PubMed

    Elnazer, Hesham Y; Sampson, Anthony; Baldwin, David

    2015-03-01

    Lithium treatment remains an important part of the management of many patients with bipolar disorder, but the incidence of treatment-emergent sexual dysfunction with lithium is uncertain, and little is known about how it might be managed. Systematic computerised literature search of preclinical and clinical studies. Thirteen relevant papers were identified. Preclinical studies suggest lithium can reduce testosterone levels and impair nitric oxide mediated relaxation of cavernosal tissue. Clinical reports suggest lithium may reduce sexual thoughts and desire, worsen erectile function and reduce sexual satisfaction. Concomitant benzodiazepine prescription with lithium is associated with an increased risk of sexual dysfunction. Sexual dysfunction during lithium treatment appears significantly associated with a lower level of overall functioning and may reduce compliance. The findings of this systematic review reveal the paucity of information about the incidence, associated factors and management of sexual dysfunction with lithium treatment and highlight the need for well-designed studies in this area. Copyright © 2015 John Wiley & Sons, Ltd.

  3. Female sexual dysfunction after ileal pouch-anal anastomosis.

    PubMed

    Ogilvie, J W; Goetz, L; Baxter, N N; Park, J; Minami, S; Madoff, R D

    2008-07-01

    The aim was to measure female sexual function after total proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis using a validated scoring system and to determine the impact of pouch function on sexual function. A cross-sectional survey was performed using a modified version of the Female Sexual Function Index (FSFI-m). Measures of pouch function, including the Faecal Incontinence Severity Index, were also evaluated. Of 166 women eligible for inclusion, 90 responded to the questionnaires and 83 of these reported sexual activity. The mean age of the 83 women was 38.4 years and the mean time since pouch formation was 6.2 years. Thirty-nine women (47.0 per cent) had an FSFI-m score of 26 or less, indicating sexual dysfunction. The association between sexual dysfunction and stool leakage interfering with the ability to enjoy sexual activity tended toward significance (P = 0.071), but other measures of pouch function were not associated with sexual dysfunction. Some 55-80 per cent of respondents perceived no change or improved performance in the six domains of sexual function. Almost half of the respondents reported having sexual dysfunction. Although poor pouch function was not identified as an important predictor of sexual dysfunction in this series, larger studies may be required to identify associated prognostic factors clearly. (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  4. Female sexual function, dysfunction, and pregnancy: implications for practice.

    PubMed

    Murtagh, Jessica

    2010-01-01

    Women's sexual function is a complex and dynamic interplay of variables that involve physical, emotional, and psychosocial states. Sexual dysfunction may occur at any level, and diagnosing such issues begins with careful assessment through a sexual health history. However, discussions about female sexual health and function are often deficient in the primary care setting. This article reviews the published research on female sexual function, sexual dysfunction, and sexual function in pregnancy to gain a better understanding of how these aspects of a woman's life impact the health care services she receives. The evaluation of female sexual function is in need of consistent measurement tools and more dialogue during health care visits. Women's health care practitioners have an opportunity to advance patient satisfaction and overall health by evaluating and communicating with female patients about their sexual function.

  5. Bladder, Bowel, and Sexual Dysfunction in Parkinson's Disease

    PubMed Central

    Sakakibara, Ryuji; Kishi, Masahiko; Ogawa, Emina; Tateno, Fuyuki; Uchiyama, Tomoyuki; Yamamoto, Tatsuya; Yamanishi, Tomonori

    2011-01-01

    Bladder dysfunction (urinary urgency/frequency), bowel dysfunction (constipation), and sexual dysfunction (erectile dysfunction) (also called “pelvic organ” dysfunctions) are common nonmotor disorders in Parkinson's disease (PD). In contrast to motor disorders, pelvic organ autonomic dysfunctions are often nonresponsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity) involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, peripheral myenteric pathology causing slowed colonic transit (loss of rectal contractions) and central pathology causing weak strain and paradoxical anal sphincter contraction on defecation (PSD, also called as anismus) are responsible for the bowel dysfunction. In addition, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the pelvic organ dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. Dietary fibers, laxatives, and “prokinetic” drugs such as serotonergic agonists are used to treat bowel dysfunction in PD. Phosphodiesterase inhibitors are used to treat sexual dysfunction in PD. These treatments might be beneficial in maximizing the patients' quality of life. PMID:21918729

  6. Antidepressant-associated sexual dysfunction: impact, effects, and treatment.

    PubMed

    Higgins, Agnes; Nash, Michael; Lynch, Aileen M

    2010-01-01

    Sexual dysfunction is a common side effect of antidepressants and can have significant impact on the person's quality of life, relationships, mental health, and recovery. The reported incidence of sexual dysfunction associated with antidepressant medication varies considerably between studies, making it difficult to estimate the exact incidence or prevalence. The sexual problems reported range from decreased sexual desire, decreased sexual excitement, diminished or delayed orgasm, to erection or delayed ejaculation problems. There are a number of case reports of sexual side effects, such as priapism, painful ejaculation, penile anesthesia, loss of sensation in the vagina and nipples, persistent genital arousal and nonpuerperal lactation in women. The focus of this article is to explore the incidence, pathophysiology, and treatment of antidepressant iatrogenic sexual dysfunction.

  7. Female sexual dysfunction in patients with endometriosis: Indian scenario

    PubMed Central

    Mishra, Vineet V.; Nanda, Sakshi; Gandhi, Khushali; Aggarwal, Rohina; Choudhary, Sumesh; Gondhali, Raveendra

    2016-01-01

    BACKGROUND: Female sexual dysfunction (FSD) in Indian women is often overlooked due to cultural beliefs and considered as social taboos. Sexuality is an important and integral part of life. There are many causes of sexual dysfunction, but the prevalence of FSD in endometriotic patients is still underdiagnosed. MATERIALS AND METHODS: Study design - Cross-sectional observational study conducted at tertiary care center, from June 2015 to March 2016. Sample size - Fifty-one patients in reproductive age group (18–47 years) who were diagnosed with endometriosis on diagnostic laparoscopy were included. Methods - FSD was assessed with a detailed 19-item female sexual function index questionnaire. All six domains of sexual dysfunction, i.e., desire, arousal, lubrication, orgasm, satisfaction, and pain were studied. Exclusion - Patients with other gynecological, medical or surgical history were excluded. RESULTS: Out of 51 patients with endometriosis, 47.06% of patients had sexual dysfunction. With the increase in staging of endometriosis, sexual dysfunction prevalence is also rising. FSD was 100% in patients with severe endometriosis as compared to 33.33% in minimal endometriosis. CONCLUSION: Every individual deserves good sexual life. The sexual dysfunction associated with endometriosis should also be taken into consideration while managing these patients. PMID:28216913

  8. Childhood Sexual Abuse as a Predictor of Adult Female Sexual Dysfunction: A Study of Couples Seeking Sex Therapy.

    ERIC Educational Resources Information Center

    Sarwer, David B.; Durlak, Joseph A.

    1996-01-01

    A study of 359 married women who sought sex therapy with their spouses found a connection between adult female sexual dysfunction and childhood sexual abuse. Abuse involving sexual penetration was specifically associated with adult sexual dysfunction. Future research on additional variables that contribute to sexual dysfunction is urged. (CR)

  9. Childhood Sexual Abuse as a Predictor of Adult Female Sexual Dysfunction: A Study of Couples Seeking Sex Therapy.

    ERIC Educational Resources Information Center

    Sarwer, David B.; Durlak, Joseph A.

    1996-01-01

    A study of 359 married women who sought sex therapy with their spouses found a connection between adult female sexual dysfunction and childhood sexual abuse. Abuse involving sexual penetration was specifically associated with adult sexual dysfunction. Future research on additional variables that contribute to sexual dysfunction is urged. (CR)

  10. Factors influencing fluoxetine-induced sexual dysfunction in female rats

    PubMed Central

    Adams, Sarah; Heckard, Danyeal; Hassell, James; Uphouse, Lynda

    2012-01-01

    Treatment with selective serotonin reuptake inhibitors, such as fluoxetine, produces sexual side effects with low sexual desire being the most prevalent effect in females. In few studies have preclinical models for such antidepressant-induced sexual dysfunction been fruitful. In the current manuscript, the effects of fluoxetine on multiple measures of female sexual motivation and sexual receptivity were examined. Ovariectomized, Fischer rats were primed with 10 μg estradiol benzoate and 500 μg progesterone. Partner preference, active investigation of the male, and measures of sexual behavior were examined after injection with 15 mg/kg fluoxetine. Factors (pretesting for sexual behavior, size of the test arena, non-contact time with a male) that differ among experiments designed to study antidepressant-induced female rat sexual dysfunction were studied. The male preference ratio was not affected by fluoxetine treatment but active investigation of the male was reduced; lordosis behavior was inhibited and pretesting for sexual receptivity amplified fluoxetine's inhibition; size of the testing arena or non-contact experience with the male had no effect. Regardless of test condition, when given the opportunity to escape from the male, fluoxetine-treated females displayed escape behavior. Measures of male preference and active investigation, but not lordosis behavior, appeared to be affected by fluoxetine's impact on activity. The collective data provided a behavioral profile of fluoxetine-induced sexual dysfunction. These findings reinforce the value of multiple measures when attempting to model antidepressant-induced female sexual dysfunction. PMID:22835821

  11. Sexual Dysfunctions: Relationship to Childhood Sexual Abuse and Early Family Experiences in a Nonclinical Sample.

    ERIC Educational Resources Information Center

    Kinzl, Johann F.; And Others

    1995-01-01

    This study evaluated 202 female university students for early familial experience and childhood sexual abuse (CSA) in relation to adult sexual disorders: (1) victims of multiple CSA more frequently reported sexual desire disorders; and (2) single-incident victims and nonvictims reported no significantly different rates of sexual dysfunction.…

  12. Sexual Dysfunctions: Relationship to Childhood Sexual Abuse and Early Family Experiences in a Nonclinical Sample.

    ERIC Educational Resources Information Center

    Kinzl, Johann F.; And Others

    1995-01-01

    This study evaluated 202 female university students for early familial experience and childhood sexual abuse (CSA) in relation to adult sexual disorders: (1) victims of multiple CSA more frequently reported sexual desire disorders; and (2) single-incident victims and nonvictims reported no significantly different rates of sexual dysfunction.…

  13. Sexual activity and sexual dysfunction of women in the perinatal period: a longitudinal study.

    PubMed

    Wallwiener, Stephanie; Müller, Mitho; Doster, Anne; Kuon, Ruben Jeremias; Plewniok, Katharina; Feller, Sandra; Wallwiener, Markus; Reck, Corinna; Matthies, Lina Maria; Wallwiener, Christian

    2017-04-01

    Reduced sexual activity and dysfunctional problems are highly prevalent in the perinatal period, and there is a lack of data regarding the degree of normality during pregnancy. Several risk factors have been independently associated with a greater extent of Female Sexual Dysfunction (FSD). Therefore, this study aimed to assess the prevalence of sexual inactivity and sexual dysfunctions in German women during the perinatal period and the verification of potential risk factors. Questionnaires were administered to 315 women prenatally (TI 3rd trimester) and postpartum (TII 1 week, TIII 4 months), including the Female Sexual Function Index (FSFI), the Edinburgh Postnatal Depression Scale (EPDS), and the Questionnaire of Partnership (PFB). The frequency of sexual inactivity was 24% (TI), 40.5% (TII), and 19.9% (TIII). Overall, 26.5-34.8% of women were at risk of sexual dysfunction (FSFI score <26.55) at all measurement points. Sexual desire disorder was the most prevalent form of Female sexual dysfunction. Furthermore, especially breastfeeding and low partnership quality were revealed as significant risk factors for sexual dysfunctional problems postpartum. Depressive symptoms having a cesarean section and high maternal education were correlated with dysfunctional problems in several subdomains. Findings indicated that women at risk of FSD differed significantly in aspects of partnership quality, breastfeeding, mode of delivery, maternal education, and depressive symptoms. Aspects of perinatal sexuality should be routinely implemented in the counseling of couples in prenatal classes.

  14. Female sexual dysfunction with combined oral contraceptive use.

    PubMed

    Lee, Jean Jasmin M L; Tan, Thiam Chye; Ang, Seng Bin

    2017-06-01

    Combined oral contraceptive pills (COCs) remain one of the most popular forms of contraception to prevent unwanted pregnancy in women. While it is known that COCs can cause sexual dysfunction in women, there is currently no recommendation to screen for sexual function before and after initiation of COCs. We propose that, based on the evidence available, assessment of sexual function should be done at initiation of COCs, as well as at regular intervals thereafter. This would allow COC-related sexual dysfunction to be managed early, such as by switching the patient to newer-generation COCs or other forms of contraception. Copyright: © Singapore Medical Association.

  15. High prevalence of sexual dysfunction in a vulvovaginal specialty clinic

    PubMed Central

    Gordon, Dina; Gardella, Carolyn; Eschenbach, David; Mitchell, Caroline M.

    2014-01-01

    Objective Our study evaluated the presence and predictors of sexual dysfunction in a vulvovaginal specialty clinic population. Materials & Methods Women who presented to a vulvovaginal specialty clinic were eligible to enroll. Participants completed a questionnaire, including Female Sexual Function Index (FSFI) to assess sexual dysfunction and Patient Health Questionnaire (PHQ)-9 depression screen, and underwent a standardized physical exam, with vaginal swabs collected for wet mount and culture. Logistic regression assessed the relationship between sexual dysfunction and clinical diagnosis. Results We enrolled 161 women, aged 18–80 years (median = 36), presenting with vulvovaginal complaints. Median symptom duration was 24 months; 131 women (81%) reported chronic symptoms (≥12 months). By PHQ-9, 28 (17%) women met depression criteria. In the month prior to assessment, 86 (53%) women experienced sexual dysfunction. Women were primarily diagnosed with vaginitis (n = 46, 29%), vestibulodynia/vulvitis (n = 70; 43%), lichen planus or lichen sclerosus (n = 24; 15%). Controlling for age, sexual dysfunction did not correlate with chronic symptoms (IRR 0.86, 95% CI 0.50–1.48), depression (IRR 1.24; 95% CI 0.59, 2.58), or presence of any of the three main diagnoses (IRR 1.16, 95% CI 0.47, 2.88). Discussion Sexual dysfunction is present in over half of women presenting to a vulvovaginitis referral clinic, more than twice the rate in the wider population. PMID:25259664

  16. Sexual dysfunction in young women with breast cancer.

    PubMed

    Kedde, H; van de Wiel, H B M; Weijmar Schultz, W C M; Wijsen, C

    2013-01-01

    The objective of this study was to determine the prevalence of sexual dysfunction in young women with breast cancer in the Netherlands, and to assess the relationship between sexual dysfunction, treatment methods and treatment-related complaints. Also, the interest among women with breast cancer in receiving care for sexual dysfunction was determined. Data on sexual functioning were collected through an internet questionnaire. Respondents were included if they had been diagnosed with breast cancer within the past 6 years and were currently 45 years of age or younger. Results were compared with a representative sample of the general Dutch population Of the women who were still undergoing treatment, 64 % had a sexual dysfunction. In women who had completed treatment, this was 45 %. All assessed dysfunctions were more common among these young women with breast cancer in comparison with women in the Dutch population. Particularly, early menopause and hormone therapy caused long-term occurence of genital arousal disorder. Radical mastectomy caused long-term occurrence of female orgasmic disorder, and early menopause dyspareunia. Half of the women reported that the topic "changes in sexual functioning" had been brought up during treatment, mostly on the initiative of the health professional. Six out of 10 women with a sexual dysfunction who felt a need for care did not consult a health professional. Sexual dysfunctions are highly prevalent among young women with breast cancer. This appears to improve after treatment has been completed, but women are far from recovered. The initiative to discuss sexuality should lie with the health professional. Including sexuality within treatment guidelines will prevent women with breast cancer from being deprived of care.

  17. The Sexual Disgust Questionnaire; a psychometric study and a first exploration in patients with sexual dysfunctions.

    PubMed

    van Overveld, Mark; de Jong, Peter J; Peters, Madelon L; van Lankveld, Jacques; Melles, Reinhilde; ter Kuile, Moniek M

    2013-02-01

    Disgust may be involved in sexual problems by disrupting sexual arousal and motivating avoidance of sexual intercourse. To test whether heightened disgust for sexual contaminants is related to sexual dysfunctions, the Sexual Disgust Questionnaire (SDQ) has recently been developed. Previous research showed that particularly women with vaginismus display a generally heightened dispositional disgust propensity and heightened disgust toward stimuli depicting sexual intercourse. To determine the psychometric properties of the SDQ and test whether heightened disgust toward sexual stimuli is specific to vaginismus or can be observed in other sexual dysfunctions as well. First, a large sample of undergraduates and university employees completed the SDQ (N = 762) and several trait disgust indices. Next, women with vaginismus (N = 39), dyspareunia (N = 45), and men with erectile disorder (N = 28) completed the SDQ and were compared to participants without sexual problems (N = 70). SDQ to index sexual disgust. The SDQ proved a valid and reliable index to establish disgust propensity for sexual stimuli. Supporting construct validity of the SDQ, sexual disgust correlated with established trait indices. Furthermore, sexual disgust and willingness to handle sexually contaminated stimuli were associated with sexual functioning in women, but not in men. Specifically women with vaginismus displayed heightened sexual disgust compared to women without sexual problems, while men with erectile disorders demonstrated a lower willingness to handle sexually contaminated stimuli compared to men without sexual problems. The SDQ appears a valid and reliable measure of sexual disgust. The pattern of SDQ-scores across males and females with and without sexual dysfunctions corroborates earlier research suggesting that disgust appraisals are involved especially in vaginismus and supports the view that the difficulty with vaginal penetration experienced by women in vaginismus may partly be due to

  18. Pharmacological management of atypical antipsychotic-induced weight gain.

    PubMed

    Baptista, Trino; ElFakih, Yamily; Uzcátegui, Euderruh; Sandia, Ignacio; Tálamo, Eduardo; Araujo de Baptista, Enma; Beaulieu, Serge

    2008-01-01

    Excessive bodyweight gain was reported during the 1950s as an adverse effect of typical antipsychotic drug treatment, but the magnitude of bodyweight gain was found to be higher with the atypical antipsychotic drugs that were introduced after 1990. Clozapine and olanzapine produce the greatest bodyweight gain, ziprasidone and aripiprazole have a neutral influence, and quetiapine and risperidone cause an intermediate effect. In the CATIE study, the percentage of patients with bodyweight gain of >7% compared with baseline differed significantly between the antipsychotic drugs, i.e. 30%, 16%, 14%, 12% and 7% for olanzapine, quetiapine, risperidone, perphenazine (a typical antipsychotic) and ziprasidone, respectively (p<0.001). Appetite stimulation is probably a key cause of bodyweight gain, but genetic polymorphisms modify the bodyweight response during treatment with atypical antipsychotics. In addition to nutritional advice, programmed physical activity, cognitive-behavioural training and atypical antipsychotic switching, pharmacological adjunctive treatments have been assessed to counteract excessive bodyweight gain. In some clinical trials, nizatidine, amantadine, reboxetine, topiramate, sibutramine and metformin proved effective in preventing or reversing atypical antipsychotic-induced bodyweight gain; however, the results are inconclusive since few randomized, placebo-controlled clinical trials have been conducted. Indeed, most studies were short-term trials without adequate statistical power and, in the case of metformin, nizatidine and sibutramine, the results are contradictory. The tolerability profile of these agents is adequate. More studies are needed before formal recommendations on the use of these drugs can be made. Meanwhile, clinicians are advised to use any of these adjunctive treatments according to their individual pharmacological and tolerability profiles, and the patient's personal and family history of bodyweight gain and metabolic dysfunction.

  19. [Sexual function and factors associated with sexual dysfunction in climacteric women.

    PubMed

    Cavalcanti, Isabela Franco; Farias, Polyana da Nóbrega; Ithamar, Lucas; Silva, Vilma Maria da; Lemos, Andrea

    2014-11-01

    To evaluate the sexual function and factors associated with sexual dysfunction in climacteric women. A cross-sectional study was conducted on 173 women aged 35 to 65 years old, with a steady partner during the last 6 months, who are literate, without cognitive impairment, and with sexual activity for at least 6 months. The instrument used to assess sexual performance was the Sexual Quotient, female version. The association between sexual dysfunction and sociodemographic data, personal, obstetric and sexual history was determined by Pearson's χ2 test and strength of association by the odds ratio (OR) with a 95% confidence interval (95%CI). In this study, 46.2% of the women reported sexual dysfunction. There was a decrease in the chance of sexual dysfunction for the age group between 35 and 49 years old (OR=0.3; 95%CI 0.2-0.6) and for women who felt comfortable talking about sex (OR=0.5; 95%CI 0.2-0.8). However, the presence of osteoporosis (OR=3.3; 95%CI 1.5-7.6), urinary incontinence (OR=2.0; 95%CI 1.1-3.7), and surgical corrections of the pelvic floor (OR=2.2; 95%CI 1.1-4.5) increased this chance. The frequency of sexual dysfunction in women aged 35 to 65 years old was 46.2% and factors such as osteoporosis, urinary incontinence and surgical corrections of the pelvic floor increased the chance of sexual dysfunction.

  20. Dopamine and norepinephrine responses to film-induced sexual arousal in sexually functional and sexually dysfunctional women.

    PubMed

    Meston, C M; McCall, K M

    2005-01-01

    This study was designed to assess potential differences between sexually functional and dysfunctional women in dopamine (DA) and norepinephrine (NE) responses to erotic stimuli. Blood levels of homovanillic acid (HVA; the major metabolite of DA) and NE were taken during the showing of a nonsexual and a sexual film from 9 women with female sexual arousal disorder and hypoactive sexual desire disorder and from 13 sexually functional women. We assessed sexual arousal subjectively using a self-report scale and physiologically using a vaginal photoplethysmograph. HVA levels significantly decreased in sexually functional and dysfunctional women during the erotic versus during the neutral film. NE levels were not significantly different for either group of women during the neutral and erotic films. Sexually dysfunctional women had significantly higher levels of NE during both the neutral and erotic films compared with functional women. Subjective or physiological arousal differences between neutral and erotic films were not significantly different between functional and dysfunctional women.

  1. Early maladaptive schemas and sexual dysfunction in men.

    PubMed

    Quinta Gomes, Ana Luísa; Nobre, Pedro

    2012-02-01

    The objective of the present study was to investigate the role played by early maladaptive schemas (EMS) on male sexual functioning and clarify the way these nuclear cognitive structures discriminate men with and without sexual dysfunction. A total of 242 men participated in the study (a community sample of 200 men and a clinical sample of 42 men with a DSM-IV diagnosis of sexual dysfunction). The community sample was divided into a control group (n=147) and a sub-clinical group (n=53), according to the cutoff scores of the International Index of Erectile Dysfunction (Rosen et al., 1997). All participants completed a set of measures assessing EMS (Young & Brown, 1989), sexual functioning (Rosen et al., 1997), psychopathology (Derogatis & Spencer, 1982), and cognitive schemas activated in hypothetical unsuccessful sexual situations (Nobre & Pinto-Gouveia, 2009a). Findings supported the hypothesis of a typical cognitive pattern in men with sexual difficulties. After controlling for psychopathology, men with sexual dysfunction reported more dependence/incompetence EMS and activated more difference, helpless, and particularly incompetence schemas in hypothetical unsuccessful sexual situations, in comparison to sexually healthy men. These results have important therapeutic implications for sex therapy.

  2. Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence.

    PubMed

    Nascimento, Elisabete Rodrigues; Maia, Ana Claudia Ornelas; Pereira, Valeska; Soares-Filho, Gastão; Nardi, Antonio Egidio; Silva, Adriana Cardoso

    2013-11-01

    The aim of this study was to conduct a systematic review of the literature regarding the prevalence of sexual dysfunction in patients with cardiovascular diseases. An article search of the ISI Web of Science and PubMed databases using the search terms "sexual dysfunction", "cardiovascular diseases", "coronary artery disease", "myocardial infarct" and "prevalence" was performed. In total, 893 references were found. Non-English-language and repeated references were excluded. After an abstract analysis, 91 references were included for full-text reading, and 24 articles that evaluated sexual function using validated instruments were selected for this review. This research was conducted in October 2012, and no time restrictions were placed on any of the database searches. Reviews and theoretical articles were excluded; only clinical trials and epidemiological studies were selected for this review. The studies were mostly cross-sectional, observational and case-control in nature; other studies used prospective cohort or randomized clinical designs. In women, all domains of sexual function (desire, arousal, vaginal lubrication, orgasm, sexual dissatisfaction and pain) were affected. The domains prevalent in men included erectile dysfunction and premature ejaculation and orgasm. Sexual dysfunction was related to the severity of cardiovascular disease. When they resumed sexual activity, patients with heart disease reported significant difficulty, including a lack of interest in sex, sexual dissatisfaction and a decrease in the frequency of sexual activity.

  3. Management and rehabilitation of neurologic patients with sexual dysfunction.

    PubMed

    Basson, Rosemary; Bronner, Gila

    2015-01-01

    Neurologic disease frequently negatively affects sexual experience in multiple ways. The patient's sexual self-image, sexual function, propensity to sexual pain, and motivation to be sexually active may be impacted, as may the sexual experiences of the partner. Difficulties with mobility can limit both partners' sexual arousal and pleasure. Conditions associated with chronic pain or continence concerns add further distress. Thus sexual rehabilitation needs to address many areas. Comorbid depression is common and needs to be stabilized before definitive treatment of sexual dysfunction. Management strategies include cognitive behavioral therapy, mindfulness-based cognitive therapy, and sex therapy and, for erectile dysfunction and premature ejaculation, pharmacotherapy can be added. Benefit from all these modalities is confirmed in the general population but only pharmacologic treatment of erectile dysfunction has been studied in neurologic patients, where benefit is also seen. Testosterone is indicated only for comorbid testosterone deficit: very occasionally the neurologic condition causes secondary male hypogonadism. No androgen deficiency state has been identified in women. Results of testosterone treatment in women are conflicting: recruited women were not clearly dysfunctional and women with neurologic conditions have not been studied. Future research involving both partners using combined medical and psychologic therapy as followed in clinical practice is advocated.

  4. Bem Sex Role Inventory Undifferentiated Score: A Comparison of Sexual Dysfunction Patients with Sexual Offenders.

    ERIC Educational Resources Information Center

    Dwyer, Margretta; And Others

    1988-01-01

    Examined Bem Sex Role undifferentiated scores on 93 male sex offenders as compared with 50 male sexually dysfunctional patients. Chi-square analyses revealed significant difference: offenders obtained undifferentiated scores more often than did sexual dysfunctional population. Concluded that Bem Sex Role Inventory is useful in identifying sexual…

  5. [Multiple sclerosis and pelviperineology: Urinary and sexual dysfunctions and pregnancy].

    PubMed

    de Sèze, M; Gamé, X

    2014-06-01

    The aim was to review the literature on genito-urinary dysfunction in multiple sclerosis (MS). A literature review through the PubMed library until August, 31 2013 was carried out using the following keywords: multiple sclerosis and neurogenic bladder, neuropathic bladder, bladder, management, follow-up, urological complications, urological treatment, sexual dysfunction, female sexual function, male sexual function, erectile dysfunction, anorectal, faecal, constipation, bowel, pregnancy, parturition, delivery, breast-feeding. Genito-urinary dysfunction is frequent in MS (35-90%) and may happen soon in the disease. Urinary symptoms (10-90%) are manifold resulting in a quality of life alteration and the onset of complications in 30% of the cases requiring a long-term follow-up. Sexual dysfunctions (35-87%) are also manifold affecting all the sexuality domains in men and women. Except the phosphodiesterase V inhibitors, few treatments have been assessed in this population. Pregnancy is nowadays considered as beneficial resulting in a disease slow-down and the lack of disease worsening despite an increase in disease relapse during the post-partum first quarter. It seems to be better to consider getting pregnant after at least one year without any relapse and to emphasize an exclusive breast-feeding. Urinary and sexual dysfunctions are frequent in MS. A transdisciplinary approach including the neurologist and pelviperineology specialists facilitates a disability adapted early management. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. The medicalization of female sexual dysfunction: the need for caution.

    PubMed

    Bancroft, John

    2002-10-01

    The use of drugs such as Viagra to treat sexual dysfunction in women may be beneficial in a proportion of cases. However, there are a number of barriers to understanding and predicting which women are likely to benefit, and caution is required in approaching this clinical issue. Three relevant issues are discussed: (1) Male-female differences in sexuality. Three complimentary ways in which male and female sexuality differs are considered--women have less need for their sexuality to be influenced by reproductive hormones; their needs for sexual enjoyment and orgasm are not well met by conventional vaginal intercourse; and, as a result of the disjunction between female sexual response and reproduction and a possibly greater propensity for central inhibition of sexual response, women are more susceptible to the repressive effects of social constraints on sexuality; (2) Sex therapy. While conventional forms of sex therapy are well designed to address the particular psychological needs of women as well as men, the interface between psychological processes and physiological response is not well understood. For the same reason, we should expect difficulty in predicting when pharmacological effects on sexual response will be beneficial; (3) When is a sexual problem a sexual dysfunction? It is likely that many cases of impaired sexual response or interest in women are psychologically understandable and hence adaptive reactions to problems in the sexual relationship, and hence not dysfunctions. Until we can distinguish between such adaptive inhibitions of response and those that are maladaptive dysfunctions, we will have difficulty in predicting when pharmacological treatment will be helpful.

  7. Why is impaired sexual function distressing to women? The primacy of pleasure in female sexual dysfunction.

    PubMed

    Stephenson, Kyle R; Meston, Cindy M

    2015-03-01

    Recent research has highlighted a complex association between female sexual function and subjective distress regarding sexual activity. These findings are difficult to explain given limited knowledge as to the mechanisms through which impaired sexual function causes distress. The current study assessed whether a number of specific consequences of impaired sexual function, including decreased physical pleasure, disruption of sexual activity, and negative partner responses, mediated the association between sexual function and distress. Eighty-seven women in sexually active relationships reporting impairments in sexual function completed validated self-report measures and daily online assessments of sexual experiences. Participants completed the Sexual Satisfaction Scale for Women, the Female Sexual Function Index, and the Measure of Sexual Consequences. Results suggested that decreased physical pleasure and disruption of sexual activity, but not partner responses, statistically mediated the association between sexual function and distress. Sexual consequences represent potential maintaining factors of sexual dysfunction that are highly distressing to women. Results are discussed in the context of theoretical models of sexual dysfunction and related treatments. © 2014 International Society for Sexual Medicine.

  8. Sexual dysfunctions in schizophrenia: Professionals and patients perspectives

    PubMed Central

    Tharoor, Hema; Kaliappan, Anandhalakshmi; Gopal, Subhashini

    2015-01-01

    Background: Sexual dysfunction (SD) is not commonly reported by persons with schizophrenia unless an enquiry is made by a doctor or staff during routine clinical visits. Materials and Methods: A cross-sectional study was carried out to determine reporting of drug-induced sexual side-effects and the attitude of the treating team in clarifying or detecting this issue. Results: A vast majority of professionals (73.2%) did not enquire about SDs in routine clinical setting and admitted that they lack expertise based on the Attitude Survey Questionnaire. More than one-third of the patients (35.3%) attributed sexual side-effects to medications. Many patients (91.7%) reported good to fair tolerance to sexual side-effects according to the Psychotropic Related Sexual Dysfunction Questionnaire. Conclusion: The treating team plays a crucial role. Sexual side-effects are often under-reported and need to be addressed by the treating physician. PMID:25657463

  9. Insecure Attachment Style and Dysfunctional Sexual Beliefs Predict Sexual Coercion Proclivity in University Men.

    PubMed

    Dang, Silvain S; Gorzalka, Boris B

    2015-06-01

    Past studies have shown an association between low sexual functioning and engaging in sexually coercive behaviors among men. The mechanism of this relationship is not well understood. Moreover, most studies in this area have been done in incarcerated sex offenders. The aim of the current study was to investigate the role of potential distal predictors of sexual coercion, including insecure attachment style and dysfunctional sexual beliefs, in mediating the relationship between sexual functioning and sexual coercion. The study also seeks to extend past findings to a novel non-forensic population. Male university students (N = 367) anonymously completed online questionnaires. Participants completed the Sexual Experiences Survey, Improved Illinois Rape Myth Acceptance Scale, Hostility Towards Women Scale, Likelihood of Rape Item, Experiences in Close Relationships Scale, Dysfunctional Sexual Beliefs Scale, and Brief Sexual Functioning Questionnaire. Sexual functioning was not significantly associated with sexually coercive behaviors in our sample (r = 0.08, P = 0.247), though a significant correlation between sexual functioning and rape myth acceptance was found (r = 0.18, P = 0.007). Path analysis of all variables showed that the likelihood of rape item was the strongest correlate of sexually coercive behaviors (β = 0.34, P < 0.001), while dysfunctional sexual beliefs appeared to mediate the association between anxious attachment and likelihood of rape item score. Anxious (r = -0.27, P = 0.001) and avoidant (r = -0.19, P = 0.004) attachment also correlated significantly with lower sexual functioning. These findings suggest the relationship between sexual functioning and sexual coercion may be less robust than previously reported, and may be due to a shared association with other factors. The results elaborate on the interrelation between attachment style and dysfunctional sexual beliefs as predictors of sexual coercion

  10. Why is impaired sexual function distressing to women? The primacy of pleasure in female sexual dysfunction

    PubMed Central

    Stephenson, Kyle R.; Meston, Cindy M.

    2015-01-01

    Introduction Recent research has highlighted a complex association between female sexual function and subjective distress regarding sexual activity. These findings are difficult to explain given limited knowledge as to the mechanisms through which impaired sexual function causes distress. Aim The current study assessed whether a number of specific consequences of impaired sexual function, including decreased physical pleasure, disruption of sexual activity, and negative partner responses, mediated the association between sexual function and distress. Methods Eighty seven women in sexually active relationships reporting impairments in sexual function completed validated self-report measures and daily online assessments of sexual experiences. Main Outcome Measures Participants completed the Sexual Satisfaction Scale for Women (SSS-W), the Female Sexual Function Index (FSFI), and the Measure of Sexual Consequences (MSC). Results Results suggested that decreased physical pleasure and disruption of sexual activity, but not partner responses, statistically mediated the association between sexual function and distress. Conclusion Sexual consequences represent potential maintaining factors of sexual dysfunction that are highly distressing to women. Results are discussed in the context of theoretical models of sexual dysfunction and related treatments. PMID:25556719

  11. [Female sexual dysfunction: classification, epidemiology, diagnosis and treatment].

    PubMed

    Luria, Mijal; Hochner-Celnikier, Drorit; Mock, Moshe

    2004-11-01

    The successful pharmacological treatment of erectile dysfunction in males has led to increasing interest in the sexual problems of women. Yet in recent years there has been growing consensus regarding the differences between male and female sexuality. William Masters and Virginia Johnson's model of sexual response, revised by Helen Singer Kaplan, has been generally accepted for many decades. This model consists of 4 successive phases: desire, excitement (arousal), orgasm and resolution. Rosemary Basson has suggested a different model, valid especially in long-term relationships. According to Basson, a woman may decide to seek a stimuli necessary to ignite sexual desire, for reasons which are not sexual (such as the need for intimacy or emotional bonding). The desire develops at a latter stage, as a consequence and not as a cause. As the understanding of the sexual response grows, new methods of classification and treatment are being developed. Female sexual dysfunction is common, frequently neglected and has a significant impact on the lives of women. It has a diverse etiology including anatomical, physiological, medical as well as psychological and social factors. The assessment of these disorders incorporates both medical and psychological evaluation. The treatment includes education, improvement of inter-personal communication, behavioral treatment and the solution of medical problems. Different medications are being developed but most have yet to be proven effective. This review presents the female sexual response as it is understood today and the different methods of classification, diagnosis and treatment of female sexual dysfunction.

  12. Advances in the understanding and behavioural management of sexual dysfunctions.

    PubMed

    Rao, Telkar Srinivasa Sathyanarayana; Tandon, Abhinav

    2014-09-01

    Sexual medicine is a branch often neglected by professionals from different specialties associated with it. However, research in this field has picked up in recent years, owing to recently renewed interest in upholding the sexual rights of the population in general and lesbian, gay, bisexual and transgender groups in particular. The recently released Diagnostic and statistical manual of mental disorders, fifth edition, by the American Psychiatric Association in May 2013 has stirred up the supporters and critics (of Diagnostic and statistical manual of mental disorders, fifth edition) alike. Diagnostic and statistical manual of mental disorders, fifth edition, has updated diagnostic criteria for some of the sexual disorders to improve understanding and diagnostic validity. Certain sexual dysfunctions have been regrouped and sexual response cycle-based classification has been partially withdrawn. Research in the area of behavioral management of sexual dysfunctions has given some novel concepts, particularly for women. Although improvements in behavioral management (of sexual dysfunctions) and classification/diagnostic criteria in Diagnostic and statistical manual of mental disorders, fifth edition, is a step forward in the field of sexual medicine, we need to further improve our understanding in many of the lacunae, still bearing on the field of sexual medicine, lest we may fall at the first hurdle.

  13. The clinical relevance of sexual dysfunction in systemic sclerosis.

    PubMed

    Bruni, C; Raja, J; Denton, C P; Matucci-Cerinic, M

    2015-12-01

    Systemic sclerosis is a chronic multi-organ autoimmune disease, leading to important clinical and psychological implications. Among organ complications, sexual dysfunction is a major issue for both male and female gender, with high prevalence and great impact on quality of life, although frequently not addressed by both clinicians and patients. While erectile dysfunction is the most common cause of sexual problems in males, genital tract and general physical changes are major contributors to sexual impairment in females. This review presents current state of the art on this topic, discussing published data on presentation, evaluation and therapeutic options. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Sexual function and dysfunction in older HIV-positive individuals.

    PubMed

    Russell, Darren B

    2011-12-01

    With many parts of the world seeing an aging cohort of people living with HIV (PLHIV), it is becoming clear that some organ systems in these individuals are at a greater risk of disease. There are effects on sexual functioning in aging PLHIV, with many studies finding higher levels of sexual dysfunction in HIV-positive individuals compared with those who are HIV-negative. HIV itself, along with antiretroviral agents, may cause dysfunction. Treatment involves making an assessment of the dysfunction and using the usual methods available, although treatment may be complicated by hormonal deficiencies in HIV-positive individuals, along with the effects of antiretroviral therapy, and drug interactions involving such medications. Furthermore, the issue of HIV transmission needs to be addressed in those seeking treatment for sexual dysfunction.

  15. Female Sexual Dysfunction: Is It a Treatable Disease?

    PubMed

    Houman, Justin; Feng, Tom; Eilber, Karyn S; Anger, Jennifer T

    2016-04-01

    Female sexual dysfunction affects approximately 40% of women (Sexual problems and distress in United States women: prevalence and correlates; Shifren et al., Obstet Gynecol, 112(5): 970-978, 2008). Due to its multi-factorial etiology, a wide variety of treatments are available that address specific symptoms, but no treatment exists that treats the overall disorder. Significant strides have recently been made in an effort to treat the plethora of symptoms associated with this disorder. The purpose of this article is to provide an overview of recent research on the available treatments for female sexual dysfunction. We discuss novel agents such as flibanserin, as well as various mechanical devices and hormonal treatments aimed at the specific subtypes of female sexual dysfunction.

  16. Management of sexual dysfunction in Parkinson’s disease

    PubMed Central

    Vodušek, David B.

    2011-01-01

    Nonmotor symptoms, among them sexual dysfunction, are common and underrecognized in patients with Parkinson disease; they play a major role in the deterioration of quality of life of patients and their partners. Loss of desire and dissatisfaction with their sexual life is encountered in both genders. Hypersexuality (HS), erectile dysfunction and problems with ejaculation are found in male patients, and loss of lubrication and involuntary urination during sex are found in female patients. Tremor, hypomimia, muscle rigidity, bradykinesia, ‘clumsiness’ in fine motor control, dyskinesias, hypersalivation and sweating may interfere with sexual function. Optimal dopaminergic treatment should facilitate sexual encounters of the couple. Appropriate counselling diminishes some of the problems (reluctance to engage in sex, problems with ejaculation, lubrication and urinary incontinence). Treatment of erectile dysfunction with sildenafil and apomorphine is evidence based. HS or compulsive sexual behaviour are side effects of dopaminergic therapy, particularly by dopaminergic agonists, and should be treated primarily by diminishing their dose. Neurologists should actively investigate sexual dysfunction in their Parkinsonian patients and offer treatment, optimally within a multidisciplinary team, where a dedicated professional would deal with sexual counselling. PMID:22164191

  17. Exercise therapy for sexual dysfunction after prostate cancer.

    PubMed

    Cormie, Prue; Newton, Robert U; Taaffe, Dennis R; Spry, Nigel; Galvão, Daniel A

    2013-12-01

    Sexual dysfunction is one of the most common, distressing and persistent adverse effects of prostate cancer treatment, and has a profound effect on quality of life for the patient and his partner. Current health-care provisions are inadequate to address the demand for the management of sexual dysfunction, with approximately half of prostate cancer survivors reporting unmet sexual health-care needs. Management strategies predominately involve pharmacological interventions to address the direct physiological effects of prostate cancer treatment on erectile function. However, the aetiology of sexual dysfunction is multifaceted and considerable physiological and psychological adverse effects of prostate cancer treatments, which are not addressed by pharmacological intervention, contribute to sexual dysfunction. Exercise has established efficacy for improving many of these factors in men with prostate cancer, including changes in body composition (especially to counteract body feminization), fatigue, physical function, risk of comorbid conditions, depression, anxiety and quality of life. Emerging evidence indicates that exercise also has a positive effect on sexual desire and sexual activity in men with prostate cancer.

  18. Sexual dysfunctions in non-heterosexual men - literature review.

    PubMed

    Grabski, Bartosz; Kasparek, Krzysztof

    2017-02-26

    The paper aims to present results and discuss methodology of research conducted so far on sexual dysfunction in non-heterosexual men, as well as to form suggestions for future research and clinical practice. The present paper is a continuation of our earlier paper, which discussed the specific context of the issue connected with the characteristics of gay sexual orientation and the social situation those men face. There is little research on dysfunctions and sexual problems in non-heterosexual men, and none has been conducted in Poland. The research that has been done is characterized by inconsistent methodology that is far from perfect, and varied results which cannot be compared. There are still many unanswered questions in the field. The issues connected with research that require attention include the choice of samples and their representativeness, and the accuracy of the methods used for identifying sexual dysfunctions. It is also still not clear whether sexual problems occur more often in non-heterosexual than heterosexual men, how non-heterosexual men deal with those problems, and how the problems influence their functioning. Another issue that requires a deeper understanding is the connections between sexual dysfunctions in this group and various aspects of the so-called minority stress, such as internalized homophobia and experiencing discrimination, psychoactive substance abuse, HIV infection, and the sexual and partnership lifestyle.

  19. Proposal for changes in diagnostic criteria for sexual dysfunctions.

    PubMed

    Segraves, Robert; Balon, Richard; Clayton, Anita

    2007-05-01

    Officially sanctioned diagnostic criteria have a major influence on treatment decisions and on how populations are defined for clinical research. The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association has had a major influence on research concerning the treatment of sexual disorders and has been criticized on numerous grounds. The purpose of this article is to describe the evolution of criteria sets in the DSM and to critically evaluate suggestions for modification of this system. All living members of the DSM work groups on sexual dysfunction were contacted regarding their recollections of the evolution of criteria sets. Literature concerning diagnostic criteria for the sexual dysfunctions in the DSM, as well as literature suggesting modification of this system, was reviewed. Recommendations for changes in the DSM-V system were based upon a review of the evidence concerning optimal criteria for each diagnostic entity. The original diagnostic system from sexual disorders in the DSM was developed by expert opinion, literature searches, and solicitation of feedback for other experts in the field. There have been minimal changes in the DSM criteria for sexual dysfunctions because of the requirement that there be substantial empirical data before modification of the system would be considered. An international consensus group has suggested major modification in criteria concerning female sexual dysfunctions. There is a growing database that documents the need to change criteria for premature ejaculation. It is recommended that some of the suggested modifications to the criteria sets for sexual dysfunctions be adopted by the DSM-V committee. It is also recommended that specific criteria related to duration and severity be adopted, in order to clearly distinguish sexual disorders from transient alterations in sexual function related to life stress and relationship discord.

  20. Sexual and gonadal dysfunction in chronic kidney disease: Pathophysiology.

    PubMed

    Rathi, Manish; Ramachandran, Raja

    2012-03-01

    Sexual and gonadal dysfunction/infertility are quite common in patients with chronic kidney disease. Forty percent of male and 55% of female dialysis patients do not achieve orgasm. The pathophysiology of gonadal dysfunction is multifactorial. It is usually a combination of psychological, physiological, and other comorbid factors. Erectile dysfunction in males is mainly due to arterial factors, venous leakage, psychological factors, neurogenic factors, endocrine factors, and drugs. Sexual dysfunction in females is mainly due to hormonal factors and manifests mainly as menstrual irregularities, amenorrhea, lack of vaginal lubrication, and failure to conceive. Treatment of gonadal dysfunction in chronic kidney disease is multipronged and an exact understanding of underlying pathology is essential in proper management of these patients.

  1. [Sexual dysfunction: Changing conceptions and criteria of classification].

    PubMed

    Hoyer, Jürgen; Velten, Julia

    2017-07-26

    Sexual response is the result of a complex interaction of psychological, physiological, interpersonal, social and cultural factors. Those factors - as well as sexual behavior - are subject to permanent change. In this study, we investigated how the growth of basic knowledge and constantly changing social-cultural conditions impact the scientific definition of sexual dysfunctions, which controversies exist and to what degree these changes counteract the common tendencies of medicalization and stigmatization of sexual difficulties. With reference to the leading international classification systems of mental disorders and on the basis of the current scientific literature, we comment and reflect the changed criteria of sexual dysfunctions in women and men. The new revised criteria for sexual dysfunctions are more objective, which provides an enhanced basis for valid diagnoses. The concept of sexual aversion is considered obsolete and no longer being pursued. Nevertheless, there are obvious differences between the revised classification systems, especially regarding the dualistic perspective of sexual problems as either caused by psychological versus organic factors. Further change is predetermined.

  2. Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction.

    PubMed

    Brotto, Lori; Atallah, Sandrine; Johnson-Agbakwu, Crista; Rosenbaum, Talli; Abdo, Carmita; Byers, E Sandra; Graham, Cynthia; Nobre, Pedro; Wylie, Kevan

    2016-04-01

    Psychological, interpersonal, and sociocultural factors play a significant role in making one vulnerable to developing a sexual concern, in triggering the onset of a sexual difficulty, and in maintaining sexual dysfunction in the long term. To focus on psychological and interpersonal aspects of sexual functioning in women and men after a critical review of the literature from 2010 to the present. This report is part 1 of 2 of our collaborative work during the 2015 International Consultation on Sexual Medicine for Committee 2. Systematic review of the literature with a focus on publications since 2010. Our work as sexual medicine clinicians is essentially transdisciplinary, which involves not only the collaboration of multidisciplinary professionals but also the integration and application of new knowledge and evaluation and subsequent revision of our practices to ensure the highest level of care provided. There is scant literature on gender non-conforming children and adolescents to clarify specific developmental factors that shape the development of gender identity, orientation, and sexuality. Conversely, studies consistently have demonstrated the interdependence of sexual function between partners, with dysfunction in one partner often contributing to problems in sexual functioning and/or sexual satisfaction for the other. We recommend that clinicians explore attachment styles of patients, childhood experiences (including sexual abuse), onset of sexual activity, personality, cognitive schemas, infertility concerns, and sexual expectations. Assessment of depression, anxiety, stress, substance use and post-traumatic stress (and their medical treatments) should be carried out as part of the initial evaluation. Clinicians should attempt to ascertain whether the anxiety and/or depression is a consequence or a cause of the sexual complaint, and treatment should be administered accordingly. Cognitive distraction is a significant contributor to sexual response problems

  3. Animal Models for the Study of Female Sexual Dysfunction

    PubMed Central

    Marson, Lesley; Giamberardino, Maria Adele; Costantini, Raffaele; Czakanski, Peter; Wesselmann, Ursula

    2017-01-01

    Introduction Significant progress has been made in elucidating the physiological and pharmacological mechanisms of female sexual function through preclinical animal research. The continued development of animal models is vital for the understanding and treatment of the many diverse disorders that occur in women. Aim To provide an updated review of the experimental models evaluating female sexual function that may be useful for clinical translation. Methods Review of English written, peer-reviewed literature, primarily from 2000 to 2012, that described studies on female sexual behavior related to motivation, arousal, physiological monitoring of genital function and urogenital pain. Main Outcomes Measures Analysis of supporting evidence for the suitability of the animal model to provide measurable indices related to desire, arousal, reward, orgasm, and pelvic pain. Results The development of female animal models has provided important insights in the peripheral and central processes regulating sexual function. Behavioral models of sexual desire, motivation, and reward are well developed. Central arousal and orgasmic responses are less well understood, compared with the physiological changes associated with genital arousal. Models of nociception are useful for replicating symptoms and identifying the neurobiological pathways involved. While in some cases translation to women correlates with the findings in animals, the requirement of circulating hormones for sexual receptivity in rodents and the multifactorial nature of women’s sexual function requires better designed studies and careful analysis. The current models have studied sexual dysfunction or pelvic pain in isolation; combining these aspects would help to elucidate interactions of the pathophysiology of pain and sexual dysfunction. Conclusions Basic research in animals has been vital for understanding the anatomy, neurobiology, and physiological mechanisms underlying sexual function and urogenital pain

  4. Sexual dysfunction in women with cancer.

    PubMed

    Falk, Sandy J; Dizon, Don S

    2013-10-01

    Approximately 14 million people have a history of cancer in the United States alone, and the number is expected to increase with time. This has prompted an appreciation of the quality of life for survivors. Women treated for cancer identify gynecologic issues as a major concern for both general health and the negative impact on sexual function that follow the cancer diagnosis and subsequent treatment. Unfortunately, issues related to sexual health continue to be underappreciated. Although comprehensive cancer centers have adopted specialized centers for survivorship issues, including those involving sexual health, consultations are not widely available in most communities. We provide background information on female sexual health, examine the impact of cancer treatment on sexual function, and discuss some of the major sexual health issues of women who have received a cancer diagnosis and been subsequently treated. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Sexual dysfunction in women with diabetic kidney.

    PubMed

    Satta, Ersilia; Magno, Carlo; Galì, Alessandro; Inferrera, Antonino; Granese, Roberta; Aloisi, Carmela; Buemi, Michele; Bellinghieri, Guido; Santoro, Domenico

    2014-01-01

    Few studies address alteration of sexual function in women with diabetes and chronic kidney disease (CKD). Quality of life surveys suggest that discussion of sexual function and other reproductive issues are of psychosocial assessment and that education on sexual function in the setting of chronic diseases such as diabetes and CKD is widely needed. Pharmacologic therapy with estrogen/progesterone and androgens along with glycemic control, correction of anemia, ensuring adequate dialysis delivery, and treatment of underlying depression are important. Changes in lifestyle such as smoking cessation, strength training, and aerobic exercises may decrease depression, enhance body image, and have positive impacts on sexuality. Many hormonal abnormalities which occur in women with diabetes and CKD who suffer from chronic anovulation and lack of progesterone secretion may be treated with oral progesterone at the end of each menstrual cycle to restore menstrual cycles. Hypoactive sexual desire disorder (HSDD) is the most common sexual problem reported by women with diabetes and CKD. Sexual function can be assessed in women, using the 9-item Female Sexual Function Index, questionnaire, or 19 items. It is important for nephrologists and physicians to incorporate assessment of sexual function into the routine evaluation protocols.

  6. Sexual Dysfunction in Women with Diabetic Kidney

    PubMed Central

    Satta, Ersilia; Magno, Carlo; Galì, Alessandro; Inferrera, Antonino; Granese, Roberta; Aloisi, Carmela; Buemi, Michele; Bellinghieri, Guido; Santoro, Domenico

    2014-01-01

    Few studies address alteration of sexual function in women with diabetes and chronic kidney disease (CKD). Quality of life surveys suggest that discussion of sexual function and other reproductive issues are of psychosocial assessment and that education on sexual function in the setting of chronic diseases such as diabetes and CKD is widely needed. Pharmacologic therapy with estrogen/progesterone and androgens along with glycemic control, correction of anemia, ensuring adequate dialysis delivery, and treatment of underlying depression are important. Changes in lifestyle such as smoking cessation, strength training, and aerobic exercises may decrease depression, enhance body image, and have positive impacts on sexuality. Many hormonal abnormalities which occur in women with diabetes and CKD who suffer from chronic anovulation and lack of progesterone secretion may be treated with oral progesterone at the end of each menstrual cycle to restore menstrual cycles. Hypoactive sexual desire disorder (HSDD) is the most common sexual problem reported by women with diabetes and CKD. Sexual function can be assessed in women, using the 9-item Female Sexual Function Index, questionnaire, or 19 items. It is important for nephrologists and physicians to incorporate assessment of sexual function into the routine evaluation protocols. PMID:25276130

  7. Prevalence and determinants of male sexual dysfunctions during first intercourse.

    PubMed

    Santtila, Pekka; Sandnabba, N Kenneth; Jern, Patrick

    2009-01-01

    We explored the balance of genetic and environmental factors on sexual dysfunctions during first intercourse experience in young men. Gender role conflict theory predicts that young males should show high levels of such dysfunctions coupled with mixed affective reactions. Three thousand one hundred eighty six male twins and their siblings (M = 26.17 years, SD = 4.77) completed items on erectile dysfunction (ED), premature ejaculation (PE), contextual factors, and affective reactions during first intercourse, as well as parental attitudes towards nudity and sexuality. Twin modeling revealed a significant genetic effects for PE, but not for ED. Experiences of sexual dysfunction and both negative and positive affects during first intercourse were common among the participants. More positive parental attitudes were associated with less dysfunction and more positive affect during first intercourse. Having the first sexual intercourse with an unknown partner and while strongly intoxicated were, together with group pressure and reluctance to engage in intercourse, related to more negative and less positive affects. Erectile dysfunction during the first intercourse was related to more negative and less positive affects.

  8. Sexual dysfunction in women with type 2 diabetes mellitus.

    PubMed

    Elyasi, Forouzan; Kashi, Zahra; Tasfieh, Bentolhoda; Bahar, Adele; Khademloo, Mohammad

    2015-05-01

    Sexual dysfunction (SD) is one of the important problems in diabetic patients. The present study aimed to determine the prevalence of sexual problems in Iranian women with type 2 diabetes mellitus. A cross-sectional study was conducted among type 2 diabetic women who visited two outpatient endocrine clinics, namely Imam Hospital and Tuba clinic (Sari, Iran) in 2012. Patients were asked to complete two validated questionnaires: Female Sexual Function Index (FSFI) and The Hospital Anxiety and Depression Scale (HADS) as well as a demographic questionnaire. Analysis was performed using descriptive and analytical tests. P<0.05 was considered to be significant. One hundred and fifty women with type 2 diabetes were investigated. Most of the cases aged 40-44 years old. The mean of the total score of the FSFI questionnaire was 22. The prevalence of sexual dysfunction was 78.7% (CI: 71.4-84.4); among these, 58% (CI: 50.0-65.6) reported problems in lubrication, 50% (CI: 42.1-57.9) complained of decreased sexual desire, 50% (CI: 42.1-57.9) had problems with arousal, 47.3% (CI: 39.5-55.3) had dyspareunia, 32.7% (CI: 25.7-40.5) complained of orgasmic dysfunction and 42.7% (CI: 35.0-50.7) reported problems in sexual satisfaction. With regard to the results of the HADS questionnaire, 58.7% (CI: 50.7-66.2) of the patients had depression and 96.7% (CI: 92.4-98.6) had anxiety. This study showed the high prevalence of sexual dysfunction in diabetic women, especially among those complaining of depression. Health care professionals dealing with diabetic patients should be aware of possible presence of sexual dysfunction in female patients.

  9. Sexual dysfunction in women after low anterior resection.

    PubMed

    Yu-Hua, Lin

    2014-04-01

    Low anterior resection procedures are likely to negatively affect pelvic floor function, which are correlated with sexual dysfunction. The purpose of the study was to explore the prevalence of sexual problems in women with rectal cancer after low anterior resection (LAR). The study consisted of an LAR group (n = 32) and a group of healthy women (n = 32). Female sexual function was evaluated using the Female Sexual Function Index (FSFI). A total of 71.8% of those with LAR reported sexual dysfunction, compared to 18.8% in those who are healthy. The FSFI domain scores were significantly lower for the LAR group relative to the healthy group. Logistic regression revealed that group, education, and age were predictors of female sexual functioning. Women who have had an LAR are at higher risk of sexual function problems. The sexual function of women with LAR should be evaluated in patient discharge planning; nurses should provide more information regarding the impact of LAR on sexual function.

  10. Sexual dysfunction and infertility as late effects of cancer treatment.

    PubMed

    Schover, Leslie R; van der Kaaij, Marleen; van Dorst, Eleonora; Creutzberg, Carien; Huyghe, Eric; Kiserud, Cecilie E

    2014-06-01

    Sexual dysfunction is a common consequence of cancer treatment, affecting at least half of men and women treated for pelvic malignancies and over a quarter of people with other types of cancer. Problems are usually linked to damage to nerves, blood vessels, and hormones that underlie normal sexual function. Sexual dysfunction also may be associated with depression, anxiety, relationship conflict, and loss of self-esteem. Innovations in cancer treatment such as robotic surgery or more targeted radiation therapy have not had the anticipated result of reducing sexual dysfunction. Some new and effective cancer treatments, including aromatase inhibitors for breast cancer or chemoradiation for anal cancer also have very severe sexual morbidity. Cancer-related infertility is an issue for younger patients, who comprise a much smaller percentage of total cancer survivors. However, the long-term emotional impact of being unable to have a child after cancer can be extremely distressing. Advances in knowledge about how cancer treatments may damage fertility, as well as newer techniques to preserve fertility, offer hope to patients who have not completed their childbearing at cancer diagnosis. Unfortunately, surveys in industrialised nations confirm that many cancer patients are still not informed about potential changes to their sexual function or fertility, and all modalities of fertility preservation remain underutilised. After cancer treatment, many patients continue to have unmet needs for information about restoring sexual function or becoming a parent. Although more research is needed on optimal clinical practice, current studies suggest a multidisciplinary approach, including both medical and psychosocial treatment options.

  11. Heart Rate Variability: A Risk Factor for Female Sexual Dysfunction.

    PubMed

    Stanton, Amelia M; Lorenz, Tierney A; Pulverman, Carey S; Meston, Cindy M

    2015-09-01

    Heart rate variability (HRV) is a measure of autonomic nervous system activity, which reflects an individual's ability to adapt to physiological and environmental changes. Low resting HRV has been linked to several mental health conditions, including depression, anxiety, and alcohol dependence (Kemp et al. in Biological Psychiatry 67(11):1067-1074, 2010. doi:10.1016/j.biopsych.2009.12.012; Kemp et al. in PloS One, 7(2):e30777, 2012; Quintana et al. in Drug and Alcohol Dependence, 132(1-2):395-398, 2013. doi:10.1016/j.drugalcdep.2013.02.025). HRV has also been used as a method for indexing the relative balance of sympathetic nervous system (SNS) activity to parasympathetic nervous system activity. This balance--in particular, moderately dominant SNS activity--has been shown to play a significant role in women's genital sexual arousal in the laboratory; however, the role of SNS activity in clinically relevant sexual arousal function is unknown. The present study assessed the feasibility of using HRV as an index of women's self-reported sexual arousal function outside the laboratory. Sexual arousal function, overall sexual function, and resting HRV were assessed in 72 women, aged 18-39. Women with below average HRV were significantly more likely to report sexual arousal dysfunction (p < .001) and overall sexual dysfunction (p < .001) than both women with average HRV and women with above average HRV. In conclusion, low HRV may be a risk factor for female sexual arousal dysfunction and overall sexual dysfunction.

  12. Affective and physiological sexual response patterns: the effects of instructions on sexually functional and dysfunctional men.

    PubMed

    Heiman, J R; Rowland, D L

    1983-01-01

    To more clearly characterize the patterns of cognitive-affective and physiological responses concomitant with male sexual dysfunction, the present study compared 14 sexually dysfunctional and 16 sexually functional men. All individuals listened to two sexually explicit tapes and engaged in a self-generated fantasy, while genital, heart rate and scaled cognitive affective responses were recorded. Two types of instructions, a performance demand set and a non-demand sensate focus set, preceded the erotic tapes in counterbalanced order. As predicted, dysfunctional men showed less genital tumescence to tapes preceded by the demand than the non-demand instructions. Contrary to expectation, functional men showed greater penile tumescence to the tapes preceded by demand instructions. Self-reported sexual arousal did not follow the penile tumescence pattern but instead indicated that the dysfunctional sample was significantly less subjectively aroused to the tapes and fantasy. There were other significant differences between the groups. Dysfunctional men showed greater general psychological distress, as measured by the SCL-90, including elevated somaticism, anxiety and depression scores. During the experimental session, dysfunctional men also evidenced greater awareness of a variety of physiological responses, as well as more negative and fewer positive cognitive-affective states. These data are discussed in terms of the interaction of affective and physiological responses, differences in contextual meanings of instructional sets given the presence of a dysfunction, and theoretical and clinical conceptualizations of male sexual functioning.

  13. The Physiology of Female Sexual Function and the Pathophysiology of Female Sexual Dysfunction (Committee 13A).

    PubMed

    Levin, Roy J; Both, Stephanie; Georgiadis, Janniko; Kukkonen, Tuuli; Park, Kwangsung; Yang, Claire C

    2016-05-01

    The article consists of six sections written by separate authors that review female genital anatomy, the physiology of female sexual function, and the pathophysiology of female sexual dysfunction but excluding hormonal aspects. To review the physiology of female sexual function and the pathophysiology of female sexual dysfunction especially since 2010 and to make specific recommendations according to the Oxford Centre for evidence based medicine (2009) "levels of evidence" wherever relevant. Recommendations were made for particular studies to be undertaken especially in controversial aspects in all six sections of the reviewed topics. Despite numerous laboratory assessments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  14. Animal Models for the Study of Female Sexual Dysfunction.

    PubMed

    Marson, Lesley; Giamberardino, Maria Adele; Costantini, Raffaele; Czakanski, Peter; Wesselmann, Ursula

    2013-07-01

    Significant progress has been made in elucidating the physiological and pharmacological mechanisms of female sexual function through preclinical animal research. The continued development of animal models is vital for the understanding and treatment of the many diverse disorders that occur in women. To provide an updated review of the experimental models evaluating female sexual function that may be useful for clinical translation. Review of English written, peer-reviewed literature, primarily from 2000 to 2012, that described studies on female sexual behavior related to motivation, arousal, physiological monitoring of genital function and urogenital pain. Analysis of supporting evidence for the suitability of the animal model to provide measurable indices related to desire, arousal, reward, orgasm, and pelvic pain. The development of female animal models has provided important insights in the peripheral and central processes regulating sexual function. Behavioral models of sexual desire, motivation, and reward are well developed. Central arousal and orgasmic responses are less well understood, compared with the physiological changes associated with genital arousal. Models of nociception are useful for replicating symptoms and identifying the neurobiological pathways involved. While in some cases translation to women correlates with the findings in animals, the requirement of circulating hormones for sexual receptivity in rodents and the multifactorial nature of women's sexual function requires better designed studies and careful analysis. The current models have studied sexual dysfunction or pelvic pain in isolation; combining these aspects would help to elucidate interactions of the pathophysiology of pain and sexual dysfunction. Basic research in animals has been vital for understanding the anatomy, neurobiology, and physiological mechanisms underlying sexual function and urogenital pain. These models are important for understanding the etiology of female sexual

  15. Psychosocial pathways to sexual dysfunction among female inmates.

    PubMed

    Baltieri, Danilo Antonio

    2014-08-01

    Although health surveys on sexual issues during incarceration have shown that women report having engaged in sexual activities while in prison, studies on sexual functioning in female inmates have been largely dismissed. This study aimed to assess sexual functioning among incarcerated women and determine the psychometric and sociodemographic features that are possibly related to the risk of sexual dysfunction. This was a cross-sectional study conducted inside a penitentiary for women in São Paulo, Brazil. From June 2006 to June 2010, 315 inmates convicted of robbery or homicide were recruited. High risk of female sexual dysfunction (HRFSD) was measured using the Female Sexual Function Index and participants were also evaluated for alcohol and drug misuse, impulsiveness, depressive symptoms, and psychosocial features. Descriptive statistics and multivariate logistic regression were utilized to analyze the data. Among the participants, 253 (80.32 %) met the criteria for HRFSD. Older age, total time of imprisonment, and depressive symptoms were related to a higher risk, while the status of being married, being Black, having sexual relations with other inmates, and receiving conjugal visits were associated with a lower risk. As only 110 (34.92 %) inmates admitted to having sexual relationships inside prison, we evaluated this sub-sample separately. For this sub-sample, 61 (55.45 %) women met the criteria for HRFSD and the main factors associated with this risk were total time of imprisonment and depressive symptoms. Incarcerated women are uniquely vulnerable because they often have histories of deprivation and violence stemming from multiple sources and experience considerable psychological symptoms as a consequence of imprisonment. With the affected population rarely receiving psychosocial management for sexual dysfunction, service delivery efforts should be intensified to target this high-risk population.

  16. Survivorship: Sexual Dysfunction (Male), Version 1.2013

    PubMed Central

    Denlinger, Crystal S.; Carlson, Robert W.; Are, Madhuri; Baker, K. Scott; Davis, Elizabeth; Edge, Stephen B.; Friedman, Debra L.; Goldman, Mindy; Jones, Lee; King, Allison; Kvale, Elizabeth; Langbaum, Terry S.; Ligibel, Jennifer A.; McCabe, Mary S.; McVary, Kevin T.; Melisko, Michelle; Montoya, Jose G.; Mooney, Kathi; Morgan, Mary Ann; O’Connor, Tracey; Paskett, Electra D.; Raza, Muhammad; Syrjala, Karen L.; Urba, Susan G.; Wakabayashi, Mark T.; Zee, Phyllis; McMillian, Nicole; Freedman-Cass, Deborah

    2015-01-01

    Various anticancer treatments, especially those directed toward the pelvis, can damage blood vessels and reduce circulation of blood to the penis and/or damage the autonomic nervous system, resulting in higher rates of erectile dysfunction in survivors than in the general population. In addition, hormonal therapy can contribute to sexual problems, as can depression and anxiety, which are common in cancer survivors. This section of the NCCN Guidelines for Survivorship provides screening, evaluation, and treatment recommendations for male sexual problems, namely erectile dysfunction. PMID:24616541

  17. Female sexual dysfunction: facts and factors among gynecology outpatients.

    PubMed

    Jahan, Muna Shalima; Billah, Syed Muhammad Baqui; Furuya, Hiroyuki; Watanabe, Tetsu

    2012-01-01

    This study was aimed at assessing the female sexual dysfunction of respondents at gynecology outpatient clinics.   The cross-sectional study involved interviewing 137 female respondents from the gynecology outpatient department of Dhaka Medical College Hospital and Shaheed Suhrawardy Hospital with a semi-structured questionnaire during March-August 2007. The sociodemographic details and sexual history with sexual problems were recorded. Half (51.8%) the respondents had one or more sexual problems. Pain during intercourse (71.8%) and reduced desire (54.9%) were highest among different complaints followed by orgasmic (43.66%) and arousal problems (32.39%). Age and education were significantly associated with reduced desire (P=0.03). Delivery mode was significantly associated with inhibited desire (P=0.01) and arousal problems (P=0.003), and not significantly with pain (P=0.06). After adjusting confounding factors, parity (odds ratio [OR]=3.4, 95% confidence interval [CI]: 1.21-9.68), history of menstrual regulation (OR=2.84, 95%CI: 1.31-6.22), mental stress (OR=2.81, 95%CI: 1.05-7.50) and sexual problems of the husband (OR=3.16, 95%CI: 1.19-8.44) became risk factors for increasing odds of having dysfunction while increased frequency of intercourse showed a marginally significant reducing effect (OR=0.764, 95%CI: 0.95-1.00). This is a pioneer study in Bangladesh to postulate female sexuality, revealing pain disorder as most prevalent; the women with dysfunction were dissatisfied with their sexual life. In order to determine the cause of female sexual dysfunction, the topic needs further exploration involving intervention at regular medical investigations. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

  18. Psychopharmacology of male rat sexual behavior: modeling human sexual dysfunctions?

    PubMed

    Olivier, B; Chan, J S W; Pattij, T; de Jong, T R; Oosting, R S; Veening, J G; Waldinger, M D

    2006-01-01

    Most of our current understanding of the neurobiology, neuroanatomy and psychopharmacology of sexual behavior and ejaculatory function has been derived from preclinical studies in the rat. When a large population of male rats is tested on sexual activity during a number of successive tests, over time individual rats display a very stable sexual behavior that is either slow, normal or fast as characterized by the number of ejaculations performed. These sexual endophenotypes are postulated as rat counterparts of premature (fast rats) or retarded ejaculation (slow rats). Psychopharmacology in these endophenotypes helps to delineate the underlying mechanisms and pathology. This is illustrated by the effects of serotonergic antidepressants and serotonergic compounds on sexual and ejaculatory behavior of rats. These preclinical studies and models contribute to a better understanding of the neurobiology of ejaculation and boost the development of novel drug targets to treat ejaculatory disorders such as premature and retarded ejaculation.

  19. Prevalence of female sexual dysfunction in Brazil: A systematic review.

    PubMed

    Wolpe, Raquel E; Zomkowski, Kamilla; Silva, Fabiana P; Queiroz, Ana Paula A; Sperandio, Fabiana F

    2017-04-01

    The aim of this systematic review is to investigate the prevalence of female sexual dysfunction in the Brazilian population. This is a systematic review conducted in July 2016 in which four databases were searched: MEDLINE/Pubmed, Scopus, LILACS, and Cinahl. Two investigators extracted the primary data, which were fully analyzed, and applied the inclusion/exclusion criteria. The search found 113 results, and 20 of them compounded the scope of this study. Only four of the studies showed good methodology quality. The main diagnostics criteria used were validated questionnaires specific for sexual function assessment. Regarding the variation of prevalence values, female sexual dysfunction ranged from 13.3% to 79.3% of the studied population, while this value for changes in sexual desire ranged from 11% to 75%, arousal from 8% to 68.2%, lubrication from 29.1% to 41.4%, orgasm from 18% to 55.4%, and satisfaction from 3.3% to 42%; sexual activity frequency ranged from 55.8% to 78.5%, dyspareunia from 1.2% to 56.1%, and pleasure modifications was not addressed. Beside the divergences among studies, there is still a high prevalence of female sexual dysfunction in Brazil.

  20. Assessment of sexual function in women with pelvic floor dysfunction.

    PubMed

    Kammerer-Doak, Dorothy

    2009-05-01

    This article reviews sexual function questionnaires used in urogynecology, impact of pelvic floor dysfunction (PFD) on sexual function, and impact of surgical treatment of PFD on sexual function, with a focus on the experience and publications of validated sexual function questionnaires in the urogynecologic literature. A review of the literature was performed to obtain data on sexual function and PFD focusing on those studies that utilized validated sexual function questionnaires. Validated questionnaires assure data that are reliable, quantifiable, and reproducible. Quality-of-life questionnaires, such as The King's Health Questionnaire and the Incontinence Impact Questionnaire, include a few questions addressing sexual function but really deal with the overall impact of incontinence and/or prolapse on the patient's QOL or well-being and do not focus on sexual function. General questionnaires focused on sexual function include the Female Sexual Function Index and the Sexual History Form 12, which were designed to evaluate sexual function and have undergone validation and reliability testing in a general population. General questionnaires are not condition-specific and may not be sensitive enough to detect differences due to PFD. The Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ) is a condition-specific questionnaire focused on sexual function for use in women with PFD and has undergone rigorous validation and reliability testing. Many recent publications examining the impact of urinary incontinence (UI), fecal incontinence, and pelvic organ prolapse (POP) using validated generalized and disease-specific questionnaires have reported poorer sexual function in women with PFD. The PISQ has been used most commonly to evaluate sexual function after surgery for PFD, with increased PISQ scores in approximately 70%. Significant improvement is noted for sexual function related to physical and partner-related factors, with no changes for orgasm

  1. Endocrine aspects of sexual dysfunction in men.

    PubMed

    Morales, Alvaro; Buvat, Jacques; Gooren, Louis J; Guay, Andre T; Kaufman, Jean-Marc; Tan, Hui Meng; Torres, Luiz O

    2004-07-01

    Endocrine disorders of sex steroid hormones may adversely affect men's sexual function. Aim. To provide expert opinions/recommendations concerning state-of-the-art knowledge for the pathophysiology, diagnosis and treatment of endocrinologic sexual medicine disorders. An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a scientific and debate process. Concerning the Endocrine committee, there were eight experts from seven countries. Expert opinions/recommendations are based on grading of evidence-based medical literature, extensive internal committee discussion over 2 years, public presentation and deliberation. Hypogonadism is a clinical and biochemical syndrome characterized by a deficiency in serum androgen levels which may decrease sexual interest, quality of erections and quality of life. Biochemical investigations include testosterone and either bioavailable or calculated free testosterone; prolactin should be considered when hypogonadism has been documented. If clinically indicated, androgen therapy should maintain testosterone within the physiological range avoiding supraphysiologic values. Digital rectal examination and determination of serum prostate specific antigen values are mandatory prior to therapy and regularly thereafter. Androgen therapy is usually long-term requiring regular follow-up, frequent monitoring of blood levels and beneficial and adverse therapeutic responses. Safe and effective treatments for endocrinologic sexual medicine disorders examined by prospective, placebo-controlled, multi-institutional clinical trials are needed.

  2. Female sexual dysfunction in patients with substance-related disorders

    PubMed Central

    Diehl, Alessandra; da Silva, Rosiane Lopes; Laranjeira, Ronaldo

    2013-01-01

    OBJECTIVE: To estimate the prevalence of female sexual dysfunction symptoms and the associated risk factors in a sample of patients with substance-related disorders admitted to a specialized in-patient care unit. METHODS: This study used a cross-section design, with eight months of data collection, conducted with substance-dependent women using structured questionnaires to collect socio-demographic data and identify their drug of choice. The Drug Abuse Screening Test, Short Alcohol Dependence Data questionnaire, Fagerström Test for Nicotine Dependence, and Arizona Sexual Experience Scale were also administered. RESULTS: The sample consisted of 105 women who had a mean age of 34.8 years (SD = 12.1, range = 18-65) and were predominantly heterosexual (74.3%), single (47.6%), Caucasian (50.5%), catholic (36.2%), and educated only to the level of primary education (40%), with a monthly family income of up to one minimum salary (37.5%). In 42.9% of the patients, crack was the drug of choice; 47.6% of the sample qualified for the Drug Abuse Screening Test (substantial problems related to drugs), 43.8% exhibited Short Alcohol Dependence Data (moderate or severe dependency), 47.6% exhibited Fagerström Test for Nicotine Dependence (high or very high nicotine dependence). The prevalence of sexual dysfunction symptoms was 34.2% (95% CI = [25.3, 44.1]), and a high level of nicotine dependence and low income increased the chances of having sexual dysfunction by 2.72-fold and 2.54 fold, respectively. An association was also observed between female sexual dysfunction symptoms and schooling and levels of drug dependence. CONCLUSIONS: Female sexual dysfunction symptoms were common among this sample and primarily associated with high levels of nicotine use. PMID:23525317

  3. Female sexual dysfunction in patients with substance-related disorders.

    PubMed

    Diehl, Alessandra; Silva, Rosiane Lopes da; Laranjeira, Ronaldo

    2013-01-01

    To estimate the prevalence of female sexual dysfunction symptoms and the associated risk factors in a sample of patients with substance-related disorders admitted to a specialized in-patient care unit. This study used a cross-section design, with eight months of data collection, conducted with substance-dependent women using structured questionnaires to collect socio-demographic data and identify their drug of choice. The Drug Abuse Screening Test, Short Alcohol Dependence Data questionnaire, Fagerstrom Test for Nicotine Dependence, and Arizona Sexual Experience Scale were also administered. The sample consisted of 105 women who had a mean age of 34.8 years (SD = 12.1, range = 18-65) and were predominantly heterosexual (74.3%), single (47.6%), Caucasian (50.5%), catholic (36.2%), and educated only to the level of primary education (40%), with a monthly family income of up to one minimum salary (37.5%). In 42.9% of the patients, crack was the drug of choice; 47.6% of the sample qualified for the Drug Abuse Screening Test (substantial problems related to drugs), 43.8% exhibited Short Alcohol Dependence Data (moderate or severe dependency), 47.6% exhibited Fagerstrom Test for Nicotine Dependence (high or very high nicotine dependence). The prevalence of sexual dysfunction symptoms was 34.2% (95% CI = [25.3, 44.1]), and a high level of nicotine dependence and low income increased the chances of having sexual dysfunction by 2.72-fold and 2.54 fold, respectively. An association was also observed between female sexual dysfunction symptoms and schooling and levels of drug dependence. Female sexual dysfunction symptoms were common among this sample and primarily associated with high levels of nicotine use.

  4. Adjunctive metformin for antipsychotic-induced hyperprolactinemia: A systematic review.

    PubMed

    Bo, Qi-Jing; Wang, Zhi-Min; Li, Xian-Bin; Ma, Xin; Wang, Chuan-Yue; de Leon, Jose

    2016-03-30

    This systematic review examines adjunctive metformin therapy for the treatment of antipsychotic-induced hyperprolactinemia. A computerized search of databases in Chinese and the international databases in English provided three trials with a total of 325 patients including one randomized clinical trial (RCT) and two observational studies (single-group, before-after design). A meta-analysis could not be conducted. The quality of evidence ranged from "very low" to "moderate". Metformin patients had a significant decrease in serum prolactin level with a mean of 54.6μg/l in the three trials. In the RCT, menstruation restarted in 67% of those with menstrual disturbances versus 5% in placebo. In one observational study, 91% of patients no longer had signs or symptoms of galactorrhea. In the RCT, adverse drug reactions (ADRs) occurred at similar incidence rates among metformin and placebo patients, except that no significant increases in nausea, insomnia and agitation occurred which were not associated with discontinuations. Our systematic review indicated that adjunctive metformin significantly lowered prolactin level and relieved prolactin-related symptoms in patients with antipsychotic-induced hyperprolactinemia. Future higher quality RCTs need to verify the currently available limited evidence based on three trials which suggest that adjunctive metformin may be used effectively and safely for antipsychotic-induced hyperprolactinemia.

  5. Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women(∗): (∗)2016 ISSM Female Sexual Dysfunction Prize.

    PubMed

    Wåhlin-Jacobsen, Sarah; Kristensen, Ellids; Pedersen, Anette Tønnes; Laessøe, Nanna Cassandra; Cohen, Arieh S; Hougaard, David M; Lundqvist, Marika; Giraldi, Annamaria

    2017-03-01

    The female sexual response is complex and influenced by several biological, psychological, and social factors. Testosterone is believed to modulate a woman's sexual response and desire, because low levels are considered a risk factor for impaired sexual function, but previous studies have been inconclusive. To investigate how androgen levels and psychosocial factors are associated with female sexual dysfunction (FSD), including hypoactive sexual desire disorder (HSDD). The cross-sectional study included 428 premenopausal women 19 to 58 years old who completed a questionnaire on psychosocial factors and had blood sampled at days 6 to 10 in their menstrual cycle. Logistic regression models were built to test the association among hormone levels, psychosocial factors, and sexual end points. Five different sexual end points were measured using the Female Sexual Function Index and the Female Sexual Distress Scale: impaired sexual function, sexual distress, FSD, low sexual desire, and HSDD. Serum levels of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate, and androsterone glucuronide were analyzed using mass spectrometry. After adjusting for psychosocial factors, women with low sexual desire had significantly lower mean levels of free testosterone and androstenedione compared with women without low sexual desire. None of the androgens were associated with FSD in general or with HSDD in particular. Relationship duration longer than 2 years and mild depressive symptoms increased the risk of having all the sexual end points, including FSD in general and HSDD in particular in multivariate analyses. In this large cross-sectional study, low sexual desire was significantly associated with levels of free testosterone and androstenedione, but FSD in general and HSDD in particular were not associated with androgen levels. Length of relationship and depression were associated with FSD including HSDD. Wåhlin-Jacobsen S, Kristensen E, Tønnes Pedersen A

  6. Sexual Enhancement Groups for Dysfunctional Women: An Evaluation

    ERIC Educational Resources Information Center

    Leiblum, Sandra R.; Ersner-Hershfield, Robin

    1977-01-01

    Three groups of women with sexual dysfunction were evaluated pretreatment and posttreatment. Two groups did not involve partner participation, while the third group included partners on two occasions. Results for all groups were similar. The question of whether orgasm through coitus alone is a reasonable goal is raised and challenged. (Author)

  7. Sexual Enhancement Groups for Dysfunctional Women: An Evaluation

    ERIC Educational Resources Information Center

    Leiblum, Sandra R.; Ersner-Hershfield, Robin

    1977-01-01

    Three groups of women with sexual dysfunction were evaluated pretreatment and posttreatment. Two groups did not involve partner participation, while the third group included partners on two occasions. Results for all groups were similar. The question of whether orgasm through coitus alone is a reasonable goal is raised and challenged. (Author)

  8. [Sexual dysfunction in men with spinal injuries].

    PubMed

    Stien, Ragnar

    2008-02-14

    Spinal injuries may disturb men's sexual functions in various ways. Review article based on extensive clinical experience, lecturing, research and selected articles. A spinal injury may disrupt or disturb the connection between the brain's main centres for sexual function to the genitals. This often leads to extensive problems with erection, ejaculation, orgasm and fertility. Hormonal affection of sexuality is not much altered. Libido problems are of a more psychological nature, such as a poor self-esteem and lack of understanding from the surroundings. Sedative effects of medicines affect all aspects of sexuality. About 80% of men with spinal injuries have erection problems; mainly erection of short duration that can be treated with medicines administered orally (such as phosphodiesterase inhibitors) or by self injection of alpha-adrenergic inhibitors directly into the sinusoids in the penis. Only 10-15% ejaculate spontaneously. Ejaculation may be assisted in various ways, the vibro-ejaculation method being the most effective. The semen quality is reduced, possibly because of altered neurogen control of sperm maturation. Modern techniques for in vitro fertilisation combined with assisted ejaculation and careful control of the semen quality, has made it possible for most spinal-injured men to have their own children.

  9. Insecure Attachment Style and Dysfunctional Sexual Beliefs Predict Sexual Coercion Proclivity in University Men

    PubMed Central

    Dang, Silvain S; Gorzalka, Boris B

    2015-01-01

    Introduction Past studies have shown an association between low sexual functioning and engaging in sexually coercive behaviors among men. The mechanism of this relationship is not well understood. Moreover, most studies in this area have been done in incarcerated sex offenders. Aims The aim of the current study was to investigate the role of potential distal predictors of sexual coercion, including insecure attachment style and dysfunctional sexual beliefs, in mediating the relationship between sexual functioning and sexual coercion. The study also seeks to extend past findings to a novel non-forensic population. Methods Male university students (N = 367) anonymously completed online questionnaires. Main Outcome Measures Participants completed the Sexual Experiences Survey, Improved Illinois Rape Myth Acceptance Scale, Hostility Towards Women Scale, Likelihood of Rape Item, Experiences in Close Relationships Scale, Dysfunctional Sexual Beliefs Scale, and Brief Sexual Functioning Questionnaire. Results Sexual functioning was not significantly associated with sexually coercive behaviors in our sample (r = 0.08, P = 0.247), though a significant correlation between sexual functioning and rape myth acceptance was found (r = 0.18, P = 0.007). Path analysis of all variables showed that the likelihood of rape item was the strongest correlate of sexually coercive behaviors (β = 0.34, P < 0.001), while dysfunctional sexual beliefs appeared to mediate the association between anxious attachment and likelihood of rape item score. Anxious (r = −0.27, P = 0.001) and avoidant (r = −0.19, P = 0.004) attachment also correlated significantly with lower sexual functioning. Conclusions These findings suggest the relationship between sexual functioning and sexual coercion may be less robust than previously reported, and may be due to a shared association with other factors. The results elaborate on the interrelation between attachment

  10. Female sexual dysfunction among Egyptian patients with chronic hepatitis C.

    PubMed

    Elshimi, Esam; Morad, Wesam; Mohamad, Noha Ezzat; Shebl, Nashwa; Waked, Imam

    2014-03-01

    Chronic hepatitis C is associated with many extrahepatic manifestations that impact and impair the quality of life. Hepatitis C virus (HCV) infection has a high prevalence in Egypt and carries with the diagnosis many social impacts and stigmatization correlates that further impair social function. This might negatively impact patients and their sexual function. Sexuality and sexual function have not been studied well in patients with HCV, especially in women. To investigate sexual dysfunction in Egyptian women with chronic hepatitis C. Female Sexual Function Index (FSFI) scores of patients with hepatitis C, both total and for individual domains, were compared with those of controls. The self-administered FSFI questionnaire was completed by 112 sexually active female patients with chronic hepatitis C without liver cirrhosis prior to initiation of therapy by pegylated interferon and ribavirin. Their results were compared to those of 225 age- and socioeconomic class-matched sexually active healthy females. Significantly more patients than controls had questionnaire scores below the threshold of female sexual dysfunction (FSD) (79% vs. 21%, P < 0.05), and the mean total score for the patients was significantly lower than that for controls (19.54 ± 6.2 vs. 28.43 ± 4.9 P < 0.001). The patients' scores in all domains of the questionnaire were significantly lower than those of the controls. Chronic hepatitis C negatively impacts female sexual function, affecting all domains of the sex cycle; this warrants further studies and needs to be addressed as part of a comprehensive therapy plan to improve patients' quality of life. © 2013 International Society for Sexual Medicine.

  11. Hypoactive sexual desire dysfunction in community-dwelling older women.

    PubMed

    Zeleke, Berihun M; Bell, Robin J; Billah, Baki; Davis, Susan R

    2017-04-01

    To determine the prevalence of hypoactive sexual desire dysfunction (HSDD) and its associated factors in women aged 65 to 79 years. A questionnaire-based, cross-sectional study was conducted amongst community-dwelling older women. Participants were recruited between April and August 2014 from a national database based on electoral rolls. Sexual function and sexual distress were assessed by the Female Sexual Function Index and the Female Sexual Distress Scale-Revised, respectively. HSDD was defined as the presence of both low sexual desire and sexually related personal distress. The mean ± SD age of the 1,548 women was 71 ± 3.4 years and 52.6% were partnered. Among the participants, 88.0% (95% confidence interval [CI], 86.3%-89.6%) had low sexual desire, 15.5% (95% CI, 13.8%-17.4%) had sexually related personal distress, and 13.6% (95% CI, 11.9%-15.4%) had HSDD. The HSDD was more common among partnered than among unpartnered women (23.7% vs 5.9%; P < 0.001). Being partnered (adjusted odds ratio [AOR] = 4.21; 95% CI, 2.50-7.07), having vaginal dryness during intercourse (AOR = 2.37; 95% CI, 1.58-3.55), having symptomatic pelvic floor dysfunction (AOR = 1.92; 95% CI, 1.29-2.92), and having moderate-to-severe depressive symptoms (AOR = 4.15; 95% CI, 2.16-7.96) were independently associated with having HSDD. In a subanalysis, HSDD was more common among sexually active than sexually inactive women (31.5% vs 17.3%; P < 0.001). Furthermore, 32% (95% CI, 27.7%-38.3%) of partnered sexually active women had HSDD, as did 22% (95% CI, 11.5%-37.8%) of unpartnered sexually active women. HSDD is common and associated with potentially modifiable risk factors in older women. It should not be assumed that unpartnered older women are sexually inactive or are not distressed by low sexual desire.

  12. Sexual and urinary dysfunction after proctectomy for rectal cancer.

    PubMed

    Eveno, C; Lamblin, A; Mariette, C; Pocard, M

    2010-02-01

    Sexual and urinary dysfunction occur frequently after rectal surgery. Total mesorectal excision (TME) is currently the optimal technique for resection of rectal cancer, providing superior carcinological and functional outcomes. Age, pre-operative radiation therapy, abdominoperineal resection, and surgery which fails to respect the "sacred planes" of TME are the four major risk factors for post-operative sexual and urinary sequelae. In the era of TME, postoperative sexual dysfunction ranges from 10-35%, depending on the scores used to assess it, while urinary sequelae have decreased to less than 5%. The place of laparoscopic surgery remains to be defined, particularly with respect to these complications. It is essential to inform the patient pre-operatively about the possibility of such disorders not only for patient informed consent but also to help with correct post-operative management of the problem. Management is multifaceted, and includes psychological, pharmacological, and sometimes surgical therapy. (c) 2010 Elsevier Masson SAS. All rights reserved.

  13. Psychological and interpersonal dimensions of sexual function and dysfunction

    PubMed Central

    Assalian, Pierre

    2013-01-01

    Introduction Sex therapy techniques comprise behavioural and cognitive as well as psychodynamic and educational interventions, like reading (‘bibliotherapy’), videotapes and illustrations of anatomical models. Contemporary approaches focus on desire, pleasure and satisfaction. Discussion It is important to assess medical and biological factors involved in the genesis of sexual dysfunctions. Sex therapy techniques were developed by Masters and Johnson, and their premise was to eliminate ‘performance anxiety’ by emphasising the undemanding nature of the sexual relation. New methods were introduced, like Internet-administered techniques, and ‘mindfulness therapy’, and they proved to be effective. Conclusions Psychological treatments have some relieving effects on sexual dysfunction, but for studies of the outcomes it is difficult to meet the requirements of evidence-based medicine. PMID:26558085

  14. Persistent sexual dysfunction after discontinuation of selective serotonin reuptake inhibitors.

    PubMed

    Csoka, Antonei B; Csoka, A; Bahrick, Audrey; Mehtonen, Olli-Pekka

    2008-01-01

    Sexual dysfunctions such as low libido, anorgasmia, genital anesthesia, and erectile dysfunction are very common in patients taking selective serotonin reuptake inhibitors (SSRIs). It has been assumed that these side effects always resolve after discontinuing treatment, but recently, four cases were presented in which sexual function did not return to baseline. Here, we describe three more cases. Case #1: A 29-year-old with apparently permanent erectile dysfunction after taking fluoxetine 20 mg once daily for a 4-month period in 1996. Case #2: A 44-year-old male with persistent loss of libido, genital anesthesia, ejaculatory anhedonia, and erectile dysfunction after taking 20-mg once daily citalopram for 18 months. Case #3: A 28-year-old male with persistent loss of libido, genital anesthesia, and ejaculatory anhedonia since taking several different SSRIs over a 2-year period from 2003-2005. No psychological issues related to sexuality were found in any of the three cases, and all common causes of sexual dysfunction such as decreased testosterone, increased prolactin or diabetes were ruled out. Erectile capacity is temporarily restored for Case #1 with injectable alprostadil, and for Case #2 with oral sildenafil, but their other symptoms remain. Case #3 has had some reversal of symptoms with extended-release methylphenidate, although it is not yet known if these prosexual effects will persist when the drug is discontinued. SSRIs can cause long-term effects on all aspects of the sexual response cycle that may persist after they are discontinued. Mechanistic hypotheses including persistent endocrine and epigenetic gene expression alterations were briefly discussed.

  15. Sexual (Dys)function after Urethroplasty

    PubMed Central

    2016-01-01

    There is a paucity of published literature on the andrological consequences of urethral repair. Until recently authors have focused mainly on technical aspects and objective results. Reported outcomes of urethral reconstruction surgery have traditionally focused only on urodynamic parameters such as flow rates. Patient reported outcome measures have largely been neglected and there is a scarcity of well conducted systematic studies on the subject. For these reasons whether the different components of sexual life are more or less affected by different types of urethral reconstruction remains largely unknown. In an attempt to clarify the available scientific evidence, the authors make a critical review of available literature, systematizing it by sexual domain and study type. Brief pathophysiological correlations are discussed. PMID:27051420

  16. Overactive bladder and its effects on sexual dysfunction among women.

    PubMed

    Ergenoglu, Ahmet M; Yeniel, Ahmet Özgür; Itil, Ismail Mete; Askar, Niyazi; Meseri, Reci; Petri, Eckhard

    2013-10-01

    To evaluate the relation between overactive bladder (OAB) and sexual dysfunction in sexually active nurses without stress urinary incontinence and pelvic organ prolapse. Prospective, observational study. Tertiary care center. 200 nurses, under 49 years of age. Data were obtained with Turkish language-validated questionnaires between January 2011 and June 2011. OAB was diagnosed using the Overactive Bladder Awareness Tool (OAB AT). Scores on the Overactive Bladder Symptom and Health-related Quality of Life Questionnaire Short Form (OABq-SF), the Health-related Quality of Life Questionnaire Short Form (HRQOL), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire Short Form (PISQ-12). Of the 127 enrolled volunteers, 51 were diagnosed with OAB. The mean age of the participants was 37.8 ± 7.3 years. After controlling for age, body mass index, and parity, OAB did not significantly affect PISQ-12 scores, but significantly worsened OABq-SF scores. No strong correlation was noted between the parts of the OABq-SF and the domains of the PISQ-12. OAB is a common problem among sexually active young women and significantly affects their quality of life. However, OAB-related sexual dysfunction plays a limited role among sexually active nurses. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. Standards for clinical trials in male sexual dysfunction: erectile dysfunction and rapid ejaculation.

    PubMed

    Hirsch, Mark; Donatucci, Craig; Glina, Sidney; Montague, Drogo; Montorsi, Francesco; Wyllie, Michael

    2004-07-01

    The introduction of safe and effective therapies for sexual dysfunctions depend upon appropriate clinical protocol design, study procedures, data collection and analysis. To provide recommendations/guidelines concerning state-of-the-art knowledge for standards for clinical trials in sexual dysfunction in men, particularly in the areas of erectile dysfunction and rapid ejaculation. An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Standards for Clinical Trials in Male Sexual Dysfunction Committee, there were six experts from four countries. Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. Drug development requires a multiphased approach. Phase 1 studies investigate multiple-dose safety, tolerability and pharmacokinetic issues. Phase 2 programs explore dose ranging (lowest effective, maximally tolerated and toxic doses). Phase 3 trials provide the substantial evidence including drug-drug interaction data and studies in special populations. Clinical studies require validated outcome assessment instruments conducted in defined but representative patient populations. Daily diaries or per-event questionnaires are patient-reported outcomes that assist in retrospective questionnaire interpretation. A qualified biostatistician should calculate the sample power for the trial, type of statistical model and design employed, use of covariate or subgroup analyses, and calculation of effect sizes. More research is needed in

  18. Executive Dysfunction Predicts Delinquency But Not Characteristics of Sexual Aggression Among Adolescent Sexual Offenders.

    PubMed

    Burton, David; Demuynck, Sophia; Yoder, Jamie R

    2016-12-01

    Our aim in this study was to evaluate executive function and its relationship to delinquency and sexual crime in adolescents incarcerated for sexual crimes. Based on self-report data, 196 male adolescent sexual offenders from a Midwest state reported high rates of executive dysfunction. Although such deficits did not relate to the number of victims of sexual abuse, severity, or degree of force used in commission of the sexual crimes, poor executive function was significantly predictive of both general delinquency and felony theft. In both measures of delinquent conduct, behavioral regulation dysfunction was predictive of the frequency of commission of the crimes, whereas metacognition was not. Research and treatment implications are offered. © The Author(s) 2014.

  19. Sexuality and sexual dysfunction in spinal cord-injured men in Turkey.

    PubMed

    Akman, Ramazan Yavuz; Coşkun Çelik, Evrim; Karataş, Metin

    2015-01-01

    To provide a comprehensive evaluation of sexual function and dysfunction in spinal cord-injured men based on self-reports of patients. Forty-seven spinal cord-injured men who completed the spinal shock and rehabilitation period were included. Patients were asked to complete a questionnaire developed to assess social status, sexual activities, abilities, and sexuality education after injury. Neurologic levels of patients were classified according to American Spinal Cord Injury Association protocol. Erectile function was evaluated by International Index of Erectile Function-5 (IIEF-5) questionnaire. Patients were aged between 20 and 62 years (mean: 35.2). Twenty-eight patients had T10 and above, 15 between T11 and L2, and 4 cauda conus injury. While 61.7% of the patients declared sexual activity, 93.6% declared some degree of erection. Mean IIEF-5 score was 5.3 and 87.3% of the patients had moderate to severe erectile dysfunction. Continuation of sexual activity after injury is very important and has a great impact on quality of life and interpersonal relationships for spinal cord-injured men. More attention must be given to sexuality after spinal cord injury. A very high rate of sexual dysfunction in spinal cord-injured patients was found and the importance of sexual education was emphasized in this study.

  20. Ethnic differences in sexual dysfunction among diabetic and nondiabetic males: the Oxford Sexual Dysfunction Study.

    PubMed

    Malavige, Lasantha S; Wijesekara, Pabasi; Seneviratne Epa, Danesha; Ranasinghe, Priyanga; Levy, Jonathan C

    2013-02-01

    Erectile dysfunction (ED), premature ejaculation (PE), and reduced libido are common yet poorly investigated complications of diabetes especially among South Asians (SA). To determine possible variations in prevalence and interassociations of ED, PE, and reduced libido among SA and Europids with and without diabetes. Men with diabetes and a randomly selected sample of age-matched nondiabetic men from 25 general practitioners in eight primary care trusts in the United Kingdom were invited to participate in a linguistically validated questionnaire-based study in English, Hindi, Urdu, Panjabi, Tamil, and Sinhala languages. ED, assessed by International Index of Erectile Function (IIEF-5), PE, evaluated using the Premature Ejaculation Diagnostic Tool, and libido, assessed by asking participants to grade their desire for sexual activity. Sample size was 510 (SA: 184, Europid: 326). Mean age was 56.9 ± 9.7 years. There was no difference in erectile function when assessed by IIEF between SA and Europids with diabetes (84.8% and 84.1%, respectively). The overall prevalence of PE was 28.8% (32.6% and 25.8% in those with and without diabetes, respectively, P = NS). Among men with diabetes, the prevalence of PE was 45.8% and 22.4% for SA and Europids, respectively (P < 0.001). In those without diabetes, this figure was 41.9% in SA and 20.2% in Europids (P < 0.001). There was a significant trend of increasing prevalence of PE with increasing severity grade of ED (P < 0.001). Reduced libido was reported by 26.9% men (32.8% and 22.0% in those with and without diabetes, respectively, P < 0.01), with no significant ethnic difference. The association between reduced libido and increasing severity grades of ED was also significant (P < 0.001). No significant difference was observed in the prevalence of ED between SA and Europid men with diabetes. PE was significantly more common in the SA men irrespective of their diabetes status. © 2012 International Society for Sexual Medicine.

  1. Social phobia and sexual problems: A comparison of social phobic, sexually dysfunctional and normal individuals.

    PubMed

    Munoz, Valentina; Stravynski, Ariel

    2010-03-01

    This study sought to test the putative link between social phobia and sexual functioning. Three groups consisting of 106 social phobic, 164 sexually dysfunctional and 111 normal participants were assessed in terms of sexual functioning, social anxiety, social functioning and general psychopathology. Although social phobic men were less sexually active than normal men, they were as sexually satisfied. Social phobic women were alike their normal counterparts in all respects. Overall, social phobic individuals were not more prone to report sexual problems than normal individuals despite reporting the severest levels of social anxiety. Theoretically, our results are best understood as supporting an interpersonal conception of social phobia and a related socio-cultural perspective regarding sexual roles.

  2. Pharmacologic treatment strategies for sexual dysfunction in patients with epilepsy and depression.

    PubMed

    Stimmel, Glen L; Gutierrez, Mary A

    2006-08-01

    Sexual dysfunction is a frequently encountered comorbid condition in patients with many medical and psychiatric conditions, such as epilepsy and depression. Most depressed patients experience some type of sexual dysfunction, decreased sexual desire being the most common. The association of sexual dysfunction with epilepsy is less clear. Changes in sex hormone levels are common in patients with epilepsy and may be attributable to the disease or to antiepileptic drugs (AEDs). Sexual dysfunction associated with depression or epilepsy is generally treated according to standard guidelines for the management of sexual disorders, since data from special populations are not available. The most common forms of female sexual dysfunction are lack of sexual desire and difficulty achieving orgasm. There are no approved pharmacotherapies for female hypoactive sexual desire disorder or female orgasmic disorder. Female sexual arousal disorder is treated with estrogen replacement therapy when indicated or vaginal lubricants. The most common male sexual dysfunction disorders are premature ejaculation and erectile dysfunction. Phosphodiesterase type-5 inhibitor drugs are now the first-line treatment for erectile dysfunction, and selective serotonin reuptake inhibitors and topical anesthetic creams are nonapproved but effective treatments for premature ejaculation. Testosterone and aromatase inhibitors have been used investigationally to treat sexual dysfunction in men taking AEDs. Patient education and follow-up appointments are essential to ensure optimal outcomes of pharmacologic treatments for sexual dysfunction.

  3. Sexuality in eating disorders patients: etiological factors, sexual dysfunction and identity issues. A systematic review.

    PubMed

    Castellini, Giovanni; Lelli, Lorenzo; Ricca, Valdo; Maggi, Mario

    2016-02-01

    The scientific community appears to be less interested in sexuality of eating disorders (EDs) as compared to other psychiatric or medical comorbidities. However, a clear association between sexual problems and ED psychopathology was reported from different perspectives. The overarching goal of this systematic review was to evaluate the general approach of the scientific literature toward the topic of sexuality and EDs. In particular, four different categories of research have been individuated, encompassing the role of puberty, and sexual abuse in the pathogenesis of the disorders, sexual dysfunctions, and the association between sexual orientation and EDs psychopathology. Timing of puberty with its hormonal consequences and the changes in the way persons perceive their own body represent a crucial period of life for the onset of the disorder. Sexual abuse, and especially childhood sexual abuse are well-recognized risk factors for the development of ED, determining a worse long-term outcome. Recent research overcome the approach that considers sexual activity of EDs patients, in terms of hypersexuality and dangerous sexual behaviors, considering the sexuality of EDs persons in terms of sexual desire, satisfaction, orgasm and pain. Results from this line of research are promising, and describe a clear relationship between sexual dysfunction and the core psychopathological features of EDs, such as body image disturbances. Finally, the analysis of the literature showed an association between sexual orientation and gender dysphoria with EDs psychopathology and pathological eating behaviors, confirming the validity of research developing new models of maintaining factors of EDs related to the topic of self-identity.

  4. Sexual dysfunction in obsessive compulsive disorder and panic disorder.

    PubMed

    Aksoy, Umut Mert; Aksoy, Sennur G; Maner, Fulya; Gokalp, Peykan; Yanik, Medaim

    2012-12-01

    Clinical research has provided conflicting evidence regarding sexual dysfunction in patients with OCD and PD. This study was undertaken to assess and compare certain parameters of sexual functioning in OCD and PD patients. The study population consisted of 80 patients between 20 and 60 years of age with a diagnosis of OCD or PD who were followed and treated at the anxiety outpatient unit of Bakirkoy Research and Training Hospital for Psychiatric and Neurological Disorders between 2005 and 2006. The total study population comprised of 40 patients with OCD, 40 patients with PD, and 40 healthy volunteers as the control group. Of the two questionnaires used for study purposes, the first provided information on demographic data and certain parameters of sexual functioning, while the second was the validated Turkish translation of the Golombok-Rust Sexual Satisfaction Inventory with transliteral equivalence. Male subjects with OCD had a lower age of first masturbation and first nocturnal ejaculation. Infrequency problem among female and male patients with OCD occurred in 63.6% and 57.1%, respectively. Corresponding figures for PD patients were 36% and 38%. Thus, infrequency problem was more frequent among OCD patients. Sexual avoidance was found in 60.6% of female OCD patients and in 64% of female PD patients. Anorgasmia was detected in 24.2% of the female subjects with OCD. Sexual dysfunction unrelated to pharmacotherapy has been found to occur in OCD and PD. Assessment of sexual functioning in these individuals before treatment may help prevent deterioration of sexual function that may occur upon introduction of psychotropic medications.

  5. Avoiding experiences: sexual dysfunction in women with a history of sexual abuse in childhood and adolescence.

    PubMed

    Staples, Jennifer; Rellini, Alessandra H; Roberts, Sarah P

    2012-04-01

    Women with a history of sexual abuse during childhood/adolescence experience a high rate of sexual dysfunction. Evidence also suggests that they often use avoidant coping strategies, such as substance abuse, dissociation, and emotional suppression, which are likely factors implicated with their psychopathology. There is a dearth of information on potential psychological mechanisms affecting the sexuality of these women. Therefore, it is relevant to investigate whether avoidance, an important cognitive mechanism associated with anxiety disorders, relates to sexual functioning in this population. In this study, participants with (N = 34) and without (N = 22) a history of sexual abuse prior to age 16 years completed questionnaires on severity of sexual abuse, sexual functioning, and a tendency to avoid experiences. A three-step hierarchical regression investigated the effects of childhood/adolescent sexual abuse and avoidance tendencies on different aspects of sexual functioning. A significant interaction between childhood/adolescent sexual abuse and avoidance tendencies was found for orgasm function, with the combination of sexual abuse and avoidance tendencies explaining lower orgasm function. These findings suggest that, for women with a history of early sexual abuse, the tendency to avoid interpersonal closeness and avoid emotional involvement predicts orgasm functioning.

  6. Diagnosing Sexual Dysfunction in Men and Women: Sexual History Taking and the Role of Symptom Scales and Questionnaires.

    PubMed

    Hatzichristou, Dimitris; Kirana, Paraskevi-Sofia; Banner, Linda; Althof, Stanley E; Lonnee-Hoffmann, Risa A M; Dennerstein, Lorraine; Rosen, Raymond C

    2016-08-01

    A detailed sexual history is the cornerstone for all sexual problem assessments and sexual dysfunction diagnoses. Diagnostic evaluation is based on an in-depth sexual history, including sexual and gender identity and orientation, sexual activity and function, current level of sexual function, overall health and comorbidities, partner relationship and interpersonal factors, and the role of cultural and personal expectations and attitudes. To propose key steps in the diagnostic evaluation of sexual dysfunctions, with special focus on the use of symptom scales and questionnaires. Critical assessment of the current literature by the International Consultation on Sexual Medicine committee. A revised algorithm for the management of sexual dysfunctions, level of evidence, and recommendation for scales and questionnaires. The International Consultation on Sexual Medicine proposes an updated algorithm for diagnostic evaluation of sexual dysfunction in men and women, with specific recommendations for sexual history taking and diagnostic evaluation. Standardized scales, checklists, and validated questionnaires are additional adjuncts that should be used routinely in sexual problem evaluation. Scales developed for specific patient groups are included. Results of this evaluation are presented with recommendations for clinical and research uses. Defined principles, an algorithm and a range of scales may provide coherent and evidence based management for sexual dysfunctions. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  7. Advances in pharmacotherapy for treating female sexual dysfunction.

    PubMed

    Nappi, Rossella E; Cucinella, Laura

    2015-04-01

    'Female sexual dysfunction' (FSD) is an umbrella term comprising a range of common disorders, including hypoactive sexual desire, reduced subjective and/or physical genital arousal (poor sensation, vasocongestion, lubrication), sexual pain and inability to achieve orgasm/satisfaction, which are multidimensional by nature and often coexisting. Psychological and contextual factors have a significant influence on organic components of sexual response and behavior and a tailored medical approach to sexual symptoms is inevitably limited. The paper reports the most recent advances in pharmacotherapy for women taking into account the biopsychosocial model. Hormone therapy, including estrogens, testosterone, tibolone and dehydroepiandrosterone, are discussed in term of efficacy and safety in postmenopausal women both for female sexual interest/arousal disorder (FSIAD) and genito-pelvic pain/penetration disorder. Ospemifene, a selective estrogen receptor modulator, approved to treat dyspareunia at menopause, is also discussed. Data on psychoactive agents for treatment of FSIAD in premenopausal women are discussed, including the potential use of on-demand combined hormonal (testosterone) and non-hormonal (buspirone or sildenafil) treatments to address possible neurophysiological profiles of women. We are still waiting for an approved pharmacotherapy for FSD. This is not the result of gender inequality in sexual medicine, but it reflects the need of balancing benefits and risks in order to provide effective and safe treatments to women of any age.

  8. The impact of vulvar lichen sclerosus on sexual dysfunction.

    PubMed

    Haefner, Hope K; Aldrich, Nely Z; Dalton, Vanessa K; Gagné, Hélène M; Marcus, Stephanie B; Patel, Divya A; Berger, Mitchell B

    2014-09-01

    Lichen sclerosus (LS) is a chronic inflammatory condition that is known to arise on the vulva. Many women with LS report vulvar pain, often affecting a patient's quality of life. In this study, the sexual function of LS patients, with and without pain, was compared to control populations. A case-control study to examine the relationship between LS and sexual dysfunction was conducted. A total of 335 women presenting to the gynecology clinic were included in the study: 197 women with biopsy confirmed LS were compared to two control groups (95 asymptomatic women were "healthy" controls and 43 women had vulvovaginal candidiasis) on self-reported current health complaints, medical and surgical history and current symptoms such as pain and itching, type and frequency of sexual activity, and satisfaction with sexual activity. Women with LS reported less frequent sexual activity than healthy controls (p=0.007) and Candida controls (p=0.04). Currently sexually active women with LS were significantly less likely to report vaginal intercourse (71.6%) than healthy controls (89.0%, p=0.003) or Candida controls (100%, p=0.0003), even though similar proportions of all three groups reported that vaginal intercourse was important. Satisfaction towards the quality of current sexual activity was significantly lower among women with LS compared with both the healthy and Candida control groups. 23.7% of women with LS reported that sexual activity was rarely or never satisfactory as compared with 0% of healthy controls (p<0.0001) and 6.5% of Candida controls (p=0.03). Women with LS have less frequent sexual activity and less satisfying sexual activity when compared with controls.

  9. The Impact of Vulvar Lichen Sclerosus on Sexual Dysfunction

    PubMed Central

    Aldrich, Nely Z.; Dalton, Vanessa K.; Gagné, Hélène M.; Marcus, Stephanie B.; Patel, Divya A.; Berger, Mitchell B.

    2014-01-01

    Abstract Background: Lichen sclerosus (LS) is a chronic inflammatory condition that is known to arise on the vulva. Many women with LS report vulvar pain, often affecting a patient's quality of life. In this study, the sexual function of LS patients, with and without pain, was compared to control populations. Materials and Methods: A case-control study to examine the relationship between LS and sexual dysfunction was conducted. A total of 335 women presenting to the gynecology clinic were included in the study: 197 women with biopsy confirmed LS were compared to two control groups (95 asymptomatic women were “healthy” controls and 43 women had vulvovaginal candidiasis) on self-reported current health complaints, medical and surgical history and current symptoms such as pain and itching, type and frequency of sexual activity, and satisfaction with sexual activity. Results: Women with LS reported less frequent sexual activity than healthy controls (p=0.007) and Candida controls (p=0.04). Currently sexually active women with LS were significantly less likely to report vaginal intercourse (71.6%) than healthy controls (89.0%, p=0.003) or Candida controls (100%, p=0.0003), even though similar proportions of all three groups reported that vaginal intercourse was important. Satisfaction towards the quality of current sexual activity was significantly lower among women with LS compared with both the healthy and Candida control groups. 23.7% of women with LS reported that sexual activity was rarely or never satisfactory as compared with 0% of healthy controls (p<0.0001) and 6.5% of Candida controls (p=0.03). Conclusion: Women with LS have less frequent sexual activity and less satisfying sexual activity when compared with controls. PMID:25162790

  10. Predictors of sexual dysfunction incidence and remission in men.

    PubMed

    Martin, Sean A; Atlantis, Evan; Lange, Kylie; Taylor, Anne W; O'Loughlin, Peter; Wittert, Gary A

    2014-05-01

    The progress and determinants of sexual dysfunction in middle-aged and elderly men remain unclear. To describe the incidence or remission and biopsychosocial predictors of erectile dysfunction (ED) and low sexual desire (SD). Erectile function (International Index of Erectile Function) and sexual desire (Sexual Desire Inventory 2) were assessed at follow-up. Sociodemographic, lifestyle, and health-related factors were examined in multivariate models of ED and low SD. Data were collected from 810 randomly selected men residing in northern and western Adelaide, Australia, and aged 35-80 years at baseline, who made clinic visits 5 years apart. At baseline, 23.2% (n = 123) of men had ED. ED incidence and remission were observed in 31.7% (n = 179) and 29.0% (n = 71) of eligible men, respectively. At baseline, 19.2% (n = 165) had low solitary sexual desire, and 6.0% (n = 50) had low dyadic sexual desire; incidence of low sexual desire occurred in 17.6% (n = 83) (solitary) and 8.3% (n = 51) (dyadic), while remission occurred in 15.4% (n = 68) (solitary) and 22.6% (n = 40) (dyadic) of men. In the final regression models, predictors of incident ED were higher age, lower income, higher abdominal fat mass, low alcohol intake, higher risk of obstructive sleep apnea (OSA) risk, voiding lower urinary tract symptoms (LUTS), depression, and diabetes. Predictors of ED remission were lower age, current employment, and absence of voiding LUTS, angina, diabetes, and dyslipidemia. Predictors of low dyadic SD incidence included higher age, never having been married, widowhood, being unemployed, being retired, insufficient physical activity, and low alcohol intake. Predictors of low dyadic SD remission were being married, not being widowed, higher income, lower abdominal fat mass, lower OSA risk, and higher plasma testosterone. Predictors of low solitary SD included never having been married, being unemployed, low alcohol intake, lower testosterone

  11. Sexual dysfunction in partial epilepsy: a deficit in physiologic sexual arousal.

    PubMed

    Morrell, M J; Sperling, M R; Stecker, M; Dichter, M A

    1994-02-01

    Men and women with epilepsy frequently complain of sexual dysfunction. We studied the sexual response in men and women with partial epilepsy of temporal lobe origin (TLE) by measuring genital blood flow (GBF) during sexual arousal. Nine women and eight men with TLE and 12 women and seven men as controls completed inventories for symptoms of depression, sexual experience, and sexual attitude and underwent measurement of digital pulse and GBF during alternating segments of sexually neutral and erotic videotape. Subjective ratings of arousal to the videotape were obtained. We calculated digital pulse and GBF response as the percentage increase in pulse amplitude during the erotic compared with the preceding sexually neutral film. No subject group reported symptoms of significant depression on the inventory. However, men and women with epilepsy had fewer sexual experiences than subjects without epilepsy, and women with epilepsy imagined specific sexual activities to be more anxiety-producing and less arousing than did women without epilepsy. Men and women with TLE had a diminished GBF response. The mean increase in GBF in men with TLE was 184% versus 660% for controls (p = 0.01). Women with TLE had a mean increase of 117% versus 161% for controls (p < 0.01). Digital pulse did not vary across stimulus conditions. Subjective ratings for all groups indicated moderate sexual arousal. We conclude that there is a diminution in one aspect of physiologic sexual arousal in some men and women with TLE.

  12. Sexual dysfunctions and lower urinary tract symptoms in ankylosing spondylitis.

    PubMed

    Dhakad, Urmila; Singh, Bhupendra Pal; Das, Siddharth Kumar; Wakhlu, Anupam; Kumar, Puneet; Srivastava, Durgesh; Dhoan, Pooja; Nolkha, Nilesh

    2015-11-01

    To determine sexual dysfunctions and urinary symptoms in male ankylosing spondylitis (AS) patients and their association with various disease and patient factors. In this prospective case control study conducted at a tertiary care teaching institution, 100 males with AS were compared to 100 controls using International Index of Erectile Function-15 (IIEF), International Prostate Symptom Score (IPSS), Hospital Anxiety and Depression Scale (HADS) and a global question for overall relationship with their partners. Bath AS Functional Index (BASFI), visual analogue scale pain scores, patient global assessment scale and Bath AS Disease Activity Index were also assessed in the AS group. Chi-square test, unpaired t-test and univariate and multivariate binary logistic regression analyses were used to analyze the data. Anxiety, depression, erectile dysfunction (ED), orgasmic dysfunction, intercourse dissatisfaction, overall sexual dissatisfaction, altered overall relationship with partner and lower urinary tract symptoms (LUTS) were significantly (P < 0.05) higher in the AS group as compared to controls. Sexual desire, severe LUTS and bothersome LUTS (quality of life score > 2) were not different (P = 0.76, 0.82 and 0.30 respectively) between the two groups. ED was associated with anxiety, depression, longer disease duration, higher BASFI and higher age in AS patients (P = 0.02, 0.001, 0.02, 0.003 and 0.001 respectively). AS is associated with higher incidence of sexual dysfunction in male patients. ED is associated with anxiety, depression, longer duration of disease, higher BASFI score and higher age in AS patients. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  13. [Role of hormones in sexual dysfunctions, homosexuality, transsexualism and deviant sexual behavior: diagnostic and therapeutic consequences].

    PubMed

    Buvat, J; Lemaire, A; Ratajczyk, J

    1996-11-01

    Hormones only play a minor role in sexual dysfunctions. They are clearly involved only in erectile dysfunction. Total testosterone is low in 8% of those patients, but only 32% of them are improved with androgen therapy. Free testosterone is also electively decreased in 30% and bioavailable (non SHBG bound) testosterone in 15%. However androgen-therapy is still less effective in these subgroups. Plain hyperprolactinemia is found in only 0,7% of the cases. Half of them result from a pituitary adenoma. The other endocrine dysfunctions are still scarcer. This data cannot justify a systematic determination of serum prolactin and testosterone in sexual dysfunctions. A cost effective hormonal screening is proposed, whereas the role of androgen-therapy in erectile dysfunction with or without hypogonadism is discussed. The hypothesis of an "inverted brain sexual differentiation" in homosexuality and for transsexualism, resulting from an abnormal antenatal endocrine milieu is reviewed. It cannot obviously explain by itself these conditions, but some amazing morphological findings in transsexual people do not permit to totally refute it. Lastly the role of androgens in paraphilia and parapaphilia related disorders seems limited to the arousal of an abnormal sexual behaviour previously scheduled by non hormonal mechanisms. However anti-androgens are in such cases one of the main effective treatment.

  14. Sexual dysfunction in 2013: Advances in epidemiology, diagnosis and treatment

    PubMed Central

    Lee, King Chien Joe; Fahmy, Nader; Brock, Gerald B.

    2013-01-01

    Objectives To provide a contemporary review of the epidemiology, diagnosis and treatment of premature ejaculation (PE) and erectile dysfunction (ED). Methods We searched for English-language articles published in the past 12 months using the PubMed database. Relevant articles on the subjects of sexual dysfunction, ED and PE were selected for review. Conclusions Recent studies on male sexual dysfunction have provided new therapeutic possibilities. Tramadol, a well-used analgesic, has a new role in the treatment of PE. Super-selective targeting of dorsal penile nerves by surgery or cryoablative technologies might become a viable treatment option for refractory PE in the future. The role of ED as a harbinger of important comorbidities allows for the early detection and intervention of these conditions, which can optimise therapeutic outcomes. The long-term effect of chronic phosphodiesterase-5 inhibitors on endothelial dysfunction, the angiogenic potential of low-intensity extracorporeal shock wave therapy, and further advances in drug-eluting endovascular stents might in future allow clinicians to treat ED more definitively. PMID:26558082

  15. [Urinary disorders, sexual dysfunction and hypersexuality in Parkinson's disease].

    PubMed

    Vázquez-Sáánchez, F; Rodríguez-Martínez, E; Arés-Luque, A

    2010-02-08

    As Parkinson's disease progresses, its non-motor manifestations become increasingly more apparent to the point where, in advances phases of the disease, they are the most important clinical symptoms. A very wide range of non-motor symptoms can appear in Parkinson's disease. Impairment of the urinary function and the sexual function (understood as the capacity to carry out sexual activity) can be seen as belonging to the dysautonomic disorders. Hypersexuality would be included within the group of impulse control disorders. This study reviews the epidemiology, phenomenology and treatment of urinary disorders, sexual dysfunction and hypersexuality as non-motor symptoms of Parkinson's disease. Urinary disorders are the most frequent non-motor symptom in Parkinson's disease. They usually present as nocturia, urgency and increased mictional frequency (pollakiuria). Preferred treatment is with anticholinergic agents. Sexual dysfunction is a frequent complaint in patients with Parkinson. It has a multifactorial aetiology and is more frequent in males than in females. In males it manifests mainly as incapacity to achieve an erection, premature ejaculation or loss of the capacity to ejaculate, whereas in females the predominant signs are decreased libido, lowered arousal and difficulty in reaching an orgasm. Hypersexuality affects young males above all and has been related to the use of dopamine agonists.

  16. Vajikarana: Treatment of sexual dysfunctions based on Indian concepts

    PubMed Central

    Dalal, P. K.; Tripathi, Adarsh; Gupta, S. K.

    2013-01-01

    Vajikarana or Vrishya chikitsa is a one of eight major specialty of the Ashtanga Ayurveda. This subject is concerned with aphrodisiacs, virility and improving health of progeny. As per Charak Samhita, by proper use of these formulations, one becomes endowed with good physique, potency, strength, and complexion and sexually exhilarated and sexually potent. This in turn is helpful in many common sexual dysfunctions, including Infertility, Premature Ejaculation and Erectile dysfunction. The therapy is preceded by living in strict compliance with the directions mentioned in Ayurvedic classics, various methods of body cleansing and other non-medicinal strategies like sexual health promoting conduct, behavior and diet. Certain individualized herbal and herbo-mineral combinations are administered as per the nature of a person according to the Ayurveda. Many limitations need to be considered before considering the use of theses therapy like lack of scientific studies, possibilities of adulteration in the herbal and herbo-mineral combinations available in market and possibilities of unexpected side-effects etc., The article calls upon initiating research in this area so that claims of ancient Ayurvedic texts could be substantiated and vajikaran therapy may be utilized by modern medicine. PMID:23858267

  17. Antipsychotic-induced akathisia in delirium: A systematic review.

    PubMed

    Forcen, Fernando Espi; Matsoukas, Konstantina; Alici, Yesne

    2016-02-01

    Akathisia is a neuropsychiatric syndrome characterized by subjective and objective restlessness. It is a common side effect in patients taking antipsychotics and other psychotropics. Patients with delirium are frequently treated with antipsychotic medications that are well known to induce akathisia as a side effect. However, the prevalence, phenomenology, and management of akathisia in patients with delirium remain largely unknown. The purpose of this review was to examine the medical literature in order to establish the current state of knowledge regarding the prevalence of antipsychotic-induced akathisia in patients with delirium. A systematic review of the literature was conducted using the EMBASE, MEDLINE, PsycINFO, and CINAHL databases. Ten studies addressing the incidence of akathisia in patients taking antipsychotic medication for delirium were identified and included in our review. The included studies reported a variable prevalence of antipsychotic-induced akathisia. A higher prevalence was found in patients taking haloperidol. Among atypical antipsychotics, paliperidone and ziprasidone were associated with a higher risk of akathisia. The risk for akathisia appeared to be a dose-related phenomenon. Studies using specific scales for evaluation of akathisia in delirium are lacking. Some populations, such as patients with cancer or terminally ill patients in palliative care settings taking antipsychotics for the treatment of delirium, could be at higher risk for development of akathisia as a side effect.

  18. Antipsychotic-induced akathisia in delirium: A systematic review

    PubMed Central

    FORCEN, FERNANDO ESPI; MATSOUKAS, KONSTANTINA; ALICI, YESNE

    2017-01-01

    Objective Akathisia is a neuropsychiatric syndrome characterized by subjective and objective restlessness. It is a common side effect in patients taking antipsychotics and other psychotropics. Patients with delirium are frequently treated with antipsychotic medications that are well known to induce akathisia as a side effect. However, the prevalence, phenomenology, and management of akathisia in patients with delirium remain largely unknown. The purpose of this review was to examine the medical literature in order to establish the current state of knowledge regarding the prevalence of antipsychotic-induced akathisia in patients with delirium. Method A systematic review of the literature was conducted using the EMBASE, MEDLINE, PsycINFO, and CINAHL databases. Some 10 studies addressing the incidence of akathisia in patients taking antipsychotic medication for delirium were identified and included in our review. Results The included studies reported a variable prevalence of antipsychotic-induced akathisia. A higher prevalence was found in patients taking haloperidol. Among atypical antipsychotics, paliperidone and ziprasidone were associated with a higher risk of akathisia. The risk for akathisia appeared to be a dose-related phenomenon. Significance of results Studies using specific scales for evaluation of akathisia in delirium are lacking. Some populations, such as patients with cancer or terminally ill patients in palliative care settings taking antipsychotics for the treatment of delirium, could be at higher risk for development of akathisia as a side effect. PMID:26087817

  19. Sexual distress, sexual dysfunction and relationship quality in women with systemic sclerosis: correlation with clinical variables.

    PubMed

    Rosato, E; Rossi, C; Molinaro, I; Di Giulio, M A; Trombetta, A C; Marra, A M; Gigante, A; Barbano, B; Quarta, S; Pisarri, S; Afeltra, A; Salsano, F

    2014-01-01

    To assess the rate of sexual distress, sexual dysfunction and relationship quality and their association with clinical variables in women with systemic sclerosis (SSc), 102 sexually active women with SSc were recruited. Sexual distress, sexual dysfunction and dissatisfaction with relationship quality were investigated by Female Sexual Distress Scale Revised (FSDS-R), Female Sexual Function Index (FSFI) and Dyadic Adjustment Scale (DAS), respectively. The patients underwent medical examinations and nailfold videocapillaroscopy (NVC). Of the 102 patients, 37 (36%) reported sexual distress with FSDS-R score >11, 45 (44%) had sexual dysfunction with FSFI score <19 and 49 (48%) were not satisfied with relationship quality with DAS score <100. There was a negative correlation (p<0.001, R= -0.30) between FSDS-R and FSFI. No correlation was found between FSDS-R and DAS. FSFI showed a positive correlation with DAS (p<0.0001, R= 0.36). Age correlated negatively (p<0.05, R= -0.26) with FSFI, while FSDS-R and DAS did not correlate (p>0.05) with age. SSc women with digital ulcers (DU) had a reduction of FSFI and DAS compared with women without DU. In patients with late capillaroscopic pattern, mean value of FSFI was significantly lower than the other two capillaroscopic patterns. DAS decreased with progression of capillaroscopic damage. In a high percentage of women with SSc FSDS-R was increased, while FSFI and DAS were reduced. Age correlated negatively with FSFI, while skin score showed a negative correlation with DAS. Digital vascular damage negatively influenced FSFI and DAS.

  20. The Impact of Body Awareness on Sexual Arousal in Women with Sexual Dysfunction

    PubMed Central

    Seal, Brooke N.; Meston, Cindy M.

    2010-01-01

    Introduction The impact of self-awareness during sexual activity has been widely discussed. However, research has been largely focused on the effects of performance anxiety in male erectile functioning. It has been suggested that physical appearance concerns may have a similar influence on sexual function in women as does men’s self-awareness about erectile function. However, the role that physical appearance or awareness of one’s body may play in female sexual response has received little empiric attention. Aim To examine the effects of body awareness and self-report levels of body esteem on sexual response in 21 sexually dysfunctional women. Methods Body awareness was induced in one of two counterbalanced sessions. A full-length mirror was placed in front of participants throughout the experimental session, and participants were instructed to use the mirror to place 10 electrodes on each side of their bodies to prepare for a possible electrocardiogram. This methodology was used to ensure that women looked at themselves in the mirror and became more aware of their bodies during the experimental session. Main Outcome Measures Self-reported mental arousal, perceptions of physical arousal, physiological sexual arousal, affect, anxiety, and cognitive distraction responses to erotica. Results Results showed that subjective mental sexual arousal and perceptions of physical sexual arousal increased in response to erotica in the Body Awareness condition compared to in the No Body Awareness condition. These results were not accounted for by level of body esteem. There were no changes in physiological sexual arousal, affect, anxiety, or level of cognitive distraction across the two conditions. Conclusions Findings suggest that awareness of one’s body is related to increased subjective sexual response in conditions where cognitive distraction does not occur. It is particularly noteworthy that the current sample was made up of sexually dysfunctional women, all of whom

  1. "Don't Look Now": The Role of Self-Focus in Sexual Dysfunction.

    ERIC Educational Resources Information Center

    Wiederman, Michael W.

    2001-01-01

    Couples and family counselors may aid in the remedy of sexual dysfunction when it has a cognitive or psychological basis. One important source of sexual dysfunction is cognitive distraction that results from certain forms of self-focus during sexual activity with a partner, a phenomenon sex therapists have labeled spectatoring. Introduces sensate…

  2. Asexuality: Sexual Orientation, Paraphilia, Sexual Dysfunction, or None of the Above?

    PubMed

    Brotto, Lori A; Yule, Morag

    2017-04-01

    Although lack of sexual attraction was first quantified by Kinsey, large-scale and systematic research on the prevalence and correlates of asexuality has only emerged over the past decade. Several theories have been posited to account for the nature of asexuality. The goal of this review was to consider the evidence for whether asexuality is best classified as a psychiatric syndrome (or a symptom of one), a sexual dysfunction, or a paraphilia. Based on the available science, we believe there is not sufficient evidence to support the categorization of asexuality as a psychiatric condition (or symptom of one) or as a disorder of sexual desire. There is some evidence that a subset of self-identified asexuals have a paraphilia. We also considered evidence supporting the classification of asexuality as a unique sexual orientation. We conclude that asexuality is a heterogeneous entity that likely meets conditions for a sexual orientation, and that researchers should further explore evidence for such a categorization.

  3. Prevalence of female sexual dysfunction among Indian fertile females

    PubMed Central

    Mishra, Vineet V.; Nanda, Sakshi; Vyas, Bhumika; Aggarwal, Rohina; Choudhary, Sumesh; Saini, Suwa Ram

    2016-01-01

    Background: Female sexual dysfunction (FSD) is described as difficulty experienced by a female during any stage of a normal sexual activity including physical pleasure, desire, arousal, or orgasm. There are various factors responsible for FSD including psychological status of a person, gynecological or medical problems, long use of certain drugs, and social beliefs. Objectives: To study the prevalence and various factors associated with FSD. Materials and Methods: Study Design - This study design was a cross-sectional observational study conducted at Tertiary Care Centre, in Ahmedabad from June 2015 to March 2016. Sample Size - One hundred and fifty-three fertile females in reproductive age group (20–47 years) were included in the study. Written and informed consent was obtained from all the females. Methods - FSD was assessed with a detailed 19-item female sexual function index questionnaire. All six domains of sexual dysfunction, i.e., desire, arousal, lubrication, orgasm, satisfaction, and pain were studied. Various associated factors such as gynecological or psychological problems were also studied. Exclusion - Infertile patients were excluded from the study. Results: The prevalence of FSD was 55.55% among 153 fertile females. FSD was more prevalent in the age group of 26–30 years and with duration of marriage >16 years. FSD was also more common in females with middle education and those belonging to upper middle socioeconomic status. Psychological stress was significantly associated with FSD. Conclusion: It is right of every female to lead healthy sexual life as it is key to happiness in marriage. Females with FSD can be managed with proper counseling and treating the underlying etiology. PMID:28096637

  4. Sexual dysfunction ın multiple sclerosis: gender differences.

    PubMed

    Celik, Dilaram Billur; Poyraz, Esra Çoşkuner; Bingöl, Ayhan; Idiman, Egemen; Ozakbaş, Serkan; Kaya, Derya

    2013-01-15

    To assess the frequency and nature of sexual dysfunction in multiple sclerosis (MS) patients and to investigate the relationships of SD with clinical, demographic and psychosocial factors by comparing MS patients with and without SD. Eighty-nine patients were included, 45 males and 44 females, aging an average of 37.4 ± 8.6 years (range:21-56). We applied Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) and Arizona Sexual Experiences Scale (ASEX) to all patients. Disability was evaluated with the expanded disability status scale (EDSS). 60.7% (n=54) of patients reported SD according to MSISQ scores. Women exhibited significantly higher MSISQ scores than men (42.6 ± 12.9 and 36.6 ± 13.3, respectively; P=0.034). Women (7.9%) also reported to experience sexual arousal difficulties significantly more than men (1.1%) (P=0.024) according to ASEX. The patients were classified into three MSISQ-19 subscales, Primary, Secondary and Tertiary SD. The most common reported dimension of SD was secondary (32.5%, n=41). In this dimension of SD, patients mostly complained of pain-burning, memory-concentration problems and bowel symptoms. A significant relationship was found between Secondary SD and both EDSS score and disease duration (r=0.34 p=0.001 and r=0.21 p=0.042, respectively). Tertiary SD was also associated with EDSS score (r=0.23 p=0.03). Sexual Dysfunction, a frequent problem for MS patients, is associated with gender. Women reported more SD than men. Secondary SD symptoms were the most common complaints for both men and women. Nonetheless women had more secondary SD symptoms than men. The emotional dimension of SD is related with disability. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Sexual dysfunction in patients with peripheral nervous system lesions.

    PubMed

    Podnar, Simon; Vodušek, David B

    2015-01-01

    Peripheral nervous system (PNS) disorders may cause sexual dysfunction (SD) in patients of both genders. These disorders include mainly polyneuropathies (particularly those affecting the autonomic nervous system (ANS)) and localized lesions affecting the innervation of genital organs. Impaired neural control may produce a malfunction of the genital response consisting of loss of genital sensitivity, erectile dysfunction, loss of vaginal lubrication, ejaculation disorder, and orgasmic disorder. In addition, there is often a loss of desire which actually has a complex pathogenesis, which goes beyond the mere loss of relevant nerve function. In patients who have no manifest health problems - particularly men with erectile dysfunction - one should always consider the possibility of an underlying polyneuropathy; in patients with SD after suspected denervation lesions of the innervation of genital organs within the lumbosacral spinal canal and in the pelvis, clinical neurophysiologic testing may clarify the PNS involvement. SD can alter self-esteem and lower patients' quality of life; opening up a discussion on sexual issues should be a part of the management of patients with PNS disorders. They may greatly benefit from counseling, education on coping strategies, and specific treatments.

  6. Prevalence and Predictive Factors of Sexual Dysfunction in Iranian Women: Univariate and Multivariate Logistic Regression Analyses

    PubMed Central

    Direkvand-Moghadam, Ashraf; Suhrabi, Zainab; Akbari, Malihe

    2016-01-01

    Background Female sexual dysfunction, which can occur during any stage of a normal sexual activity, is a serious condition for individuals and couples. The present study aimed to determine the prevalence and predictive factors of female sexual dysfunction in women referred to health centers in Ilam, the Western Iran, in 2014. Methods In the present cross-sectional study, 444 women who attended health centers in Ilam were enrolled from May to September 2014. Participants were selected according to the simple random sampling method. Univariate and multivariate logistic regression analyses were used to predict the risk factors of female sexual dysfunction. Diffe rences with an alpha error of 0.05 were regarded as statistically significant. Results Overall, 75.9% of the study population exhibited sexual dysfunction. Univariate logistic regression analysis demonstrated that there was a significant association between female sexual dysfunction and age, menarche age, gravidity, parity, and education (P<0.05). Multivariate logistic regression analysis indicated that, menarche age (odds ratio, 1.26), education level (odds ratio, 1.71), and gravida (odds ratio, 1.59) were independent predictive variables for female sexual dysfunction. Conclusion The majority of Iranian women suffer from sexual dysfunction. A lack of awareness of Iranian women's sexual pleasure and formal training on sexual function and its influencing factors, such as menarche age, gravida, and level of education, may lead to a high prevalence of female sexual dysfunction. PMID:27688863

  7. A possible dopaminergic mechanism in the serotonergic antidepressant-induced sexual dysfunctions.

    PubMed

    Alcántara, A G

    1999-01-01

    The administration of antidepressant serotoninergic medication is associated with the presentation of sexual dysfunctions. This seems to be mediated by the activation of the 5-HT2 receptors. Segraves (1995) has proposed that the inhibition of noradrenergic transmission by serotonin may be the mechanism which causes the antidepressant-induced sexual dysfunctions. The inhibition which the 5-HT2 receptors carry out on dopaminergic transmission leads us to propose this mechanism as also participating in the antidepressant-induced sexual dysfunctions.

  8. [Sexual dysfunction is frequent in patients with anal fistulas and anal fissures].

    PubMed

    Broholm, Malene; Møller, Henrik; Gögenur, Ismail

    2015-02-23

    Anal fistulas and fissures are frequent disorders. Affected patients may have significant psychosocial and sexual dysfunction. A few studies have investigated patients with anal fissures and fistulas with regard to sexual dysfunction. These studies showed a significant degree of sexual dysfunction among the affected patients. Data are surprisingly limited in this field. More studies are needed to describe this issue and to define a successful treatment for these patients.

  9. Sexual Dysfunction in Male Subjects Receiving Trifluoperazine, Risperidone, or Olanzapine: Rates Vary With Assessment Questionnaire

    PubMed Central

    Nebhinani, Naresh; Avasthi, Ajit

    2012-01-01

    Objective: To assess the rate and typology of sexual dysfunction in male subjects receiving trifluoperazine, risperidone, or olanzapine using the Arizona Sexual Experience Scale (ASEX), the Psychotropic Related Sexual Dysfunction Questionnaire (PRSexDQ), and the sexual function section of the modified Udvalg for Kliniske Undersøgelser Side Effect Rating Scale (UKU). Method: The sample included 100 men with psychotic disorders (F2 category of the ICD-10) and receiving trifluoperazine (n = 20), risperidone (n = 30), or olanzapine (n = 50) for at least 3 months’ duration. Subjects with a history of sexual dysfunction prior to antipsychotic intake or chronic medical illness were excluded. A cross-sectional design was employed, and data were collected over a 1½-year period from March 2009 to August 2010. Results: The rate of sexual dysfunction varied from scale to scale among the 100 subjects. The rate of sexual dysfunction was 25% on the ASEX, 37% on the PRSexDQ, and 40% on the UKU. Sexual dysfunction in the trifluoperazine, risperidone, and olanzapine groups was 20%, 43%, and 16%, respectively, on the ASEX; 35%, 50%, and 30%, respectively, on the PRSexDQ; and 40%, 50%, and 34%, respectively, on the UKU. The most common sexual dysfunction as assessed on all scales was decreased libido, except for the risperidone group on the ASEX. Conclusions: Sexual dysfunction is quite prevalent in subjects receiving antipsychotic medications. In our study, rate of sexual dysfunction was highest for risperidone, followed by trifluoperazine and olanzapine. However, the rate of sexual dysfunction varied from scale to scale. Hence, there is a need for a comprehensive instrument to assess sexual dysfunction in patients receiving antipsychotics. PMID:22943029

  10. Hyperthyroidism: a risk factor for female sexual dysfunction.

    PubMed

    Atis, Gokhan; Dalkilinc, Ayhan; Altuntas, Yuksel; Atis, Alev; Gurbuz, Cenk; Ofluoglu, Yilmaz; Cil, Esra; Caskurlu, Turhan

    2011-08-01

    Hyperthyroidism is a common hormonal disorder in women that may cause female sexual dysfunction (FSD). To assess sexual function in women with hyperthyroidism. A total of 40 women with clinical hyperthyroidism and 40 age-matched voluntary healthy women controls were included in the study. All the subjects were evaluated with a detailed medical and sexual history, including a Female Sexual Function Index (FSFI) questionnaire for sexual status and the Beck Depression Inventory (BDI) for psychiatric assessment. The levels of serum thyroid-stimulating hormone (TSH), thyroid hormones, sex hormone binding globulin (SHBG), total testosterone (tT), free testosterone (fT), prolactin, estradiol, follicle-stimulating hormone, and luteinizing hormone were measured. The mean total FSFI scores were 24.2 ± 9.96 in the hyperthyroidic group and 29 ± 10.4 in the control group (P < 0.0001). Desire (P < 0.040), arousal (P < 0.0001), lubrication (P < 0.0001), orgasm (P < 0.0001), satisfaction (P < 0.0001), and pain (P < 0.007) domain scores were also significantly lower in women with hyperthyroidism. The mean BDI score for hyperthyroidic patients was significantly greater than the score for the control group (P < 0.0001). The mean SHBG level in the hyperthyroidic group was found to be significantly higher than the level in the controls (P < 0.0001), whereas the mean fT level in the hyperthyroidic group was lower than in the control group (P < 0.0001). The FSFI score showed a significant negative correlation with the serum SHBG (r = -0.309, P = 0.005), free triiodothyronine (r = -0.353, P = 0.006) and free tetraiodothyronine (r = -0.305, P = 0.018) levels, BDI scores (r = -0.802, P = 0.0001) and positive correlation with tT (r = 0.284, P = 0.011), fT (r = 0.407, P = 0.001), and TSH (r = 0.615, P = 0.0001) levels. A significant percentage of women with clinical hyperthyroidism had sexual dysfunction. Increased depressive symptoms, increased SHBG level, and decreased fT levels were all

  11. Stem Cells in Male Sexual Dysfunction: Are We Getting Somewhere?

    PubMed

    Soebadi, Mohammad Ayodhia; Milenkovic, Uros; Weyne, Emmanuel; Castiglione, Fabio; Albersen, Maarten

    2017-04-01

    Stem cells for sexual disorders are steadily being introduced into clinical trials. Two conditions of importance are the main target for this line of treatment, especially when regarding the wide array of translational and basic science highlighting the potential advantages of regenerative therapy: erectile dysfunction (ED) and more recently Peyronie disease (PD). Cellular therapy offers a treatment modality that might reverse disease progression. It would be used in a curative setting, in contrast to other pharmaceutical agents that are currently available. To review basic preclinical studies and recent clinical trials of stem cells on ED and PD. A search of the medical literature for the following terms was performed using PubMed: stem cells, cellular therapy, erectile dysfunction, Peyronie's disease, and clinical trial. A non-systematic narrative review and critical reflection on preclinical and clinical studies administering stem cells for ED and PD in animal models and human subjects. Numerous studies have confirmed the beneficial functional effects of stem cell injection in established animal models on ED and PD. Various stem cell types have been adopted, from embryonic to adult mesenchymal cell types. Each cell type offers distinctive advantages and disadvantages. Diverse administrations of stem cells were investigated, with insignificant variability in the ultimate results. Stem cells appear to have a pronounced paracrine effect, rather than the classic engraftment and differentiation hypothesis. Phase 1 clinical trials using stem cells have not reported any severe adverse events in animals. However, these results cannot be extrapolated to draw any conclusions about efficacy in human patients. Stem cells have an established efficacy in preclinical studies and early clinical trials. Studies are currently being published demonstrating the safety of intrapenile injection of autologous bone marrow- and adipose tissue-derived stem cells. Soebadi MA, Milenkovic U

  12. Female sexual dysfunction and hormonal status in multiple sclerosis patients.

    PubMed

    Lombardi, Giuseppe; Celso, Maria; Bartelli, Mario; Cilotti, Antonio; Del Popolo, Giulio

    2011-04-01

    Literature holds no information on a correlation between blood hormonal levels, in particular sex hormones and the sexual response of women with multiple sclerosis (MS). To investigate a possible correlation between hormonal status and the sexual response of females with MS. The Female Sexual Function Index (FSFI) questionnaire was used to determine sexual dysfunctions (SDs). Methods for measuring blood hormones were chemiluminescence immunoassay, electrochemiluminescence immunoassay, enzyme immunoassay, and radioimmunoassay. During the screening phase, 55 women of reproductive age were recruited and completed the FSFI. In the first phase of the study females underwent a hematic hormonal evaluation on the third day of their menstrual cycle. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), thyroid stimulating hormone (TSH), cortisol, dehydroepiandrosterone sulphate (DHEA-S), androstenedione, 17[alpha]-hydroxyprogesterone, total and free testosterone, 17 beta estradiol, inhibin and sex hormone binding globulin (SHBG), and thyroid hormones (fT3 and fT4) were checked. On the day 20-21 into their menstrual cycle the progesterone hematic value was noted. Patients with amenorrhea had all hormones tested once with a random blood drawing. After a 3-month period patients began phase 2, completing the FSFI again. The same blood hormones were investigated. Fifty-four females completed the study. Thirty-one continued to manifest at least one SD: desire (57.4%) was the most common. Overall, 36.4% showed abnormal hormonal alterations. The most frequent was 40% for 17 beta-estradiol. None of the FSFI domains, including the total score, revealed any statistically significant correlation to the hormones investigated. No statistically significant clinical predictive factors for blood hormone abnormalities were detected; comparing females with and without SD, P = 0.250 using chi-squared test was reached. Notable percentages of blood hormonal

  13. Multidisciplinary Management of Sexual Dysfunction, Perineal Pain, and Elimination Dysfunction in a Woman with Multiple Sclerosis

    PubMed Central

    Bogliatto, Fabrizio; Bacchio, Leonardo

    2017-01-01

    Background: Multiple sclerosis (MS) is a chronic disease that commonly affects young women and is associated with sexual dysfunction (SD) and lower anourogenital dysfunction, which affect quality of life. We evaluated the importance of an integrated multidisciplinary approach in the Lower Female Ano-Uro-Genital Network (LFAUGN) to manage a variety of complex symptoms. Methods: A 40-year-old woman with MS and primary concerns about perineal pain and SD was treated by a trained midwife from the LFAUGN and a physical therapist after a multidisciplinary diagnostic process that included gynecologic evaluation for perineal pain and SD, physiatric assessment, urologic assessment for bladder retention (BR), and surgical examination for obstructed defecation syndrome (ODS). Physical therapy was integrated with pharmacologic therapy for ODS and with self-catheterization for BR. Results: After 5 months of treatment, the patient reported improvement in functional perineal parameters and perineal pain (visual analogue scale score: 9 at T1 vs. 5 at T2), with resolution of pelvic floor hypertonia. Furthermore, ODS and BR symptoms improved (5-item score: 18 of 20 at T1 vs. 10 of 20 at T2; 1 self-catheterization daily, with postvoid residual volume [PRV] <200 mL at T1 vs. 1 self-catheterization weekly, with PRV <100 mL at T2) and sexual satisfaction increased (Female Sexual Function Index score: 18 of 36 at T1 vs. 23 of 36 at T2). Conclusions: These results suggest that physical therapy, as an integral component of a multidisciplinary approach in a multiprofessional network, may play a pivotal role in improving anourogenital dysfunction and sexual satisfaction. PMID:28243183

  14. Significant Resolution of Female Sexual Dysfunction after Bariatric Surgery

    PubMed Central

    Bond, Dale S.; Wing, Rena R.; Vithiananthan, Sivamainthan; Sax, Harry C.; Roye, G. Dean; Ryder, Beth A.; Pohl, Dieter; Giovanni, Jeannine

    2010-01-01

    Background We previously reported that the majority of women seeking bariatric surgery had female sexual dysfunction (FSD) as defined by the validated Female Sexual Function Index (FSFI). Objective The current study examined whether FSD resolves after bariatric surgery. Setting The Miriam Hospital, Providence RI, USA. Methods Fifty-four reportedly sexually active women (43.3±9.5 years) completed the FSFI pre- and 6-months post-operatively after a mean excess weight loss (%EWL) of 42.3% [Laparoscopic adjustable gastric banding (LAGB) n=38; %EWL=34.6±15.7; Roux-en-Y gastric bypass (RYGB) n=16; %EWL=60.0±21.2). The FSFI assesses sexual function across six domains with higher scores indicating better sexual function. Summing of these scores yields a FSFI-total score (range=2–36 with ≤26.55=FSD). Results Before surgery, 34 women (63%) had scores indicative of FSD. By 6-months after surgery, FSD had resolved in 23 of these 34 (68%) women, and only 1 woman developed FSD. In the entire sample, there were significant (p<0.05) improvements from pre- to post-surgery on all FSFI domains. FSFI-total scores improved after LAGB (24.2±5.9 to 29.1±4.1, p<0.001) and RYGB (23.7±7.7 to 30.0±4.7, p<0.001). In regression analyses, being married, younger age, and worse preoperative sexual function were related to greater sexual function improvements. Postoperatively, participants’ FSFI-total scores were indistinguishable from published normative controls (29.4±4.3 vs. 30.5±5.3, p=0.18). Conclusion FSD resolved in a large percentage of women. Sexual functioning in the entire sample improved to levels consistent with normative controls. This improvement in sexual function did not depend on surgery type or weight loss amount, and appears to be an additional benefit for women undergoing bariatric surgery. PMID:20678969

  15. Antipsychotic-induced metabolic and cardiovascular side effects in schizophrenia: a novel mechanistic hypothesis.

    PubMed

    Scigliano, Giulio; Ronchetti, Gabriele

    2013-04-01

    The use of antipsychotics is hindered by the frequent occurrence of metabolic and cardiovascular side effects, resulting in worsened quality of life and greater mortality as a result of cardiovascular and cerebrovascular disorders in schizophrenia patients than the comparable general population. The various antipsychotics induce extrapyramidal symptoms, impaired glucose and lipid metabolism, weight gain, hypertension and arrhythmias, with variable frequency. Second-generation antipsychotics appear to have several advantages over first-generation antipsychotics, including a claimed better action on cognitive function and the negative symptoms of schizophrenia, and lower frequency of extrapyramidal side effects; however, their use is associated with a greater frequency of metabolic and cardiovascular disturbances. The mechanisms of these important side effects are not well understood, and generic approaches (psychoeducational programmes and symptomatic therapies) have been proposed to limit their severity. Extensive data from the literature indicate that autonomic nervous system dysfunction--intrinsic to schizophrenia and strongly exacerbated by antipsychotic treatment--is the cause of the pervasive metabolic and vascular dysfunctions associated with schizophrenia. In this article, we marshal further literature data to argue that the metabolic and cardiovascular side effects of antipsychotics are primarily mediated by their ability to block peripheral dopamine receptors, which physiologically modulate sympathetic activity. We also propose that these effects might be overcome by providing peripheral dopaminergic stimulation.

  16. The Association Between Female Sexual Dysfunction and the Husband's Erectile Dysfunction: Evidence from Married Couples in Hong Kong.

    PubMed

    Zhang, Huiping; Fan, Susan; Yip, Paul

    2016-01-01

    Little is known about the association between the sexual functioning of each partner in a heterosexual married couple. By using a community-based survey of Hong Kong Chinese couples in 2012, this study attempted to examine the relation between female sexual dysfunction and their husbands' erectile dysfunction. Among the 1,518 female and 1,059 male respondents, 944 sexually active couples were eligible for the analysis, with mean age of 39.3 ± 6.8 years (range = 21-50) for the wives and 43.6 ± 8.6 years (range = 18-80) for the husbands. Of the wives, 27.0% reported at least one form of female sexual dysfunction and 5.0% of the husbands reported erectile dysfunction. After adjusting for the female's age and other risk factors, the total and domain scores of female sexual dysfunction were not associated with her husband's erectile dysfunction except for physical pain during sexual intercourse. Therefore, whether to screen the partner's sexual function depends on the age of the female clients.

  17. Assessment of Sexual Activity and Dysfunction in Medically Underserved Women with Gynecologic Cancers

    PubMed Central

    Bradford, Andrea; Fellman, Bryan; Urbauer, Diana; Gallegos, Jessica; Meaders, Kristen; Tung, Celestine; Ramondetta, Lois

    2015-01-01

    Background Sexual dysfunction is a common long-term side effect of treatments for gynecologic cancer. Studies of sexual problems in gynecologic cancer survivors overrepresent White non-Hispanic, highly educated, and married women. Less is known about the sexual health needs of women in medically underserved populations. We therefore conducted a study to characterize sexual activity and sexual function in this population. Methods We recruited patients attending two gynecologic oncology clinics in a large public healthcare system that primarily serves uninsured and low-income patients. Participants were invited to complete a one-time survey to assess sexual function, sexual communication, sexual distress, relationship adjustment, depression, anxiety, prior help-seeking and help-seeking preferences, and reasons for sexual inactivity. Data were analyzed using descriptive statistics and multivariate models to predict sexual activity status and sexual dysfunction. Results Among 243 participants, the majority (n=160, 65.8%) were not sexually active in the past 4 weeks, most often due to lack of a partner or lack of desire for sex. Just over one-fourth of sexually active participants were identified as likely cases of sexual dysfunction. Greater endorsement of depressive symptoms predicted both sexual inactivity and sexual dysfunction in multivariate analyses. Prior help-seeking for sexual problems was uncommon; however, a significant minority of participants expressed interest in receiving care for sexual problems. Conclusions Gynecologic cancer survivors in our medically underserved population have high rates of sexual inactivity and sexual dysfunction. Future research should identify feasible strategies to address barriers to sexual health care in low-resource settings. PMID:26325527

  18. Psychological impact and sexual dysfunction in men with and without spinal cord injury.

    PubMed

    Cobo Cuenca, Ana I; Sampietro-Crespo, Antonio; Virseda-Chamorro, Miguel; Martín-Espinosa, Noelia

    2015-02-01

    The World Health Organization recognizes sexual health as a fundamental right that should be guaranteed to all individuals. Sexual dysfunction affects various aspects in the lives (physical, psychic, and social) of affected persons. To assess the different types of sexual dysfunction, the quality of life (QOL), depression, anxiety, and levels of self-esteem observed in 165 men with sexual dysfunction, both with and without spinal cord injury (SCI). Case control study of 85 men with SCI and sexual dysfunction, and 80 men without SCI that have sexual dysfunction. The Sexual Health Evaluation Scale, the Fugl-Meyer Life Satisfaction Questionnaire scale, the Hospital Anxiety and Depression Scale, the Evaluation of the Sexual Health Scale, and Rosenberg's Self-esteem Scale were all used for data collection. Of the members in group A (with SCI), 89.4% (76) showed erectile dysfunction, and 75.2% (64) reported anejaculation. In group B (without SCI), 75 (96.8%) showed erectile dysfunction, and 58.7% (47) had disorders of sexual desire. In group A, 16.47 % (14) showed signs of depression, and 35.3% (30) had signs of anxiety. In group B, 30% (24) had elevated scores regarding depression, and 48.75% (39) had high scores for anxiety. All of the participants reported a high general QOL and a high satisfaction with their QOL but reported that their satisfaction with their sexual lives was only at the acceptable level. Social QOL is significantly higher in the SCI group (t Student P=0.031). The QOL, self-esteem, and anxiety and depression levels are significantly correlated. Men with sexual dysfunction strive to adapt to their situations, with the relationship between the type of sexual dysfunction and the QOL, mood (depression), and self-esteem all being important considerations. Sexuality and employment status are the areas where men with spinal cord injuries report less satisfaction. © 2014 International Society for Sexual Medicine.

  19. Treatment of homosexual and heterosexual sexual dysfunction in male-only groups of mixed sexual orientation.

    PubMed

    Everaerd, W; Dekker, J; Dronkers, J; van der Rhee, K; Staffeleu, J; Wiselius, G

    1982-02-01

    Males complaining of erectile and ejaculatory dysfunctions were treated in a structured therapy program. Twenty-one males of heterosexual, homosexual, or bisexual orientation were divided into five groups, with two male therapists for each group. Patients were those usually considered difficult to treat in that 16 had a primary sexual dysfunction with an average duration of 6 years. Extensive evaluations were made before therapy, at the completion of therapy, and at 2-months follow-up. Pre-therapeutic, post-therapeutic, and follow-up measurements indicated that the program was highly successful.

  20. A biopsychosocial approach to women's sexual function and dysfunction at midlife: A narrative review.

    PubMed

    Thomas, Holly N; Thurston, Rebecca C

    2016-05-01

    A satisfying sex life is an important component of overall well-being, but sexual dysfunction is common, especially in midlife women. The aim of this review is (a) to define sexual function and dysfunction, (b) to present theoretical models of female sexual response, (c) to examine longitudinal studies of how sexual function changes during midlife, and (d) to review treatment options. Four types of female sexual dysfunction are currently recognized: Female Orgasmic Disorder, Female Sexual Interest/Arousal Disorder, Genito-Pelvic Pain/Penetration Disorder, and Substance/Medication-Induced Sexual Dysfunction. However, optimal sexual function transcends the simple absence of dysfunction. A biopsychosocial approach that simultaneously considers physical, psychological, sociocultural, and interpersonal factors is necessary to guide research and clinical care regarding women's sexual function. Most longitudinal studies reveal an association between advancing menopause status and worsening sexual function. Psychosocial variables, such as availability of a partner, relationship quality, and psychological functioning, also play an integral role. Future directions for research should include deepening our understanding of how sexual function changes with aging and developing safe and effective approaches to optimizing women's sexual function with aging. Overall, holistic, biopsychosocial approaches to women's sexual function are necessary to fully understand and treat this key component of midlife women's well-being. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. A biopsychosocial approach to women’s sexual function and dysfunction at midlife: A narrative review

    PubMed Central

    Thomas, Holly N.; Thurston, Rebecca C.

    2016-01-01

    A satisfying sex life is an important component of overall well-being, but sexual dysfunction is common, especially in midlife women. The aim of this review is (a) to define sexual function and dysfunction, (b) to present theoretical models of female sexual response, (c) to examine longitudinal studies of how sexual function changes during midlife, and (d) to review treatment options. Four types of female sexual dysfunction are currently recognized: Female Orgasmic Disorder, Female Sexual Interest/Arousal Disorder, Genito-Pelvic Pain/Penetration Disorder, and Substance/Medication-Induced Sexual Dysfunction. However, optimal sexual function transcends the simple absence of dysfunction. A biopsychosocial approach that simultaneously considers physical, psychological, sociocultural, and interpersonal factors is necessary to guide research and clinical care regarding women’s sexual function. Most longitudinal studies reveal an association between advancing menopause status and worsening sexual function. Psychosocial variables, such as availability of a partner, relationship quality, and psychological functioning, also play an integral role. Future directions for research should include deepening our understanding of how sexual function changes with aging and developing safe and effective approaches to optimizing women’s sexual function with aging. Overall, holistic, biopsychosocial approaches to women’s sexual function are necessary to fully understand and treat this key component of midlife women’s well-being. PMID:27013288

  2. Male sexual dysfunction and infertility associated with neurological disorders

    PubMed Central

    Fode, Mikkel; Krogh-Jespersen, Sheila; Brackett, Nancy L; Ohl, Dana A; Lynne, Charles M; Sønksen, Jens

    2012-01-01

    Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperitoneal surgery, diabetes, congenital spinal abnormalities, multiple sclerosis and spinal cord injury. Erectile dysfunction can be managed by an increasingly invasive range of treatments including medications, injection therapy and the surgical insertion of a penile implant. Retrograde ejaculation is managed by medications to reverse the condition in mild cases and in bladder harvest of semen after ejaculation in more severe cases. Anejaculation might also be managed by medication in mild cases while assisted ejaculatory techniques including penile vibratory stimulation and electroejaculation are used in more severe cases. If these measures fail, surgical sperm retrieval can be attempted. Ejaculation with penile vibratory stimulation can be done by some spinal cord injured men and their partners at home, followed by in-home insemination if circumstances and sperm quality are adequate. The other options always require assisted reproductive techniques including intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection. The method of choice depends largely on the number of motile sperm in the ejaculate. PMID:22138899

  3. Cervical cancer survivors' and partners' experiences with sexual dysfunction and psychosexual support.

    PubMed

    Vermeer, Willemijn M; Bakker, Rinske M; Kenter, Gemma G; Stiggelbout, Anne M; Ter Kuile, Moniek M

    2016-04-01

    The purpose of the study was to assess experiences with sexual dysfunctions, psychosexual support, and psychosexual healthcare needs among cervical cancer survivors (CCSs) and their partners. Semi-structured interviews were conducted with CCSs (n = 30) and their partners (n = 12). Many participants experienced one or more sexual dysfunctions often causing feelings of distress. Most participants reported having been asked about their sexual functioning, although attention for sexual functioning was often limited and medically oriented. Considering sexuality a taboo topic hampered some participants to seek help. Many participants desired information about treatment consequences for sexual functioning, practical advice on dealing with dysfunctions, and reassurance that it is common to experience sexual dysfunction. A website was generally considered a useful and accessible first resource for information about sexual functioning after cancer. Sexual dysfunctions are often distressing. Many patients and partners experience psychosexual healthcare needs, but the provided information and care is generally limited. Psychosexual support should go beyond physical sexual functioning and should take aspects such as sexual distress, relationship satisfaction, and the partner perspective into account. Additionally, offering more practical and reassuring information about sexuality after cervical cancer would be valuable for both CCSs and their partners.

  4. Family Trauma and Dysfunction in Sexually Abused Female Adolescent Psychiatric Control Groups.

    ERIC Educational Resources Information Center

    Wherry, Jeffrey N.; And Others

    1994-01-01

    Differences in family trauma, stressors, and dysfunction among adolescent psychiatric inpatients grouped by sexual abuse self-reports were investigated. Family trauma/dysfunction was determined from a composite score derived from the Traumatic Antecedents Scale. The results indicated that sexually abused adolescents reported more family…

  5. Family Trauma and Dysfunction in Sexually Abused Female Adolescent Psychiatric Control Groups.

    ERIC Educational Resources Information Center

    Wherry, Jeffrey N.; And Others

    1994-01-01

    Differences in family trauma, stressors, and dysfunction among adolescent psychiatric inpatients grouped by sexual abuse self-reports were investigated. Family trauma/dysfunction was determined from a composite score derived from the Traumatic Antecedents Scale. The results indicated that sexually abused adolescents reported more family…

  6. Selective Serotonin Reuptake Inhibitor-Induced Sexual Dysfunction in Adolescents: A Review.

    ERIC Educational Resources Information Center

    Scharko, Alexander M.

    2004-01-01

    Objective: To review the existing literature on selective serotonin reuptake inhibitor (SSRI)-induced sexual dysfunction in adolescents. Method: A literature review of SSRI-induced adverse effects in adolescents focusing on sexual dysfunction was done. Nonsexual SSRI-induced adverse effects were compared in adult and pediatric populations.…

  7. The effects of state and trait self-focused attention on sexual arousal in sexually functional and dysfunctional women.

    PubMed

    Meston, Cindy M

    2006-04-01

    This study examined the effects of state self-focused attention on sexual arousal and trait self-consciousness on sexual arousal and function in sexually functional (n=16) and dysfunctional (n=16) women. Self-focused attention was induced using a 50% reflectant television screen in one of two counterbalanced sessions during which self-report and physiological sexual responses to erotic films were measured. Self-focused attention significantly decreased vaginal pulse amplitude (VPA) responses among sexually functional but not dysfunctional women, and substantially decreased correlations between self-report and VPA measures of sexual arousal. Self-focused attention did not significantly impact subjective sexual arousal in sexually functional or dysfunctional women. Trait private self-consciousness was positively related to sexual desire, orgasm, compatibility, contentment and sexual satisfaction. Public self-consciousness was correlated with sexual pain. The findings are discussed in terms of Masters and Johnson's [Masters, W. H. & Johnson, V. E. (1970). Human sexual inadequacy. Boston: Little, Brown) concepts of "spectatoring" and "sensate focus."

  8. Female sexual dysfunction in androgenetic alopecia: Case-control study

    PubMed Central

    Sancak, Eyup Burak; Oguz, Sevilay; Akbulut, Tugba; Uludag, Aysegul; Akbas, Alpaslan; Kurt, Omer; Akbulut, Mehmet Fatih

    2016-01-01

    Introduction: We sought to evaluate the association of female sexual dysfunction (FSD) with androgenetic alopecia (AGA) and metabolic syndrome (MetS) in premenopausal women. Methods: From December 2013 to June 2015, we performed a case-control, prospective study of 115 patients with AGA and 97 age-matched control patients without AGA from among premenopausal women who visited dermatology clinics of the two reference hospitals. Comprehensive history, anthropometric measurements, and questionnaire administration were performed for each of the total of 212 women. The Female Sexual Function Index (FSFI) was used to assess the key dimensions of female sexual function. AGA was assessed and graded by an experienced dermatologist according to Ludwig’s classification. The MetS assessment was made according to the NCEP-ATP III criteria. Results: In univariate analysis, age, weight, waist circumference, hip circumference, waist-to-hip ratio, body mass index (BMI), AGA, MetS, cardiovascular event, marital status, hypertension, high fasting plasma glucose, high triglyceride, large waist, total testosterone, and free testosterone were associated with presence of FSD. In logistic regression analysis, age (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.13–1.30; p<0.001), AGA (OR 3.42, 95% CI 1.31–8.94; p=0.017), MetS (OR 5.39, 95% CI 1.34–21.62; p=0.012), and free testosterone (OR 0.18, 95% CI 0.09–0.37; p<0.001) were independently associated with FSD. Conclusions: Our study suggests that age, AGA, MetS, and free testosterone may have strong impact on sexual function in premenopausal women. Further studies with population-based and longitudinal design should be conducted to confirm this finding. PMID:28255417

  9. Sexual dysfunctions and difficulties in denmark: prevalence and associated sociodemographic factors.

    PubMed

    Christensen, Birgitte S; Grønbaek, Morten; Osler, Merete; Pedersen, Bo V; Graugaard, Christian; Frisch, Morten

    2011-02-01

    Sexual dysfunctions and difficulties are common experiences that may impact importantly on the perceived quality of life, but prevalence estimates are highly sensitive to the definitions used. We used questionnaire data for 4415 sexually active Danes aged 16-95 years who participated in a national health and morbidity survey in 2005 to estimate the prevalence of sexual dysfunctions and difficulties and to identify associated sociodemographic factors. Overall, 11% (95% CI, 10-13%) of men and 11% (10-13%) of women reported at least one sexual dysfunction (i.e., a frequent sexual difficulty that was perceived as a problem) in the last year, while another 68% (66-70%) of men and 69% (67-71%) of women reported infrequent or less severe sexual difficulties. Estimated overall frequencies of sexual dysfunctions among men were: premature ejaculation (7%), erectile dysfunction (5%), anorgasmia (2%), and dyspareunia (0.1%); among women: lubrication insufficiency (7%), anorgasmia (6%), dyspareunia (3%), and vaginismus (0.4%). Highest frequencies of sexual dysfunction were seen in men above age 60 years and women below age 30 years or above age 50 years. In logistic regression analysis, indicators of economic hardship in the family were positively associated with sexual dysfunctions, notably among women. In conclusion, while a majority of sexually active adults in Denmark experience sexual difficulties with their partner once in a while, approximately one in nine suffer from frequent sexual difficulties that constitute a threat to their well-being. Sexual dysfunctions seem to be more common among persons who experience economic hardship in the family.

  10. Female Sexual Dysfunction in Presymptomatic Mutation Carriers and Patients with Huntington's Disease.

    PubMed

    Kolenc, Matej; Kobal, Jan; Podnar, Simon

    2017-01-01

    Although in Huntington's disease (HD) movement, cognition, and personality are most significantly affected, autonomic dysfunction should not be neglected. In women with HD sexual dysfunction has not been adequately studied yet. To report sexual dysfunction in a systematically studied cohort of female HD patients and compare it with controls of a similar age. In female HD patients and presymptomatic HD mutation carriers, we compared the Female Sexual Function Index (FSFI) questionnaire, neurologic assessment using the Unified Huntington's Disease Rating Scale (UHDRS) and the Total Functional Capacity (TFC). Of 44 female HD patients and 9 presymptomatic HD mutation carriers, 30 HD patients and 8 HD mutation carriers responded our invitation to complete FFSI questionnaire. Finally, 23 HD women with a partner were compared to 47 controls with a partner. HD patients had more problems with sexual arousal, lubrication, orgasm and sexual satisfaction. By contrast, we found no difference in sexual desire and pain. Sexual dysfunction progressed in parallel with the decline in the TFC; severe sexual dysfunction occurred with TFC <7/13. Our study demonstrated a significant impact of HD on female sexual function that progressed with patients' functional decline and impaired patients' quality of life. Sexual dysfunction may be caused by progression of the disease itself, side effects of medication, and comorbidities like depression or dementia.

  11. Sexual dysfunction and neuroendocrine correlates of posttraumatic stress disorder in combat veterans: Preliminary findings.

    PubMed

    Lehrner, Amy; Flory, Janine D; Bierer, Linda M; Makotkine, Iouri; Marmar, Charles R; Yehuda, Rachel

    2016-01-01

    Sexual dysfunction is not a symptom of PTSD but is a common clinical complaint in trauma survivors with this disorder. In that there are biological parallels in the neuroendocrine processes underlying both PTSD and sexual behavior, we conducted an exploratory investigation of the relationship of PTSD and related neuroendocrine indicators with sexual dysfunction in armed service veterans. Major Depressive Disorder, highly comorbid with PTSD and sexual dysfunction, was also assessed. In veterans with PTSD, sexual problems were associated with plasma DHEA and cortisol, urinary catecholamines, and glucocorticoid sensitivity, even when controlling for the effects of comorbid depression. In a subsample analysis, testosterone levels did not distinguish PTSD or sexual dysfunction, suggesting that sexual problems reported by veterans in this sample were not the result of organic disorder. PTSD did predict higher dihydrotestosterone (DHT) levels, which were associated with sexual problems. More detailed assessment of sexual dysfunction in biologically informed studies of PTSD is warranted to clarify the relationships of PTSD symptomatology and related neurobiology with sexual dysfunction.

  12. Relationship between CYP 2D6 metabolic status and sexual dysfunction in paroxetine treatment.

    PubMed

    Zourková, Alexandra; Hadasová, Eva

    2002-01-01

    This article describes the incidence of sexual dysfunction in 30 patients subjected to long-term treatment by paroxetine in dependence on the P 450 CYP 2D6 isoenzyme metabolic status. Measured on the Arizona Sexual Experience Scale (ASEX; McGahuey, Delgado, & Gelenberg, 1999), the incidence of sexual dysfunction in patients converted to CYP 2D6 poor metabolizers was markedly higher compared with patients who had no history of such conversion, a difference that reached the level of statistical significance. Our article discusses the incidence of sexual dysfunction in connection with reduced CYP 2D6 capacity.

  13. A systematic review of the literature on female sexual dysfunction prevalence and predictors.

    PubMed

    West, Suzanne L; Vinikoor, Lisa C; Zolnoun, Denniz

    2004-01-01

    Interest in human sexuality began in the 18th century, but formal and more rigorous studies focused on sexual satisfaction and sexual practices were published in the early 1900s. Alfred Kinsey's pioneering work on sexuality, in which he surveyed over 10,000 men and women age 16 and older, began in the late 1930s. In the mid-1960s, Masters and Johnson published their seminal work characterizing the sexual response cycle. Since then, numerous researchers have attempted to understand and to quantify "normal" sexual behaviors using survey techniques. We conducted a systematic review of the published literature on the prevalence of female sexual dysfunction overall and, more specifically, on sexual desire disorder, arousal difficulties, anorgasmia, and dyspareunia. The review also encompassed dysfunction related to the reproductive factors, such as pregnancy, hysterectomy, and menopause. We included sexual dysfunction comorbid with diabetes, depression, and antidepressant therapies. In total, 85 studies are summarized in this review, which spans literature from the early 1900s to the present. We performed a quality assessment of each study, defining quality based on the representativeness of the population studied and the rigor of the instruments used for assessing sexual dysfunction. Although none of the 85 studies included in the review met both standards of quality, some met one criterion and not the other. Definitions of female sexual dysfunction have been developed and refined recently, but there is an urgent need to determine measurable outcomes that can be used for future work.

  14. Antipsychotic Induced Dopamine Supersensitivity Psychosis: A Comprehensive Review.

    PubMed

    Yin, John; Barr, Alasdair M; Ramos-Miguel, Alfredo; Procyshyn, Ric M

    2017-01-01

    Chronic prescription of antipsychotics seems to lose its therapeutic benefits in the prevention of recurring psychotic symptoms. In many instances, the occurrence of relapse from initial remission is followed by an increase in dose of the prescribed antipsychotic. The current understanding of why this occurs is still in its infancy, but a controversial idea that has regained attention recently is the notion of iatrogenic dopamine supersensitivity. Studies on cell cultures and animal models have shown that long-term antipsychotic use is linked to both an upregulation of dopamine D2-receptors in the striatum and the emergence of enhanced receptor affinity to endogenous dopamine. These findings have been hypothesized to contribute to the phenomenon known as dopamine supersensitivity psychosis (DSP), which has been clinically typified as the foundation of rebound psychosis, drug tolerance, and tardive dyskinesia. The focus of this review is the update of evidence behind the classification of antipsychotic induced DSP and an investigation of its relationship to treatment resistance. Since antipsychotics are the foundation of illness management, a greater understanding of DSP and its prevention may greatly affect patient outcomes.

  15. Antipsychotic Induced Dopamine Supersensitivity Psychosis: A Comprehensive Review

    PubMed Central

    Yin, John; Barr, Alasdair M.; Ramos-Miguel, Alfredo; Procyshyn, Ric M.

    2017-01-01

    Chronic prescription of antipsychotics seems to lose its therapeutic benefits in the prevention of recurring psychotic symptoms. In many instances, the occurrence of relapse from initial remission is followed by an increase in dose of the prescribed antipsychotic. The current understanding of why this occurs is still in its infancy, but a controversial idea that has regained attention recently is the notion of iatrogenic dopamine supersensitivity. Studies on cell cultures and animal models have shown that long-term antipsychotic use is linked to both an upregulation of dopamine D2-receptors in the striatum and the emergence of enhanced receptor affinity to endogenous dopamine. These findings have been hypothesized to contribute to the phenomenon known as dopamine supersensitivity psychosis (DSP), which has been clinically typified as the foundation of rebound psychosis, drug tolerance, and tardive dyskinesia. The focus of this review is the update of evidence behind the classification of antipsychotic induced DSP and an investigation of its relationship to treatment resistance. Since antipsychotics are the foundation of illness management, a greater understanding of DSP and its prevention may greatly affect patient outcomes. PMID:27264948

  16. The Blood-Testis Barrier and Male Sexual Dysfunction following Spinal Cord Injury

    DTIC Science & Technology

    2014-10-01

    AWARD NUMBER: W81XWH-12-1-0481 TITLE: The Blood-Testis Barrier and Male Sexual Dysfunction following Spinal Cord Injury PRINCIPAL INVESTIGATOR...AND SUBTITLE: l The Blood-Testis Barrier and Male Sexual Dysfunction following Spinal Cord Injury 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-12-1...input into the male sexual organs. SCI-dependent male infertility is characterized by a significant reduction in numbers and quality of functional

  17. Sexual dysfunction in women who were molested as children: one response pattern and suggestions for treatment.

    PubMed

    McGuire, L S; Wagner, N N

    1978-01-01

    A common pattern of women who were sexually molested as children and seek treatment for sexual dysfunction is described. The arousal, rather than the orgasmic, component is involved. The reasons for the evolution of this particular dysfunction are discussed. Treatment should extend the period of sensate focus and address the issues of the woman's anger, her need for control, and her guilt. Excellent results can be achieved in helping the patient to experience physical intimacy and the pleasure of sexual arousal.

  18. Sex Offenders Seeking Treatment for Sexual Dysfunction--Ethics, Medicine, and the Law.

    PubMed

    Phillips, Elizabeth A; Rajender, Archana; Douglas, Thomas; Brandon, Ashley F; Munarriz, Ricardo

    2015-07-01

    The treatment of sexual dysfunction in patients with prior sexual offenses poses ethical and legal dilemmas. Sex offenders are not obligated by law to disclose this history to medical professionals. Over 20% of sex offenders experience sexual dysfunction; however, the number of sex offenders seeking evaluation for sexual dysfunction is unknown. The aims of this study were to determine the incidence and characteristics of sex offenders seeking treatment in our clinic; and to review data regarding sex offender recidivism and ethics pertaining to the issue as it relates to treating physicians. Sex offenders were identified via three methods: new patient screening in a dedicated sexual medicine clinic, chart review of those on intracavernosal injection (ICI) therapy for erectile dysfunction (ED), and review of patient's status-post placement of penile prosthesis. Charts were cross-referenced with the U.S. Department of Justice National Sex Offender Public Website. Patient characteristics and details of offenses were collected. The main outcome measures used were a self-reported sexual offense and national registry data. Eighteen male sex offenders were identified: 13 via new patient screening; 3 by review of ICI patients; 1 by review of penile prosthesis data; and 1 prior to penile prosthesis placement. All were primarily referred for ED. Of those with known offenses, 64% were level 3 offenders (most likely to re-offend). The same number had committed crimes against children. All those with complete data had multiple counts of misconduct (average 3.6). Ninety-four percent (17/18) had publicly funded health care. Twelve (67%) were previously treated for sexual dysfunction. Registered sex offenders are seeking and receiving treatment for sexual dysfunction. It is unknown whether treatment of sexual dysfunction increases the risk of recidivism of sexual offenses. Physicians currently face a difficult choice in deciding whether to treat sexual dysfunction in sex

  19. Factors associated with sexual dysfunction in Jordanian women and their sexual attitudes

    PubMed Central

    Abu Ali, Ruba M.; Al Hajeri, Rabaa M.; Khader, Yousef S.; Ajlouni, Kamel M.

    2009-01-01

    BACKGROUND: Female sexual dysfunction (FSD) is defined as disorders of libido, arousal, and orgasm, as well as sexual pain, that leads to personal distress or interpersonal difficulties. Social aspects of FSD have been understudied. The aim of this study was to explore the social aspects of FSD and sexual attitudes of Jordanian women. SUBJECTS AND METHODS: Six hundred thirteen married females were studied between October 2006 and August 2007 at the National Center for Diabetes, Endocrinology and Genetics (NCDEG), Amman, Jordan. Females were interviewed using a special questionnaire that was suitable to our culture and added to the Arabic translation of the Female Sexual Function Index (FSFI) Questionnaire. RESULTS: Older age was associated with a decreased total FSD index and its domain scores. Women with obesity were more likely to have impaired arousability and impaired capability of reaching orgasm. About 58.5% of women reported that they prepared themselves if they had sexual desire and 68.2% reported wearing special attire for this purpose. Only 37.2% of women could ask their husband for a special excitement. CONCLUSIONS: FSD is prevalent in Jordan. Its social aspects are understudied and need more research in the future. PMID:19584582

  20. Prevalence and Correlates of Sexual Dysfunction in Men and Women With Type 2 Diabetes.

    PubMed

    Rutte, Anne; van Splunter, Maaike M I; van der Heijden, Amber A W A; Welschen, Laura M C; Elders, Petra J M; Dekker, Jacqueline M; Snoek, Frank J; Enzlin, Paul; Nijpels, Giel

    2015-01-01

    This study aimed to assess the prevalence and correlates of sexual dysfunction in a sample of Dutch men and women with type 2 diabetes. Patients with type 2 diabetes who were between the ages of 40 and 75 years from 4 Dutch diabetes centers were asked to complete self-report questionnaires covering sociodemographic characteristics, medical characteristics, clinical depression (Center for Epidemiological Studies), and sexual dysfunction (in men: International Index of Erectile Function; in women: Female Sexual Function Index). In total, 158 type 2 diabetes patients (68% men) completed the cross-sectional survey. On the basis of predefined criteria, 69% of men and 70% of women were classified with some degree of sexual dysfunction. Univariable logistic regression analyses revealed that sexual dysfunctions were associated with higher age, clinical depression (Center for Epidemiological Studies score ≥16), and one or more diabetes-related complications in both men and women. Multivariable logistic regression analyses revealed that clinical depression was most strongly associated with both male (OR = 6.87, 95% CI [1.77, 26.63]) and female (OR = 9.33, 95% CI [1.03, 84.87]) sexual dysfunction. In conclusion, sexual dysfunction is highly prevalent in men and women with type 2 diabetes and is associated with higher age, clinical depression, and diabetes-related complications. These results suggest that addressing sexual dysfunction in diabetes care is important.

  1. Psychological and interpersonal dimensions of sexual function and dysfunction in women: An update

    PubMed Central

    Althof, Stanley E.; Needle, Rachel B.

    2013-01-01

    Introduction We reviewed the psychological and interpersonal dimensions of female sexual function and dysfunction. Methods We identified articles published in 1970–2013 using the keywords ‘female sexual dysfunction’, ‘sexual desire’, ‘sexual arousal’, ‘female orgasmic disorder’, ‘sex therapy’, ‘psychotherapy’, ‘behaviour therapy’ and ‘Internet therapy’. Over 200 articles were reviewed (Level of evidence 2b). Results and conclusions We identified the major psychological variables affecting female sexual function. The outcomes of psychological treatment interventions are reported. A collaboration between healthcare practitioners from different disciplines is necessary in the evaluation, treatment and education of female patients with sexual dysfunction. The assessment of female and couples’ sexual dysfunction should ideally include an enquiry about the predisposing, precipitating, maintaining and contextual factors. PMID:26558096

  2. Sexual dysfunction among women with Schizophrenia-A cross sectional study from India.

    PubMed

    Simiyon, Manjula; Chandra, Prabha S; Desai, Geetha

    2016-12-01

    Sexual dysfunction among women usually has a multifactorial etiology and is also difficult to study in cultures where open discussions about sexuality are not common. Not much is known about sexual function in women with schizophrenia even though it may have a significant impact on their quality of life and maybe influenced by several factors.

  3. Standards for clinical trials in sexual dysfunctions of women: research designs and outcomes assessment.

    PubMed

    Heiman, Julia R; Guess, Marsha K; Connell, Kathleen; Melman, Arnold; Hyde, Janet Shibley; Segraves, R Taylor; Wyllie, Michael G

    2004-07-01

    Clinical trials on sexual dysfunctions in women are limited in spite of the fact that sexual dysfunctions are likely more common in women than in men. Currently there are no medications approved for treatment in women, and limited data on drug efficacy or psychological efficacy in well-controlled studies. To provide recommendations/guidelines concerning state-of-the-art knowledge for the research design and outcome assessment standards for clinical trials in women's sexual dysfunctions. An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Standards for Clinical Trials in Women's Sexual Dysfunctions Committee, there were seven experts from two countries. Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. A comprehensive update was created which included references and recommended guidelines for rationale and design of clinical trials, study populations, outcome assessments, protocol design and implementation, data analysis and reporting, as well as ethical and clinical issues related to sexual dysfunction research. There is a need for more research in developing standards to be used when performing clinical trials and outcomes assessment research in sexual dysfunctions of women.

  4. Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).

    PubMed

    Rosen, Raymond C; Giuliano, Francois; Carson, Culley C

    2005-06-01

    Sexuality is an essential aspect of a couple's relationship and has a significant impact on life satisfaction. Benign prostatic hyperplasia (BPH) is a condition that commonly affects older men and is often associated with lower urinary tract symptoms (LUTS) and sexual dysfunction. Men with moderate-to-severe LUTS are at increased risk for sexual dysfunction, including moderate-to-severe erectile dysfunction (ED), ejaculatory dysfunction (EjD), and hypoactive desire (HD). The results of several recent large-scale studies have shown a consistent and strong relationship between LUTS and both ED and EjD. It appears that the pathophysiological mechanisms of LUTS and the related prostatic enlargement of BPH as well as certain treatments for this condition may have an impact on both the erection and ejaculation components of the sexual response. Validated questionnaires that assess sexual function provide clinicians with valuable information to help guide treatment selection decisions. Effective medical therapies for LUTS associated with BPH include alpha(1)-adrenergic receptor antagonists (i.e., alfuzosin, doxazosin, tamsulosin, and terazosin) and 5alpha-reductase inhibitors (i.e., finasteride and dutasteride). The side effects of these medications, including sexual dysfunction, are important distinguishing features. The successful management of patients with LUTS associated with BPH should include assessments of sexual function and monitoring of medication-related sexual side effects. For men with LUTS and sexual dysfunction, an appropriate integrated management approach, based on each patient's symptoms and outcome objectives, is warranted.

  5. The prevalence of sexual activity, and sexual dysfunction and behaviours in postmenopausal woman in Poland

    PubMed Central

    Lew-Starowicz, Zbigniew; Szymańska, Monika

    2016-01-01

    Introduction Despite the aging of the population, there is limited data available about sexual life and behaviours among of postmenopausal and late postmenopausal women. Aim of the study was to assess the prevalence of sexual dysfunction, behaviours, and preferences in the Polish population in 2015. Material and methods This observational survey study involved 538 women, of whom 220 were over 50 years old. The main focus was on the differences and changes between older age groups, mainly 50-59 years and over 60 years. Results For 80.9% of the women above 50 years old, sex played at least a moderately important role in life. Sex was definitely important and very important for 40.45% of them. Most women over 50 years old (65.5%) were sexually active. Regardless of age, the respondents were more likely to have sexual intercourse several times a month. Less than half of the women over 50 years old (42.7%) realised their sexual fantasies. Women in the group of 50-59 years old statistically less often than younger women declared that the frequency of intercourse they had was too small. There was a statistical tendency showing that women up to 49 years old declared more sexual problems than older women. Women over 50 years old reported fewer problems in comparison to younger women, e.g. less often they claimed that sex is not pleasurable (p = 0.064). Conclusions The prevalence of sexual activity declines with age, yet a substantial number of woman engage in vaginal intercourse, oral sex, and masturbation even past the seventh decade of life. PMID:27980527

  6. Contemporary Prevalence of Pretreatment Urinary, Sexual, Hormonal, and Bowel Dysfunction

    PubMed Central

    Resnick, Matthew J.; Barocas, Daniel A.; Morgans, Alicia K.; Phillips, Sharon E.; Chen, Vivien W.; Cooperberg, Matthew R.; Goodman, Michael; Greenfield, Sheldon; Hamilton, Ann S.; Hoffman, Karen E.; Kaplan, Sherri H.; Paddock, Lisa E.; Stroup, Antoinette M.; Wu, Xiao-Cheng; Koyama, Tatsuki; Penson, David F.

    2016-01-01

    BACKGROUND The authors investigated the prevalence of pretreatment urinary, sexual, hormonal, and bowel dysfunction in a contemporary, population-based prostate cancer cohort. They also explored the associations between baseline function and age, comorbidity, and timing of baseline survey completion with respect to treatment. METHODS The Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study is a population-based, prospective cohort study that enrolled 3691 men with incident prostate cancer during 2011 and 2012. Pretreatment function was ascertained using the Expanded Prostate Cancer Index-26 (EPIC-26). Data were stratified by age, comorbidity, and timing of baseline survey completion with respect to treatment. Unadjusted and multivariable linear regression analyses were performed to evaluate the relations between exposures and pretreatment function. RESULTS After applying exclusion criteria, the study cohort comprised 3072 men. A strikingly high proportion of men reported inability to obtain erections satisfactory for intercourse (45%) and some degree of urinary incontinence (17%) at baseline. Sexual function was particularly age-sensitive, with patients aged ≤60 years reporting summary scores in excess of 30 points higher than patients aged ≥75 years (P <.001). Compared with the healthiest men, highly comorbid patients reported less favorable function in each domain, including urinary incontinence (summary score, 89.5 vs 74.1; P <.001) and sexual function (summary score, 70.8 vs 32.9; P <.001). Although statistically significant differences in summary scores were identified between patients who completed the baseline questionnaire before treatment (52%) versus after treatment (48%), the absolute differences were small (range, 1–3 points). CONCLUSIONS Patients with newly diagnosed prostate cancer exhibit a wide distribution of pretreatment function. The current data may be used to redefine the population “at risk” for treatment

  7. Sexual Dysfunction Improved in Heroin-Dependent Men after Methadone Maintenance Treatment in Tianjin, China

    PubMed Central

    Zhang, Minying; Zhang, Huifang; Shi, Cynthia X.; McGoogan, Jennifer M.; Zhang, Baohua; Zhao, Linglong; Zhang, Mianzhi; Rou, Keming; Wu, Zunyou

    2014-01-01

    Objective To investigate whether methadone maintenance treatment (MMT) is correlated with sexual dysfunction in heroin-dependent men and to determine the prevalence and risk factors of sexual dysfunction among men on MMT. Methods The study included a retrospective survey and a cross-sectional survey which contained interviews of 293 men who are currently engaged in MMT. The results of the two surveys were compared. For a subset of 43 participants, radioimmunoassay was additionally conducted using retrospective and prospective blood samples to test the levels of plasma testosterone and luteinizing hormone. Other study evaluations were the International Index of Erectile Function (IIEF-15), and Self-rating Depression Scale. Results Sexual dysfunction in all five IIEF-15 domains (erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) was strongly associated with long-term use of heroin. A decrease in the severity of sexual dysfunction was associated with MMT initiation. Erectile dysfunction, lack of sexual desire, inability to orgasm, and lack of intercourse satisfaction were significantly correlated with increasing age of the participants. Methadone dose and duration of methadone treatment were not found to be associated with sexual dysfunction. The level of plasma testosterone significantly declined during methadone treatment, but results from multivariate analysis indicated low levels of testosterone were not the main cause of sexual dysfunction. No correlation between reported depression status and sexual function was found. Conclusions While high levels of sexual dysfunction were reported by heroin-dependent men in our study before and after MMT initiation, MMT appears to be correlated with improved sexual function in the population of the study. PMID:24520361

  8. On categorization and quantification of women's sexual dysfunctions: an epidemiological approach.

    PubMed

    Oberg, K; Fugl-Meyer, A R; Fugl-Meyer, K S

    2004-06-01

    The objectives of this study are to compare the two definitions of female sexual dysfunction, namely dysfunction per se (A category) and personal distress caused by dysfunction (B category), and to gauge their associations with some sociodemographic aspects and level of sexual well-being. The subjects were a nationally representative sample of sexually active Swedish women (n: 1056) aged 18-65 y, who participated in a combined structured interview/questionnaire investigation. The functions analysed were: self-reported sexual desire, interest, lubrication, orgasm, genital pain and vaginism, which were subclassified for the A and B categories into no, mild (sporadically occurring) and manifest dysfunction. Sexual well-being was reported along a six-grade scale ranging from very satisfied to very dissatisfied. The sociodemographic items registered were: education, occupation, financial situation, social group, immigrant status, location of domicile and church-going. Aggregated mild and manifest dysfunction per se of sexual interest, orgasm and vaginal lubrication were reported by about 60-90%. More than one-third had dyspareunia, but few reported vaginism. Mild dysfunctions were clearly more common than manifest dysfunctions. Not fully 45% of those with manifest low interest and orgasm perceived these dysfunctions as manifestly distressing, while in 60-70% lubricational insufficiency of dyspareunia led to manifest distress. Age and the included sociodemographic variables had marginal or no influence on sexual functions. A four-factor sexual function pattern was identified, closely linking A and B categories in a pairwise manner. Three factors, labelled sexual desire, orgasm and genital function were powerful classifiers (discriminant analysis) of level of sexual well-being. Hence, it is a matter of taste whether to use the A or the B category. Together, they can explain the gross level of satisfaction with sexual life to an adequate extent.

  9. High Triglycerides Predicts Arteriogenic Erectile Dysfunction and Major Adverse Cardiovascular Events in Subjects With Sexual Dysfunction.

    PubMed

    Corona, Giovanni; Cipriani, Sarah; Rastrelli, Giulia; Sforza, Alessandra; Mannucci, Edoardo; Maggi, Mario

    2016-09-01

    The atherogenic role of triglycerides (TG) remains controversial. The aim of the present study is to analyze the contribution of TG in the pathogenesis of erectile dysfunction (ED) and to verify the value of elevated TG in predicting major adverse cardiovascular events (MACE). An unselected series of 3,990 men attending our outpatient clinic for sexual dysfunction was retrospectively studied. A subset of this sample (n = 1,687) was enrolled in a longitudinal study. Several clinical, biochemical, and instrumental (penile color Doppler ultrasound; PCDU) factors were evaluated. Among the patients studied, after adjustment for confounders, higher TG levels were associated with arteriogenic ED and a higher risk of clinical and biochemical hypogonadism. Conversely, no association between TG and other sexual dysfunctions was observed. When pathological PCDU parameters-including flaccid acceleration (<1.17 m/sec(2)) or dynamic peak systolic velocity (PSV <35 cm/sec)-were considered, the negative association between impaired penile flow and higher TG levels was confirmed, even when subjects taking lipid-lowering drugs or those with diabetes were excluded from the analysis (OR = 6.343 [1.243;32.362], P = .026 and 3.576 [1.104;11.578]; P = .34 for impaired acceleration and PSV, respectively). Similarly, when the same adjusted models were applied, TG levels were associated with a higher risk of hypogonadism, independently of the definition criteria (OR = 2.892 [1.643;5.410], P < .0001 and 4.853 [1.965;11.990]; P = .001 for total T <12 and 8 nM, respectively). In the longitudinal study, after adjusting for confounders, elevated TG levels (upper quartile: 162-1686 mg/dL) were independently associated with a higher incidence of MACE (HR = 2.469 [1.019;5.981]; P = .045), when compared to the rest of the sample. Our data suggest an association between elevated TG and arteriogenic ED and its cardiovascular (CV) risk stratification. Whether the use of TG lowering drugs

  10. Toward a More Evidence-Based Nosology and Nomenclature for Female Sexual Dysfunctions-Part II.

    PubMed

    Parish, Sharon J; Goldstein, Andrew T; Goldstein, Sue W; Goldstein, Irwin; Pfaus, James; Clayton, Anita H; Giraldi, Annamaria; Simon, James A; Althof, Stanley E; Bachmann, Gloria; Komisaruk, Barry; Levin, Roy; Spadt, Susan Kellogg; Kingsberg, Sheryl A; Perelman, Michael A; Waldinger, Marcel D; Whipple, Beverly

    2016-12-01

    Current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) definitions of sexual dysfunction do not identify all sexual problems experienced clinically by women and are not necessarily applicable for biologic or biopsychosocial management of female sexual dysfunction. A unified nomenclature system enables clinicians, researchers, and regulatory agencies to use the same language and criteria for determining clinical end points, assessing research results, and managing patients. To develop nomenclature with classification systems for female sexual desire, arousal, and orgasm disorders with definitions pertinent to clinicians and researchers from multiple specialties who contribute to the field of sexual medicine. Key national and international opinion leaders diverse in gender, geography, and areas of expertise met for 2 days to discuss and agree to definitions of female sexual desire, arousal, and orgasm disorders and persistent genital arousal disorder. The attendees consisted of 10 psychiatrists and psychologists; 12 health care providers in specialties such as gynecology, internal medicine, and sexual medicine; three basic scientists; and one sexuality educator, representing an array of societies working within the various areas of sexual function and dysfunction. A unified set of definitions was developed and accepted for use by the International Society for the Study of Women's Sexual Health (ISSWSH) and members of other stakeholder societies participating in the consensus meeting. Current DSM-5 definitions, in particular elimination of desire and arousal disorders as separate diagnoses and lack of definitions of other specific disorders, were adapted to create ISSWSH consensus nomenclature for distressing sexual dysfunctions. The ISSWSH definitions include hypoactive sexual desire disorder, female genital arousal disorder, persistent genital arousal disorder, female orgasmic disorder, pleasure dissociative orgasm disorder, and

  11. Assessment of Sexual Dysfunction Symptoms in Female Drug Users: Standardized vs. Unstandardized Methods.

    PubMed

    Diehl, Alessandra; Rassool, G Hussein; dos Santos, Manoel Antônio; Pillon, Sandra Cristina; Laranjeira, Ronaldo

    2016-01-01

    The aim of this study is to evaluate whether there is a difference in the identified prevalence between the assessment of symptoms of sexual dysfunction in female drug users using a standardized scale and by means of a nonstandardized set of questions about sexual dysfunctions. A cross-sectional study was conducted with two groups of substance-dependent women using the Drug Abuse Screening Test, the Short Alcohol Dependence Data questionnaire, the Fagerström Test for Nicotine Dependence for the evaluation of the severity of dependence, and the Arizona Sexual Experience Scale. In both groups, the severity of dependence and the prevalence of symptoms of sexual dysfunctions in women were similar. The use of standardized and nonstandardized instruments to assess sexual dysfunction symptoms is an essential resource for the provision of good-quality care to this clientele.

  12. Sexual dysfunction in women with epilepsy: role of antiepileptic drugs and psychotropic medications.

    PubMed

    Gutierrez, Mary A; Mushtaq, Romila; Stimmel, Glen

    2008-01-01

    Sexual dysfunction is a frequently encountered comorbid disorder in patients with neurological and psychiatric disorders. Importantly, sexual dysfunction can also occur as a treatment emergent adverse effect of a number of commonly used psychotropic and antiepileptic medications, and can include decreased libido, erectile dysfunction, disordered arousal, delayed orgasm, and anorgasmia. These effects can occur in both men and women, and can be seen across age groups. Understanding the neurobiology of normal sexual response, as well as the pharmacologic mechanisms of these commonly used medications can enable the clinician to predict how medication use may impact different phases of sexual response. Discussion of the current treatment strategies for female sexual dysfunction is also elucidated in this chapter.

  13. Sexual dysfunction: the 'prima ballerina' of hypertension-related quality-of-life complications.

    PubMed

    Manolis, Athanasios; Doumas, Michael

    2008-11-01

    Sexual dysfunction is currently considered a serious quality-of-life-related health problem, exerting a major impact on patients' and their sexual partners' life. Available data indicate that essential hypertension is a risk factor for sexual dysfunction, as male and female sexual dysfunction is more prevalent in hypertensive patients than normotensive individuals. Several mechanisms have been implicated in the pathogenesis of sexual dysfunction in hypertensive patients, and major determinants include severity and duration of hypertension, age, and antihypertensive therapy. Female sexual dysfunction, although more frequent than its male counterpart, remains largely under-recognized. Older antihypertensive drugs (diuretics, beta-blockers, centrally acting) exert negative results, whereas newer drugs have either neutral (calcium antagonists, angiotensin-converting enzyme inhibitors) or beneficial effects (angiotensin receptor blockers). Erectile dysfunction is related to ischemic heart disease and might be an 'early therapeutic window' of asymptomatic coronary artery disease. It seems of utmost importance for every physician treating hypertensive patients to become familiar with sexual dysfunction (through better education and specific seminars) for the proper management of these patients.

  14. Associations of Body Mass Index and Physical Activity With Sexual Dysfunction in Breast Cancer Survivors.

    PubMed

    Paiva, Carlos Eduardo; Rezende, Fabiana Faria; Paiva, Bianca Sakamoto Ribeiro; Mauad, Edmundo Carvalho; Zucca-Matthes, Gustavo; Carneseca, Estela Cristina; Syrjänen, Kari Juhani; Schover, Leslie R

    2016-11-01

    Sexual dysfunction is a common and distressing consequence of breast cancer (BC) treatment. In the present study, we investigated the sexual functioning of BC patients and its association with women's personal characteristics and cancer treatments. In this cross-sectional study, sexual function was assessed using the Female Sexual Function Index (FSFI). The health-related quality of life (HRQOL) was measured using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and its breast module BR-23. Of the 235 participants approached, 216 participants were included in the study. Of these, 63 patients reported no sexual activity in the last month and thus were analyzed only in relation to the sexual desire domain of FSFI. A total of 154 (71.3 %) patients were classified with hypoactive sexual desire disorder (HSDD). From those patients reporting sexual activity in the last month, 63.3 % (97 out of 153) were classified with sexual dysfunction. Using hierarchical logistic regression, the variance explained (change in R (2)) by the addition of body mass index (BMI) and mild to moderate physical activity in the prediction models of sexual dysfunction and HSDD were 6.8 and 7.2 %, respectively. Age, BMI, and physical activity were independently associated with sexual dysfunction and HSDD. Additionally, BC patients with sexual dysfunction reported lower scores on global HRQOL, role functioning, and fatigue. Based on our findings, BC survivors should be encouraged to practice regular physical activity and to lose weight in order to avoid sexual dysfunction. However, future clinical trials are needed to confirm these findings.

  15. Sexual dysfunction in patients with irritable bowel syndrome and non-ulcer dyspepsia.

    PubMed

    Fass, R; Fullerton, S; Naliboff, B; Hirsh, T; Mayer, E A

    1998-01-01

    The prevalence and type of sexual dysfunction in patients with functional gastrointestinal (GI) disorders involving the upper (functional dyspepsia) or lower GI tract (irritable bowel syndrome) were studied in 683 patients seen at a tertiary referral center and a comparison group of 247 community volunteers. Associations between sexual dysfunction and type and severity of GI symptoms, and psychological symptoms were examined. All subjects were evaluated with a validated bowel syndrome questionnaire, which included questions about sexual function. Psychological symptom severity was assessed by SCL-90R. The prevalence of self-reported sexual dysfunction in patients with functional GI disorders was 43.3% and did not differ by gender, age stratification or disease subtype: irritable bowel syndrome (IBS); non-ulcer dyspepsia (NUD), and IBS + NUD. In the comparison subjects without IBS symptoms and those with IBS symptoms but not seeking health care (IBS non-patients), the reported sexual dysfunction prevalence was significantly lower (16.1 and 24.4%, respectively, p < 0.005). Decreased sexual drive was the symptom most commonly reported by both male (36.2%) and female (28.4%) patients. Dyspareunia was reported by 16.4% of females and 4% of males with IBS, but was rarely observed in patients with NUD. Report of sexual dysfunction was positively associated with perceived GI symptom severity, but not with psychological symptom severity. Sexual dysfunction should be incorporated into the quality-of-life assessment of patients with functional GI disorders and addressed in future outcome studies.

  16. Reduced Treatment-Emergent Sexual Dysfunction as a Potential Target in the Development of New Antidepressants

    PubMed Central

    Baldwin, David S.; Palazzo, M. Carlotta; Masdrakis, Vasilios G.

    2013-01-01

    Pleasurable sexual activity is an essential component of many human relationships, providing a sense of physical, psychological, and social well-being. Epidemiological and clinical studies show that depressive symptoms and depressive illness are associated with impairments in sexual function and satisfaction, both in untreated and treated patients. The findings of randomized placebo-controlled trials demonstrate that most of the currently available antidepressant drugs are associated with the development or worsening of sexual dysfunction, in a substantial proportion of patients. Sexual difficulties during antidepressant treatment often resolve as depression lifts but can endure over long periods and may reduce self-esteem and affect mood and relationships adversely. Sexual dysfunction during antidepressant treatment is typically associated with many possible causes, but the risk and type of dysfunction vary with differing compounds and should be considered when making decisions about the relative merits and drawbacks of differing antidepressants. A range of interventions can be considered when managing patients with sexual dysfunction associated with antidepressants, including the prescription of phosphodiesterase-5 inhibitors, but none of these approaches can be considered “ideal.” As treatment-emergent sexual dysfunction is less frequent with certain drugs, presumably related to differences in their pharmacological properties, and because current management approaches are less than ideal, a reduced burden of treatment-emergent sexual dysfunction represents a tolerability target in the development of novel antidepressants. PMID:23431429

  17. Sexual dysfunction and chronic pain: the role of psychological variables and impact on quality of life.

    PubMed

    Kwan, Kellie S H; Roberts, Lindy J; Swalm, Delphin M

    2005-12-01

    We report two studies examining the prevalence of sexual dysfunction, and the role of psychological variables, including quality of life, on sexual activity in patients at the commencement of an outpatient cognitive-behavioural pain management programme. In Study 1, 151 patients with non-cancer pain, predominantly of musculoskeletal origin, completed a range of standardised measures, including the Pain Disability Index, Beck Depression Inventory and Coping Strategies Questionnaire. Sexual dysfunction was common, and using stepwise multiple regression analysis was found to be more frequently reported by those with greater disability and depression, shorter pain duration, and infrequent use of coping self-statements. Study 2 was a pilot investigation of the impact of sexual dysfunction on quality of life (as measured by the WHOQOL-100) in a similar sample (n=41). Although sexual dysfunction was again commonly reported, subjects perceived it had less importance in quality of life than did other factors. The combined results support the previously proposed notion of adaptation to the impact of chronic illness on sexual function. In conclusion, sexual dysfunction is common in this population and is predicted by psychological factors and pain duration. However, other issues impact more significantly on quality of life. Therapeutic approaches to sexual dysfunction in these patients might best be focused on improving psychological factors, particularly depression and coping skills.

  18. Sexual dysfunction in clinically stable patients with bipolar disorder receiving lithium.

    PubMed

    Grover, Sandeep; Ghosh, Abhishek; Sarkar, Siddharth; Chakrabarti, Subho; Avasthi, Ajit

    2014-08-01

    There is limited data on the prevalence of sexual dysfunction in patients with bipolar disorder receiving lithium. This study aimed to evaluate the prevalence of sexual dysfunction in patients with bipolar disorder receiving lithium and to study the correlates of sexual dysfunction. One hundred clinically stable patients with bipolar disorder (Global Assessment for Functioning score of >70, Hamilton Depression Rating Scale score of ≤7 and Young Mania Rating Scale score of ≤7, and no change in medications at least in the last 3 months) receiving lithium were evaluated on Arizona Sexual Experience Scale and Brief Adherence Rating Scale. The mean age of study sample was 44.3 years. The mean Hamilton Depression Rating Scale score was 1.06 (SD, 1.7) and the mean Young Mania Rating Scale score was 0.1 (SD, 0.5) and the mean Global Assessment for Functioning scale score was 84 (SD, 6.0). The mean duration of lithium use was approximately 119.62 (SD, 99.6) months, and the mean dose of lithium was 799.5 (SD, 251.4) mg/d. Of the 100 patients, approximately one third of the patients (n = 37) were found to have sexual dysfunction as per Arizona Sexual Experience Scale. Compared with those without sexual dysfunction, those with sexual dysfunction were older (t value = 3; P = 0.003). Those with sexual dysfunction had lower level of functioning (Global level of functioning score of 81.7 vs 85.5; t value = 3.2; P = 0.002), higher number of other adverse effects with lithium (total number of other adverse effects, 2.9 vs 1.4; t value = 4.2; P < 0.001), and poor medication compliance. To conclude, the present study suggests that approximately one third of the patients receiving lithium experience sexual dysfunction, and it is associated with poor medication adherence.

  19. What kind of sexual dysfunction is most common among overweight and obese women in reproductive age?

    PubMed

    Rabiepoor, S; Khalkhali, H R; Sadeghi, E

    2017-03-01

    The aim of this study was to investigate the association between body mass index (BMI) and sexual health and determine what kind of sexual dysfunction is most common among overweight and obese women in reproductive age from Iran. A cross-sectional descriptive design was adopted. The data of 198 women who referred to health centers during 2014-2015 in Iran were collected through convenient sampling. Data were collected using a demographic questionnaire, female sexual function and sexual satisfaction indexes. Participants' heights and weights were recorded in centimeters and kilogram. Data were analyzed applying descriptive statistics, one-way analysis of variance, regression logistic analysis and χ(2). P-values<0.05 were considered significant. The mean age of women was 29.89±7.01 and ages ranged from 17 to 45 years. 85.9% of the participants had sexual dysfunction, and 69.7% had dissatisfaction and low satisfaction. According to our evaluations, orgasm dysfunction had the most frequency; on the other hand, desire dysfunction and pain dysfunction had the lowest frequency among overweight and obese women, respectively. Using logistic regression analysis, we have shown that BMI affected on sexual satisfaction, but there was not significant differences between BMI and sexual function. This article concludes that all women especially women with overweight and obesity should be counseled about health outcomes related to sexual activity. This article concludes that all women especially women with overweight and obesity should be counseled about health outcomes related to sexual activity.

  20. The relationship between sexual dysfunction and quality of marital relationship in genital and breast cancers women.

    PubMed

    Fahami, Fariba; Mohamadirizi, Soheila; Savabi, Mitra

    2017-01-01

    The concept of sexual dysfunction is dysfunction in desire and emotional - social that it is Impact on the sexual response cycle and can cause stress and interpersonal difficulties. Quality of marital relationship is one of the important factors predicting sexual function disorders, which varies among different cancers. The purpose of this study is to determine the relationship between sexual dysfunction and quality of marital relationship in genital and breast cancers in women. This correlational study was conducted on 150 breast and genital cancers in women referred to Sayedoshohada and Milad hospitals in Isfahan city through a two-stage sampling method. Participants completed questionnaires about demographic/disease and sexual function questionnaire (44 questions) and quality of marital relationship (11 questions). Collected data were analyzed using SPSS version 14 software, statistical test such as, Pearson correlation coefficient tests independent t- student, one way ANOVA. The results showed that 70.7% of women had breast cancer and 29.3% had gynaecological cancer. 60% of patient had good quality of marital relationship and 19.3% sexual dysfunction. There was a significant correlation between sexual function and quality of marital relationship (P = <0.001). There was a significant correlation between sexual function disorder and quality of marital relationship. The inclusion of patients educational programs and couple therapy in cancer disease rehabilitation program is important in order to improve the quality of marital relationship and subsequent sexual dysfunction in cancer patients.

  1. Heart Rate Variability in Male Sexual Arousal and Erectile Dysfunction

    DTIC Science & Technology

    2007-01-22

    Materials b. Self -Report i. Beck Depression Inventory (BDI-II) ii. Beck Anxiety Inventory (BAI) iii. Sexual Arousal Questionnaire (SAQ) c...vary in type, duration, and origin, most adversely affect intimate relationships, quality of life, and self -esteem (Heiman, 2002). Despite the...factors by increasing sexual self -confidence, spontaneity of sexual encounters, sexual desire, overall sexual satisfaction (Dean, Hackett, Gentile

  2. Sexual dysfunction and sexual quality of life among the physically challenged in the Kumasi metropolis, Ghana.

    PubMed

    Owiredu, William K B A; Owusu, Alexander O; Amidu, Nafiu; Quaye, Lawrence; Gyasi-Sarpong, Christian K; Dapare, Peter P M; Alidu, Huseini

    2015-01-22

    Despite the fact that the physically disabled have difficulties in many aspects of their lives, including sexuality, society often ignores these needs or assume that they have no such needs. This cross-sectional study therefore seeks to determine the prevalence of sexual dysfunction (SD) and its impact on the quality of life among persons with physical disability residing in the Kumasi metropolis, Ghana. This study was conducted among 235 persons with physical disability dwelling in communities within the Kumasi metropolis, Ghana between September 2011 and April 2012. All participants were evaluated by using a semi-structured questionnaire, the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire and the Sexual Quality of Life questionnaire (SQoL). Self-designed semi-structured questionnaire was also administered to each consented study participant for socio-demographic information. The response rates were 72% and 63.6% for male and female respectively. The age range of the male was 19-74 years with 61.1% being married whilst the age range of the female was 20-66 years with 54.3% being married. 30% and 7.1% of the male and female respectively consumed alcohol beverage. The mean Sexual quality of life (SQoL) score was slightly higher in the females (57.7 ± 15.8), ranging from 25.6 to 97.8. Univariate analysis of the male data showed that the only significant factor that tends to increase the male SD was alcohol (OR: 24.6; CI: 1.4 - 14.9; p = 0.0071). The prevalence of SD was higher among the female populace (65.7%) compared to the 64.4% for the male populace though very closely comparable. Except for non-communication (NC) and anorgasmia (impotence in males), all other areas of difficulty had higher percentages in males than females. The prevalence of sexual dysfunction among the physically challenged is comparable to prevalence rates in the able male and female population. This could impact significantly on their self-esteem and quality of

  3. Prevalence and risk factors of sexual dysfunction in postpartum Australian women.

    PubMed

    Khajehei, Marjan; Doherty, Maryanne; Tilley, P J Matt; Sauer, Kay

    2015-06-01

    Female sexual dysfunction is highly prevalent and reportedly has adverse impacts on quality of life. Although it is prevalent after childbirth, women rarely seek advice or treatment from health care professionals. The aim of this study was to assess the sexual functioning of Australian women during the first year after childbirth. Postpartum women who had given birth during the previous 12 months were invited to participate in this cross-sectional study. A multidimensional online questionnaire was designed for this study. This questionnaire included a background section, the Female Sexual Function Index, the Patient Health Questionnaire (PHQ-8), and the Relationship Assessment Scale. Responses from 325 women were analyzed. Almost two-thirds of women (64.3%) reported that they had experienced sexual dysfunction during the first year after childbirth, and almost three-quarters reported they experienced sexual dissatisfaction (70.5 %). The most prevalent types of sexual dysfunction reported by the affected women were sexual desire disorder (81.2%), orgasmic problems (53.5%), and sexual arousal disorder (52.3%). The following were significant risk factors for sexual dysfunction: fortnightly or less frequent sexual activity, not being the initiator of sexual activity with a partner, late resumption of postnatal sexual activity (at 9 or more weeks), the first 5 months after childbirth, primiparity, depression, and relationship dissatisfaction. Sexual satisfaction is important for maintaining quality of life for postpartum women. Health care providers and postpartum women need to be encouraged to include sexual problems in their discussions. © 2015 International Society for Sexual Medicine.

  4. Sexual dysfunction and dissatisfaction in chronic hepatitis C patients.

    PubMed

    Fábregas, Bruno Cópio; Moura, Alexandre Sampaio; Ávila, Renata Eliane de; Faria, Marjore Novaes; Carmo, Ricardo Andrade; Teixeira, Antônio Lúcio

    2014-01-01

    The prevalence of sexual dysfunction (SD) and dissatisfaction with sexual life (DSL) in patients with chronic hepatitis C virus infection (CHC) was jointly investigated via a thorough psychopathological analysis, which included dimensions such as fatigue, impulsiveness, psychiatric comorbidity, health-related quality of life (HRQL) and sociodemographic and clinical characteristics. Male and female CHC patients from an outpatient referral center were assessed using the Brief Fatigue Inventory, the Barrat Impulsiveness Scale, the Beck Depression Inventory (BDI), the Hospital Anxiety and Depression Scale, the Hamilton Anxiety Scale (HAM-A), and the World Health Organization Quality of Life Scale-Brief Version (WHOQOL-BREF). Structured psychiatric interviews were performed according to the Mini-International Neuropsychiatric Interview. SD was assessed based on specific items in the BDI (item 21) and the HAM-A (item 12). DSL was assessed based on a specific question in the WHOQOL-BREF (item 21). Multivariate analysis was performed according to an ordinal linear regression model in which SD and DSL were considered as outcome variables. SD was reported by 60 (57.1%) of the patients according to the results of the BDI and by 54 (51.4%) of the patients according to the results of the HAM-A. SD was associated with older age, female gender, viral genotype 2 or 3, interferon-α use, impulsiveness, depressive symptoms, antidepressant and benzodiazepine use, and lower HRQL. DSL was reported by 34 (32.4%) of the patients and was associated with depressive symptoms, anxiety symptoms, antidepressant use, and lower HRQL. The prevalence of SD and DSL in CHC patients was high and was associated with factors, such as depressive symptoms and antidepressant use. Screening and managing these conditions represent significant steps toward improving medical assistance and the HRQL of CHC patients.

  5. General practitioners' procedures for sexual history taking and treating sexual dysfunction in primary care.

    PubMed

    Ribeiro, Sofia; Alarcão, Violeta; Simões, Rui; Miranda, Filipe Leão; Carreira, Mário; Galvão-Teles, Alberto

    2014-02-01

    Good history-taking skills are the first step towards achieving a correct diagnosis of sexual dysfunction (SD). However, studies show most general practitioners (GPs) do not take the initiative to ask the patient about SD, and when diagnosing a condition, they tend to give preference to their own criteria over clinical guidelines. The aim of this study is to characterize GPs' attitudes towards taking sexual history, identifying its frequency and focus, and to describe GPs' diagnostics and therapeutic approaches including the use of clinical guidelines, exploring patients' and doctor-related differences. Cross-sectional study using confidential self-administrated questionnaires applied to GPs working in primary healthcare units in the Lisbon region. Data concerning GPs' consultation of guidelines, active exploration of SD in male and in female patients, and focus on sexual history taking was collected. Of the 50 participants (73.5% response rate), 15.5% actively ask their patients about SD. The main reasons for asking patients about their sexuality are diabetes (84.0%), prescription of medication with adverse effects on sexuality (78.0%), and family planning (72.0%), the latter being a significantly more frequent reason for GPs with 20 or less years of practice. Routine sexual history taking (22.0%) appears as one of the least mentioned motives. The percentage of appointments with active exploration of SD was positively associated with guidelines' consultation, as well as considering the specialty as a good source of information and having longer appointments when SD is mentioned. However, 76.0% report not having consulted any guidelines in the previous year. Lack of time (31.6%) and low accessibility (25.0%) were referred to as the main reasons for not consulting guidelines. Routine sexual history taking and consultation of guidelines about SD are not yet a generalized practice in primary care. Data should be interpreted with caution as they are self

  6. Prevalence and predictors of female sexual dysfunction: a protocol for a systematic review

    PubMed Central

    2014-01-01

    Background Sexual function is an essential component of life. For this reason, sexual dysfunction can have a negative impact on the wellbeing of men and women alike. Since the turn of the 21st century, research on female sexual dysfunction (FSD) has gained momentum. While FSD is often assessed in people with ill health, sexual dysfunction is an illness of its own entity and is also prevalent in non-patient populations. A critical review of current literature on female sexual dysfunction in general populations will shed light on possible determinants as well as at-risk groups. Thus, the aim of this systematic review is to assess the prevalence and the predictors of female sexual dysfunction in general populations. Methods/Design A systematic review of current literature on FSD will be performed. Studies will be considered for review if they report quantitative data on the prevalence of female sexual dysfunction. Outcome measures will include the prevalence of FSD, the time period assessed, and significant predictors for each domain of FSD. The scientific databases MEDLINE, EMBASE, PsycINFO, and Web of Science will be systematically searched in cooperation with a medical research librarian. Hand searches for further relevant publications will also be undertaken. Screening of search results and extraction of data from included studies will be conducted cooperatively by two authors. The quality of the studies will be appraised and documented. Results will be compiled and presented in evidence tables. Discussion In the past decade, population-based studies on female sexual dysfunction have increased in number and grown more varied in their cultural settings. This review aims to provide a current overview of the prevalence of female sexual dysfunction in populations from various countries, cultures, and age groups in order to provide a better understanding of its effect on women's lives today. PMID:25015232

  7. Urinary and sexual dysfunction rates and risk factors following rectal cancer surgery.

    PubMed

    Duran, Eyup; Tanriseven, Mustafa; Ersoz, Nail; Oztas, Muharrem; Ozerhan, Ismail Hakki; Kilbas, Zafer; Demirbas, Sezai

    2015-11-01

    The aim of this study was to express the effects of demographic characteristics, the type of the surgery, tumour characteristics and adjuvant therapy on urinary and sexual dysfunctions. Pre-operational urinary and sexual dysfunctions of the patients were evaluated by using the surveys prepared according to International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF) in men and Index of Female Sexual Function (IFSF) in women. A total of 56 patients were included in the study; 20 of them were women and 36 of them were men. The mean age was 56. Abdominoperineal resection (APR) was performed on 11 patients, and low anterior resection (LAR) was performed on 45. The post-treatment IPSS classes were worsened at a rate of 12.7 % compared to the pre-treatment. The mean post-treatment sexual dysfunction score of both men and women were decreased by 27.5 and 17.8 %, respectively. Rectal tumours located in the lower part resulted in more sexual dysfunction. The tumour in the 1/3 lower part of the rectal area was determined to be the most effective factor that caused both urinary and sexual dysfunction. Patients should be informed about the urinary and sexual dysfunctions in the pre-operative consultations.

  8. Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis.

    PubMed

    Atlantis, Evan; Sullivan, Thomas

    2012-06-01

    Depression is frequently associated with sexual dysfunction in both men and women. To examine whether depression predicts sexual dysfunction and, conversely, whether sexual dysfunction predicts depression. A systematic review and meta-analysis was conducted. PubMed and EMBASE biomedical answers electronic databases were searched for relevant studies up to November 2011. Reference lists of relevant articles were hand-searched and expert opinions were sought. Studies identified for inclusion had to be prospective cohort studies in adult populations that reported an association between depression and sexual dysfunction variables. Odds ratios (ORs), prioritized where available, or relative risks (RRs) were pooled across studies using random-effects meta-analysis models. Eight citations included for review yielded six studies on depression and risk of sexual dysfunction in 3,285 participants followed for 2-9 years, and six studies on sexual dysfunction and risk of depression in 11,171 participants followed for 1-10 years. Depression increased the risk of sexual dysfunction in pooled unadjusted (RR/OR 1.52 with 95% confidence intervals [1.02, 2.26]) and adjusted (RR/OR 1.71 [1.05, 2.78]) meta-analyses but not in the partially adjusted model (RR/OR 1.41 [0.90, 2.23]). There was significant heterogeneity between studies, but after removal of a single outlying study was diminished and the pooled partially adjusted, RR/OR increased to 1.69 (1.15, 2.47). Sexual dysfunction increased the odds of depression in the pooled unadjusted (OR 2.30 [1.74, 3.03]), adjusted (OR 3.12 [1.66, 5.85]), and partially adjusted (OR 2.71 [1.93, 3.79]) meta-analyses; heterogeneity was significant only in the adjusted model. Meta-regression analyses did not detect significant sources of heterogeneity in either examination. Clinicians should be aware of a bidirectional association between depression and sexual dysfunction. Patients reporting sexual dysfunction should be routinely screened for

  9. Sexual dysfunction and its determinants in Moroccan women with rheumatoid arthritis

    PubMed Central

    Khnaba, Dina; Rostom, Samira; Lahlou, Racha; Bahiri, Rachid; Abouqal, Redouane; Hajjaj-Hassouni, Najia

    2016-01-01

    Introduction To assess the prevalence of sexual dysfunction in married women with rheumatoid arthritis (RA) and compare it with a control group and to determine its association with clinical and disease activity factors. Methods We conducted a cross-sectional study including sixty married women with a confirmed diagnosis of Rheumatoid Arthritis according to the American College of Rheumatology (ACR)/ European League against Rheumatism (EULAR) 2010 Criteria, aged 18 or over and having sexual activity. Our controls were healthy volunteers women matched for age. Clinical and sociodemographic characteristics were collected. Sexual function was assessed by a self-reported questionnaire the index of female sexual function (FSFI). Sociodemographic and disease activity profiles were compared between those who had and did not have sexual dysfunction. Results The prevalence of female sexual dysfunction in women with rheumatoid arthritis attending El Ayachi hospital was 71.9%, it was 54% in controls. There was a significant difference in the total FSFI score between patients 18.29±9.09 and controls 23.05±7.91 (p=0.016). We found a statistically significant difference between the two groups in almost all dimensions of sexual function (desire, arousal, orgasm, satisfaction), except for pain and lubrication. In multivariate analysis, pain assessed by visual analogue scale (VAS) and depression assessed by hospital anxiety and depression score (HAD) were the independent determinants of sexual dysfunction. Conclusion Our study suggests that sexual dysfunction is more common among patients with RA compared to controls. These dysfunctions were related to desire, arousal, orgasm and satisfaction. Pain and depression appear to be the most important predictors of sexual dysfunction. PMID:27583080

  10. Sexual Dysfunction in Women Undergoing Fertility Treatment in Iran: Prevalence and Associated Risk Factors

    PubMed Central

    Bakhtiari, Afsaneh; Basirat, Zahra; Nasiri-Amiri, Fatemeh

    2016-01-01

    Background: Sexual dysfunctions are one of the most fundamental difficulties for infertile women, which can be as the cause of infertility. This study investigated the prevalence of this disorder and associated factors in order to improve infertility treatment process and the quality of life of women referring to infertility center. Methods: A cross sectional study was performed on 236 women who referred to Fatima Zahra infertility center of Babol, Iran. Data collection tool was a questionnaire contained two parts; demographic characteristics and infertility information. Also, data for sexual dysfunction was obtained through diagnostic interview based on the international classification DSM-IV. For data analysis, logistic and linear regression analysis were used. The p<0.05 was considered significant. Results: Most of women (84.9%) suffered from primary infertility and the mean duration of infertility was 60.2±8.4 months. The prevalence of sexual dysfunction was 55.5% (n=131); including dyspareunia in 28% (n=66), impaired sexual desire and lack of orgasm in 26.3% (n=62 patients), vaginismus in 15.2% (n=36) and lack of sexual stimulation in 13.6% (n=32). Binary logistic regression analysis showed that age, sexual satisfaction and history of mental illness had a significant effect on the probability of experiencing the sexual dysfunction. Conclusion: There is a high prevalence of sexual dysfunction among infertile women. Considering the interaction between sexual dysfunction and infertility, professional health care centers should be sensitive to this effect. Also, more attention must be paid on marital relationships, economic and social situation and infertility characteristics in order to prevent sexual dysfunction development through early screening and psychological interference. PMID:26962480

  11. Standards for Clinical Trials in Male and Female Sexual Dysfunction: II. Patient-Reported Outcome Measures.

    PubMed

    Fisher, William A; Gruenwald, Ilan; Jannini, Emmanuele A; Lev-Sagie, Ahinoam; Lowenstein, Lior; Pyke, Robert E; Reisman, Yakov; Revicki, Dennis A; Rubio-Aurioles, Eusebio

    2016-12-01

    The second article in this series, Standards for Clinical Trials in Male and Female Sexual Dysfunction, focuses on measurement of patient-reported outcomes (PROs). Together with the design of appropriate phase I to phase IV clinical trials, the development, validation, choice, and implementation of valid PRO measurements-the focus of the present article-form the foundation of research on treatments for male and female sexual dysfunctions. PRO measurements are assessments of any aspect of a patient's health status that come directly from the patient (ie, without the interpretation of the patient's responses by a physician or anyone else). PROs are essential for assessing male and female sexual dysfunction and treatment response, including symptom frequency and severity, personal distress, satisfaction, and other measurements of sexual and general health-related quality of life. Although there are some relatively objective measurements of sexual dysfunction (ie, intravaginal ejaculatory latency time, frequency of sexual activity, etc), these measurements do not comprehensively assess the occurrence and extent of sexual dysfunction or treatment on the patient's symptoms, functioning, and well-being. Data generated by a PRO instrument can provide evidence of a treatment benefit from the patient's perspective. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  12. Sexual dysfunction related to psychotropic drugs: a critical review. Part III: mood stabilizers and anxiolytic drugs.

    PubMed

    La Torre, A; Giupponi, G; Duffy, D M; Pompili, M; Grözinger, M; Kapfhammer, H P; Conca, A

    2014-01-01

    Sexual dysfunction is a potential side effect of mood stabilizers and anxiolytic drugs: this article presents a critical review of the current literature. Although many studies have been published on sexual side effects of psychopharmacological treatment, only a minority relate to mood stabilizers and anxiolytic drugs. Most of these studies are not methodologically robust, few are RCTs and most did not use a validated rating scale to evaluate sexual functioning. In addition, many of the studies on sexual dysfunction associated with mood stabilizers and anxiolytic drugs are limited by other methodological flaws. While there is evidence to suggest that mood stabilizers, with some exceptions, negatively affect sexual functioning, there is still insufficient evidence to draw any clear conclusions about the effects of anxiolytic drugs on sexual function. There is some weak evidence to indicate that switching from enzyme-inducing to non-enzyme-inducing anticonvulsant drugs, could be clinically useful. Some researchers recommend that sexual dysfunction in patients taking antiepileptic drugs should in general be treated according to standard guidelines for the management of sexual dysfunction, since reliable data on special populations is not available. However, specific approaches may be useful, but cannot yet be recommended until further validating research has been conducted. We did not find evidence supporting the use of any specific treatment strategy for sexual dysfunction associated with anxiolytic treatment. This study was conducted in 2013 using the paper and electronic resources of the library of the Azienda Provinciale per i Servizi Sanitari (APSS) in Trento, Italy (http://atoz.ebsco.com/Titles/2793). The library has access to a wide range of databases including DYNAMED, MEDLINE Full Text, CINAHL Plus Full Text, The Cochrane Library, Micromedex healthcare series, BMJ Clinical Evidence. The full list of available journals can be viewed at http

  13. Sexual dimorphism and thyroid dysfunction: a matter of oxidative stress?

    PubMed

    Fortunato, Rodrigo S; Ferreira, Andrea C F; Hecht, Fabio; Dupuy, Corinne; Carvalho, Denise P

    2014-05-01

    Thyroid diseases, such as autoimmune disease and benign and malignant nodules, are more prevalent in women than in men, but the mechanisms involved in this sex difference is still poorly defined. H₂O₂ is produced at high levels in the thyroid gland and regulates parameters such as cell proliferation, migration, survival, and death; an imbalance in the cellular oxidant-antioxidant system in the thyroid may contribute to the greater incidence of thyroid disease among women. Recently, we demonstrated the existence of a sexual dimorphism in the thyrocyte redox balance, characterized by higher H₂O₂ production, due to higher NOX4 and Poldip2 expression, and weakened enzymatic antioxidant defense in the thyroid of adult female rats compared with male rats. In addition, 17β-estradiol administration increased NOX4 mRNA expression and H₂O₂ production in thyroid PCCL3 cells. In this review, we discuss the possible involvement of oxidative stress in estrogen-related thyroid pathophysiology. Our current hypothesis suggests that a redox imbalance elicited by estrogen could be involved in the sex differences found in the prevalence of thyroid dysfunctions.

  14. Laser irradiation of penile blood as treatment of sexual dysfunctions

    NASA Astrophysics Data System (ADS)

    Koultchavenia, Ekaterina V.; Khomyakov, Victor T.

    2001-05-01

    40-60% of the men of average age suffer from the violations of sexual functions. Impotence doesn't make direct threat to life; nevertheless this disease essentially reduces quality of life, and consequently deserves the most steadfast attention. There are many methods of treatment of erectile dysfunction. However they are connected with a reception of medicines, which is expensive and has a number of contraindications, or with invasive procedures, or with surgical intervention, that also not always is desirable. We have developed the original device permitting to cause passive erection by creation of a local decompression. The second stage is the effect by an infrared laser radiation (denseness of a potency 4.2 mWt/sm2, continuous radiation with length of a wave 0.89 microns, exposition 5 minutes) on erection glans penis. We observed 24 patients with the complaints on insufficient erection (18), premature ejaculation (6); 2 patients in addition presented the complaint on small sizes of the penis. Age of the patients was 24-46 years, on the average 34.3 years. All have received treatment from 15 sessions in day.

  15. Manufacturing desire: the commodification of female sexual dysfunction.

    PubMed

    Fishman, Jennifer R

    2004-04-01

    The process of bringing new drugs to market interweaves commercialism, science, clinical medicine, and governmental regulation. Through their authority and public persona as medical experts, academic clinical trial researchers studying these pharmaceuticals are integral to this process, serving as mediators between producers (the pharmaceutical companies) and consumers (clinicians and patients) of new drugs through a complex set of exchange networks. Using examples from my ethnographic research on the search for pharmaceuticals to treat what has become known as female sexual dysfunction, this paper explores the links academic researchers make with drug manufacturers and consumer markets. Academic researchers have become an integral aspect of drug development, not only by conducting clinical trial research, but also by participating in a number of other activities that assist pharmaceutical companies in identifying and creating new markets. In this paper, i examine how researchers attend professional meetings where they present clinical trial data, lecture at continuing medical education conferences, and offer themselves as ' experts' to raise awareness about disorders and their treatments. Modifying a sociology of technology approach, this paper focuses on the actors in the social network who mediate the junctions between technological producers and consumers. This extends work in this area through theorizing the linkages between exchange networks, commodification techniques, and technoscientific developments.

  16. Sexual dysfunction and relationship stress: how does this association vary for men and women?

    PubMed

    McCabe, Marita P; Connaughton, Catherine

    2017-02-01

    This paper examines the association between relationship stress and sexual dysfunction. The results demonstrated a strong association between female sexual dysfunction (FSD) and relationship stress, and between male sexual dysfunction (MSD) and relationship stress among their female partners. No studies examined the association between FSD and relationship stress of male partners. Treatment for MSD was associated with improved relationship stress for female partners, but no studies were located that examined this association for treatment of FSD. These findings suggest that FSD and relationship stress are strongly related, but the association does not seem to be so strong for men. The review highlights the need for further research in this field to inform therapy for both sexual dysfunction and relationship problems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Sexual function assessment and the role of vasoactive drugs in female sexual dysfunction.

    PubMed

    Rosen, Raymond C

    2002-10-01

    Despite the high prevalence of sexual problems in women, relatively few clinical trials have been conducted to date of either vasoactive drugs (e.g., sildenafil, apomorphine) or hormone replacement therapy or a combination of the two on sexual function problems in women. This article addresses the key conceptual and methodological issues to be addressed in clinical trials, particularly in the area of response outcomes or efficacy assessment. In particular, the use of self-report questionnaires and event-log or diary-based responses as primary outcome variables or endpoints in clinical trials is considered. Physiological measures, such as the vaginal photoplethysmograph probe, are being used in early proof of concept studies. There may be some value in the use of these measures for proof-of-concept and early dose-finding studies. Physiological measures are not used in large-scale, multicenter clinical trials, where patient-based or diary measures are clearly preferable. Clinical trials in this area should also make use of the new consensus classification system for female sexual dysfunction in determining inclusion and exclusion criteria for the trial.

  18. Prevalence of Sexual Concerns and Sexual Dysfunction among Sexually Active and Inactive Men and Women with Screen‐Detected Type 2 Diabetes

    PubMed Central

    Charles, Morten; Kristensen, Ellids; Lauritzen, Torsten; Sandbæk, Annelli; Giraldi, Annamaria

    2015-01-01

    Abstract Introduction Type 2 diabetes negatively impacts sexual health. Only limited information is available regarding sexual health among sexually inactive patients with type 2 diabetes. Aim The aim of this study was to examine the prevalence of sexual concerns among sexually active and sexually inactive men and women with type 2 diabetes and of sexual dysfunction (SD) among sexually active. Methods Data from the Anglo–Danish–Dutch Study of Intensive Treatment in People with Screen‐Detected Diabetes in Primary Care‐Denmark study was used. A total of 1,170 Danish patients with screen‐detected type 2 diabetes attended a health examination, including assessment of sexual concerns using self‐report questionnaires and of SD using the Female Sexual Function Index (FSFI‐R) and the International Index of Erectile Function (IIEF‐5) instruments. Main Outcome Measures The main outcome measures used regarding sexual concerns are the following: prevalence of failure to fill sexual needs, of experiencing sexual distress, finding it important to have a good sexual life, and additionally, prevalence of SD. Results Data regarding sexual activity status during the last 12 months were available among 583 men and 377 women. Seventeen percent of men and 47% of women reported to be sexually inactive, among whom 57% of men and 42% of women reported failure to fill sexual needs; 31% of men and 10% of women that it was important to have a good sexual life, and 32% of men and 11% of women that they were experiencing sexual distress. Around half of men and women were excluded from the SD analysis, mainly because of reporting lack of sexual intercourse during the last 4 weeks. Among those included, 54% of men and 12% of women were found to have SD. Conclusions Sexual inactivity is highly prevalent among middle‐aged and older men and women with early type 2 diabetes and these patients often have sexual concerns. The high exclusion rates when assessing SD using the FSFI

  19. Co-relationship between sexual dysfunction and high-risk sexual behavior in patients receiving buprenorphine and naltrexone maintenance therapy for opioid dependence.

    PubMed

    Ramdurg, Santosh; Ambekar, Atul; Lal, Rakesh

    2015-01-01

    People suffering from substance dependence suffer from various sexual dysfunctions and are at risk for indulging in various high-risk sexual behaviors and thus are vulnerable to acquire various infections such as HIV/AIDS and other sexually transmitted infections. The aim of the study was to evaluate the correlation between sexual dysfunction and high-risk sexual behavior in opioid-dependent men receiving buprenorphine and naltrexone maintenance therapy. Semi-structured questionnaire, brief male sexual functioning inventory and HIV-risk taking behavior scale was administered to a sample of 60 sexually active men, receiving buprenorphine (n = 30) and naltrexone (n = 30) maintenance therapy for opioid dependence. The main outcomes are correlation between severity of sexual dysfunction and HIV-risk taking behavior. The study results showed 83% of the men on buprenorphine and 90% on naltrexone reported at least one of the sexual dysfunction symptoms. There was a negative correlation between sexual dysfunction and HIV-risk taking behavior that suggest severe the dysfunction, higher the risk taking behavior. Significant correlation was present with overall sexual dysfunction and HIV-risk taking behavior (P = 0.028 and in naltrexone receiving group premature ejaculation versus HIV-risk taking behavior however, (P = 0.022, P < 0.05) there were no significant differences among both the groups except above findings. Conclusion was treatment is associated with sexual dysfunctions and HIV-risk taking behavior, which has clinical implication. Future research should explore this further using biochemical analyses.

  20. The Gay Men Sex Studies: prevalence of sexual dysfunctions in Belgian HIV(+) gay men.

    PubMed

    Vansintejan, Johan; Janssen, Joris; Van De Vijver, Erwin; Vandevoorde, Jan; Devroey, Dirk

    2013-01-01

    The aim of this Internet-based survey was to investigate the prevalence and associated predictors of sexual dysfunctions in Belgian self-reported HIV-positive men who have sex with other men. Of the 72 participants, 56% had a mild-to-severe erectile dysfunction, and 15% reported a hypoactive sexual desire disorder. The prevalence of premature ejaculation and anodyspareunia was 18% for both. Independent predictors for erectile dysfunction were frequency of masturbation, frequency of sex with partner, use of erectile enhancement drugs, having a passive sex role, and not having a steady relationship. Independent predictors for hypoactive sexual desire disorder were frequency of masturbation and having a lower lifetime number of sexual partners. Independent predictors for premature ejaculation were not having a steady relationship, having a lower lifetime number of sexual partners, and a lower level of education. The only independent predictor for anodyspareunia was having an active sex role.

  1. The Activation of Incompetence Schemas in Response to Negative Sexual Events in Heterosexual and Lesbian Women: The Moderator Role of Personality Traits and Dysfunctional Sexual Beliefs.

    PubMed

    Peixoto, Maria Manuela; Nobre, Pedro

    2017-01-06

    Personality traits and dysfunctional sexual beliefs have been described as vulnerability factors for sexual dysfunction in women, and have also been proposed as dispositional variables for the activation of incompetence schemas in response to negative sexual events. However, no study has tested the role of personality traits and dysfunctional sexual beliefs in the activation of incompetence schemas. The current study aimed to assess the moderator role of neuroticism, extraversion, and dysfunctional sexual beliefs in the association between frequency of unsuccessful sexual episodes and activation of incompetence schemas in heterosexual and lesbian women. An online survey was completed by 1,121 women (831 heterosexual; 290 lesbian). Participants completed the NEO Five-Factor Inventory (NEO-FFI), the Sexual Dysfunctional Beliefs Questionnaire-Female Version (SDBQ), and the Questionnaire of Cognitive Schemas Activated in Sexual Context (QCSASC). Findings indicate that neuroticism moderates the association between frequency of negative sexual events and activation of incompetence schemas in heterosexual women. Moreover, several sexual beliefs also act as moderators of the relationship between negative sexual episodes and the activation of cognitive schemas in both heterosexual and lesbian women. Overall, findings support the cognitive-emotional model of sexual dysfunctions, emphasizing the role of personality traits and dysfunctional sexual beliefs as facilitators of the activation of incompetence schemas in response to negative events in women.

  2. Antipsychotic-induced hyperprolactinaemia, hypogonadism and osteoporosis in the treatment of schizophrenia.

    PubMed

    O'Keane, Veronica

    2008-03-01

    Treatment of schizophrenic illness usually involves the long-term administration of antipsychotic drugs. Most antipsychotic agents antagonise the actions of endogenous dopamine (DA) at DA-2 receptors in the brain. The relative affinity for, and binding time to, DA-2 receptors was considered to be one of the key determinants of the antipsychotic potency of classical antipsychotic drugs. Some newer atypical antipsychotics, of which clozapine is the prototype, have a relatively poor affinity for DA-2 receptors; whereas other atypical antipsychotics are potent DA-2 antagonists. The propensity of antipsychotic agents to cause hyperprolactinaemia is related to their potency in antagonising DA-2 receptors on the anterior pituitary. In our studies, bone loss was consistently related to DA-2 antagonist potency of antipsychotic drugs, rather than their classification using conventional 'typical' versus 'atypical' systems. It is established that hyperprolactinaemia causes suppression of the reproductive endocrine axis and consequent bone mineral density (BMD) loss. Results from our group and others have demonstrated that a similar pathophysiological process is occurring in individuals with antipsychotic-induced hyperprolactinaemia. We found high rates of osteoporosis and osteopenia in those taking long-term antipsychotic drugs, and this was related to the dose and duration of treatment. Bone loss was associated with hypogonadism in male and female groups. Young Caucasian women appear to be particularly vulnerable to developing hyperprolactinaemia and the associated hypogonadism and bone loss. The occurrence of menstrual dysfunction should alert clinical suspicions of hyperprolactinaemia and bone de-mineralisation. Lastly, there are no published trials examining the effects of hormone replacement on BMD in those taking long-term antipsychotic drugs, but preliminary findings from our studies suggest that active management of bone loss in those with antipsychotic-associated bone

  3. Definitions of Sexual Dysfunctions in Women and Men: A Consensus Statement From the Fourth International Consultation on Sexual Medicine 2015.

    PubMed

    McCabe, Marita P; Sharlip, Ira D; Atalla, Elham; Balon, Richard; Fisher, Alessandra D; Laumann, Edward; Lee, Sun Won; Lewis, Ron; Segraves, Robert T

    2016-02-01

    Definitions of sexual dysfunctions in women and men are critical in facilitating research and enabling clinicians to communicate accurately. To present the new set of definitions of all forms of sexual dysfunction in women and men adopted by the Fourth International Consultation on Sexual Medicine (ICSM) held in 2015. Classification systems, including the International Classification of Diseases, 10th Edition and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and systems that focus on only specific types of sexual dysfunctions (e.g., the International Society for Sexual Medicine definition for premature ejaculation) were reviewed. Evidence-based definitions were retained, gaps in definitions were identified, and outdated definitions were updated or discarded. Where evidence was insufficient or absent, expert opinion was used. Some definitions were self-evident and termed clinical principles. The evidence to support the various classification systems was carefully evaluated. A more comprehensive analysis of this evidence can be found in two other articles in this journal that consider the incidence and prevalence and the risk factors for sexual dysfunction in men and women. These data were used to shape the definitions for sexual dysfunction that have been recommended by the 2015 ICSM. The definitions that have been adopted are those that are most strongly supported by the literature at this time or are considered clinical principles or consensus of experts' opinions. As more research and clinical studies are conducted, there likely will be modifications of at least some definitions. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  4. Sexual Dysfunction in Men Receiving Methadone Maintenance Treatment: Clinical History and Psychobiological Correlates.

    PubMed

    Gerra, Gilberto; Manfredini, Matteo; Somaini, Lorenzo; Maremmani, Icro; Leonardi, Claudio; Donnini, Claudia

    2016-01-01

    A variety of studies evidenced a relationship between drug use disorders and sexual dysfunction. In particular, heroin and opioid agonist medications to treat heroin dependence have been found to be associated with erectile dysfunction and reduced libido. Controversial findings also indicate the possibility of factors other than the pharmacological effects of opioid drugs concurring to sexual dysfunction. With the present study, we investigated the link between sexual dysfunction and long-term exposure to opioid receptor stimulation (heroin dependence, methadone maintenance treatment, methadone dosage), the potentially related hormonal changes reflecting hypothalamus-pituitary-gonadal axis function and prolactin (PRL) pituitary release, the role of adverse childhood experiences in the clinical history and the concomitant symptoms of comorbid mental health disorders in contributing to sexual problems. Forty male patients participating in a long-term methadone treatment program were included in the present study and compared with 40 healthy control subjects who never used drugs nor abused alcohol. All patients and controls were submitted to the Arizona Sexual Experiences Scale (ASEX), Child Experiences of Care and Abuse-Questionnaire (CECA-Q) and the Symptom Check List-90 Scale. A blood sample for testosterone and PRL assays was collected. Methadone dosages were recorded among heroin-dependent patients on maintenance treatment. Methadone patients scored significantly higher than controls on the 5-item rating ASEX scale, on CECA-Q and on Symptoms Check List 90 (SCL 90) scale. Testosterone plasma levels were significantly lower and PRL levels significantly higher in methadone patients with respect to the healthy control group. ASEX scores reflecting sexual dysfunction were directly and significantly correlated with CECA-Q neglect scores and SCL 90 psychiatric symptoms total score. The linear regression model, when applied only to addicted patients, showed that

  5. Assessment of sexual dysfunction and determination of its risk factors in the Republic of Korea.

    PubMed

    Choi, Hoon; Kim, Jae-Heon; Park, Jae-Young; Shim, Ji-Sung; Lee, Jeong-Gu; Yoon, Hae-Young; Bae, Jae-Hyun

    2014-04-01

    To assess sexual function among women via self-evaluation of female sexual dysfunction (FSD) and to determine risk factors for FSD among Korean women. A preliminary questionnaire-based study in Ansan, Korea, enrolled 935 women between January and December 2010. Participants completed the Female Sexual Function Index and a self-administered survey. Participants were divided into 2 groups: in the recognized group (RG), women were aware of their sexual problems; in the unrecognized group (URG), women were not. The prevalence of FSD was 46.1% (n=431). The prevalence of recognized FSD was 21.5% (n=201), whereas that of unrecognized FSD was 24.6% (n=230) Younger women showed a significantly more positive attitude toward sex compared with older individuals (P<0.001). Sexual desire, sexual arousal, dyspareunia, lubrication, and sexual satisfaction were factors of sexual dysfunction in the RG. In the URG, sexual arousal, sexual desire, orgasm, dyspareunia, and sexual satisfaction were identified as significant factors. Women in the RG had positive attitudes toward sex, whereas those in the URG had negative attitudes. Women who were unsatisfied with their sexual life did not express a need for treatment. The sociocultural background of Korean women should be considered in the diagnosis and treatment of FSD. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

  6. An investigation of sexual dysfunction in female partners of men with erectile dysfunction: how interviews expand on questionnaire responses.

    PubMed

    Conaglen, H M; O'Connor, E J; McCabe, M P; Conaglen, J V

    2010-01-01

    Using the Female Sexual Function Index (FSFI) for investigating female sexual function has become widespread. A score of 26.5 has been suggested as delineating 'functional' from 'dysfunctional' women. This study aimed to understand in greater detail what contributes to changes in women's FSFI scores while their partners are taking oral erectile medications for erection problems. Couples randomized to receive two erectile medications for two 3-month phases, completed questionnaires. FSFI scores were augmented by individual interviews at baseline, 3 and 6 months, in order to better understand what the scores meant in the context of ED medication use. In all, 50% of the women scored <26.5 at baseline; of these 56% recovered by 6 months. A number of 'dysfunctional' women recorded low FSFI scores solely as a result of their partner's ED. Overall, 22% were still 'dysfunctional' at 6 months, but one third of these appeared 'functional' at 3 months. A further group of women continued to record low scores despite reporting much improved sexual satisfaction. The women's interviews elaborate on their FSFI results, with five themes emerging to provide more clarity about the relative changes seen in a prospective study situation, and potentially in clinical practise contexts. The increasing use of questionnaires to determine sexual function should be supplemented with good clinical interviewing. The interview details explain how FSFI fluctuations occurred and contain clinical implications for research and practise in the area of couple's sexuality.

  7. The frequency of sexual dysfunctions in male partners of women with vaginismus in a Turkish sample.

    PubMed

    Dogan, S; Dogan, M

    2008-01-01

    The aim of this investigation is to determine the sexual history traits, sexual satisfaction level and frequency of sexual dysfunctions in men whose partners have vaginismus. The study included 32 male partners of vaginismic patients, who presented at a psychiatry department. Subjects were evaluated by a semi-structured questionnaire. The questionnaire was developed by researchers for assessing sexually dysfunctional patients and included detailed questions with regard to socio-demographic variables, general medical and sexual history. All participants also received the Golombok Rust Inventory of Sexual Satisfaction (GRISS). According to DSM-IV-TR criteria, 65.6% of the investigated males were diagnosed with one or more sexual dysfunctions. The most common problem was premature ejaculation (50%) and the second one was erectile dysfunction (28%). The transformed GRISS subscale scores provided similar data. It is concluded that the assessment of sexual functions of males who have vaginismic partners should be an integral part of the management procedure of vaginismus for optimal outcome.

  8. Sexual dysfunction in outpatients with schizophrenia in Turkey: a cross-sectional study

    PubMed Central

    HOCAOGLU, Cicek; CELIK, Fatmagul H; KANDEMIR, Gokhan; GUVELI, Hulya; BAHCECI, Bulent

    2014-01-01

    Background Sexual dysfunction is one of several factors related to medication compliance in patients taking antipsychotic medication but the magnitude of this problem is unknown. Aim Compare the self-reported sexual functioning of clinically stable patients with schizophrenia taking antipsychotic medication to that of healthy controls using the Turkish version of the 5-item Arizona Sexual Experience Scale (ASEX). This scale, which has previously been validated in Turkey, assesses 5 components of sexual function: sex drive, sexual arousal, vaginal lubrication/penile erection, ability to achieve orgasm, and satisfaction with orgasm. Methods The Scale for the Assessment of Positive Symptoms, the Scale for Assessment of Negative Symptoms, and ASEX were administered to 101 clinically stable outpatients with schizophrenia (38 females and 63 males). The ASEX was also administered to 89 control subjects (41 females and 48 males) without a history of mental illness. Respondents were classified as having sexual dysfunction if ASEX total score (range 5-30) >18, if any ASEX item score (range 1-6) ≥ 5, or if 3 or more ASEX items ≥4. Results Male patients with schizophrenia have significantly more self-reported sexual dysfunction than healthy controls (46% vs. 8%). The prevalence of sexual dysfunction is higher in female patients than in male patients (68% vs. 46%), but it was also very high in healthy female controls (68%), so the sexual dysfunction of female patients cannot be attributed to their illness or to the medications they are taking. Within the patient group, there was no significant relationship between the severity of positive or negative symptoms and the severity of sexual dysfunction, and the severity of sexual function was not different between patients taking first-generation or second-generation antipsychotic medications. Conclusions The very different findings by gender in Turkey highlights the importance of assessing location-specific and gender

  9. Methodological problems in the evaluation of drug induced sexual dysfunction for oral contraceptives.

    PubMed

    Guichoux, J Y

    1993-01-01

    Some oral contraceptive (OC) users experience sexual dysfunction. For example, recent studies on sexual dysfunction suggest that 0.5-1% of OC users experience a decreased libido, and 33% of them drop-out of the studies. Even though there are many OC users, researchers have not exerted much energy in studying sex al dysfunction. Sexuality surveys do not tend to yield reliable data. Researchers tend not to consider OCs as normal drugs. Thus, it is difficult to understand the link between adverse effects and OC use. Problems in studies of female sexuality revolve around assessment criteria. Clinical criteria related to female sexuality in the literature are usually decreased libido, vaginal dryness, and lack of orgasm. Yet, the studies rarely scale, standardize, or really validate the severity of these criteria. Various questionnaires used to assess female sexuality in OC users include well-being, sexual interest questionnaire, sex role behavior scale, sexual experience scale, and questions addressing sexual daydreaming and sexual fantasies. They tend to go beyond basic clinical parameters and raise more questions than they provide solid answers. To concretely compare OC users and nonusers, researchers need to obtain a baseline value on sexual activity 1 month before cases begin OC use. No large study with solid assessment criteria has yet included both comparable groups and placebo groups. Thus, both biases and confounding factors render the data unreliable. Perhaps the way to expand knowledge on OCs' relationship with female sexuality is to consider quality of life, i.e., sexuality as a parameter that can be improved or worsened. Standard studies and common methodology do not lend themselves to investigating OC use and female sexuality.

  10. Treatments of Female Sexual Dysfunction Symptoms during Pregnancy: A Systematic Review of the Literature.

    PubMed

    Ribeiro, Meireluci Costa; Nakamura, Mary Uchiyama; Torloni, Maria Regina; Scanavino, Marco de Tubino; do Amaral, Maria Luiza Sant'Ana; Puga, Maria Eduarda Dos Santos; Mattar, Rosiane

    2014-01-01

    There is a high prevalence of sexual dysfunction symptoms in pregnancy. These symptoms can have a negative impact on women's quality of life and affect couples' relationship. To perform a systematic review of the literature to assess the effectiveness and safety of treatments for sexual dysfunction symptoms during pregnancy. Six electronic databases (MEDLINE, EMBASE, LILACS, Cochrane CENTRAL, PSYCOINFO, and SCIRUS) were searched from inception to January 2013, without language restrictions. Five trial registers were also assessed for ongoing trials. Trials that reported any type of treatment for female sexual dysfunction symptoms during pregnancy were eligible for inclusion. Screening, data extraction and quality assessment were performed in duplicate. The main outcome was the effectiveness of different treatments for female sexual dysfunction symptoms during pregnancy. A secondary outcome was safety of proposed treatments. One thousand one hundred thirty-seven citations were retrieved, four were selected for full-text reading, and two randomized trials (159 participants) were included. One study reported a significant increase in mean total sexual function scores of 44 women in the 1st trimester of pregnancy, 4 weeks after an educative intervention (mean difference 7.0, 95% confidence interval 4.1-9.9). The second study did not detect significant differences in the sexual behavior of 71 women in the 2nd trimester of pregnancy, 12 weeks after an educational session. Results could not be pooled due to heterogeneity between the studies. Based on the findings of this review, it is not possible to make any clear and definitive recommendation regarding the effectiveness and safety of interventions used for the treatment of sexual dysfunction symptoms in pregnancy. Ribeiro MC, Nakamura MU, Torloni MR, Scanavino MT, do Amaral MLS, Puga MES, and Mattar R. Treatments of female sexual dysfunction symptoms during pregnancy: A systematic review of the literature. Sex Med Rev

  11. Sigmund Freud and his impact on our understanding of male sexual dysfunction.

    PubMed

    Hartmann, Uwe

    2009-08-01

    Sigmund Freud was one of the most influential thinkers and theorists of the 20th century. His groundbreaking work laid the foundation to many concepts and theories relevant to modern sexual medicine. To evaluate Freud's approaches to the understanding of male sexual dysfunction both in their historical context and with respect to their significance for contemporary research and therapy of sexual problems. After a brief biographical sketch, two of Freud's writings, the widely acclaimed "Three Essays on the Theory of Sexuality" from 1905, and a short article entitled "The Most Prevalent Form of Degradation in Erotic Life" from 1912, were analyzed, especially for their relevance to present treatment concepts of male sexual dysfunction. In Freud's clinical practice "psychical impotence" was a highly prevalent complaint. In his view, this dysfunction was caused by an inhibition due to an unresolved neurotic fixation leading to an arrest of the libidinal development. The result is a splitting of the tender and the sensual dimension of sexuality, most notably in the so-called madonna-whore complex. The degree of this dissociation (total or partial) determines the severity of the ensuing sexual dysfunction. In Freud's rather pessimistic view, the erotic life of civilized people tends to be characterized by some degree of this condition. While some of Freud's theories are obsolete today, many parts of his work appear to be astonishingly modern, even in the light of current neurobiological research and recent models of sexual dysfunction. Above all, Freud was an extremely gifted observer of human behavior who shows us that in many cases, sexual dysfunctions are no isolated phenomena, but have their roots in biographically based intrapsychic or interpersonal conflicts.

  12. The impact of frequently encountered cardiovascular risk factors on sexual dysfunction in rheumatic disorders.

    PubMed

    Anyfanti, P; Pyrpasopoulou, A; Triantafyllou, A; Doumas, M; Gavriilaki, E; Triantafyllou, G; Gkaliagkousi, E; Chatzimichailidou, S; Petidis, K; Avagianou, P-A; Zamboulis, C; Aslanidis, S; Douma, S

    2013-07-01

    Traditional cardiovascular risk factors have been acknowledged as major contributors to sexual dysfunction in the general population. The purpose of this study was to explore their impact on sexual function in rheumatologic patients. A total of 557 consecutive rheumatologic patients, 449 females and 108 males, had their sexual function evaluated with the Female Sexual Functioning Index (FSFI) and the International Index of Erectile Function (IIEF) questionnaire respectively. Personal data regarding presence of cardiovascular risk factors were collected and analysed in association with the FSFI and IIEF scores. Mean age of the participants was 54.1 ± 14.1 years, mean body mass index was 27.5 ± 5.29 and mean systolic and diastolic blood pressure was 130.5 ± 19.82 and 79.5 ± 10.51 mmHg respectively. Hypertension was present in 39% of the participants, diabetes mellitus in 10.2%, dyslipidaemia in 33.6% and history of cardiovascular events in 8.6%, whereas smoking was recorded by 28.4% and alcohol consumption by 7.4%. Sexual dysfunction affected 68.6% of our study population (73.5% of females and 48.1% of males, p < 0.001). Logistic regression analysis revealed that age was the only factor associated with a significantly higher prevalence of sexual dysfunction (p < 0.001 for both genders, p = 0.013 in males and p < 0.001 in females). Increased age was identified as the only independent predictor of sexual dysfunction in our population. Apart from age, traditional cardiovascular risk factors failed to explain the increased prevalence of sexual dysfunction in these patients. Other contributing factors (physical and/or psychological) might account for the increased occurrence of sexual dysfunction in rheumatic disorders.

  13. Risk Factors for Sexual Dysfunction Among Women and Men: A Consensus Statement From the Fourth International Consultation on Sexual Medicine 2015.

    PubMed

    McCabe, Marita P; Sharlip, Ira D; Lewis, Ron; Atalla, Elham; Balon, Richard; Fisher, Alessandra D; Laumann, Edward; Lee, Sun Won; Segraves, Robert T

    2016-02-01

    This article presents a review of previous research concerning risk factors for sexual dysfunction in women and men. The aim is to evaluate past research studies to determine the contribution of all risk factors to the development and maintenance of sexual dysfunction among women and men. Studies were organized under a biopsychosocial framework, with the bulk of studies of women and men having investigated the role of biological factors. The outcome measures were the data on factors for sexual dysfunction. Many more studies investigated risk factors for sexual dysfunction in men than in women. For women and men, diabetes, heart disease, urinary tract disorders, and chronic illness were significant risk factors for sexual dysfunction. Depression and anxiety and the medications used to treat these disorders also were risk factors for sexual dysfunction in women and men. In addition, substance abuse was associated with sexual dysfunction. Many other social and cultural factors were related to sexual dysfunction in women and men. Psychosocial factors are clearly risk factors for sexual dysfunction. Women and men with sexual dysfunction should be offered psychosocial evaluation and treatment, if available, in addition to medical evaluation and treatment. The impact of social and cultural factors on sexual function requires substantially more research. The evidence that erectile dysfunction is a harbinger of other forms of cardiovascular disease is strong enough to recommend that clinical evaluation for occult cardiovascular disease should be undertaken in men who do not have known cardiovascular disease but who develop organic erectile dysfunction, especially in men younger than 70 years. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  14. Orgasmic dysfunction

    MedlinePlus

    Inhibited sexual excitement; Sex - orgasmic dysfunction; Anorgasmia; Sexual dysfunction - orgasmic; Sexual problem - orgasmic ... of knowledge about sexual function Negative feelings about sex (often learned in childhood or teen years) Shyness ...

  15. Androgens and Female Sexual Function and Dysfunction--Findings From the Fourth International Consultation of Sexual Medicine.

    PubMed

    Davis, Susan R; Worsley, Roisin; Miller, Karen K; Parish, Sharon J; Santoro, Nanette

    2016-02-01

    Androgens have been implicated as important for female sexual function and dysfunction. To review the role of androgens in the physiology and pathophysiology of female sexual functioning and the evidence for efficacy of androgen therapy for female sexual dysfunction (FSD). We searched the literature using online databases for studies pertaining to androgens and female sexual function. Major reviews were included and their findings were summarized to avoid replicating their content. Quality of data published in the literature and recommendations were based on the GRADES system. The literature supports an important role for androgens in female sexual function. There is no blood androgen level below which women can be classified as having androgen deficiency. Clinical trials have consistently demonstrated that transdermal testosterone (T) therapy improves sexual function and sexual satisfaction in women who have been assessed as having hypoactive sexual desire disorder. The use of T therapy is limited by the lack of approved formulations for women and long-term safety data. Most studies do not support the use of systemic dehydroepiandrosterone therapy for the treatment of FSD in women with normally functioning adrenals or adrenal insufficiency. Studies evaluating the efficacy and safety of vaginal testosterone and dehydroepiandrosterone for the treatment of vulvovaginal atrophy are ongoing. Available data support an important role of androgens in female sexual function and dysfunction and efficacy of transdermal T therapy for the treatment of some women with FSD. Approved T formulations for women are generally unavailable. In consequence, the prescribing of T mostly involves off-label use of T products formulated for men and individually compounded T formulations. Long-term studies to determine the safety of T therapy for women and possible benefits beyond that of sexual function are greatly needed. Copyright © 2016. Published by Elsevier Inc.

  16. Prevalence of sexual dysfunctions and other sexual disorders in adults with attention-deficit/hyperactivity disorder compared to the general population.

    PubMed

    Bijlenga, D; Vroege, J A; Stammen, A J M; Breuk, M; Boonstra, A M; van der Rhee, K; Kooij, J J S

    2017-08-22

    Attention-deficit/hyperactivity disorder (ADHD) is characterized by symptoms of inattention and/or hyperactivity and impulsivity that lead to dysfunctioning in daily life. One of the affected areas of life that has so far not been studied in ADHD is sexual functioning. The goal of this study was to assess prevalence of sexual dysfunctions and other sexual disorders among adults with ADHD. A total of n = 136 adult patients treated in a Dutch outpatient ADHD clinic filled out two questionnaires to screen for sexual dysfunctions and other sexual disorders. We compared the prevalence of sexual dysfunctions and other sexual disorders in our ADHD patient population to results from two large surveys among the general Dutch population. We found that 39% of the male and 43% of the female ADHD patients had symptoms of a sexual dysfunction, and 17% of the male and 5% of the female ADHD patients had symptoms of any other sexual disorder. Only one male patient had received a diagnosis of a sexual disorder at this clinic prior to study participation. In conclusion, sexual dysfunctions and other sexual disorders are highly prevalent in adults with ADHD. Screening for sexual disorders should be therefore standard procedure during diagnostic assessment.

  17. Does post-traumatic stress disorder carry a higher risk of sexual dysfunctions?

    PubMed

    Arbanas, Goran

    2010-05-01

    Previous studies have shown that patients with post-traumatic stress disorder (PTSD) have a higher incidence of sexual dysfunction. However, such studies have not examined the influence of traumatic experience on sexual dysfunction. This study was conducted to compare various components of sexual functioning among five groups of males: (i) untreated patients with PTSD; (ii) patients with PTSD treated with selective serotonin reuptake inhibitors (SSRIs); (iii) untreated patients with subthreshold PTSD symptoms; (iv) patients with subthreshold PTSD symptoms treated with SSRIs; and (v) subjects who had suffered a traumatic experience but presented no mental disorder. All participants were evaluated using the Clinician-Administered PTSD Scale, the Minnesota Multiphasic Personality Inventory, the Structured Clinical Interview, and the International Index of Erectile Function. Results on individual subscales of the International Index of Erectile Function in men with PTSD symptoms and subthreshold PTSD symptoms, treated and untreated. Patients with PTSD did not differ from patients with subthreshold PTSD symptoms in any of the domains of sexual functioning. Differences were found between this group and subjects with no mental disorder only in the domain of sexual desire. Patients with subthreshold PTSD symptoms treated with SSRIs showed better results in all domains of sexual functioning in comparison with those treated with PTSD. The results show that patients who suffered a traumatic experience have the same level of sexual functioning (or the same incidence of sexual dysfunction) regardless of the severity of PTSD. Treatment with SSRIs helps reduce sexual problems in patients with subthreshold PTSD symptoms.

  18. The association of sexual dysfunction and substance use among a community epidemiological sample.

    PubMed

    Johnson, Sharon D; Phelps, Deborah L; Cottler, Linda B

    2004-02-01

    This study examines the prevalence of DSM-III sexual dysfunctions and their association with comorbid drug and alcohol use in a community epidemiologic sample. The data for these analyses are based on the Epidemiological Catchment Area Project, a multistage probability study of the incidence and prevalence of psychiatric disorders in the general population conducted in 1981-83. Only the sample of 3,004 adult community residents in the St. Louis area was queried on DSM-III sexual dysfunctions of inhibited orgasm, functional dyspareunia (painful sex), inhibited sexual excitement (i.e., lack of erection/arousal), and inhibited sexual desire. There was a prevalence rate of 11% for inhibited orgasm, 13% for painful sex, 5% for inhibited sexual excitement, 7% for inhibited sexual desire, and 26% for any of these sexual dysfunctions (14% for men and 33% for women). The prevalence of qualifying lifetime substance use among the population was 37%, with males meeting more drug and alcohol use criteria than females. After controlling for demographics, health status variables, and psychiatric comorbidity (depression disorder, generalized anxiety disorder, antisocial personality disorder, and residual disorders), inhibited orgasm was associated with marijuana and alcohol use. Painful sex was associated with illicit drug use and marijuana use. Inhibited sexual excitement was more likely among illicit drug users. Inhibited sexual desire was not associated with drug or alcohol use.

  19. Animal models of female sexual dysfunction: basic considerations on drugs, arousal, motivation and behavior.

    PubMed

    Ågmo, Anders

    2014-06-01

    Female sexual dysfunctions are a heterogeneous group of symptoms with unknown but probably varying etiology. Social factors may contribute both to the prevalence and to the origin of these dysfunctions. The present review focuses on female hypoactive sexual desire disorder, sexual arousal disorder and orgasmic disorder. These disorders are generally the most common, according to epidemiological studies, and they can all be considered as disorders of motivation. An incentive motivational model of sexual behavior, applicable to humans as well as to non-human animals, is described and the dysfunctions placed into the context of this model. It is shown that endocrine alterations as well as observable alterations in neurotransmitter activity are unlikely causes of the disorders. A potential role of learning is stressed. Nevertheless, the role of some transmitters in female rodent sexual behavior is analyzed, and compared to data from women, whenever such data are available. The conclusion is that there is no direct coincidence between effects on rodent copulatory behavior and sexual behavior in women. Based on these and other considerations, it is suggested that sexual approach behaviors rather than copulatory reflexes in rodents might be of some relevance for human sexual behavior, and perhaps even for predicting the effects of interventions, perhaps even the effects of drugs. Female copulatory behaviors, including the proceptive behaviors, are less appropriate. The common sexual dysfunctions in women are not problems with the performance of copulatory acts, but with the desire for such acts, by feeling aroused by such acts and experiencing the pleasure expected to be caused by such acts. Finally, it is questioned whether female sexual dysfunctions are appropriate targets for pharmacological treatment.

  20. Finger and penile tactile sensitivity in sexually functional and dysfunctional diabetic men.

    PubMed

    Morrissette, D L; Goldstein, M K; Raskin, D B; Rowland, D L

    1999-03-01

    Tactile sensitivity of the penis is related to sexual functioning, however its role in diabetic erectile problems is unclear. We evaluated penile sensitivity in 10 diabetic men with erectile dysfunction, 17 sexually functional diabetic men and 14 control subjects. Finger and penile thresholds and ratings of intensity and pleasantness for finger and penis were assessed using vibrotactile stimulation. Glycosylated haemoglobin and total and bioavailable testosterone measurements were determined and subjects completed self-reports on sexual function. Diabetic men with erectile problems had higher values of glycosylated haemoglobin than sexually functional diabetic men (p = 0.02) and both groups had lower bioavailable testosterone than control subjects (p< or =0.05). Sexually dysfunctional diabetic men had a higher finger threshold than the other two groups (p<0.01). Penile threshold for the sexually dysfunctional group was also marginally higher compared with the functional diabetic group (p<0.052) but did not differ from control subjects (p = 0.09). Diabetic men with erectile dysfunction exhibited different response patterns than sexually functional men on dimensions of intensity and pleasantness to penile stimulation. Although these data do not directly implicate subjective response to penile stimulation in diabetic erectile problems, they suggest such anomalous response could be one contributing factor.

  1. How Did Erectile Dysfunction Become "Natural"? A Review of the Critical Social Scientific Literature on Medical Treatment for Male Sexual Dysfunction.

    PubMed

    Wentzell, Emily

    2017-01-06

    This article reviews the multidisciplinary social science literature assessing the social consequences of medical treatment for male sexual dysfunction. This literature applies medicalization theory and social constructionist approaches to gender to assert that Euro-American cultural ideals of masculinity and sexuality, as well as ageism and ableism, determine which sexual changes and experiences get defined as "dysfunction" and shape the marketing and use of medical treatments for those changes. These medical responses assuage the suffering of men who become unable to meet cultural ideals for sexuality but in the process make reductive norms for male sexuality seem biologically natural. In addition, the critical social science research suggests that an economic logic underlies the process of redefining diversity and change in men's sexual function as medical pathology. However, comparative qualitative data on men's and their sexual partners' experiences of sexuality and aging across world regions suggest that people do not universally accept the narrow ideals of male sexuality embedded in medical discourse regarding men's sexual dysfunction. The diversity in people's sexual desires across the life course and their responses to sexual function change highlight the cultural nature of medical definitions of sexual dysfunction.

  2. Antidepressant-induced sexual dysfunction during treatment with fluoxetine, sertraline and trazodone; a randomized controlled trial.

    PubMed

    Khazaie, Habibolah; Rezaie, Leeba; Rezaei Payam, Nastarn; Najafi, Farid

    2015-01-01

    Selective serotonin reuptake inhibitors (SSRIs) are common treatments for patients with major depressive disorder (MDD). However, adverse effects of SSRIs on sexual function are common in the treatment of patients with MDD. There is a discrepancy in the reported frequency of SSRI-induced sexual dysfunction. On the other hand, there is also less evidence about sexual dysfunction with serotonin receptor antagonists and reuptake inhibitors (SARIs). Therefore, we aimed to assess sexual dysfunction in MDD patients who received fluoxetine, sertraline and trazodone. In a single-blind, randomized, controlled trial in Kermanshah, Iran, during 2009-2010, 195 patients who met the DSMIV-IR criteria for MDD were enrolled. The patients completed the Hamilton Depression Rating Scale (HAM-D) and the sexual function questionnaire (SFQ). Eligible patients were allocated in three treatment groups (receiving fluoxetine, sertraline or trazodone) for 14 weeks randomly. Measurement of HAMD was repeated in 4-week interval. Analysis for comparing sexual dysfunction among three groups and men and women was performed. There were 102 men and 93 women in the three groups receiving fluoxetine (n=64), sertraline (n=67) and trazodone (n=64). There was no significant difference in the sexual dysfunction of the patients in the three groups at baseline (P>.05). After treatment, both men and women who had received fluoxetine had the most impairment in desire/drive items (43%-51% and 44%-50%, respectively), while patients receiving trazodone had the least impairment in these items (12%-18% and 23%-24%, respectively). Trazodone was also induced with a lower rate of impairment in arousal/orgasm items in men (9%-15%) compared with the other two drugs. Compared with fluoxetine and trazodone, sertraline was associated with intermediate impairment in sexual function (39%-42% in desire/drive items and 32%-39% in arousal/orgasm items) that was lower than that with fluoxetine and more than that with trazodone

  3. Serotonin reuptake inhibitor-induced sexual dysfunction and its treatment: a large-scale retrospective study of 596 psychiatric outpatients.

    PubMed

    Keller Ashton, A; Hamer, R; Rosen, R C

    1997-01-01

    In the present study, a large-scale retrospective case review was undertaken to assess the incidence and type of sexual dysfunctions associated with serotonin reuptake inhibitor (SRI) therapy, in addition to the effects of three pharmacological antidotes (yohimbine, amantadine, cyproheptadine) on SRI-induced sexual dysfunctions. A retrospective chart review was conducted on 596 patients treated with SRIs in an outpatient psychiatric practice between July 1991 and September 1994. Patients who reported new-onset sexual dysfunction during this time were categorized as having SRI-induced sexual dysfunctions. Sexual difficulties were characterized by type and duration, and the background characteristics and psychiatric diagnoses of all patients were recorded. Psychiatric outcome and sexual functioning at follow-up were independently assessed by a single psychiatrist by means of a 4-point rating scale. Sexual dysfunction symptoms were clearly associated with SRI administration in 97 (16.3%) cases. The most common problems reported were orgasmic delay or anorgasmia and hypoactive sexual desire. Sexual difficulties were more frequent among men (23.4%) and married patients of both sexes (22.3%), whereas psychiatric diagnosis and type of SRI were unrelated to the occurrence of sexual problems. Of the patients with sexual dysfunction, 45 (46.4%) opted for a trial of antidote therapy with yohimbine, amantadine, or cyproheptadine. All three antidotes were found to be safe and relatively effective, although yohimbine was significantly more effective than amantadine or cyproheptadine in reversing SRI-induced sexual dysfunction.

  4. [Sexual dysfunction secondary to SSRIs. A comparative analysis in 308 patients].

    PubMed

    Montejo, A I; Llorca, G; Izquierdo, J A; Ledesma, A; Bousoño, M; Calcedo, A; Carrasco, J L; Daniel, E; de Dios, A; de la Gándara, J; Derecho, J; Franco, M; Gómez, M J; Macías, J A; Martín, T; Pérez, V; Sánchez, J M; Sánchez, S; Vicens, E

    1996-01-01

    The authors analyze the incidence of sexual dysfunction (SD) with different SSRIs (Fluoxetine, Fluvoxamine, Paroxetine and Sertraline) and hence the qualitative and quantitative changes in SD throughout time 308 outpatients (169 women, 139 men; mean +/- SD age = 41 +/- 7) under treatment with SSRIs were interviewed with an SD questionnaire designed for this purpose by the authors including questions about the following items decreased libido, delayed orgasm or anorgasmia, delayed ejaculation inability to ejaculation, impotence and general sexual satisfaction. Patients with the following criteria were included: normal sexual function before SSRIs intake, exclusive treatment with SSRIs or associated with benzodiazepines, previous heterosexual or self-orone current sexual practices. We excluded patients with previous sexual dysfunction, association of SSRIs with neuroleptics, recently hormone intake and significant medical illnesses. There is a significant increase in the incidence of SD when the physicians ask the patients direct questions (55.29%) versus spontaneous SD reported (14.2%). There are some significant differences among different SSRIs paroxetine provoked more delay of orgasm/ejaculation and more impotence than fluvoxamine, fluoxetine and sertraline (Chi square p < 0.05). Only 22.6% of the patients had a good tolerance about their sexual dysfunction. SD has positive correlation with the dose. The patients experienced substantial improvement in sexual function when the dose was diminished or the drug was withdrawn. Men showed more incidence of sexual dysfunction than women but women's sexual dysfunction was more intense than men. Seven of nine patients (77.7%) experienced total improvement when the treatment was changed to Moclobemide (450 mg/day) and two of four patients (50%) improved when treatment was changed to Amineptine.

  5. Self-limiting Atypical Antipsychotics-induced Edema: Clinical Cases and Systematic Review

    PubMed Central

    Umar, Musa Usman; Abdullahi, Aminu Taura

    2016-01-01

    A number of atypical antipsychotics have been associated with peripheral edema. The exact cause is not known. We report two cases of olanzapine-induced edema and a brief review of atypical antipsychotic-induced edema, possible risk factors, etiology, and clinical features. The recommendation is given on different methods of managing this side effect. PMID:27335511

  6. Loxapine for Reversal of Antipsychotic-Induced Metabolic Disturbances: A Chart Review

    ERIC Educational Resources Information Center

    Jain, Seema; Andridge, Rebecca; Hellings, Jessica A.

    2016-01-01

    Loxapine substitution is a promising option for patients with autism spectrum disorder (ASD) who develop antipsychotic-induced metabolic illness. We performed a chart review of 15 adolescents and adults meeting DSM-IV-TR criteria for ASD, all with antipsychotic-associated weight gain, who received low dose loxapine in an attempt to taper or…

  7. Brief Report: Metformin for Antipsychotic-Induced Weight Gain in Youth with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Wink, Logan K.; Adams, Ryan; Pedapati, Ernest V.; Dominick, Kelli C.; Fox, Emma; Buck, Catherine; Erickson, Craig A.

    2017-01-01

    Antipsychotic treatment in youth with autism spectrum disorder (ASD) is becoming increasingly common, placing individuals at risk for antipsychotic-induced weight gain and associated complications. Metformin hydrochloride, a biguanide medication FDA-approved for treatment of type-2 diabetes in youth, may hold promise for treatment of…

  8. Loxapine for Reversal of Antipsychotic-Induced Metabolic Disturbances: A Chart Review

    ERIC Educational Resources Information Center

    Jain, Seema; Andridge, Rebecca; Hellings, Jessica A.

    2016-01-01

    Loxapine substitution is a promising option for patients with autism spectrum disorder (ASD) who develop antipsychotic-induced metabolic illness. We performed a chart review of 15 adolescents and adults meeting DSM-IV-TR criteria for ASD, all with antipsychotic-associated weight gain, who received low dose loxapine in an attempt to taper or…

  9. Treatment of sexual dysfunctions in male-only groups: predicting outcome.

    PubMed

    Dekker, J; Dronkers, J; Staffeleu, J

    1985-01-01

    Forty men complaining of sexual dysfunctions were treated in male-only groups, using RET, masturbation exercises and social skills training. Sexual functioning improved and social anxiety decreased. Combining these data with previously reported data on 21 men, we tried to predict treatment outcome. Sexual functioning of men with a steady partner and men with varying partners improved; in men without partner(s) no effect could be demonstrated, probably due to a methodological artifact. Inhibited sexual desire was associated with a poor outcome. Several other variables (among them type of dysfunction, social anxiety, age, educational level) did not predict improvement of sexual functioning. This method seems to provide adequate treatment for various complaints of men with quite different backgrounds.

  10. Sexual dysfunction in patients with polycystic ovary syndrome and its affected domains

    PubMed Central

    Eftekhar, Tahereh; Sohrabvand, Farnaz; Zabandan, Neda; Shariat, Mamak; Haghollahi, Fedyeh; Ghahghaei-Nezamabadi, Akram

    2014-01-01

    Background: Polycystic Ovary Syndrome (PCOS) is presented with characteristic complications such as chronic an ovulation, obesity, and hyperandrogenism which can affect sexual function in women of reproductive age. Objective: Herein we evaluated the frequency and predisposing factors of sexual dysfunction in infertile PCOS patients. Materials and Methods: In this cross-sectional study, 130 married women with a definite diagnosis of PCOS who were referred due to infertility were recruited. They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire. Results: The frequency of sexual dysfunction was verified 57.7% in PCOS patients with the domains of desire and arousal being commonly affected in 99.2% and 98.5%of cases respectively. BMI had a significant effect on sexual desire and arousal (p=0.02) while the effect of hirsutism was significant on all domains (p<0.001 for total FSFI score) except for dyspareunia. Conclusion: PCOS patients markedly suffer from sexual dysfunction as comorbidity. It seems appropriate to screen all PCOS patients for sexual function with a simple short questionnaire such as FSFI. Targeted interventions could be considered to help improve their quality of life along with other treatments. PMID:25408703

  11. The relationship between childhood sexual/physical abuse and sexual dysfunction in patients with social anxiety disorder.

    PubMed

    Tekin, Atilla; Meriç, Ceren; Sağbilge, Ezgi; Kenar, Jülide; Yayla, Sinan; Özer, Ömer Akil; Karamustafalioğlu, Oğuz

    2016-01-01

    Childhood traumatic events are known as developmental factors for various psychiatric disorders. The aim of this study was to investigate the effects of childhood sexual and physical abuse (CSA/CPA), and co-morbid depression on sexual functions in patients with social anxiety disorder (SAD). Data obtained from 113 SAD patients was analysed. Childhood traumatic experiences were evaluated using the Childhood Trauma Questionnaire, and the Arizona Sexual Experience Scale was used for the evaluation of the sexual functions. The data from interviews performed with SCID-I were used for determination of Axis I diagnosis. The Beck Anxiety Scale, Beck Depression Scale and Liebowitz Social Anxiety Scale were administered to each patient. History of childhood physical abuse (CPA) was present in 45.1% of the SAD patients, and 14.2% had a history of childhood sexual abuse (CSA). Depression co-diagnosis was present in 30.1% of SAD patients and 36.3% had sexual dysfunction. History of CSA and depression co-diagnosis were determined as two strong predictors in SAD patients (odds ratio (OR) for CSA, 7.83; 95% CI, 1.97-31.11; p = 0.003 and OR for depression, 3.66; 95% CI, 1.47-9.13; p = 0.005). CSA and depression should be considered and questioned as an important factor for SAD patients who suffer from sexual dysfunction.

  12. [Sexual complaints and dysfunction among PLHIV receiving ARV treatment for ten years in Senegal].

    PubMed

    Diaw, J; Taverne, B; Coutherut, J

    2014-10-01

    The sexual health of people who have been living with HIV (PLHIV) and who have been receiving ARV drug treatment for several years is still a virtually unexplored topic in Africa today. A study was conducted in Senegal on people who have been treated with ARVs for ten years. Half of those interviewed believe that their sexuality has deteriorated. HIV infection has become a chronic disease in which sexual dysfunction related to the disease or age is interpreted in the context of popular representations of HIV infection and those on sexuality defined by social norms.

  13. Anatomy and physiology of female sexual function and dysfunction: classification, evaluation and treatment options.

    PubMed

    Berman, J R; Adhikari, S P; Goldstein, I

    2000-07-01

    Female sexual dysfunction is a significant age-related, progressive and highly prevalent problem that affects a substantial number of women in the United States. The female sexual response cycle is initiated by neurotransmitter-mediated vascular and nonvascular smooth muscle relaxation resulting in increased pelvic blood flow, vaginal lubrication, and clitoral and labial engorgement. These mechanisms are mediated by a combination of neuromuscular and vasocongestive events. Physiological impairments that interfere with the normal female sexual response bring about complaints associated with diminished sexual arousal, libido, vaginal lubrication, genital sensation, and ability to achieve orgasm. Therapy aimed at restoring hormone levels as well as genital blood flow will be discussed.

  14. Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015.

    PubMed

    McCabe, Marita P; Sharlip, Ira D; Lewis, Ron; Atalla, Elham; Balon, Richard; Fisher, Alessandra D; Laumann, Edward; Lee, Sun Won; Segraves, Robert T

    2016-02-01

    The incidence and prevalence of various sexual dysfunctions in women and men are important to understand to designate priorities for epidemiologic and clinical research. This manuscript was designed to conduct a review of the literature to determine the incidence and prevalence of sexual dysfunction in women and men. Members of Committee 1 of the Fourth International Consultation on Sexual Medicine (2015) searched and reviewed epidemiologic literature on the incidence and prevalence of sexual dysfunctions. Key older studies and most studies published after 2009 were included in the text of this article. The outcome measures were the reports in the various studies of the incidence and prevalence of sexual dysfunction among women and men. There are more studies on incidence and prevalence for men than for women and many more studies on prevalence than incidence for women and men. The data indicate that the most frequent sexual dysfunctions for women are desire and arousal dysfunctions. In addition, there is a large proportion of women who experience multiple sexual dysfunctions. For men, premature ejaculation and erectile dysfunction are the most common sexual dysfunctions, with less comorbidity across sexual dysfunctions for men compared with women. These data need to be treated with caution, because there is a high level of variability across studies caused by methodologic differences in the instruments used to assess presence of sexual dysfunction, ages of samples, nature of samples, methodology used to gather the data, and cultural differences. Future research needs to use well-validated tools to gather data and ensure that the data collection strategy is clearly described. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  15. Sexual dysfunction in dialysis patients: does vitamin D deficiency have a role?

    PubMed

    Kidir, Veysel; Altuntas, Atila; Inal, Salih; Akpinar, Abdullah; Orhan, Hikmet; Sezer, Mehmet Tugrul

    2015-01-01

    Sexual dysfunction and vitamin D deficiency are highly prevalent in dialysis patients. Low levels of vitamin D have been linked to many diseases. To the best of our knowledge, the relationship between vitamin D and sexual dysfunction in dialysis patients has not been previously reported in the literature. Cholecalciferol, 50,000 IU/week, was orally administered to 37 dialysis patients with vitamin D insufficiency for 3 months followed by dosage of 10,000 IU every other week for 3 months. The Arizona Sexual Experiences Scale (ASEX), Hospital Anxiety and Depression Scale and Pittsburgh Sleep Quality Index questionnaires were filled out by all patients at baseline and at the sixth month of the study. Sexual dysfunction, poor sleep quality, anxiety and depression rates were 83.7%, 45.9%, 18.9% and 48.6%, respectively in all patients. ASEX total score was found to be positively correlated with age and was negatively correlated with serum 25(OH)D level and serum albumin level. After cholecalciferol treatment, 25(OH)D levels increased significantly, however no significant change was observed in any of the parameters. In multivariate linear regression analysis, age and 25(OH)D level were found to be independent predictors of ASEX total score. Vitamin D deficiency seems to contribute to sexual dysfunction in dialysis patients. However, it was observed in this study that; cholecalciferol replacement given to dialysis patients with vitamin D insufficiency did not result in any significant changes in sexual functions.

  16. A Multidimensional Comparison of Maritally and Sexually Dysfunctioned Couples.

    ERIC Educational Resources Information Center

    Berg, Phyllis; Snyder, Douglas K.

    The Marital Satisfaction Inventory (MSI) is a potential instrument for differentiating couples with specific sexual distress from those with more general marital complaints. Couples (N=45) expressing primary complaints of dissatisfaction with their sexual relationship and couples (N=45) expressing primary complaints of generalized marital distress…

  17. A Multidisciplinary Approach to Sexual Dysfunction in Medical Education

    ERIC Educational Resources Information Center

    Foley, Sallie; Wittmann, Daniela; Balon, Richard

    2010-01-01

    Objective: Addressing sexual health concerns in medical practice has been an emerging concept for the past two decades. However, there have been very few educational opportunities in medical training that would prepare future physicians for such a responsibility. Since assessing and treating sexual problems requires knowledge that encompasses many…

  18. Sexual dysfunctions and psychological disorders associated with type IIIa chronic prostatitis: a clinical survey in China.

    PubMed

    Mo, Mu-Qiong; Long, Ling-Li; Xie, Wen-Lin; Chen, Sai; Zhang, Wen-Hui; Luo, Can-Qiao; Deng, Li-Wen

    2014-12-01

    Chronic prostatitis (CP) is a frequent prostate-related complaint, impacts negatively on quality of life and is mostly of unclear etiology. Increasing attention has been paid to the prevalence of sexual dysfunctions in CP patients; however, the impact of specific types of CP and the correlation of sexual dysfunctions with psychological disorders associated with CP are not well understood. Type IIIa CP is characterized by chronic pelvic pain, urination symptoms and white blood cells in expressed prostatic secretion, but free of bacterial infection. A population of 600 type IIIa CP patients were randomly selected and 40 normal man were included as the control group. Queries were conducted by urologists. The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Index of Erectile Function (IIEF-5) and the Symptom Checklist 90-R were used to evaluate the symptoms and severity of prostatitis, erectile dysfunctions and psychological problems, respectively. Scores of ejaculatory pain and premature ejaculation were also collected. Our study revealed that sexual dysfunctions are frequently associated with this specific type of CP. The prevalence of erectile dysfunction, premature ejaculation and ejaculatory pain was 19, 30 and 30 %, respectively. A variety of psychological problems exist among type IIIa CP patients, including depression, anxiety, somatization, obsessive-compulsive and interpersonal sensitivity. In particular, the severity of erectile dysfunctions, but not premature ejaculation and ejaculatory pain, correlated significantly with depression and anxiety. Our data indicate that a moderate level of sexual dysfunctions exists among the type IIIa CP patients, and highlight the association of depression and anxiety with erectile dysfunction in CP patients, suggestting that special attention should be paid to these psychological issues in clinical treatments of the prostatitis symptoms and the associated erectile dysfunctions.

  19. Behavior and Symptom Change Among Women Treated with Placebo for Sexual Dysfunction

    PubMed Central

    Bradford, Andrea; Meston, Cindy M.

    2011-01-01

    Introduction In clinical trials of drug treatments for women’s sexual dysfunction, placebo responses have often been substantial. However, little is known about the clinical significance, specificity, predictors, and potential mechanisms of placebo response in sexual dysfunction. Aim We aimed to determine the nature and predictors of sexual function outcomes in women treated with placebo for female sexual arousal disorder (FSAD). Methods We conducted a secondary analysis of data from the placebo arm of a 12-week, multisite, randomized controlled pharmaceutical trial for FSAD (N = 50). We analyzed the magnitude, domain specificity, and clinical significance of sexual function scores at baseline, 4, 8, and 12 weeks (post-treatment). We examined longitudinal change in sexual function outcomes as a function of several baseline variables (e.g., age, symptom-related distress) and in relation to changes in sexual behavior frequency during the trial. Main Outcome Measure Female Sexual Function Index total score. Results The magnitude of change at post-treatment was clinically significant in approximately one-third of placebo recipients. Effect sizes were similar across multiple aspects of sexual function. Symptom improvement was strongly related to the frequency of satisfying sexual encounters during treatment. However, the relationship between sexual encounter frequency and outcome varied significantly between participants. Conclusions A substantial number of women experienced clinically significant improvement in sexual function during treatment with placebo. Changes in sexual behavior during the trial, more so than participant age or symptom severity at baseline, appeared to be an important determinant of outcome. Contextual and procedural aspects of the clinical trial may have influenced outcomes in the absence of an active drug treatment. PMID:20849412

  20. Subjective quality of life and sexual dysfunction in outpatients with schizophrenia or schizoaffective disorder.

    PubMed

    Bushong, Mark E; Nakonezny, Paul A; Byerly, Matthew J

    2013-01-01

    The objective of this research was to examine the association between sexual dysfunction and subjective quality of life in outpatients with schizophrenia and schizoaffective disorder. The authors evaluated a sample of 238 adult outpatients with diagnoses of schizophrenia or schizoaffective disorder who took quetiapine, olanzapine, or risperidone at study entry with a 1-time rating of the Arizona Sexual Experience Scale and the general life satisfaction scale item of the quality of life index. The authors used multiple linear robust regression and Spearman partial correlation coefficient to examine the relation between subjective quality of life (measured by the general life satisfaction scale item) and sexual functioning (measured by the Arizona sexual experience scale). The authors found a significant negative linear relation between the Arizona Sexual Experience Scale total score and the general life satisfaction scale item for the overall sample (r(s) = -0.16, p = .01), but not separately for men or women. Sexual dysfunction in men and women with schizophrenia and schizoaffective disorder is associated with decreased subjective quality of life, although the magnitude of the effect size was relatively small. Improving clinicians' awareness of the importance of sexual dysfunction in patients may improve tolerability and subsequent treatment outcomes.

  1. Ethical and Sociocultural Aspects of Sexual Function and Dysfunction in Both Sexes.

    PubMed

    Atallah, Sandrine; Johnson-Agbakwu, Crista; Rosenbaum, Talli; Abdo, Carmita; Byers, E Sandra; Graham, Cynthia; Nobre, Pedro; Wylie, Kevan; Brotto, Lori

    2016-04-01

    This study aimed to highlight the salient sociocultural factors contributing to sexual health and dysfunction and to offer recommendations for culturally sensitive clinical management and research as well for an ethically sound sexual health care, counseling and medical decision-making. There are limited data on the impact of sociocultural factors on male and female sexual function as well as on ethical principles to follow when clinical care falls outside of traditional realms of medically indicated interventions. This study reviewed the current literature on sociocultural and ethical considerations with regard to male and female sexual dysfunction as well as cultural and cosmetic female and male genital modification procedures. It is recommended that clinicians evaluate their patients and their partners in the context of culture and assess distressing sexual symptoms regardless of whether they are a recognized dysfunction. Both clinicians and researchers should develop culturally sensitive assessment skills and instruments. There are a number of practices with complex ethical issues (eg, female genital cutting, female and male cosmetic genital surgery). Future International Committee of Sexual Medicine meetings should seek to develop guidelines and associated recommendations for a separate, broader chapter on ethics. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  2. Sexual Dysfunction in Heroin Dependents: A Comparison between Methadone and Buprenorphine Maintenance Treatment

    PubMed Central

    Yee, Anne; Danaee, Mahmoud; Loh, Huai Seng; Sulaiman, Ahmad Hatim; Ng, Chong Guan

    2016-01-01

    Introduction Methadone has long been regarded as an effective treatment for opioid dependence. However, many patients discontinue maintenance therapy because of its side effects, with one of the most common being sexual dysfunction. Buprenorphine is a proven alternative to methadone. This study aimed to investigate sexual dysfunction in opioid-dependent men on buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT). The secondary aim was to investigate the correlation between sexual dysfunction and the quality of life in these patients. Methods Two hundred thirty-eight men participated in this cross-sectional study. Four questionnaires were used, the Mini International Neuropsychiatric Interview, Opiate Treatment Index, Malay version of the International Index of Erectile Function 15 (Mal-IIEF-15), and World Health Organization Quality of Life-BREF Scale. Multivariate analysis of covariance was used to examine the relationship between MMT and BMT and the Mal-IIEF 15 scores while controlling for all the possible confounders. Results The study population consisted of 171 patients (71.8%) on MMT and 67 (28.2%) on BMT. Patients in the MMT group who had a sexual partner scored significantly lower in the sexual desire domain (p < 0.012) and overall satisfaction (p = 0.043) domain compared with their counterparts in the BMT group. Similarly, patients in the MMT group without a sexual partner scored significantly lower in the orgasmic function domain (p = 0.008) compared with those in the BMT group without a partner. Intercourse satisfaction (p = 0.026) and overall satisfaction (p = 0.039) were significantly associated with the social relationships domain after adjusting for significantly correlated sociodemographic variables. Conclusions Sexual functioning is critical for improving the quality of life in patients in an opioid rehabilitation program. Our study showed that buprenorphine causes less sexual dysfunction than methadone. Thus

  3. Sexual dysfunction related to drugs: a critical review. Part IV: cardiovascular drugs.

    PubMed

    La Torre, A; Giupponi, G; Duffy, D; Conca, A; Catanzariti, D

    2015-01-01

    Sexual dysfunction is a potential side effect of cardiovascular drugs: this article is a critical review of the current literature. Many studies have been published on this topic. Most of these studies are not methodologically robust, few are RCTs and most did not use a validated rating scale to evaluate sexual functioning. In addition, other methodological flaws limit greatly the conclusions of these studies. Most studies relate to male populations and only a few have been conducted on women. Also, the majority of studies on sexual dysfunction induced by cardiovascular drugs relate to antihypertensive drugs. While there is evidence to suggest that older antihypertensive drugs (diuretics, beta-blockers, centrally acting agents) have a negative impact on erectile function, newer agents seem to have either neutral (ACE inhibitors, calcium antagonists) or beneficial effects (i. e., angiotensin receptor blockers, nebivolol). Other cardiovascular drugs analyzed in this review also appear to have an inhibitory action on sexual function. For men, there is some weak evidence supporting the use of specific treatment strategies for sexual dysfunction associated with these drugs. This study was conducted in 2014 using the paper and electronic resources of the library of the "Azienda Provinciale per i Servizi Sanitari (APSS)" in Trento, Italy (http://atoz.ebsco.com/Titles/2793). The library has access to a wide range of databases including DYNAMED, MEDLINE Full Text, CINAHL Plus Full Text, The Cochrane Library, Micromedex healthcare series, BMJ Clinical Evidence. The full list of available journals can be viewed at http://atoz.ebsco.com/Titles/2793 or at the APSS web site (http://www.apss.tn.it). In completing this review, a literature search was conducted using the key words "cardiovascular", "adrenergic beta antagonist", "α1-adrenoceptor antagonist", "angiotensin converting enzyme inhibitor", "angiotensin receptor antagonist", "angiotensin receptor blocker", "beta blocker

  4. Association between mental health disorders and sexual dysfunction in patients suffering from rheumatic diseases.

    PubMed

    Anyfanti, Panagiota; Pyrpasopoulou, Athina; Triantafyllou, Areti; Triantafyllou, Georgios; Gavriilaki, Eleni; Chatzimichailidou, Sofia; Gkaliagkousi, Eugenia; Petidis, Konstantinos; Aslanidis, Spyros; Douma, Stella

    2014-11-01

    Sexual functioning may be notoriously affected in patients suffering from rheumatic diseases, yet the extent to which physical and/or psychological factors contribute to sexual dysfunction in this particular group of patients remains underinvestigated. This cross-sectional study aimed at investigating whether an association exists between psychological status (anxiety, depression) and sexual dysfunction, independently of other physical factors, in patients with rheumatic disorders. A total of 509 consecutive rheumatologic patients, aged 54.7 ± 14.2 years, 423 female and 86 male, were studied. Female and male sexual function was evaluated with the Female Sexual Dysfunction Index (FSFI) and the International Index of Erectile Function (IIEF) questionnaire, respectively. The Hamilton Anxiety Scale and the Zung Self-Rating Depression Scale were used to detect presence of anxiety and depression, respectively. Sexual dysfunction affected 69.9%, anxiety 37.5%, and depression 22% of our patients. A strong and negative correlation was found between anxiety and both FSFI (r = -0.169, P < 0.001) and IIEF score (r = -0.304, P = 0.004). Similarly, depressive symptomatology was strongly and negatively correlated with both FSFI (r = -0.178, P < 0.001) and IIEF score (r = -0.222, P = 0.04). In the logistic regression analysis, apart from increasing age and female sex, depression (P = 0.027) and anxiety (P = 0.049) were identified as the only predictors of sexual dysfunction, even after adjustment for a variety of physical factors. Mental distress and sexual dysfunction are extremely common in rheumatologic patients. Sexual dysfunction is significantly associated with anxiety and depression in both men and women and may be independently predicted by their presence in this group of patients. Physicians dealing with rheumatologic patients should be aware of these results and incorporate screening and treatment of the above comorbidities in

  5. Bibliotherapy in the treatment of sexual dysfunctions: a meta-analysis.

    PubMed

    van Lankveld, J J

    1998-08-01

    This article describes the combined effect of 12 controlled studies of bibliotherapy for sexual dysfunctions, comprising data on 397 participants, who were treated in 16 bibliotherapy groups. A mean effect size of 0.68 SDs at posttreatment was found (0.50 when weighted for sample size). This effect eroded at follow-up. No influence on effect size was found for either bibliotherapy implementation characteristics or study methodology. Studies were largely limited to bibliotherapeutic administration of the directed practice approach to orgasmic disorders. The efficacy of bibliotherapy has not yet been investigated sufficiently for evaluation of its use for other sexual dysfunctions or for its comparison with other therapeutic approaches for sexual dysfunctions.

  6. Sexual dysfunction and unprotected anal intercourse among men who have sex with men in two Chinese cities.

    PubMed

    Tsui, Hi Yi; Lau, Joseph T F; Feng, T; Hong, F; Cai, Y; Zhou, H; Liu, X

    2014-01-01

    This study investigated the associations between sexual dysfunction and unprotected anal intercourse among adult Chinese men who have sex with men; 519 participants who had had anal sex (past 12 months) were recruited from gay venues (Hong Kong and Shenzhen) and from the Internet (Hong Kong). Respectively, 48.9% and 59.6% (p< .05) of the Hong Kong and Shenzhen participants had had at least one type of sexual dysfunction for 3 consecutive months (past 12 months); the difference may be explained by differential income levels or other factors. After adjustment for significant background variables, three variables related to sexual dysfunction (premature ejaculation, erectile dysfunction, and experienced at least one sexual dysfunction) were significantly associated with unprotected anal intercourse in the Hong Kong (adjusted odds ratio = 1.65-2.80) and Shenzhen samples (adjusted odds ratio = 5.46-6.41). Anxiety about sex was significant only in the Shenzhen sample (adjusted odds ratio = 8.67). The associations may be results of coping toward sexual dysfunction. Sexual dysfunction is prevalent and may contribute to unprotected anal intercourse among men who have sex with men in China. Physiological damages of receptive anal sex may contribute to some types of sexual dysfunction. However, one limitation is that participants were not asked about insertion/receptive anal sex. HIV interventions targeting men who have sex with men in China need to take counseling related to sexual dysfunction into account.

  7. Sexual dysfunction and its impact on quality of life in Chinese patients with schizophrenia treated in primary care.

    PubMed

    Hou, Cai-Lan; Zang, Yu; Rosen, R C; Cai, Mei-Ying; Li, Yan; Jia, Fu-Jun; Lin, Yong-Qiang; Ungvari, Gabor S; Ng, Chee H; Chiu, Helen F K; Xiang, Yu-Tao

    2016-02-01

    Sexual dysfunction in schizophrenia patients is common. In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians. Illness- or treatment-related sexual dysfunction in this patient population has been never studied. This study describes the prevalence and correlates of sexual dysfunction and its impact on quality of life (QOL) in patients with schizophrenia treated in primary care in China. A total of 607 patients with schizophrenia treated in 22 randomly selected primary care services in China formed the study sample. Patients' socio-demographic and clinical characteristics including sexual function and QOL were recorded using a standardized protocol and data collection. Sexual dysfunction was present in 69.9% of all patients; 60.7% in males and 80.6% in females. Multiple logistic regression analysis revealed that female gender, being single, older age and use of first-generation antipsychotics were independently and significantly associated with more sexual dysfunction accounting for 23.5% of its variance (P<0.001). Unexpectedly, sexual dysfunction was not associated with lower QOL. High rate of sexual dysfunction was reported in the majority of patients with schizophrenia treated in primary care in China. Given its negative impact on social adjustment, QOL and treatment adherence, efforts should be made to address sexual dysfunction in this patient population. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Psychosocial profile of male patients presenting with sexual dysfunction in a psychiatric outpatient department in Mumbai, India

    PubMed Central

    Kalra, Gurvinder; Kamath, Ravindra; Subramanyam, Alka; Shah, Henal

    2015-01-01

    Introduction: Sexual dysfunction can occur due to biological problems, relationship problems, lack of proper sexual knowledge or a combination of these. India is often known as the land of Kamasutra. But as far as sexuality research is concerned, there is a paucity of relevant data from India. In view of this, we conducted a study to assess the psychosocial profile of males presenting with sexual dysfunction to psychiatry out-patient department of a tertiary medical hospital. Materials and Methods: Hundred consecutive male patients presenting with sexual dysfunction were screened using Arizona Sexual Experiences Scale for clinical sexual dysfunction and after obtaining their informed consent were included in this study. They were assessed using a semi-structured proforma, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria, Mini-International Neuropsychiatric Interview, and Dyadic Adjustment Scale. Results: Majority of our respondents were in the 18–30 years age group and were married. The main source of sex knowledge for 69% of them was peer group. Age of onset of masturbation was 11–13 years for 43% of them. Premature ejaculation was the most common sexual dysfunction seen in the respondents. Marital discord was seen in significantly lesser number of respondents (32.35%) as also major depressive disorder that was seen in only 16%. Discussion: Premature ejaculation was the most common sexual dysfunction in our sample. Despite the sexual dysfunction, marital discord and depression were seen less commonly in our respondents. PMID:25657457

  9. Psychosocial profile of male patients presenting with sexual dysfunction in a psychiatric outpatient department in Mumbai, India.

    PubMed

    Kalra, Gurvinder; Kamath, Ravindra; Subramanyam, Alka; Shah, Henal

    2015-01-01

    Sexual dysfunction can occur due to biological problems, relationship problems, lack of proper sexual knowledge or a combination of these. India is often known as the land of Kamasutra. But as far as sexuality research is concerned, there is a paucity of relevant data from India. In view of this, we conducted a study to assess the psychosocial profile of males presenting with sexual dysfunction to psychiatry out-patient department of a tertiary medical hospital. Hundred consecutive male patients presenting with sexual dysfunction were screened using Arizona Sexual Experiences Scale for clinical sexual dysfunction and after obtaining their informed consent were included in this study. They were assessed using a semi-structured proforma, Diagnostic and Statistical Manual of Mental Disorders, 4(th) Edition, Text Revision criteria, Mini-International Neuropsychiatric Interview, and Dyadic Adjustment Scale. Majority of our respondents were in the 18-30 years age group and were married. The main source of sex knowledge for 69% of them was peer group. Age of onset of masturbation was 11-13 years for 43% of them. Premature ejaculation was the most common sexual dysfunction seen in the respondents. Marital discord was seen in significantly lesser number of respondents (32.35%) as also major depressive disorder that was seen in only 16%. Premature ejaculation was the most common sexual dysfunction in our sample. Despite the sexual dysfunction, marital discord and depression were seen less commonly in our respondents.

  10. Female sexual dysfunction (FSD): Prevalence and impact on quality of life (QoL).

    PubMed

    Nappi, Rossella E; Cucinella, Laura; Martella, Silvia; Rossi, Margherita; Tiranini, Lara; Martini, Ellis

    2016-12-01

    Female sexual dysfunction (FSD) and quality of life (QOL) are both multidimensional and have a bidirectional relationship across the reproductive life span and beyond. Methodological difficulties exist in estimating the real prevalence of FSD because it is hard to determine the level of distress associated with sexual symptoms in a large-scale survey. Approximately 40-50% of all women report at least one sexual symptom, and some conditions associated with hormonal changes at menopause, such as vulvovaginal atrophy (VVA) and hypoactive sexual desire disorder (HSDD), have a significant impact on sexual function and QOL. Sexual distress peaks at midlife, declines with age and is strongly partner-related. Many postmenopausal women are still sexually active, especially if they are in a stable partnership. Even though sexual functioning is impaired, a variety of psychosocial factors may maintain sexual satisfaction. That being so, health care providers (HCPs) should proactively address sexual symptoms at midlife and in older women, from a balanced perspective. Adequate counselling should be offered. Women with distressing symptoms may benefit from tailored hormonal and non-hormonal therapies, whereas women without distress related to their sexual experiences should not receive any specific treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Sexual dysfunctions in alcohol-dependent men: A study from north India

    PubMed Central

    Pendharkar, Shreyas; Mattoo, Surendra K.; Grover, Sandeep

    2016-01-01

    Background & objectives: Sexual dysfunctions have been reported in alcohol-dependent men. Most of the studies conducted had limitation of using non-validated measures of sexual dysfunction and sampling design. This study was, therefore, conducted to determine the typology, demographic and clinical correlates of sexual dysfunction in alcohol-dependent men. Methods: One hundred and one patients with alcohol dependence (AD) attending the Drug De-addiction and Treatment Centre and 50 healthy controls were evaluated in this cross-sectional study. Participants in both the groups were assessed on Arizona Sexual experience scale (ASEX), Dyadic Adjustment Scale (DAS), Hamilton Depression Rating Scale (HDRS) and State-Trait Anxiety Inventory (STAI). In addition, patients with AD were assessed on Severity of Alcohol Dependence Questionnaire (SADQ) for severity of AD and revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar) to ensure that no participant was in active alcohol withdrawal state. Results: Overall, 58.4 per cent of patients in the AD group had sexual dysfunction. Among the domains, the highest frequency was seen for dysfunction for arousal (57.4%), followed by problems in desire (54.4%), erection (36.6%), satisfaction with orgasm (34.6%) and ability to reach orgasm was least affected (12.87%). The patient and control groups differed significantly in overall dyadic adjustment, in the domains of dyadic satisfaction and affective expression. Interpretation & conclusions: The finding of this study showed that a significant proportion of patients with AD has sexual dysfunction. Longitudinal studies using validated assessment tools should be done to confirm these findings. PMID:28139538

  12. Systematic Review of Sexual Dysfunction Among Veterans with Post-Traumatic Stress Disorder.

    PubMed

    Bentsen, Ida L; Giraldi, Annamaria G E; Kristensen, Ellids; Andersen, Henrik S

    2015-04-01

    The clinical observations that many Vietnam veterans complained of sexual problems after returning from active duty have led to the question of a correlation between post-traumatic stress disorder (PTSD) and sexual dysfunction (SD). The purpose of this review is to systematically review the current literature regarding SD in male veterans with PTSD. A systematic literature search, primarily in PubMed, the Cochrane database, and PsycINFO, was conducted. The keywords Sexual Dysfunction, Psychological OR Sexual Dysfunction, Physiological AND Stress Disorders, and Post-Traumatic were used. All manuscripts with relevance to the aim of the review were reviewed and considered. A total of 123 results were generated from the search. There were 11 publications regarding SD in veterans with PTSD included in the review. The included studies are described in detail in the Results section. All but one study found an increased and significant prevalence of SD among male veterans with PTSD, especially erectile dysfunction and decreased sexual desire. SD increased in patients with PTSD, with a prevalence between 8.4% and 88.6%; the large prevalence range were partly the result of methodological differences. Only two studies have examined the correlation between the severity of PTSD symptoms and SD, with conflicting results. Samples were of relatively moderate size. Only a few confounding factors were accounted for in the included studies. Increasing evidence suggests a correlation between PTSD and SD, but still, relatively few studies have addressed these questions. Further investigation is needed into the correlation between PTSD and SD, preferably taking severity of PTSD symptoms into account, along with confounders such as use of psychotropic medication, somatic illness, drug and alcohol abuse, and comorbid psychiatric illness. Bentsen IL, Giraldi AGE, Kristensen E, and Andersen HS. Systematic review of sexual dysfunction among veterans with post-traumatic stress disorder. Sex

  13. Late-stage clinical development in lower urogenital targets: sexual dysfunction

    PubMed Central

    Azam, Usman

    2006-01-01

    In recent years, late-stage clinical drug development that primarily focuses on urogenital targets has centered around four areas of medical need (both unmet need and aiming to improve on existing therapies). These include male sexual dysfunction (MSD), female sexual dysfunction (FSD), prostatic pathology (neoplastic, pre-neoplasitic, and non-neoplastic), and improvement in lower urinary tract symptoms. Despite the regulatory approval of compounds to treat erectile dysfunction (ED), benign prostatic hyperplasia, a number of treatments for overactive bladder, and stress urinary incontinence, there remains a deficiency in addressing a number of conditions that arise out of pathophysiological dysfunction resulting in lower urogenital tract sexual conditions. In terms of late-stage clinical development, significant progress has most recently been made in MSD development, especially in understanding further a common and complex sexual dysfunction – that of premature ejaculation. The search also continues for compounds that improve ED in terms of better efficacy and superior safety profile compared to the currently marketed phosphodiesterase-5-inhibitors. Whilst there are no approved medications to treat the subtypes of FSD, there has been significant progress in attempting to better understand how to appropriately assess treatment benefit in clinical trial settings for this difficult to diagnose and treat condition. This review will focus on late-stage human clinical development pertaining to MSD and FSD. PMID:16465180

  14. Effect of Attachment Styles to Parents on Sexual Dysfunction Domains of Married Women

    PubMed Central

    Nia, Anvar Sadat Nayebi; Salari, Parvin; Sharifi, Nasibeh; Nooghani, Hadi Jabbari

    2017-01-01

    Introduction According to Bowbly attachment theory, attachment of a baby and its main care provider, influences on social growth and the baby’s feelings throughout its life. The present study was performed aim to determine the effect of attachment style to parents on domains of sexual dysfunction in married women. Methods This cross-sectional study was carried out on two hundred married women who were fertile, and referred private and governmental gynecology clinics in Mashhad, Iran, in 2014. Data collection tools were three questionnaires; Demographic and marital questionnaire, Female sexual function index questionnaire, and Adult attachment style questionnaire. Data were analyzed by SPSS version 20 (IBM© SPSS© Statistics version 20 using independent-samples t-test and logistic regression. The statistical tests were performed at the 95% confidence interval. Result Mean of safe attachment style to parents in all aspect of sexual dysfunction was significantly lower (p≤0.01), however, mean of distant attachment style to parents in all aspects of sexual dysfunction was significantly higher (p≤0.05). Conclusion Secure and distance attachment style to the mother showed maximum power of prediction for sexual dysfunction, which indicates the importance of attachment to parents and its impact on adult relationships. PMID:28243413

  15. Effect of Attachment Styles to Parents on Sexual Dysfunction Domains of Married Women.

    PubMed

    Nia, Anvar Sadat Nayebi; Salari, Parvin; Sharifi, Nasibeh; Nooghani, Hadi Jabbari

    2017-01-01

    According to Bowbly attachment theory, attachment of a baby and its main care provider, influences on social growth and the baby's feelings throughout its life. The present study was performed aim to determine the effect of attachment style to parents on domains of sexual dysfunction in married women. This cross-sectional study was carried out on two hundred married women who were fertile, and referred private and governmental gynecology clinics in Mashhad, Iran, in 2014. Data collection tools were three questionnaires; Demographic and marital questionnaire, Female sexual function index questionnaire, and Adult attachment style questionnaire. Data were analyzed by SPSS version 20 (IBM© SPSS© Statistics version 20 using independent-samples t-test and logistic regression. The statistical tests were performed at the 95% confidence interval. Mean of safe attachment style to parents in all aspect of sexual dysfunction was significantly lower (p≤0.01), however, mean of distant attachment style to parents in all aspects of sexual dysfunction was significantly higher (p≤0.05). Secure and distance attachment style to the mother showed maximum power of prediction for sexual dysfunction, which indicates the importance of attachment to parents and its impact on adult relationships.

  16. Co-relationship between sexual dysfunction and high-risk sexual behavior in patients receiving buprenorphine and naltrexone maintenance therapy for opioid dependence

    PubMed Central

    Ramdurg, Santosh; Ambekar, Atul; Lal, Rakesh

    2015-01-01

    Introduction: People suffering from substance dependence suffer from various sexual dysfunctions and are at risk for indulging in various high-risk sexual behaviors and thus are vulnerable to acquire various infections such as HIV/AIDS and other sexually transmitted infections. AIM: The aim of the study was to evaluate the correlation between sexual dysfunction and high-risk sexual behavior in opioid-dependent men receiving buprenorphine and naltrexone maintenance therapy. Materials and Methods: Semi-structured questionnaire, brief male sexual functioning inventory and HIV-risk taking behavior scale was administered to a sample of 60 sexually active men, receiving buprenorphine (n = 30) and naltrexone (n = 30) maintenance therapy for opioid dependence. Results: The main outcomes are correlation between severity of sexual dysfunction and HIV-risk taking behavior. The study results showed 83% of the men on buprenorphine and 90% on naltrexone reported at least one of the sexual dysfunction symptoms. There was a negative correlation between sexual dysfunction and HIV-risk taking behavior that suggest severe the dysfunction, higher the risk taking behavior. Significant correlation was present with overall sexual dysfunction and HIV-risk taking behavior (P = 0.028 and in naltrexone receiving group premature ejaculation versus HIV-risk taking behavior however, (P = 0.022, P < 0.05) there were no significant differences among both the groups except above findings. Conclusion: Conclusion was treatment is associated with sexual dysfunctions and HIV-risk taking behavior, which has clinical implication. Future research should explore this further using biochemical analyses. PMID:26257480

  17. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports

    PubMed Central

    Park, Brian Y.; Wilson, Gary; Berger, Jonathan; Christman, Matthew; Reina, Bryn; Bishop, Frank; Klam, Warren P.; Doan, Andrew P.

    2016-01-01

    Traditional factors that once explained men’s sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain's motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography’s unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use. In the interim, a simple diagnostic protocol for assessing patients with porn-induced sexual dysfunction is put forth. PMID:27527226

  18. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports.

    PubMed

    Park, Brian Y; Wilson, Gary; Berger, Jonathan; Christman, Matthew; Reina, Bryn; Bishop, Frank; Klam, Warren P; Doan, Andrew P

    2016-08-05

    Traditional factors that once explained men's sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain's motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography's unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use. In the interim, a simple diagnostic protocol for assessing patients with porn-induced sexual dysfunction is put forth.

  19. Sexual dysfunction in an Internet sample of U.S. men who have sex with men.

    PubMed

    Hirshfield, Sabina; Chiasson, Mary Ann; Wagmiller, Robert L; Remien, Robert H; Humberstone, Mike; Scheinmann, Roberta; Grov, Christian

    2010-09-01

    Relatively little is known about sexual dysfunction (SD) in men who have sex with men (MSM). In order to better understand SD symptoms in MSM, we assessed self-reported SD symptoms, individually and by latent class analysis (LCA). In 2004-2005 an Internet sample of U.S. MSM was recruited from gay-oriented sexual networking, chat and news websites. The analytic sample comprised 7,001 men aged 18 or older who reported lifetime male sex partners and oral or anal sex with a male partner in their most recent encounter within the past year. Seven questions on SD symptoms that occurred during the past 12 months inquired about low sexual desire, erection problems, inability to achieve an orgasm, performance anxiety, premature ejaculation, pain during sex, and sex not being pleasurable. Self-reported symptoms of SD were high. Overall, 79% of men reported one or more SD symptoms in the past year, with low sexual desire, erection problems, and performance anxiety being the most prevalent. Four distinct underlying patterns of sexual functioning were identified by LCA: no/low SD, erection problems/performance anxiety, low desire/pleasure, and high SD/sexual pain. High SD/sexual pain was distinguished from the other patterns by club drug use and use of prescription and non-prescription erectile dysfunction medication before sex in the past year. Additionally, men associated with the high SD/sexual pain group were younger, single, more likely to have poor mental and physical health, and more likely to have been diagnosed with a sexually transmitted infection in the past year compared to men in the no/low SD group. LCA enabled us to identify underlying patterns of sexual functioning among this sample of MSM recruited online. Future research should investigate these distinct subgroups with SD symptoms in order to develop tailored treatments and counseling for SD. © 2009 International Society for Sexual Medicine.

  20. Reduced sexual dysfunction with aripiprazole once-monthly versus paliperidone palmitate: results from QUALIFY

    PubMed Central

    Loze, Jean-Yves; Forray, Carlos; Baker, Ross A.; Sapin, Christophe; Peters-Strickland, Timothy; Beillat, Maud; Nylander, Anna-Greta; Hertel, Peter; Steen Andersen, Henrik; Eramo, Anna; Hansen, Karina; Naber, Dieter

    2017-01-01

    Sexual dysfunction, a common side effect of antipsychotic medications, may be partly caused by dopamine antagonism and elevation of prolactin. In QUALIFY, a randomized study, aripiprazole once-monthly 400 mg (AOM 400), a dopamine D2 receptor partial agonist, showed noninferiority and subsequent superiority versus paliperidone palmitate (PP), a dopamine D2 receptor antagonist, on the Heinrichs–Carpenter Quality-of-Life Scale (QLS) in patients with schizophrenia aged 18–60 years. Sexual dysfunction (Arizona Sexual Experience Scale) and serum prolactin levels were also assessed. Odds for sexual dysfunction were lower with AOM 400 versus PP [week 28 adjusted odds ratio (95% confidence interval), 0.29 (0.14–0.61); P=0.0012] in men [0.33 (0.13–0.86); P=0.023], women [0.14 (0.03–0.62); P=0.0099], and patients aged 18–35 years [0.04 (<0.01–0.34); P=0.003]. Among patients shifting from sexual dysfunction at baseline to none at week 28, there was a trend toward greater improvement in the QLS total score. The mean (SD) prolactin concentrations decreased with AOM 400 [−150.6 (274.4) mIU/l] and increased with PP [464.7 (867.5) mIU/l] in both men and women. Six PP-treated patients experienced prolactin-related adverse events. In addition to greater improvement on QLS, patients had a lower risk for sexual dysfunction and prolactin elevation with AOM 400 versus PP in QUALIFY. PMID:28252452

  1. Hormones and Female Sexual Dysfunction: Beyond Estrogens and Androgens--Findings from the Fourth International Consultation on Sexual Medicine.

    PubMed

    Worsley, Roisin; Santoro, Nanette; Miller, Karen K; Parish, Sharon J; Davis, Susan R

    2016-03-01

    In recent years, multiple hormones have been investigated in relation to female sexual function. Because consumers can easily purchase products claiming to contain these hormones, a clear statement regarding the current state of knowledge is required. To review the contribution of hormones, other than estrogens and androgens, to female sexual functioning and the evidence that specific endocrinopathies in women are associated with female sexual dysfunction (FSD) and to update the previously published International Society of Sexual Medicine Consensus on this topic. The literature was searched using several online databases with an emphasis on studies examining the physiologic role of oxytocin, prolactin, and progesterone in female sexual function and any potential therapeutic effect of these hormones. The association between common endocrine disorders, such as polycystic ovary syndrome, pituitary disorders, and obesity, and FSD also was examined. Quality of data published in the literature and recommendations were based on the Grading of Recommendations Assessment, Development and Education system. There is no evidence to support the use of oxytocin or progesterone for FSD. Treating hyperprolactinemia might lessen FSD. Polycystic ovary syndrome, obesity, and metabolic syndrome could be associated with FSD, but data are limited. There is a strong association between diabetes mellitus and FSD. Further research is required; in particular, high-quality, large-scale studies of women with common endocrinopathies are needed to determine the impact of these prevalent disorders on female sexual function. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  2. A Qualitative Study of the Relationship Between Methamphetamine Abuse and Sexual Dysfunction in Male Substance Abusers

    PubMed Central

    Dolatshahi, Behrouz; Farhoudian, Ali; Falahatdoost, Mozhgan; Tavakoli, Mahmoud; Rezaie Dogahe, Ebrahim

    2016-01-01

    Background Increased prevalent use of methamphetamine is a global public challenge. Information on drug use can be helpful in preventing high-risk behavior related to drug abuse. Objectives This study aims to investigate the sexual function changes related to methamphetamine use in the male clients of public and private addiction treatment centers. Patients and Methods In this qualitative study, 45 men (35 methamphetamine users, 5 family members of the users, and 5 psychiatrists or physicians who were famous for treating or researching addiction) are involved. An in-depth interview was done with therapists and key individuals. Results The results show that the effects of methamphetamine on sexual function are not identical. The first usage is concomitant with the increased duration of sex, an increase in the quality and quantity of sexual pleasure, a delighted orgasm, and feeling more control of the sex act. These effects gradually decrease. A decreased libido and various sexual dysfunctions such as erectile dysfunction, premature ejaculation, and losing control during the sex act will appear over time. Conclusions There are differences in the libido and sexual functions of methamphetamine users. Personal perceptions of one’s sexual function may be affected by cognitive changes resultant from the drug. Drug-use prevention, addiction treatments, appropriate sexual behavior education, and harm reduction are priorities. PMID:27803891

  3. Adjuvant Radiotherapy Is Associated With Increased Sexual Dysfunction in Male Patients Undergoing Resection for Rectal Cancer

    PubMed Central

    Heriot, Alexander G.; Tekkis, Paris P.; Fazio, Victor W.; Neary, Paul; Lavery, Ian C.

    2005-01-01

    Objectives: The objectives of this study were to evaluate the effect of radiotherapy (RT) on sexual function in patients undergoing oncologic resection for rectal cancer, and to develop a mathematical model for quantifying the risk of sexual dysfunction through time for this group of patients. Methods: Data were prospectively collected on patients undergoing proctosigmoidectomy (group 1: n = 101) or adjuvant radiotherapy (40–50 Gy) and resection (group 2: n = 100) for rectal cancer at a tertiary referral center between December 1998 and July 2004. Study end points were recorded at 7 time intervals (preoperatively, 4 months, 8 months, 1 year, 2 years, 3 years, and 4 years after surgery) and included: 1) ability to have an erection, 2) maintain an erection, 3) attain orgasm, 4) dry orgasm, and 5) whether they were sexually active. Multilevel logistic regression analysis for repeated measures was used to identify factors associated with the sexual dysfunction. A predictive model was developed and internally validated by comparing observed and model-predicted outcomes. Results: Radiotherapy had an adverse effect on the ability to get an erection, maintain an erection, attain orgasm, and being sexually active in comparison with patients undergoing surgery alone (7.4%, 12.6%, 16.2%, and 13.7% reduction 8 months after surgery respectively; P < 0.05). The effect of sexual dysfunction deteriorated with age (odds ratio for erectile function, 0.40 per 10-year increase in age; 95% confidence interval, 0.29–0.49; P < 0.001). A significant variability in sexual function was present among the 7 time points with a maximal deterioration occurring at 8 months after surgery with subsequent slow but not complete recovery (P < 0.001). The predictive model showed adequate discrimination on 4 of the 5 domains of sexual dysfunction (area under the receiver operating characteristic curve >0.70). Conclusions: Radiotherapy has an adverse effect on sexual function, the effect being

  4. 5-HT2 receptors modulate the expression of antipsychotic-induced dopamine supersensitivity.

    PubMed

    Charron, Alexandra; Hage, Cynthia El; Servonnet, Alice; Samaha, Anne-Noël

    2015-12-01

    Antipsychotic treatment can produce supersensitivity to dopamine receptor stimulation. This compromises the efficacy of ongoing treatment and increases the risk of relapse to psychosis upon treatment cessation. Serotonin 5-HT2 receptors modulate dopamine function and thereby influence dopamine-dependent responses. Here we evaluated the hypothesis that 5-HT2 receptors modulate the behavioural expression of antipsychotic-induced dopamine supersensitivity. To this end, we first treated rats with the antipsychotic haloperidol using a clinically relevant treatment regimen. We then assessed the effects of a 5-HT2 receptor antagonist (ritanserin; 0.01 and 0.1mg/kg) and of a 5-HT2A receptor antagonist (MDL100,907; 0.025-0.1mg/kg) on amphetamine-induced psychomotor activity. Antipsychotic-treated rats showed increased amphetamine-induced locomotion relative to antipsychotic-naïve rats, indicating a dopamine supersensitive state. At the highest dose tested (0.1mg/kg for both antagonists), both ritanserin and MDL100,907 suppressed amphetamine-induced locomotion in antipsychotic-treated rats, while having no effect on this behaviour in control rats. In parallel, antipsychotic treatment decreased 5-HT2A receptor density in the prelimbic cortex and nucleus accumbens core and increased 5-HT2A receptor density in the caudate-putamen. Thus, activation of either 5-HT2 receptors or of 5-HT2A receptors selectively is required for the full expression of antipsychotic-induced dopamine supersensitivity. In addition, antipsychotic-induced dopamine supersensitivity enhances the ability of 5-HT2/5-HT2A receptors to modulate dopamine-dependent behaviours. These effects are potentially linked to changes in 5-HT2A receptor density in the prefrontal cortex and the striatum. These observations raise the possibility that blockade of 5-HT2A receptors might overcome some of the behavioural manifestations of antipsychotic-induced dopamine supersensitivity.

  5. Recent studies on aphrodisiac herbs for the management of male sexual dysfunction--a review.

    PubMed

    Malviya, Neelesh; Jain, Sanjay; Gupta, Vipin Bihari; Vyas, Savita

    2011-01-01

    An aphrodisiac is a type of food or drink that has the effect of making those who eat or drink it more aroused in a sexual way. Aphrodisiacs can be categorized according to their mode of action into three groups: substances that increase libido (i.e., sexual desire, arousal), substances that increase sexual potency (i.e., effectiveness of erection) and substances that increase sexual pleasure. Some well-known aphrodisiacs are Tribulus terrestrins, Withania somnifera, Eurycoma longifolia, Avena sativa, Ginko biloba, and Psoralea coryifolia. Ethnobotanical surveys have indicated a large number of plants as aphrodisiacs. The paper reviews the recent scientific validation on traditionally used herbal plants as aphrodisiac herbs for the management of sexual disorder erectile dysfunction.

  6. Sexual dysfunction, cardiovascular risk factors, and inflammatory biomarkers in women undergoing coronary angiography.

    PubMed

    Oren, Amit; Megiddo, Elinor; Banai, Shmuel; Justo, Dan

    2016-01-01

    We studied sexual dysfunction (SD) prevalence and lack of sexual activity in 117 women undergoing coronary angiography. SD was consistent with a low (≤26.55) Female Sexual Function Index questionnaire (FSFI) score. The mean age was 61.8 years (range: 40-75 years). SD prevalence was 76.1% (n = 89), and 41 (35.0%) women reported a lack of sexual activity. Regression analyses showed that only age was independently associated with SD (odds ratio 1.088; 95% confidence interval 1.024-1.157; p = .006) and lack of sexual activity (odds ratio 1.144; 95% confidence interval 1.064-1.230; p < .0001), regardless of cardiovascular risk factors, inflammatory biomarkers blood levels, and the number of stenotic coronary arteries.

  7. A Place for Sexual Dysfunctions in an Empirical Taxonomy of Psychopathology.

    PubMed

    Forbes, Miriam K; Baillie, Andrew J; Eaton, Nicholas R; Krueger, Robert F

    2017-01-25

    Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a manifestation of underlying dimensions of psychopathology (or "spectra"). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research.

  8. The Relationship between Psychological Dysfunction and Sexuality within a Marital Context. Report on a Literature Study.

    ERIC Educational Resources Information Center

    Schonnesson, Lena Nilsson

    A literature study was conducted to highlight the relationship between psychological dysfunction and sexuality within a marital context. The research reviewed suggests that women report more psychological symptoms, in particular depression, than do men. The husband's personality and functioning appeared to determine the level of marital…

  9. Treatment of Female Sexual Dysfunction Through Symbolic Modeling

    ERIC Educational Resources Information Center

    Nemetz, Georgia H.; And Others

    1978-01-01

    Clients (N=16) were randomly assigned to two groups receiving either individual or group treatment. Treatment consisted of relaxation training followed by viewing 45 videotaped vignettes depicting graduated sexual behaviors. Improvement remained stable through a one-year follow-up. Control clients showed no improvement and trends toward…

  10. Treatment of Female Sexual Dysfunction Through Symbolic Modeling

    ERIC Educational Resources Information Center

    Nemetz, Georgia H.; And Others

    1978-01-01

    Clients (N=16) were randomly assigned to two groups receiving either individual or group treatment. Treatment consisted of relaxation training followed by viewing 45 videotaped vignettes depicting graduated sexual behaviors. Improvement remained stable through a one-year follow-up. Control clients showed no improvement and trends toward…

  11. Dyspareunia and sexual dysfunction after vaginal delivery in Thai primiparous women with episiotomy.

    PubMed

    Chayachinda, Chenchit; Titapant, Vitaya; Ungkanungdecha, Anuree

    2015-05-01

    Episiotomy remains commonly practiced in Thailand. There are limited data on its impacts on sexuality among Asian women during the first postdelivery year. The aim was to study dyspareunia and sexual function at 3-12 months after vaginal delivery in Thai primiparous women with episiotomy. A total of 190 participants were approached on Day 2 postpartum. Of these, 93 sexually active women were evaluated for dyspareunia and sexual function at 3 months by using 10-cm visual analog scale and the validated Thai version of Female Sexual Function Index (TFSFI). TFSFI < 26.5 was defined as having potential sexual dysfunction. At 6 and 12 months, sexual function was evaluated by telephone interview. The prevalence of dyspareunia at 3 months and the changes of TFSFI scores during the first postdelivery year were the main outcome measures. The average age of the participants, over 90% of whom were high school finishers, was 24. Their partners were around 3 years older, and the median partnership duration was 3 years. At 3 months, 30.1% of participants reported dyspareunia. There was no association between dyspareunia and the following characteristics: pre-pregnancy dyspareunia, newborn's head circumference and birthweight and breast-feeding (P > 0.05 for all). Sexual dysfunction was demonstrated in 66.7% at 3 months, 31.0% at 6 months, and 14.9% at 12 months. From 3 to 12 months, the median TFSFI scores in all domains increased significantly. There was no difference of the scores in all domains at 3 and 12 months between women with and without dyspareunia at 3 months. However, at 6 months, those without dyspareunia had better scores in pain, orgasm, satisfaction, and total scores (P < 0.05 for all). Dyspareunia at 3 months is common in Thai primiparous women with episiotomy. Those with dyspareunia have a slower resumption of normal sexual function. © 2015 International Society for Sexual Medicine.

  12. Sexual Dysfunction in an Internet Sample of U.S. Men Who Have Sex with Men

    PubMed Central

    Hirshfield, Sabina; Chiasson, Mary Ann; Wagmiller, Robert L.; Remien, Robert H.; Humberstone, Mike; Scheinmann, Roberta; Grov, Christian

    2010-01-01

    Introduction Relatively little is known about sexual dysfunction (SD) in men who have sex with men (MSM). Aim In order to better understand SD symptoms in MSM, we assessed self-reported SD symptoms, individually and by latent class analysis (LCA). Methods In 2004–2005 an Internet sample of U.S. MSM was recruited from gay-oriented sexual networking, chat and news websites. The analytic sample comprised 7,001 men aged 18 or older who reported lifetime male sex partners and oral or anal sex with a male partner in their most recent encounter within the past year. Main Outcome Measures Seven questions on SD symptoms that occurred during the past 12 months inquired about low sexual desire, erection problems, inability to achieve an orgasm, performance anxiety, premature ejaculation, pain during sex, and sex not being pleasurable. Results Self-reported symptoms of SD were high. Overall, 79% of men reported one or more SD symptoms in the past year, with low sexual desire, erection problems, and performance anxiety being the most prevalent. Four distinct underlying patterns of sexual functioning were identified by LCA: no/low SD, erection problems/performance anxiety, low desire/pleasure, and high SD/sexual pain. High SD/sexual pain was distinguished from the other patterns by club drug use and use of prescription and non-prescription erectile dysfunction medication before sex in the past year. Additionally, men associated with the high SD/sexual pain group were younger, single, more likely to have poor mental and physical health, and more likely to have been diagnosed with a sexually transmitted infection in the past year compared to men in the no/low SD group. Conclusions LCA enabled us to identify underlying patterns of sexual functioning among this sample of MSM recruited online. Future research should investigate these distinct subgroups with SD symptoms in order to develop tailored treatments and counseling for SD. PMID:19968773

  13. Clinical and biopsychosocial determinants of sexual dysfunction in middle-aged and older Australian men.

    PubMed

    Martin, Sean; Atlantis, Evan; Wilson, David; Lange, Kylie; Haren, Matthew T; Taylor, Anne; Wittert, Gary

    2012-08-01

    Erectile dysfunction (ED) and other related sexual dysfunctions in men have recently been shown to associate with a range of conditions and biopsychosocial factors. However, few studies have been able to control for these related factors simultaneously. To determine the prevalence of and associated risk factors for ED and low solitary and dyadic sexual desire. Erectile function (International Index of Erectile Function-erectile function) and sexual desire (Sexual Desire Inventory 2), as well as associated sociodemographic, lifestyle, biological, and clinical risk factors. Data were collected from 1,195 randomly selected, community-dwelling men as part of the Florey Adelaide Male Ageing Study. The prevalence of ED, low solitary, and dyadic sexual desire was 17.7%, 67.7%, and 13.5%, respectively. Increasing age, abdominal fat mass, obstructive sleep apnea risk, and the absence of a regular partner were associated with both degrees of ED severity. Insufficient physical activity, low alcohol consumption, and hypertension were associated with mild ED only, and voiding lower urinary tract symptoms, diabetes, and lower plasma testosterone were independently associated with moderate to severe ED. Increasing age, lower alcohol consumption, insufficient physical activity, and a diagnosis of depression, anxiety, or insomnia were associated with both low dyadic and solitary sexual desire. Postschool qualifications and lower plasma testosterone were associated with low dyadic desire, whereas lower education and income, unemployment, and migration were associated with low solitary sexual desire. The absence of a regular partner and postschool qualifications were associated with higher solitary sexual desire. While ED and low dyadic and solitary sexual desire share some risk factors, we were able to demonstrate that unique factors exist for each of these domains. Attention should first be given to addressing these modifiable risk factors. © 2012 International Society for Sexual

  14. The effects of Femore™ cream on sexual dysfunction in Turkish women.

    PubMed

    Sen, Selma; Guneri, Sezer E; Sevil, Umran; Cengel, Selmin

    2014-05-01

    To investigate the effects of Femore™ cream on sexual dysfunction in menopause and women's satisfaction levels. The recent interest of public and the world of medicine in female sexual function have led to a rapid increase in the number of studies on the subject. The study was designed as an observational intervention study. The research data were collected by using a Women Information Form consisting of 13 items; a Sexual Function Index to measure sexual function; and a Satisfaction Determination Form to determine the level of satisfaction with the medical service the women received for the problems with their reproductive organs. The study was conducted with 29 menopausal women who complied with the inclusion criteria. It was found that women's average age was 52·6; that the average menarche age was 13·0; and that the average menopause age was 46·2. The major complaint of nearly all the women who were aware of their sexual dysfunction was vaginal dryness, and it was concluded that they took no precautions against this problem. The total scores obtained from the Sexual Function Index were reported to be an average of 18·8 ± 4·2 before use of Femore™ cream and an average of 42·3 ± 2·0 after use of Femore™ cream. The average score concerning satisfaction with the use of Femore™ cream was noted to be 9·06 ± 0·40. The study results suggested that applying Femore™ cream had positive influences on sexual dysfunction and all subdomains. Women's sexual health can therefore be assessed at primary care centres, and it is considered that health professionals employed at these centres, a majority of whom are female nurses and obstetricians, can play an important role in guiding women on the issue. © 2013 John Wiley & Sons Ltd.

  15. Prevalence and risk factors of female sexual dysfunction among healthcare personnel in Malaysia.

    PubMed

    Grewal, Gurdeep Singh; Gill, Jesjeet Singh; Sidi, Hatta; Gurpreet, Kaur; Jambunathan, Stephen Thevanathan; Suffee, Nusrat J; Midin, Marhani; Nik Jaafar, Nik Ruzyanei; Das, Srijit

    2014-01-01

    To determine the prevalence and risk factors of female sexual dysfunction (FSD) among healthcare personnel in selected healthcare facilities in Malaysia. This was a cross-sectional study carried out at three large healthcare facilities that were selected by convenience sampling. Within each facility, stratified random sampling was used to select suitable candidates to participate in the study (n=201). Validated questionnaires were used to assess depression, anxiety, sexual function in women and erectile dysfunction (ED) in their partners. The prevalence of FSD was 5.5%. Women with sexual dysfunction were more likely to be married longer (OR=4.08; 95% CI; 1.15-4.50), had lower frequency of sexual intercourse (OR=5.00; 95% C; 1.05-23.76) and had a spouse with ED (OR=24.35; 95% CI; 4.55-130.37). Multivariate analysis showed that ED was the strongest predictor for FSD (AOR=27.30; 95% CI; 4.706-159.08). One in eighteen female healthcare personnel suffered from FSD and presence of ED in the partner strongly impacted her sexual function, negatively. The findings highlight the importance of including the male partner in clinical assessment of FSD. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Distribution pattern of psoriasis, anxiety and depression as possible causes of sexual dysfunction in patients with moderate to severe psoriasis.

    PubMed

    Molina-Leyva, Alejandro; Almodovar-Real, Ana; Carrascosa, Jose Carlos-Ruiz; Molina-Leyva, Ignacio; Naranjo-Sintes, Ramon; Jimenez-Moleon, Jose Juan

    2015-01-01

    Psoriasis may significantly impair sexual function. Depression and organic factors appear to play a key role in this relation. However, beyond genital psoriasis, the importance of the disease's distribution patterns has not been considered. To research sexual function in psoriasis patients and investigate the roles of anxiety, depression and psoriasis' distribution patterns in sexual dysfunction. A comparative study matched for sex and age was performed. Eighty patients with moderate to severe psoriasis and 80 healthy controls were included. The participants completed the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, and the Self-Administered Psoriasis Area and Severity Index. Psoriasis was associated with sexual dysfunction, odds ratio=5.5 (CI 95% 2.6-11.3; p<0.001). Certain distribution patterns of psoriasis, involving specific body regions, were associated with an increase in sexual dysfunction in the group presenting the disease, odds ratio 7.9 (CI 95% 2.3-33.4; p<0.001). Multivariate logistic regression analysis identified anxiety and depression, and the involvement of these specific areas, as possible independent risk factors for sexual dysfunction in patients with moderate to severe psoriasis. This study identifies body areas potentially related to sexual dysfunction, independently of anxiety and depression, in psoriasis patients. The results suggest that the assessment of sexual dysfunction and the involvement of these body areas should be considered as disease severity criteria when choosing the treatment for psoriasis patients.

  17. Heterosexual anal intercourse: increasing prevalence, and association with sexual dysfunction, bisexual behavior, and venereal disease history.

    PubMed

    Brody, Stuart; Weiss, Petr

    2011-01-01

    Representative samples of the Czech population were surveyed with regard to sexual behavior in 1993, 1998, 2003, and 2008 (N = 7,720). Lifetime prevalence of Heterosexual Anal Intercourse increased from 1993 to 2008 (16.6% to 19.7% among women, 15.7% to 25.3% among men). Anal intercourse was associated with lifetime number of sex partners, current masturbation, and histories (prevalence of which increased from 1993 to 2008) of homosexual sex, prostitution, venereal disease (adjusted for number of sex partners), and women's sexual dysfunction. The authors discuss the possible reasons for the increasing prevalence and the associations. Multivariate predictors of ever having a sexual dysfunction or a venereal disease are also presented.

  18. Recognising female sexual dysfunction as an essential aspect of effective diabetes care.

    PubMed

    Phillips, Anne; Phillips, Stephen

    2015-08-01

    The following literature review will focus on sexual dysfunction in women living with diabetes, drawing on international studies in this specialist field. The key aim of this paper is generate a greater understanding and recognition of the issues facing these women and to determine a more proactive approach to identification, consultation and potential treatment options. The main findings highlight the unique role practitioners have with women with diabetes and how to facilitate partnership working. Nurses have the most frequent contact with people living with diabetes in any healthcare system. Nurses' knowledge about sexuality in relation to diabetes should improve patient education, recognition and could signal undiagnosed or increased risk of sexual dysfunction to enable treatment so care can be optimised accordingly (Sivrikaya et al., 2014).

  19. A field trial of the effectiveness of behavioral treatment for sexual dysfunctions.

    PubMed

    Sarwer, D B; Durlak, J A

    1997-01-01

    The present study was a field trial of behavioral sex therapy for 365 married couples presenting with a range of sexual dysfunctions. Treatment occurred at an outpatient sexual dysfunction clinic of a large medical center using a multidisciplinary staff. Findings supported the external validity of behavioral sex therapy. The success rate for the total sample (65%) was comparable to that of previous investigations, and there were very few dropouts (1.6%) from treatment. In addition, outcomes did not vary significantly as a function of diagnoses, gender, or a history of sexual abuse. The amount of sensate focus completed in the last week of treatment was the strongest predictor of successful treatment. For some diagnoses, however, couple comorbidity reduced treatment success. Results indicated that behavioral sex therapy is effective in real-world clinical settings.

  20. Pharmacogenetics and pharmacogenomics of sexual dysfunction: current status, gaps and potential applications.

    PubMed

    Abdel-Hamid, Ibrahim A; Andersson, Karl-Erik

    2009-10-01

    Although treatment of different types of sexual dysfunction has improved in the past decade with the introduction of phosphodiesterase type 5 inhibitors and selective serotonin reuptake inhibitors, response rates to these targeted therapies are variable. There are a number of studies in the published literature that provide proof-of-concept that genetic variation contributes to the variable response. Pharmacogenomics will most likely be one part of our therapeutic armamentarium in the future and will provide a stronger scientific basis for optimizing drug therapy on the basis of each patient's genetic constitution. This article will review English language medical literature on the state-of-the-art genetic polymorphisms of drug targets, transporters and signaling molecules as well as pharmacogenetic studies of sexual dysfunction and suggested possible applications. Collectively, the data demonstrate that pharmacogenomics in the field of sexual medicine is still in its infancy. More research will provide further intriguing new discoveries in years to come.

  1. The role of oxidative stress in antipsychotics induced ovarian toxicity.

    PubMed

    Elmorsy, Ekramy; Al-Ghafari, Ayat; Aggour, Amal Misbah; Khan, Raheela; Amer, Saad

    2017-10-01

    This study tested the hypothesis that oxidative stress could be an underlying mechanism for APs-induced ovarian cytotoxicity and reproductive dysfunction. Rat ovarian theca interstitial cells (TICs) were isolated and treated with four APs [chlorpromazine (CPZ), haloperidol (HAL), risperidone (RIS) and clozapine (CLZ)]. MTT assay was used to test the effects of these antipsychotics on TICs viability and to estimate their 50% inhibitory concentrations (IC50s). The effects of APs (IC50s and 1μM concentrations) on the activities of caspases-3, -8 and -9, reactive oxygen species (ROS) production, total intracellular glutathione and lipid peroxidation (LPO) in TICs were assessed. The effect of antioxidants (reduced glutathione (GSH) and quercetin) on the APs-induced cytotoxicity on TICs was investigated. MTT assay showed all APs to reduce TICs viability. CPZ, HAL and CLZ significantly increased the activity of caspases-3, -8 and -9 (P<0.0001, <0.0001 and <0.01, respectively). All APs at IC50s significantly (P<0.0001) increased ROS production, decreased total intracellular glutathione and increased LPO. MTT assay in the presence of antioxidants (reduced GSH (5mM) or quercetin (50mM)) showed each antioxidant to significantly inhibit the effects of APs at their IC50s on TICs viability. In conclusion, oxidative stress seems to be a possible mechanism for APs-induced ovarian and reproductive toxicity. Copyright © 2017. Published by Elsevier Ltd.

  2. Sexual rehabilitation and cancer survivorship: a state of art review of current literature and management strategies in male sexual dysfunction among prostate cancer survivors.

    PubMed

    Chung, Eric; Brock, Gerald

    2013-02-01

    The challenges for prostate cancer survivors include the surveillance of prostate cancer recurrence and management of physical, cognitive, sexual, and socioeconomic quality of life issues. Sexual function remains an important issue in men, who often continue to be interested in sex after prostate cancer treatment. The various post-prostate cancer treatment-related sexual dysfunctions are penile deformities and erectile dysfunction (ED); sexual desire and mental health; ejaculatory and orgasmic dysfunctions; and changes in partner relationship and dynamics. The aim of this study is to provide state of art review of the various male sexual dysfunctions in prostate cancer survivors and the management strategies in sexual rehabilitation. A literature search for English language original and review articles either published or e-published was performed using PubMed database. Keywords included prostate cancer, prostate cancer treatment, prostate prostatectomy (RP), sexual dysfunction, erectile dysfunction (ED), sexual desire, mental health, ejaculation, orgasmic, climacturia, and relationship. There has been considerable volume of publication in recent years on prostate cancer-related male sexual dysfunction. Penile deformities and ED shared similar pathophysiology and that penile smooth muscle fibrosis ultimately results in structural alterations and end-organ failure. Penile rehabilitation using oral phosphodiesterase type 5 (PDE5) inhibitors is considered the standard of care especially in patients who received nerve-sparing RP and should be instituted as soon as possible to protect and prevent corporal endothelial and smooth muscle damage. However, there is no consensus on the exact timing, dose, and duration of PDE5 inhibitors and its impact in non-nerve-sparing RP and other forms of prostate cancer treatment modalities. Current literature on hypoactive sexual desire, ejaculatory, and orgasmic dysfunctions in patients who received prostate cancer treatment is

  3. Viewing Sexual Stimuli Associated with Greater Sexual Responsiveness, Not Erectile Dysfunction

    PubMed Central

    Prause, Nicole; Pfaus, James

    2015-01-01

    Introduction Time spent viewing visual sexual stimuli (VSS) has the potential to habituate the sexual response and generalize to the partner context. Aim The aim of this study was to examine whether the time spent viewing VSS is related to sexual responsiveness felt in the laboratory or with a sexual partner. Methods Nontreatment-seeking men (N = 280) reported their weekly average VSS viewing in hours. VSS hours were examined in relation to the sexual arousal experienced while viewing a standardized sexual film in the laboratory and erectile problems experienced with a sexual partner. Main Outcome Measures Self-reported sexual arousal in response to sexual films and erectile problems on the International Index of Erectile Function were the main outcome measures. Results More hours viewing VSS was related to stronger experienced sexual responses to VSS in the laboratory, was unrelated to erectile functioning with a partner, and was related to stronger desire for sex with a partner. Conclusions VSS use within the range of hours tested is unlikely to negatively impact sexual functioning, given that responses actually were stronger in those who viewed more VSS. PMID:26185674

  4. Sexual dysfunction in dialysis patients: does vitamin D deficiency have a role?

    PubMed Central

    Kidir, Veysel; Altuntas, Atila; Inal, Salih; Akpinar, Abdullah; Orhan, Hikmet; Sezer, Mehmet Tugrul

    2015-01-01

    Introduction: Sexual dysfunction and vitamin D deficiency are highly prevalent in dialysis patients. Low levels of vitamin D have been linked to many diseases. To the best of our knowledge, the relationship between vitamin D and sexual dysfunction in dialysis patients has not been previously reported in the literature. Materials and methods: Cholecalciferol, 50,000 IU/week, was orally administered to 37 dialysis patients with vitamin D insufficiency for 3 months followed by dosage of 10,000 IU every other week for 3 months. The Arizona Sexual Experiences Scale (ASEX), Hospital Anxiety and Depression Scale and Pittsburgh Sleep Quality Index questionnaires were filled out by all patients at baseline and at the sixth month of the study. Results: Sexual dysfunction, poor sleep quality, anxiety and depression rates were 83.7%, 45.9%, 18.9% and 48.6%, respectively in all patients. ASEX total score was found to be positively correlated with age and was negatively correlated with serum 25(OH)D level and serum albumin level. After cholecalciferol treatment, 25(OH)D levels increased significantly, however no significant change was observed in any of the parameters. In multivariate linear regression analysis, age and 25(OH)D level were found to be independent predictors of ASEX total score. Conclusions: Vitamin D deficiency seems to contribute to sexual dysfunction in dialysis patients. However, it was observed in this study that; cholecalciferol replacement given to dialysis patients with vitamin D insufficiency did not result in any significant changes in sexual functions. PMID:26885232

  5. Evaluating Sexual Nursing Care Intervention for Reducing Sexual Dysfunction in Indonesian Cervical Cancer Survivors

    PubMed Central

    Afiyanti, Yati; Rachmawati, Imami Nur; Milanti, Ariesta

    2016-01-01

    Objective: This study aims to describe the factors affecting successful nursing care intervention on sexuality. Methods: A one-group pre- and post-test design was used. Fifty-three cervical cancer survivors and their spouses were administered with nursing care intervention on sexuality in three sessions and evaluated after 6 weeks. Results: Sexual intervention reduced dyspareunia symptoms, improved vaginal lubrication, improved sexual satisfaction, and enhanced sexual arousal, sexual desire, and orgasm among cancer survivors and their spouses. The other influencing factors also simultaneously contributed to the success of nursing care intervention. Conclusions: Nursing care intervention on sexuality could be a part of supportive nursing care and an important aspect in standard nursing care for cancer patients in Indonesia. PMID:27981170

  6. Female Sexual Dysfunction Among the Wives of Opioid-Dependent Males in Iran

    PubMed Central

    Anvar Abnavi, Marjan; Ahmadi, Jamshid; Hamidian, Sajedeh; Ghaffarpour, Sara

    2016-01-01

    Background Opiate abuse in males has significant effects on their sexual functions. In contrast, sexuality in females is a multidimensional issue that can strongly be affected by several factors in their partners. However, only a limited number of studies have assessed the role of males’ opioid dependency in their female partners’ sexual function. Objectives The present study aimed to evaluate the effect of males’ opioid dependency on their wives’ sexual function compared to the sexual function of the females whose husbands were not opioid dependent. Patients and Methods This study included 340 women who were selected through convenience sampling and divided into a control (females whose husbands were not opioid dependent) and a case group (women whose husbands were opioid dependent). The data were collected through an interview according to the DSM-IV-R criteria for female sexual dysfunctions by a senior female medical student who was one of the researchers. Finally, the data were entered into the SPSS statistical software (v. 15) and analyzed using the t-test and chi-square test. Results According to the results, the frequency of hypoactive sexual desire disorder and sexual aversion disorder in the control group was significantly higher than that of the case group (P < 0.05). Conclusions The results showed that having an addicted husband could strongly affect some sexual domains in women. It could change the pattern of desire and motivation for sexual contact in females and alter their attitude toward the sexual relationship, thereby causing disturbances in the females’ normal sexual function. PMID:27218067

  7. Male sexual dysfunction and ankylosing spondylitis: a systematic review and metaanalysis.

    PubMed

    Fan, Dazhi; Liu, Li; Ding, Ning; Liu, Si; Hu, Yanting; Cai, Guoqi; Xia, Guo; Xin, Lihong; Wang, Li; Xu, Shengqian; Xu, Jianhua; Zou, Yanfeng; Pan, Faming

    2015-02-01

    No consensus has been reached on sexual dysfunction in men with ankylosing spondylitis (AS). Our study aimed to derive a more precise estimation of the sexual function and its clinical correlations in men with AS. A metaanalysis was performed and the related literature were searched in PubMed, Elsevier Science Direct, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and in reference lists of articles and systematic reviews. Score of the International Index of Erectile Function (IIEF) was used as the outcome measurement, and standardized mean differences (SMD) with 95% CI were calculated. Eleven studies were included, including 535 men with AS and 430 male controls. Each domain of the IIEF score (erectile function: SMD -0.52, 95% CI -0.68 - -0.37; orgasmic function: -0.72, -1.03 - -0.42; sexual drive: -0.40, -0.62 - -0.18; intercourse satisfaction: -0.86, -1.15 - -0.56; and overall satisfaction: -0.61, -0.91 - -0.32) were lower in men with AS than in controls. In the subgroup analysis, the results did not change except for the sexual drive in the Asians group (-0.15, -0.42-0.13). At metaregression, no study characteristics were significantly associated with effect size of the IIEF score. Sexual function is impaired in male patients with AS and further studies are necessary to better understand risk factors for sexual dysfunction in this population.

  8. A review of the potential of medicinal plants in the management and treatment of male sexual dysfunction.

    PubMed

    Malviya, N; Malviya, S; Jain, S; Vyas, S

    2016-10-01

    Male sexual dysfunction is a common disorder that appears to be a consequence of a wide range of physical and psychological conditions. Due to mental stress, insufficient physical exercise and various aetiological factors, human being's life is becoming less pleasant, which leads to incapability to have sexual pleasure. The allopathic drugs used for sexual dysfunction are believed to produce a variety of side effects and affect other physiological processes and, ultimately, general health. Therefore, the search for natural supplement from medicinal plants is being intensified probably because of less side effects availability and affordability. Ethnobotanical surveys have indicated a large number of plants traditionally used as aphrodisiacs but only few of them are scientifically validated for the management and treatment of male sexual dysfunction. This article has summarised the medicinal plants traditionally recommended and scientifically validated for the management and treatment of male sexual dysfunction.

  9. Blood Pressure, Sexual Activity, and Dysfunction in Women With Hypertension: Baseline Findings From the Systolic Blood Pressure Intervention Trial (SPRINT).

    PubMed

    Foy, Capri G; Newman, Jill C; Berlowitz, Dan R; Russell, Laurie P; Kimmel, Paul L; Wadley, Virginia G; Thomas, Holly N; Lerner, Alan J; Riley, William T

    2016-09-01

    Sexual function, an important component of quality of life, is gaining increased research and clinical attention in older women with hypertension. To assess the association between systolic blood pressure (SBP) and other variables, and sexual activity and sexual dysfunction in hypertensive women. Baseline analysis of 635 women participants of a larger randomized clinical trial of 9361 men and women. Self-reported sexual activity (yes/no), and sexual function using the Female Sexual Function Inventory (FSFI). 452 participants (71.2%) reported having no sexual activity during the previous 4 weeks. The mean (SD) FSFI score for sexually active participants was 25.3 (6.0), and 52.6% of the sample reported a FSFI score ≤26.55 designating sexual dysfunction. In logistic regression models, SBP was not significantly associated with sexual activity (AOR = 1.002; P > .05). Older age (AOR = 0.95, P < .05), and lower education (AOR for < high school vs college degree = 0.29, P < .05) were associated with lower odds of being sexually active, as was living alone versus living with others (AOR = 0.56, P < .05). Higher weekly alcohol consumption was associated with increased odds of being sexually active (AOR = 1.39; P < .05). In logistic regression models among sexually active participants, SBP was not associated with sexual dysfunction (AOR = 1.01; P > .05). Higher depressive symptoms from the Patient Health Questionnaire-9 (PHQ-9) was associated with higher odds of sexual dysfunction (AOR = 1.24, P < .05), as was increased number of physical comorbidities (AOR = 1.25, P < .05). Diuretic use was associated with lower odds of being sexually active in participants with chronic kidney disease (AOR = 0.33, P < .05). Younger age, higher education, living with others, and higher weekly alcohol consumption were significantly associated with higher odds of being sexually active in a sample of middle-aged and older women with hypertension. Increased depressive symptoms and

  10. Relationship between SSRI-induced sexual dysfunction and central serotonergic activity based on the loudness dependence of auditory evoked potentials.

    PubMed

    Park, Young-Min

    2014-02-01

    It has been hypothesized that selective serotonin reuptake inhibitor (SSRI)-induced sexual dysfunction can occur more frequently in patients with higher central serotonergic activity, and that this higher serotonergic activity can induce inhibition of sexual desire, ejaculation, and orgasm. Thus, the aim of this study was to determine the relationship between SSRI-induced sexual dysfunction and increased serotonin. Event-related potentials for the loudness dependence of auditory evoked potentials (LDAEP) were measured in 46 patients at a single time point. The subjects' scores on the Hamilton Depression Rating Scale and Antidepressant Side-Effect Checklist were also determined by the investigators at the same time point. All patients had received SSRI monotherapy. Overall, 37 % (17/46) of the patients experienced some form of SSRI-induced sexual dysfunction: lack of sexual desire, impotence, orgasm, and menstrual abnormality or mastalgia were experienced by 21.7, 8.3, 15.2, and 20.6 % of the patients, respectively. The subjects were thus divided into two groups-those with and without sexual dysfunction-and their data were compared. There was a tendency for the LDAEP to be lower in the group with sexual dysfunction (1.04 ± 0.77 μV) than the group without sexual dysfunction (1.45 ± 0.86 μV), although the difference was not statistically significant (p = 0.086). Furthermore, the distribution of the frequency of SSRI-induced sexual dysfunction differed marginally significantly between patients with low and high LDAEP, dichotomized according to the median LDAEP on the Cz electrode (χ (2) = 3.664, p = 0.056). There was a relatively high frequency of SSRI-induced sexual dysfunction in patients with low LDAEP.

  11. [Prevalence of sexual dysfunction in primigravidae in Rio Branco, Acre State, Brazil].

    PubMed

    Lima, Adriani Castro de; Dotto, Leila Maria Geromel; Mamede, Marli Villela

    2013-08-01

    This study aimed to estimate the prevalence of sexual dysfunction prior to and during the first pregnancy. This was a cross-sectional study using postpartum interviews with 778 primigravidae who were married or in stable unions and had given birth at the two maternity hospitals in Rio Branco, Acre State, Brazil, from February 1st to July 31st, 2010. Median age was 20 years, 45% were adolescents, 19% had completed elementary school, 30% had paid jobs, and 86.5% had used public healthcare services (SUS) for childbirth. Prevalence of sexual dysfunction was 23.9% prior to pregnancy and 67.7% during pregnancy. Decreased libido was present in 20.2% prior to pregnancy and 51% during pregnancy. Decreased vaginal lubrication occurred in 29.1% during pregnancy. Dyspareunia was present in 1.2% prior to pregnancy and 14.4% during pregnancy. Some 3.3% reported sexual dissatisfaction prior to pregnancy, as compared to 10.8% during pregnancy. Women with more schooling showed higher prevalence of sexual dysfunction during (as compared to before) their first pregnancy.

  12. Physician perceptions of sexual dysfunction related to benign prostatic hyperplasia (BPH) symptoms and sexual side effects related to BPH medications.

    PubMed

    Seftel, A; Rosen, R; Kuritzky, L

    2007-01-01

    In a large-scale epidemiology study, 50% of aging men reported erectile dysfunction (ED) or ejaculatory dysfunction (EjD), with lower urinary tract symptoms (LUTS) an independent risk factor for each of these conditions. In light of the shift from urologists (UROs) to primary care/internal medicine physicians (PCPs) for the initial management of men with LUTS associated with benign prostatic hyperplasia (BPH), a survey was conducted to assess the perceptions of UROs and PCPs regarding sexual dysfunction (SD) in men with LUTS/BPH and the effects of BPH treatments (alpha(1)-adrenergic receptor antagonists (alpha-blockers) and 5alpha-reductase inhibitors (5ARIs)) on sexual function. The survey was mailed to 7500 UROs and 2500 PCPs, with 1275 (13%) surveys returned (1087 by UROs, 177 by PCPs and 11 by other specialty). Alpha-blocker monotherapy was the most common medication prescribed by both UROs (56%) and PCPs (47%). UROs estimated that 19% of their patients with LUTS/BPH experienced SD owing to their symptoms compared with the estimate of 27% by PCPs. UROs estimated that 19% of their patients experienced SD owing to their BPH medication compared with the PCP estimate of 24%. The incidence of EjD owing to BPH medications estimated by UROs (32%) was higher than that estimated by PCPs (22%); the rate of ED estimated by PCPs (34%) was higher than that estimated by UROs (23%). UROs were more aware than PCPs of the specific sexual side effects caused by alpha-blockers versus 5ARIs. These results suggest that physicians are underestimating the prevalence of SD in men with LUTS/BPH. As men with LUTS/BPH are at increased risk for SD, physicians should be especially cognizant of BPH treatment-related sexual side effects.

  13. Sexual Dysfunction, HIV, and AIDS in Men Who Have Sex with Men

    PubMed Central

    Shindel, Alan W.; Horberg, Michael A.; Smith, James F.

    2011-01-01

    Abstract HIV infection is associated with sexual dysfunction. Using validated instruments, we investigated the relationship between HIV/AIDS and sexual function in a contemporary cohort of men who have sex with men (MSM). An anonymous Internet-based survey was disseminated to MSM via organizations and social networking sites that cater to this population. Information on ethnodemographic variables, health status (including HIV status, disease stage, and other health conditions), and sexual behavior was collected. Men were categorized as HIV-negative, HIV-positive/AIDS-negative, or HIV-positive /AIDS-positive. A modified validated version of the International Index of Erectile Function (IIEF) for use in MSM and the Premature Ejaculation Diagnostic Tool (PEDT) were used to stratify risk of sexual dysfunction. The study cohort included 1361 men (236 of whom were HIV-positive) who provided complete data on HIV status, IIEF, and PEDT. There was a significant trend toward greater prevalence of erectile dysfunction (ED) in men with progressive HIV infection 40–59 years of age relative to age matched HIV-negative men (p=0.02). In a logistic regression model controlling for other variables, HIV infection without AIDS was not associated with greater odds of ED; however, HIV infection with AIDS was associated with greater odds of ED (p=0.006). In a separate logistic regression model, HIV infection with or without AIDS was not significantly associated with greater odds of premature ejaculation (p>0.05). Use of phosphodiesterase 5 (PDE5) inhibitor drugs was much more common in HIV-infected men. HIV infection is a risk factor for poorer sexual function primarily due to higher risk of erectile dysfunction in men with AIDS. PMID:21501095

  14. Change in sexual dysfunction with aripiprazole: a switching or add-on study.

    PubMed

    Mir, Amna; Shivakumar, Kuppuswami; Williamson, Richard J; McAllister, Victoria; O'Keane, Veronica; Aitchison, Katherine J

    2008-05-01

    Sexual dysfunction and raised prolactin are common adverse effects of many anti-psychotics. Aripiprazole is an atypical anti-psychotic associated with a reduction in prolactin level in anti-psychotic-induced hyperprolactinemia. Our hypothesis was that switching from another anti-psychotic to aripiprazole would be associated with a reduction in sexual dysfunction. An open label switch to aripiprazole was offered to 27 subjects with inadequate therapeutic response or intolerance to another anti-psychotic, who were followed up for 26 weeks. Serial clinical ratings included the Anti-psychotic Non-Neurological Side-Effects Rating Scale (ANNSERS), and the Sexual Functioning Questionnaire. Our primary analysis point was week 12. In both sexes, there was a significant reduction in prolactin by week 12 (P = 0.003), accompanied by a significant improvement in libido (P = 0.028). In males, both erectile and ejaculatory difficulties were also significantly reduced (P = 0.04 and P = 0.017, respectively). In females, menstrual dysfunction was also significantly reduced at week 12 (P = 0.04). By week 26, the changes in all of the above remained significant, and were accompanied by a significant increase in satisfaction in overall sexual functioning (P = 0.007), despite the fact that 54.5% of subjects at were also taking their original antipsychotic. There was also a significant decrease in the total ANNSERS score (P < 0.001) and a significant improvement in all other measures of psychopathology (PANSS, CGI-S/I, GAF-S/D, and QoL). We conclude that switching to aripiprazole or the addition of aripiprazole to another antipsychotic regime is associated with a reduction in sexual dysfunction.

  15. Correlations between sexual dysfunction, depression, anxiety, and somatic symptoms among patients with major depressive disorder.

    PubMed

    Lin, Chiao-Fan; Juang, Yeong-Yuh; Wen, Jung-Kwang; Liu, Chia-Yih; Hung, Ching-I

    2012-01-01

    The purpose of this study was to investigate the degree of correlation between sexual dysfunction and depression, anxiety, and somatic symptoms among patients with major depressive disorder (MDD) and to identify the dimension most predictive of sexual dysfunction. One-hundred and thirty-five outpatients with MDD were enrolled and were treated with open-label venlafaxine 75 mg daily for one month. The Arizona Sexual Experience Scale-Chinese Version (ASEX-CV), Depression and Somatic Symptoms Scale (DSSS), Hamilton Depression Rating Scale, and Hospital Anxiety and Depression Scale (HADS) were administered at baseline and at one-month follow-up and the improvement percentage (IP) of each scale posttreatment was calculated. Multiple linear regression was used to determine the dimension most predictive of the total ASEX-CV score. Seventy subjects (20 men, 50 women) completed the one-month pharmacotherapy and the four scales. The depression subscale of the HADS was most strongly correlated with the ASEX-CV scale and was the only subscale to independently predict the total ASEX-CV score at the two points. However, the somatic subscale of the DSSS was not correlated with any ASEX-CV item. At the endpoint, depression, anxiety, and somatic symptoms were significantly improved (IP 48.5% to 26.0%); however, very little improvement was observed in the total ASEX-CV score (IP -1.6%). The severity of sexual dysfunction among patients with MDD was most correlated with the severity of the depressive dimension, but not the severity of the somatic dimension. Further studies are indicated to explore the relationships between sexual dysfunction, depression, anxiety, and somatic symptoms.

  16. Is Pornography Use Associated with Sexual Difficulties and Dysfunctions among Younger Heterosexual Men?

    PubMed

    Landripet, Ivan; Štulhofer, Aleksandar

    2015-05-01

    Recent epidemiological studies reported high prevalence rates of erectile dysfunction (ED) among younger heterosexual men (≤40). It has been suggested that this "epidemic" of ED is related to increased pornography use. However, empirical evidence for such association is currently lacking. This study analyzes associations between pornography use and sexual health disturbances among younger heterosexual men using four large-scale online samples from three European countries. The analyses were carried out using a 2011 cross-sectional online study of Croatian, Norwegian, and Portuguese men (Study 1; N = 2,737) and a 2014 cross-sectional online study of Croatian men (Study 2; N = 1,211). Chi-square test and multivariate logistic regression were used to explore the associations between pornography use and sexual difficulties. In Study 1, erectile difficulties, inability to reach orgasm, and a lack of sexual desire were measured using the Global Study of Sexual Attitudes and Behavior indicators. In Study 2, ED was measured with the abridged International Index of Erectile Function (IIEF-5). Delayed ejaculation and a decrease of sexual desire were assessed with one-item indicators. In Study 1, only the relationship between pornography use and ED among Croatian men was statistically significant (χ(2) [2] = 18.76, P < 0.01). The association was small and inconsistent. Compared with infrequent use of pornography, moderate but not high frequency of pornography use increased the odds of reporting ED (adjusted odds ratio = 0.53, P < 0.01). In Study 2, no significant associations both between either the frequency or the recent dynamics of pornography use and male sexual dysfunctions were observed. We found little evidence of the association between pornography use and male sexual health disturbances. Contrary to raising public concerns, pornography does not seem to be a significant risk factor for younger men's desire, erectile, or orgasmic difficulties

  17. Sweet Bee Venom Pharmacopuncture May be Effective for Treating Sexual Dysfunction.

    PubMed

    Lee, Pavel; Yu, Junsang

    2014-09-01

    Sexual dysfunction (SD) is a health problem which occurs during any phase of the sexual response cycle that keeps the individual or couple from experiencing satisfaction from the sexual activity. SD covers a wide variety of symptoms like in men, erectile dysfunction and premature or delayed ejaculation, in women, spasms of the vagina and pain with sexual intercourse, in both sexes, sexual desire and response. And pharmacopuncture, i.e. injection of subclinical doses of drugs, mostly herb medicine, in acupoints, has been adopted with successful results. This case report showed the effect of bee venom on SD. A 51-year-old male patient with SD, who had a past history of taking Western medication to treat his SD and who had previously undergone surgery on his lower back due to a herniated disc, received treatments using pharmacopuncture of sweet bee venom (SBV) at Gwanwon (CV4), Hoeeum (CV1), Sinsu (BL23), and Gihaesu (BL24) for 20 days. Objectively, the patient showed improvement on most items on the International Index for Erectile Dysfunction (IIEF) like 28 to 29 out of perfect score 30 for erectile function, 10 to 10 out of perfect score 10 for orgasmic function, 6 to 8 out of perfect score 10 for sexual desire, 10 to 13 out of perfect score 15 for satisfaction with intercourse, and 6 to 8 out of perfect score 10 for overall satisfaction; subjectively, his words, the tone of his voice and the look of confidence in his eyes all indicated improvement. Among the variety of effects of SBV pharmacopuncture, urogenital problems such as SD may be health problems that pharmacopuncture can treat effectively.

  18. Cognitive Attentional Syndrome and Metacognitive Beliefs in Male Sexual Dysfunction: An Exploratory Study.

    PubMed

    Giuri, Simona; Caselli, Gabriele; Manfredi, Chiara; Rebecchi, Daniela; Granata, Antonio; Ruggiero, Giovanni Maria; Veronese, Guido

    2016-06-08

    Erectile dysfunction (ED) and premature ejaculation (PE) are two forms of male sexual disorder with both psychological and physical features. While their cognitive, attentional, and affective components have been investigated separately, there is a lack of knowledge about the role played by cognitive attentional syndrome in their onset and maintenance. The aim of the present study was to investigate the possible contribution of perseverative thinking styles and thought control strategies to the development and maintenance of ED and PE. The authors hypothesized that such modes of processing might constitute a cognitive attentional syndrome specific to these disorders and sustained by particular metacognitive beliefs. A semistructured interview was administered to 11 participants with ED and 10 with PE in order to assess their metacognitive beliefs and cognitive attentional processes. The results suggest that individuals with ED and PE adopt a range of cognitive attentional strategies aimed at improving their sexual performance, and endorse both positive and negative metacognitive beliefs about these thinking responses. Overall, their cognitive and attentional patterns worsened negative internal states, reduced sexual excitement, detached them from their bodily sensations, and hindered sexual functioning. These preliminary findings suggest that perseverative thinking, thought control strategies, and metacognitive beliefs may play a key role in the onset and maintenance of male sexual dysfunction.

  19. The prevalence of sexual dysfunction in the female health care providers in Jeddah, Saudi Arabia.

    PubMed

    Rouzi, Abdulrahim A; Sahly, Nora; Sawan, Dana; Kafy, Souzan; Alzaban, Faten

    2015-01-20

    The objective of this study was to determine the prevalence of sexual dysfunction in Saudi and non-Saudi female health care providers in Jeddah, Saudi Arabia. One -hundred twenty (60 Saudi and 60 non-Saudi) sexually active female health care professionals in Jeddah, Saudi Arabia, were anonymously surveyed using the English version of the female sexual function index questionnaire. The individual domain scores for pain, arousal, lubrication, orgasm, satisfaction, pain, and overall score for the Saudi and non-Saudi women were calculated and compared. The two groups were comparable in demographic characteristics. No statistically significant differences were found between Saudi and non-Saudi women in desire (P = .22) and arousal scores (P = .47). However, non-Saudi women had significantly higher lubrication (P < .001), orgasm (P = .015), satisfaction (P = .004), and pain scores (P = .015). The overall scores in Saudi and non-Saudi women were low (23.40 ± 4.50 compared with 26.18 ± 5.97), but non-Saudi women had a significantly higher overall score (P = .005). Taken together, sexual dysfunction is prevalent among Saudi and non-Saudi female health care providers, with Saudi women demonstrating lower scores in four sexual function domains and the overall score.

  20. Can polyacrylic acid treat sexual dysfunction in women with breast cancer receiving tamoxifen?

    PubMed

    Juliato, P T; Rodrigues, A T; Stahlschmidt, R; Juliato, C R T; Mazzola, P G

    2017-02-01

    There is a lack of safety data supporting the use of hormone therapy in women who have had breast cancer and who have complained of genitourinary syndrome of menopause (GSM). The objective was to test the efficacy of two non-hormonal therapies for vaginal dryness. This was a randomized trial with 52 women with breast cancer who were being treated with tamoxifen and who complained of vaginal dryness. The volunteers answered two questionnaires to evaluate sexual function (Female Sexual Function Index, FSFI) and a customized GSM questionnaire. The women were randomized into two groups: 25 (48.1%) in the polyacrylic acid group and 27 (51.9%) in the lubricant group, using either one of the treatments for 30 days, and after they were invited to answer the questionnaires again. There was improvement in the FSFI after both treatments. The polyacrylic acid group showed a decrease in sexual dysfunction from 96% to 24% (p < 0.0001) and the lubricant group showed a decrease from 88.9% to 55.6% (p = 0.0027). The results of this study showed that both treatments improved sexual function; however, polyacrylic acid was superior to the lubricant in treating sexual dysfunction.

  1. Paraffin Granuloma Associated with Buried Glans Penis-Induced Sexual and Voiding Dysfunction

    PubMed Central

    Chon, Wonhee; Koo, Ja Yun; Park, Min Jung; Choi, Kyung-Un; Park, Hyun Jun

    2017-01-01

    A paraffinoma is a type of inflammatory lipogranuloma that develops after the injection of an artificial mineral oil, such as paraffin or silicon, into the foreskin or the subcutaneous tissue of the penis for the purpose of penis enlargement, cosmetics, or prosthesis. The authors experienced a case of macro-paraffinoma associated with sexual dysfunction, voiding dysfunction, and pain caused by a buried glans penis after a paraffin injection for penis enlargement that had been performed 35 years previously. Herein, this case is presented with a literature review. PMID:28868821

  2. [Complications after treatment of colorectal cancer, with special focus on stomas, urological conditions and sexual dysfunction].

    PubMed

    Gögenur, Ismail; Wittendorff, Hans-Erik; Colstrup, Hans; Rosenberg, Jacob; Fischer, Anders

    2005-11-07

    In spite of improved surgical principles in colorectal surgery, patients undergoing this operation still suffer from long-term postoperative complications. Many patients have permanent stomas, and up to 60% have problems related to their stomas, the most frequent of these being parastomal hernia. In this context, the use of primary prophylaxis with mesh insertion is encouraging. Before the introduction of total mesorectal excision (TME), there was a very high rate of bladder problems and sexual dysfunction with impotence and retrograde ejaculation. The rate has been reduced dramatically since the introduction of TME, but up to 5% of patients still suffer from permanent bladder dysfunction and complete impotence.

  3. [Erectile dysfunction: results of the Brazilian Sexual Life Study].

    PubMed

    Abdo, Carmita Helena Najjar; Oliveira, Waldemar Mendes de; Scanavino, Marco de Tubino; Martins, Fernando Gonini

    2006-01-01

    To estimate the prevalence of ED and related risk factors in a sample of the Brazilian male population. Cross-sectional study was carried out with a convenience sample of 2,862 men, 18 years of age or older, using an anonymous self-administered questionnaire. ED prevalence in the sample was obtained by a general question which was directly derived from the ED definition. Data were submitted to chi-square or Student's t tests. Logistic regression analyses were used for risk factor calculations. The prevalence of ED was 45.1% (31.2% mild, 12.2% moderate and 1.7% complete). Subjects with ED presented lower self-esteem, hindered interpersonal relationships, fewer sexual intercourses per week, more extra-marital relationships, complaints of lack of libido and premature ejaculation. When compared with men aged 18-39 years, men aged 60-69 presented 2.2 higher risk of ED (95% CI; 1.4-3.4; p < 0.01), whereas men aged 70 or older presented 3.0 higher risk of ED (95% CI; 1.4-6.3; p < 0.01). Level of education was inversely proportional to risk of ED. Yellow race, unemployment, religious affiliation, prostate tumor, hypertension and depression were variables that increased ED risk. The prevalence of ED was high and comparable to that found in other studies. Subjects with ED suffer from less sexual activity and poorer quality of life. Age and lower socioeconomic level are directly proportional to ED risk. Therapeutic and preventive measures should be implemented to minimize the negative impact of this condition, especially in developing countries.

  4. Placebo response in the treatment of women's sexual dysfunctions: a review and commentary.

    PubMed

    Bradford, Andrea; Meston, Cindy M

    2009-01-01

    We reviewed the literature to determine the nature and magnitude of therapeutic response associated with placebo treatment in clinical trials for women's sexual dysfunction. We abstracted data from 16 articles to record the effect size associated with placebo treatment. In most of these studies, placebo recipients reported statistically significant improvements on one or more major endpoints relative to baseline. Although placebo responses varied across study populations and methodologies, within-group effect sizes were predominantly in the moderate range. Our findings suggest that post-menopausal women and women with hypoactive sexual desire disorder may be more likely to respond to placebo treatment.

  5. Summary of findings from the FDA regulatory science forum on measuring sexual dysfunction in depression trials.

    PubMed

    Kronstein, Phillip D; Ishida, Eiji; Khin, Ni A; Chang, Eric; Hung, H M James; Temple, Robert J; Yang, Peiling

    2015-08-01

    Sexual dysfunction is a significant treatment-emergent adverse reaction to the serotonergic antidepressants (selective serotonin reuptake inhibitors [SSRIs] and serotonin-norepinephrine reuptake inhibitors [SNRIs]). However, the rate of sexual dysfunction is often underestimated in registration trials, which have relied on unsolicited reports. We conducted a literature search to examine the rates of sexual dysfunction with SSRIs/SNRIs when these rates were ascertained by structured questionnaires or standardized instruments. Additionally, we conducted exploratory analyses of major depressive disorder (MDD) registration trial data. For the literature search, we used the PubMed and EMBASE databases, with a cutoff date of April 1, 2011. We included all the SSRIs and SNRIs that at the time had been approved for the treatment of MDD. For each of these drugs, a search was conducted with the following terms: sexual dysfunction, SD, sexual adverse effects, desire, arousal, excitement, and orgasm. For the exploratory analyses of US Food and Drug Administration in-house trial data, we searched our database for short-term (6-8 weeks), randomized, placebo-controlled MDD monotherapy trials of approved drugs included in New Drug Application submissions that used a standardized instrument to assess sexual function. For the literature search, we initially found a total of 123 nonduplicate articles, some of which included multiple studies. After screening based on our inclusion/exclusion criteria (and to remove duplicate trial-level data), we were left with 7 articles representing 11 unique studies in which sexual dysfunction was assessed with direct questioning or standardized instruments. The Changes in Sexual Functioning Questionnaire-Short-Form (CSFQ-14) and Arizona Sexual Experiences Scale (ASEX) were the only instruments represented. For the exploratory analyses of in-house MDD trial data, we found controlled studies using either the CSFQ-14 (6 trials) or ASEX (5 trials). For

  6. Sexual dysfunction and depression among Turkish women with infertile husbands: the invisible part of the iceberg.

    PubMed

    Ozkan, Burak; Orhan, Elcın; Aktas, Neslıhan; Coskuner, Enıs Rauf

    2016-01-01

    To determine the effect of male infertility on the sexual functions and level of depression among Turkish women. Fifty-six women with an infertile partner (exposed) and 48 women who conceived and gave birth without treatment (unexposed) were included in this study. The Female Sexual Function Index (FSFI) and Beck Depression Inventory (BDI) were used to determine sexual function and depression status. Statistical analyses were performed by independent samples t, Fischer's exact, and Mann-Whitney U tests. There were no significant differences in terms of demographic characteristics between groups except that unexposed women had received education for longer period of time (11.6 vs. 7.1 years, p = 0.001). Mean FSFI scores were 19.1 ± 5.5 for the exposed and 20.0 ± 3.4 for the unexposed group. The scores of sexual desire domain (3.4 ± 1.2 vs. 2.7 ± 1.2, p < 0.05), sexual dysfunction in the axis of lubrication (3.6 ± 1.4 vs. 4.0 ± 0.2, p = 0.039), and pain (4.1 ± 1.9 vs. 5.4 ± 0.8, p = 0.001) were found to be significantly higher in women with an infertile partner. According to BDI scores, these women were feeling more depressed (9.7 ± 7.3 vs. 1.4 ± 2.8, p = 0.001) than the unexposed group. Comparison of these groups indicated similar levels of sexual dysfunction. Nonetheless, we found that women with infertile partners experienced sexual problems related to lubrication and pain, even though they were in the initial stages of the treatment process for infertility. Exposed group had also higher level of depression than the unexposed group.

  7. Adjunctive Aripiprazole Versus Placebo for Antipsychotic-Induced Hyperprolactinemia: Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Li, Xianbin; Tang, Yilang; Wang, Chuanyue

    2013-01-01

    Objective To compare the safety and efficacy of adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia. Methods Population: adult patients presenting with antipsychotic-induced hyperprolactinemia diagnosed by prolactin level with or without prolactin-related symptoms. Interventions: adjunctive aripiprazole vs. adjunctive placebo. Outcome measures: adverse events and efficacy of treatment. Studies: randomized controlled trials. Results Five randomized controlled trials with a total of 639 patients (326 adjunctive aripiprazole, 313 adjunctive placebo) met the inclusion criteria. Adjunctive aripiprazole was associated with a 79.11% (125/158) prolactin level normalization rate. Meta-analysis of insomnia, headache, sedation, psychiatric disorder, extrapyramidal symptom, dry mouth, and fatigue showed no significant differences in the adjunctive aripiprazole treatment group compared with the placebo group (risk difference (Mantel-Haenszel, random or fixed) −0.05 to 0.04 (95% confidence interval −0.13 to 0.16); I2 = 0% to 68%, P = 0.20 to 0.70). However, sedation, insomnia, and headache were more frequent when the adjunctive aripiprazole dose was higher than 15 mg/day. Meta-analysis of the prolactin level normalization indicated adjunctive aripiprazole was superior to placebo (risk difference (Mantel-Haenszel, random) 0.76 (95% confidence interval 0.67 to 0.85); I2 = 43%, P<0.00001). The subgroup analysis confirmed that the subjects who received adjunctive aripiprazole 5 mg/day showed a degree of prolactin normalization similar to that of all participants. No significant differences between groups in discontinuation and improvements of psychiatric symptoms. Conclusion Adjunctive aripiprazole is both safe and effective as a reasonable choice treatment for patients with antipsychotic-induced hyperprolactinemia. The appropriate dose of adjunctive aripiprazole may be 5 mg/day. PMID:23936389

  8. Metformin treatment of antipsychotic-induced dyslipidemia: an analysis of two randomized, placebo-controlled trials.

    PubMed

    Wu, R-R; Zhang, F-Y; Gao, K-M; Ou, J-J; Shao, P; Jin, H; Guo, W-B; Chan, P K; Zhao, J-P

    2016-11-01

    Dyslipidemia is one of the most common adverse effects in schizophrenia patients treated with antipsychotics. However, there are no established effective treatments. In this study, data were pooled from two randomized, placebo-controlled trials, which were originally designed to examine the efficacy of metformin in treating antipsychotic-induced weight gain and other metabolic abnormalities. In total, 201 schizophrenia patients with dyslipidemia after being treated with an antipsychotic were assigned to take 1000 mg day(-1) metformin (n=103) or placebo (n=98) for 24 weeks, with evaluation at baseline, week 12 and week 24. The primary outcome was the low-density lipoprotein cholesterol (LDL-C) levels. After metformin treatment, the mean difference in the LDL-C value between metformin treatment and placebo was from 0.16 mmol l(-1) at baseline to -0.86 mmol l(-1) at the end of week 24, decreased by 1.02 mmol l(-1) (P<0.0001); and 25.3% of patients in the metformin group had LDL-C ≥3.37 mmol l(-1), which is significantly <64.8% in the placebo group (P<0.001) at week 24. Compared with the placebo, metformin treatment also have a significant effect on reducing weight, body mass index, insulin, insulin resistance index, total cholesterol and triglyceride, and increasing high-density lipoprotein cholesterol. The treatment effects on weight and insulin resistance appeared at week 12 and further improved at week 24, but the effects on improving dyslipidemia only significantly occurred at the end of week 24. We found that metformin treatment was effective in improving antipsychotic-induced dyslipidemia and insulin resistance, and the effects improving antipsychotic-induced insulin resistance appeared earlier than the reducing dyslipidemia.

  9. Dietary Fructose and GLUT5 Transporter Activity Contribute to Antipsychotic-Induced Weight Gain.

    PubMed

    Palavicino-Maggio, Caroline B; Kuzhikandathil, Eldo V

    2016-09-01

    Receptors for antipsychotics in the hypothalamus contribute to antipsychotics-induced weight gain; however, many of these receptors are also expressed in the intestine. The role of these intestinally-expressed receptors, and their potential modulation of nutrient absorption, have not been investigated in the context of antipsychotics-induced weight gain. Here we tested the effect of dietary fructose and intestinal fructose uptake on clozapine-induced weight gain in mice. Weight gain was determined in wild type mice and mice lacking the GLUT5 fructose transporter that were "orally-administered" 20mg/kg clozapine for 28 days. To assess the role of dietary fructose, clozapine-treated mice were fed controlled diets with different levels of fructose. Effect of clozapine treatment on intestinal fructose transport activity and expression levels of various receptors that bind clozapine, as well as several genes involved in gluconeogenesis and lipogenesis were measured using real-time RT-PCR and western blotting. Oral administration of clozapine significantly increased body weight in wild type C57BL/6 mice but not in GLUT5 null mice. The clozapine-induced weight gain was proportional to the percentage of fructose in the diet. Clozapine-treated mice increased intestinal fructose uptake without changing the intestinal expression level of GLUT5. Clozapine-treated mice expressed significantly higher levels of intestinal H1 histamine receptor in the wild type but not GLUT5 null mice. Clozapine also increased the intestinal expression of fructokinase and several genes involved in gluconeogenesis and lipogenesis. Our results suggest that increased intestinal absorption and metabolism of fructose contributes to clozapine-induced weight gain. Eliminating dietary fructose might prevent antipsychotics-induced weight gain. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email

  10. Changes in penile sensitivity following papaverine-induced erection in sexually functional and dysfunctional men.

    PubMed

    Rowland, D L; Leentvaar, E J; Blom, J H; Slob, A K

    1991-10-01

    To understand more clearly the role of penile sensitivity in sexual functioning, changes in penile thresholds resulting from papaverine-induced tumescence were studied in men who were either sexually functional or suffering from erectile dysfunction. Variable vibratory tactile stimulation was applied to 2 different sites, the base and tip of the underside of the penis. With standard psychophysical methodology, subjective thresholds were determined from a minimum of 5 threshold crossings. Results indicated a significant elevation in threshold after intracavernous papaverine injection, even though only partial erection was induced in most subjects. Men with erectile dysfunction had higher thresholds than control subjects but no difference in sensitivity was found between the base and tip of the penis. These findings indicate that low penile sensitivity is characteristic of some, although not all, men experiencing erectile problems and that this sensitivity is even lower during tumescence.

  11. Persistent Sexual Dysfunction with Finasteride 1 mg Taken for Hair Loss.

    PubMed

    Guo, Michael; Heran, Balraj; Flannigan, Ryan; Kezouh, Abbas; Etminan, Mahyar

    2016-11-01

    To examine the risk of persistent sexual dysfunction (PSD) with finasteride 1 mg. We conducted a retrospective cohort study using the IMS U.S. health claims database. From an original cohort of 6,110,723 patients, we identified 1390 men who had stopped using finasteride 1 mg and 20,000 randomly selected age- and calendar time-matched users of omeprazole from 2006 to 2014. First PSD event was defined as (1) the first PSD diagnosis through the first International Classification for Diseases, Ninth Revision, Clinical Modification) code for sexual dysfunction and (2) use of a phosphodiesterase inhibitor (sildenafil, tadalafil, or vardenafil). In the primary analysis, we identified 1390 men taking finasteride 1 mg and 20,000 omeprazole users. The mean time to first PSD event after discontinuation of a finasteride 1 mg prescription was 391 days (SD, 357 days). The rate of PSD for finasteride 1 mg users and omeprazole users was 37.9 and 15.0 per 1000 person-years, respectively. For the primary analysis of sexual dysfunction, the adjusted hazard ratio (HR) comparing finasteride 1 mg users to omeprazole users was 1.62 (1.14-2.29). Adjusted HR in the secondary analysis comparing finasteride users to omeprazole users with respect to the first phosphodiesterase inhibitor was 2.73 (2.01-3.69). The risk of PSD in men who stopped finasteride 1 mg therapy was higher than that for omeprazole users. Patients who stopped finasteride therapy sought physician visits for sexual dysfunction up to 1 year after stopping finasteride. © 2016 Pharmacotherapy Publications, Inc.

  12. Testicular prosthesis: Patient satisfaction and sexual dysfunctions in testis cancer survivors.

    PubMed

    Catanzariti, Francesco; Polito, Benedetta; Polito, Massimo

    2016-10-05

    We studied patient satisfaction about sexual activity after prosthesis implantation using validated questionnaires with the aim to discover if testicular prosthesis could be responsible of sexual dysfunctions (erectile dysfunction or premature ejaculation). We evaluated a total of 67 men who underwent radical orchiectomy for testicular cancer and a silicon testicular prosthesis implantation from January 2008 to June 2014 at our Hospital. These patients completed 5 validated questionnaires the day before orchiectomy and 6 months after surgery: the International Index of Erectile Function 5 (IIEF5), the Premature Ejaculation Diagnostic Tool (PEDT), the Body Exposure during Sexual Activities Questionnaire (BESAQ), the Body-Esteem Scale and the Rosenberg Self- Esteem Scale. We also evaluated 6 months after surgery any defects of the prosthesis complained by the patients. The questionnaires completed by patients didn't show statistically significant changes for erectile dysfunction (p > 0.05) and premature ejaculation (p > 0.05). On the contrary the psychological questionnaires showed statistically significant change for the BESAQ (p < 0.001) and the Body Esteem Scale (p < 0.001), but not for the Rosenberg Self-Esteem Scale (p > 0,05). A total of 15 patients (22.37%) were dissatisfied about the prosthesis: the most frequent complaint (8 patients; 11.94%) was that the prosthesis was firmer than the normal testis. Testicular prosthesis implantation is a safe surgical procedure that should be always proposed before orchiectomy for cancer of the testis. The defects complained by patients with testicular prosthesis are few, they don't influence sexual activity and they aren't able to cause erectile dysfunction or premature ejaculation.

  13. High frequency of sexual dysfunction in patients with male accessory gland infections.

    PubMed

    La Vignera, S; Condorelli, R; Vicari, E; D'Agata, R; Calogero, A E

    2012-05-01

    The aim of this study was to administer to two groups of patients with male accessory gland infection (MAGI), respectively, with positive or negative alterations in ultrasonography, a new diagnostic interview, arbitrarily named structured interview about MAGI (SI-MAGI), to evaluate differences between these groups, especially about the prevalence of sexual dysfunction. After ultrasound examinations, patients with MAGI were divided into two age-matched groups: positive and negative for ultrasound signs (US+ and US-). The SI-MAGI was structured into four domains (urinary tract symptoms, ejaculatory pain or discomfort, sexual dysfunction and quality-of-life impact) for a total of 30 questions with four possible answers. Infertile patients of MAGI US+ group showed scores significantly higher than MAGI US- and healthy control group in all domains (anovaP < 0.005) in relation to scores of patients with MAGI US+ and US-: in domain 1 = 16.0 ± 0.5 vs 9.0 ± 0.5, domain 2 = 21.0 ± 1.0 vs 11.0 ± 1.0, domain 3 = 23.0 ± 0.5 vs 12.0 ± 1.0 and, finally, in domain 4 = 13.0 ± 2.0 vs 6.0 ± 1.0. In particular, a higher frequency of sexual dysfunction (52%) was detected in MAGI US+ group when compared with MAGI US- (28%). This study introduces a specific set of questions, which combined with the sperm analysis, microbiological and ultrasound investigations, that altogether better express the clinical presentation of MAGI. Finally, MAGI US+ group showed a high percentage of sexual dysfunction. © 2011 Blackwell Verlag GmbH.

  14. Which are the male factors associated with female sexual dysfunction (FSD)?

    PubMed

    Maseroli, E; Fanni, E; Mannucci, E; Fambrini, M; Jannini, E A; Maggi, M; Vignozzi, L

    2016-09-01

    It has been generally assumed that partner's erectile dysfunction, premature, and delayed ejaculation play a significant role in determining female sexual dysfunction (FSD). This study aimed to evaluate the role of the male partner's sexual function, as perceived by women, in determining FSD. A consecutive series of 156 heterosexual women consulting our clinic for FSD was retrospectively studied. All patients underwent a structured interview and completed the Female Sexual Function Index (FSFI). FSFI total score decreased as a function of partner's age, conflicts within the couple, relationship without cohabitation and the habit of engaging in intercourse to please the partner; FSFI total score increased as a function of frequency of intercourse, attempts to conceive and fertility-focused intercourse. FSFI total score showed a negative, stepwise correlation with partner's perceived hypoactive sexual desire (HSD) (r = -0.327; p < 0.0001), whereas no significant correlation was found between FSFI and erectile dysfunction, premature and delayed ejaculation. In an age-adjusted model, partner's HSD was negatively related to FSFI total score (Wald = 9.196, p = 0.002), arousal (Wald = 7.893, p = 0.005), lubrication (Wald = 5.042, p = 0.025), orgasm (Wald = 9.293, p = 0.002), satisfaction (Wald = 12.764, p < 0.0001), and pain (Wald = 6.492, p = 0.011) domains. Partner's HSD was also significantly associated with somatized anxiety, low frequency of intercourse, low partner's care for the patient's sexual pleasure, and with a higher frequency of masturbation, even after adjusting for age. In patients not reporting any reduction in libido, FSFI total score was significantly lower when their partner's libido was low (p = 0.041); the correlation disappeared if the patient also experienced HSD. In conclusion, the presence of erectile dysfunction, premature, and delayed ejaculation of the partner may not act as a primary contributing factor to FSD

  15. Genetic and clinical predictors of sexual dysfunction in citalopram-treated depressed patients.

    PubMed

    Perlis, Roy H; Laje, Gonzalo; Smoller, Jordan W; Fava, Maurizio; Rush, A John; McMahon, Francis J

    2009-06-01

    Sexual dysfunction is a major contributor to treatment discontinuation and nonadherence among patients treated with selective serotonin reuptake inhibitors (SSRIs). The mechanisms by which depressive symptoms in general, as well as SSRI exposure in particular, may worsen sexual function are not known. We examined genetic polymorphisms, including those of the serotonin and glutamate systems, for association with erectile dysfunction, anorgasmia, and decreased libido during citalopram treatment. Clinical data were drawn from a nested case-control cohort derived from the STAR(*)D study, a multicenter, prospective, effectiveness trial in outpatients with nonpsychotic major depressive disorder (MDD). Self-reports of erectile dysfunction, decreased libido, or difficulty achieving orgasm based on the Patient-Rated Inventory of Side Effects were examined among Caucasian subjects (n=1473) for whom DNA and adverse effect measures were available, and who were treated openly with citalopram for up to 14 weeks. Of 1473 participants, 799 (54%) reported decreased libido; 525 (36%) reported difficulty achieving orgasm. Of 574 men, 211 (37%) reported erectile dysfunction. Using a set-based test for association, single nucleotide polymorphisms in glutamatergic genes were associated with decreased libido (GRIA3; GRIK2), difficulty achieving orgasm (GRIA1), and difficulty achieving erection (GRIN3A) (experiment-wide permuted p<0.05 for each). Evidence of association persisted after adjustment for baseline clinical and sociodemographic differences. Likewise, evidence of association was similar when the cohort was limited to those who did not report a given adverse event at the first post-baseline visit (ie, those whose adverse events were known to be treatment emergent). These hypothesis-generating analyses suggest the potential for glutamatergic treatment targets for sexual dysfunction during major depressive episodes.

  16. Drugs in early clinical development for the treatment of female sexual dysfunction.

    PubMed

    Belkin, Zoe R; Krapf, Jill M; Goldstein, Andrew T

    2015-02-01

    There is growing recognition of female sexual dysfunction (FSD) as an important women's health concern. Despite an increased awareness of the pathophysiologic components to FSD, currently, there are no drugs approved for the most common sexual complaint in women-decreased sexual desire. In response to an overwhelming demand for therapy for FSD, several drugs are undergoing development and testing. The aim of this paper is to provide the latest data on pharmacological treatments for FSD currently in Phase I and II clinical trials. These include topical alprostadil, bremelanotide (BMT), intranasal testosterone (TBS-2), intravaginal dehydroepiandrosterone (DHEA), sublingual testosterone with sildenafil, apomorphine (APO), bupropprion and trazodone. It should be noted that the definitions of FSD have recently been revised in the diagnostic and statistical manual for mental disorders (DSM) 5, with merging of hypoactive sexual desire disorder (HSDD) and female sexual arousal disorder (FSAD) into female sexual interest/arousal disorder (FSIAD). However, it is noted that the majority of clinical trials discussed in this paper use the DSM IV-R diagnoses of HSDD and FSAD. Medications in early phase trials show promise for the treatment of FSD. These therapies focus on treating many possible causes of FSD. Concerns over gender bias within the FDA need to be resolved given the need for new treatment options for FSD.

  17. [Nursing care in males with spinal cord injury and sexual dysfunction].

    PubMed

    Cobo-Cuenca, Ana Isabel; Martín-Espinosa, Noelia M; Píriz Campos, Rosa M

    2013-01-01

    The impact of spinal cord injury and its sequels requires important efforts of adaptation. In several studies, people with spinal cord injury claim to have covered most of their needs at physical, emotional and social level, but they are not yet fully satisfied with their sexual life. Sexual function is usually impaired in men with spinal cord injuries, and is sometimes related to problems of erection, ejaculation and/or orgasm. This issue is not a priority in the first phase, but it appears over the subsequent periods when patients often ask for a solution to this problem. A case-study is presented of a 25 year old male with chronic complete spinal cord injury (ASIA A), L4-L5 level, who reported sexual dysfunction and attended an annual review in the National Hospital for Paraplegics. After performing a nursing assessment using the functional health patterns of Gordon, the team proposed a nursing care plan according to the taxonomy of NANDA (North American Nursing Association), NOC (Nursing Outcome Classification) and NIC (Nursing Intervention Classification). Nurses are the healthcare professionals who have more direct and continuous contact with these patients. Specific programs need to be designed to provide them with the sexual education, which should contain adequate emotional and sexual information. We believe that an appropriate and systematic assessment of patient's sexuality, as well as the application of the (NANDA, NOC, NIC) nurse methodology, may be very helpful in improving the outcomes of these specific interventions.

  18. Pharmacotherapy for Erectile Dysfunction: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015).

    PubMed

    Hatzimouratidis, Konstantinos; Salonia, Andrea; Adaikan, Ganesan; Buvat, Jacques; Carrier, Serge; El-Meliegy, Amr; McCullough, Andrew; Torres, Luiz Otavio; Khera, Mohit

    2016-04-01

    Treatment of erectile dysfunction is based on pharmacotherapy for most patients. To review the current data on pharmacotherapy for erectile dysfunction based on efficacy, psychosocial outcomes, and safety outcomes. A review of the literature was undertaken by the committee members. All related articles were critically analyzed and discussed. Levels of evidence (LEs) and grades of recommendations (GRs) are provided based on a thorough analysis of the literature and committee consensus. Ten recommendations are provided. (i) Phosphodiesterase type 5 (PDE5) inhibitors are effective, safe, and well-tolerated therapies for the treatment of men with erectile dysfunction (LE = 1, GR = A). (ii) There are no significant differences in efficacy, safety, and tolerability among PDE5 inhibitors (LE = 1, GR = A). (iii) PDE5 inhibitors are first-line therapy for most men with erectile dysfunction who do not have a specific contraindication to their use (LE = 3, GR = C). (iv) Intracavernosal injection therapy with alprostadil is an effective and well-tolerated treatment for men with erectile dysfunction (LE = 1, GR = A). (v) Intracavernosal injection therapy with alprostadil should be offered to patients as second-line therapy for erectile dysfunction (LE = 3, GR = C). (vi) Intraurethral and topical alprostadil are effective and well-tolerated treatments for men with erectile dysfunction (LE = 1, GR = A). (vii) Intraurethral and topical alprostadil should be considered second-line therapy for erectile dysfunction if available (LE = 3, GR = C). (viii) Dose titration of PDE5 inhibitors to the maximum tolerated dose is strongly recommended because it increases efficacy and satisfaction from treatment (LE = 2, GR = A). (ix) Treatment selection and follow-up should address the psychosocial profile and the needs and expectations of a patient for his sexual life. Shared decision making with the patient (and his partner) is strongly recommended (LE = 2, GR = A). (x

  19. Phytochemicals and the breakthrough of traditional herbs in the management of sexual dysfunctions.

    PubMed

    Adimoelja, A

    2000-01-01

    Traditional herbs have been a revolutionary breakthrough in the management of erectile dysfunction and have become known world-wide as an 'instant' treatment. The modern view of the management of erectile dysfunction subscribes to a single etiology, i.e. the mechanism of erection. A large number of pharmacological agents are orally consumed and vasoactive agents inserted intraurethrally or injected intrapenially to regain good erection. Modern phytochemicals have developed from traditional herbs. Phytochemicals focus their mechanism of healing action to the root cause, i.e. the inability to control the proper function of the whole body system. Hence phytochemicals manage erectile dysfunction in the frame of sexual dysfunction as a whole entity. Protodioscin is a phytochemical agent derived from Tribulus terrestris L plant, which has been clinically proven to improve sexual desire and enhance erection via the conversion of protodioscine to DHEA (De-Hydro-Epi-Androsterone). Preliminary observations suggest that Tribulus terrestris L grown on different soils does not consistently produce the active component Protodioscin. Further photochemical studies of many other herbal plants are needed to explain the inconsistent results found with other herbal plants, such as in diversities of Ginseng, Eurycoma longifolia, Pimpinella pruacen, Muara puama, Ginkgo biloba, Yohimbe etc.

  20. Sexual dysfunction is associated with postural instability gait difficulty subtype of Parkinson's disease.

    PubMed

    Deng, Xiao; Xiao, Bin; Li, Hui-Hua; Lo, Yew-Long; Chew, Lai-Mun; Prakash, Kumar M; Tan, Eng-King

    2015-11-01

    The pathophysiology of the postural instability gait difficulty (PIGD) subtype of Parkinson's disease (PD) is unclear. Information on the spectrum of non-motor symptoms (NMS) in PIGD phenotype is limited. Our objective is to compare the spectrum of NMS in PIGD subtype compared to non-PIGD subgroup in PD patients and to determine predictive factors that are associated with PIGD phenotype. A total of 432 PD patients comprising 158 PIGD and 274 non-PIGD patients were recruited. NMS burden (frequency and severity) was assessed using non-motor symptom scale (NMSS). In the univariable analysis, NMSS total score (P = 0.0132), NMSS domain 3 (mood/apathy) score (P = 0.0108), NMSS domain 5 (attention/memory) score (P = 0.0048) and NMSS domain 8 (sexual function) score (P = 0.0052) were significantly higher in the PIGD group than in the non-PIGD group. Using multivariable logistic regression, UPDRS tremor score, UPDRS PIGD score, H&Y staging score and NMSS domain 8 (sexual function) score were found to be significantly different in the PIGD group compared to the non-PIGD group. We disclosed for the first time that PIGD patients demonstrated a greater overall NMS burden and sexual dysfunction and was an independent predictor of PIGD phenotype. Early intervention of sexual dysfunction symptoms in PIGD patients may improve their clinical management.

  1. Reduced Melanocortin Production Causes Sexual Dysfunction in Male Mice With POMC Neuronal Insulin and Leptin Insensitivity

    PubMed Central

    Faulkner, Latrice D.; Dowling, Abigail R.; Stuart, Ronald C.; Nillni, Eduardo A.

    2015-01-01

    Proopiomelanocortin (POMC)-derived peptides like α-melanocyte-stimulating hormone (MSH) substantially improve hepatic insulin sensitivity and regulate energy expenditure. Melanocortinergic agents are also powerful inducers of sexual arousal that are being investigated for a possible therapeutic role in erectile dysfunction. It is currently unclear whether reduced melanocortin (MC) activity may contribute to the sexual dysfunction accompanying obesity and type 2 diabetes. Male rodents with leptin and insulin resistance targeted to POMC neurons (leptin receptor [LepR]/insulin receptor [IR]POMC mice) exhibit obesity, hyperinsulinemia, hyperglycemia, and systemic insulin resistance. In this study, we demonstrate that LepR/IRPOMC males are also subfertile due to dramatic alterations in sexual behavior. Remarkably, these reproductive changes are accompanied by decreased α-MSH production not present when a single receptor type is deleted. Unexpectedly, behavioral sensitivity to α-MSH and MC receptor expression are also reduced in LepR/IRPOMC males, a potential adaptation of the MC system to altered α-MSH production. Together, these results suggest that concurrent insulin and leptin resistance in POMC neurons in individuals with obesity or type 2 diabetes can reduce endogenous α-MSH levels and impair sexual function. PMID:25590244

  2. Reduced melanocortin production causes sexual dysfunction in male mice with POMC neuronal insulin and leptin insensitivity.

    PubMed

    Faulkner, Latrice D; Dowling, Abigail R; Stuart, Ronald C; Nillni, Eduardo A; Hill, Jennifer W

    2015-04-01

    Proopiomelanocortin (POMC)-derived peptides like α-melanocyte-stimulating hormone (MSH) substantially improve hepatic insulin sensitivity and regulate energy expenditure. Melanocortinergic agents are also powerful inducers of sexual arousal that are being investigated for a possible therapeutic role in erectile dysfunction. It is currently unclear whether reduced melanocortin (MC) activity may contribute to the sexual dysfunction accompanying obesity and type 2 diabetes. Male rodents with leptin and insulin resistance targeted to POMC neurons (leptin receptor [LepR]/insulin receptor [IR]POMC mice) exhibit obesity, hyperinsulinemia, hyperglycemia, and systemic insulin resistance. In this study, we demonstrate that LepR/IRPOMC males are also subfertile due to dramatic alterations in sexual behavior. Remarkably, these reproductive changes are accompanied by decreased α-MSH production not present when a single receptor type is deleted. Unexpectedly, behavioral sensitivity to α-MSH and MC receptor expression are also reduced in LepR/IRPOMC males, a potential adaptation of the MC system to altered α-MSH production. Together, these results suggest that concurrent insulin and leptin resistance in POMC neurons in individuals with obesity or type 2 diabetes can reduce endogenous α-MSH levels and impair sexual function.

  3. Review of Naturopathy of Medical Mushroom, Ophiocordyceps Sinensis, in Sexual Dysfunction

    PubMed Central

    Jiraungkoorskul, Kanitta; Jiraungkoorskul, Wannee

    2016-01-01

    Sexual dysfunctions including desire, arousal, orgasm, and pain disorders are increasing worldwide due to etiological factors and aging. Several types of treatment are claimed in modern medicine, but they have serious side effects and higher costs. In fact, alternative approaches, such as the intake of plants, fungi, and insects, or their extracts, have also been practiced to enhance sexuality and ameliorate illness with notable successes. However, the scientific evidence related to the mechanisms and efficacy of these alternative medicines is both scarce and all too often unconvincing. Ophiocordyceps sinensis is an Ascomycetes fungus parasitic to Lepidoptera larvae, and has long been used as medicine to treat many illnesses and promote longevity in Chinese society. Previous investigations have shown that O. sinensis has many pharmacological activities. This review has focused on illustrating that O. sinensis can enhance libido and sexual performance, and can restore impaired reproductive functions, such as impotency or infertility, in both sexes. PMID:27041868

  4. Prevalence and degree of sexual dysfunction in a sample of women seeking bariatric surgery

    PubMed Central

    Bond, Dale S.; Vithiananthan, Siva; Leahey, Tricia M.; Thomas, J. Graham; Sax, Harry C.; Pohl, Dieter; Ryder, Beth A.; Roye, G. Dean; Giovanni, Jeannine; Wing, Rena R.

    2009-01-01

    Background Sexual functioning is shown to be impaired in women who are obese, particularly those seeking bariatric surgery. However, most prior studies evaluating sexual function in these populations have not used validated measures. We used the validated Female Sexual Function Index (FSFI) to assess prevalence of female sexual dysfunction (FSD) in a sample of over 100 women evaluated for bariatric surgery. Methods The FSFI was administered to reportedly sexually active women during their preoperative evaluation. Scores for individual FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) ranging from 0(or 1.2) to 6 were summed to produce a FSFI-total score (range = 2-36). A FSFI-total cut-off score of ≤ 26.55 was used to identify participants with FSD. Participants' FSFI- total and domain scores were compared to previously published norms available for women diagnosed with female sexual arousal disorder (FSAD) and healthy controls. Results Sixty-one of the 102 participants (59.8%) had FSFI-total scores ≤ 26.55, indicative of FSD. Older age and menopause were associated with FSD. Compared to published norms, bariatric surgery candidates had FSFI domain scores that were lower than the control group (ps <0.0001) but higher than the FSAD group (ps <0.0001), except for desire where scores were similar. Conclusion Women seeking bariatric surgery are clearly a population with substantial sexual function impairment, with 60% of participants reporting FSD. These findings highlight the need to initiate routine assessment of sexual functioning in this population and examine whether weight loss following bariatric surgery contributes to reversal of FSD. PMID:19733514

  5. Outcome measurement in female sexual dysfunction clinical trials: review and recommendations.

    PubMed

    Althof, Stanley E; Rosen, Raymond C; DeRogatis, Leonard; Corty, Eric; Quirk, Frances; Symonds, Tara

    2005-01-01

    Defining and measuring Female Sexual Dysfunction (FSD) is a complex and challenging task. Several factors have confounded the theory and measurement of FSD including: the use of an inappropriate male paradigm; difficulty in capturing the complexity of women's sexual response; an evolving but presently untested nosology; and the relative independence between subjective and objective aspects of women's sexual response. Each of these factors have contributed to the difficulty in developing meaningful and valid endpoints for clinical trials. The Food and Drug Administration's (FDA) 2000 draft guidance document for female sexual dysfunction clinical trials recommended the use of daily diary measures as primary and self-administered questionnaires (SAQs) as secondary endpoints. Event logs or diary measures may be adequate for assessing aspects of male sexual performance (e.g., erectile function), or in other therapeutic areas with discrete and readily observable endpoints (e.g., incontinence). However, psychometric theory suggests that for female sexual dysfunction clinical trials, SAQ instruments may provide more sensitive and reliable measures of outcome. We offer an alternative set of recommendations in the hope that the FDA will reconsider its position and to serve as potential guidelines for non-industry sponsored research on female sexuality as well. First, we propose that SAQs be elevated from their current status as secondary endpoints to be considered as potential primary endpoints in clinical trials of FSD. Second, we recommend that depending on the trial design and intervention under study, either an SAQ or diary measure (typically one or the other, and not both), might serve as a primary endpoint in a clinical trial. Third, SAQs and diaries should be employed, analyzed and interpreted in their particular areas of strength. Diaries are most useful for enumerating events and/or counting frequencies. SAQs are superior at gathering subjective data related to

  6. Differences in psychological health and family dysfunction by sexual victimization type in a clinical sample of African American adolescent women.

    PubMed

    Cecil, Heather; Matson, Steven C

    2005-08-01

    We examined levels of sexual victimization among a sample of 249 14- to 19-year-old African American adolescent women. Victimization was common: 32.1% reported having been raped, 33.7% had experienced sexual coercion, and 10.8% reported an attempted rape. Only 23.4% had never been victimized. We investigated whether levels of psychological health and family dysfunction varied as a function of the type of sexual victimization. Girls who had been raped had lower levels of self-esteem and mastery and higher levels of depression compared to girls who reported no sexual victimization. Significantly higher levels of family cohesion and significantly lower levels of family support were reported by girls who had been raped versus girls who reported no sexual victimization. These findings are a starting point for future studies by providing evidence that levels of mental health and family dysfunction vary by the type of sexual victimization experienced.

  7. Physicians' response to sexual dysfunction presented by a younger vs. An older adult.

    PubMed

    Gewirtz-Meydan, Ateret; Ayalon, Liat

    2016-12-16

    The aim of this study is to determine whether physicians have an age bias regarding sexual dysfunction presented by older vs. younger patients in terms of attributed diagnosis, etiology, proposed treatment and perceived prognosis. An on-line survey consisting of one of two, randomly administered, case vignettes, which differed only by the age of the patient (28 or 78). In both cases, the patient was described as suffering from occasional erectile dysfunction with a clear psychosocial indication. A total of 236 physicians responded to the survey. Overall, 110 physicians received an "old" vignette and 126 physicians received a "young" vignette. Even though both cases presented with a clear psychosocial etiology, the "older" vignette was more likely to be diagnosed with erectile dysfunction whereas the "younger" vignette was more likely to be diagnosed with performance anxiety. The "older" vignette's dysfunction was more likely to be attributed to hormonal changes, health problems and decreased sexual desire. Physicians were more likely to recommend testosterone replacement therapy (TRT) and PDE5 inhibitors (PDE5i; such as Sildenafil; Vardenafil; Tadalafil) as well as a referral to urology to the "older" vignette. In contrast, the "younger" vignette was more often referred to a sexologist and received a more positive prognosis than the older patient. This study demonstrates an age bias among physicians regarding sexuality in later life. Of particular note is the tendency to prescribe PDE5i to the older patient, despite the clear psychosocial indication presented in the case vignette. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  8. The Effect of False Physiological Feedback on Sexual Arousal in Sexually Functional and Dysfunctional Men

    DTIC Science & Technology

    2004-01-01

    Psychiatry, 156, 61-67. Cavallini G. (1991). Minoxidil versus nitroglycerin: a prospective double-blind controlled trial in transcutaneous erection...Academy of Sciences, 528, 49-58. Radomski, S.B., Herscorn, S., Rangaswamy, S. (1994). Topical minoxidil in the treatment of male erectile dysfunction

  9. Psychological correlates of sexual dysfunction in female rectal and anal cancer survivors: analysis of baseline intervention data.

    PubMed

    Philip, Errol J; Nelson, Christian; Temple, Larissa; Carter, Jeanne; Schover, Leslie; Jennings, Sabrina; Jandorf, Lina; Starr, Tatiana; Baser, Ray; DuHamel, Katherine

    2013-10-01

    Sexual dysfunction represents a complex and multifactorial construct that can affect both men and women and has been noted to often deteriorate significantly after treatment for rectal and anal cancer. Despite this, it remains an understudied, underreported, and undertreated issue in the field of cancer survivorship. This study examined the characteristics of women enrolled in an intervention trial to treat sexual dysfunction, and explored the relationship between sexual functioning and psychological well-being. There were 70 female posttreatment anal or rectal cancer survivors assessed as part of the current study. Participants were enrolled in a randomized intervention trial to treat sexual dysfunction and completed outcome measures prior to randomization. The main outcome measures are quality of life (QOL) (European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC-QLQ-C30] and Colorectal Cancer-Specific Module [QLQ-CR38]), sexual functioning (Female Sexual Functioning Index), and psychological well-being (Brief Symptom Inventory Depression/Anxiety, Impact of Events Scale-Revised, CR-38 Body Image). Women enrolled in the study intervention were on average 55 years old, predominantly Caucasian (79%), married (57%), and a median of 4 years postprimary treatment. For those reporting sexual activity at baseline (N=41), sexual dysfunction was associated with a range of specific measures of psychological well-being, all in the hypothesized direction. The Sexual/Relationship Satisfaction subscale was associated with all measures of psychological well-being (r=-0.45 to -0.70, all P<0.01). Body image, anxiety, and cancer-specific posttraumatic distress were notable in their association with subscales of sexual functioning, while a global QOL measure was largely unrelated. For sexually active female rectal and anal cancer survivors enrolled in a sexual health intervention, sexual dysfunction was significantly and consistently

  10. Comparative analysis of copper intrauterine device impact on female sexual dysfunction subtypes.

    PubMed

    Sakinci, Mehmet; Ercan, Cihangir Mutlu; Olgan, Safak; Coksuer, Hakan; Karasahin, Kazim Emre; Kuru, Oguzhan

    2016-02-01

    To examine the effect of copper intrauterine device (Cu-IUD) on female sexual dysfunction (FSD) subtypes. There were 159 sexually active women (ninety Cu-IUD users and sixty-nine women with no contraception) who attended the gynecology clinic for routine gynecologic control informed about the study and asked to fill Female Sexual Function Index (FSFI) and Beck Depression Inventory questionnaires. The prevalence of FSD was 41.1% (n=37) and 37.7% (n=26) in Cu-IUD users and control groups, respectively (p > 0.05). In analyses of mean overall and subgroup scores of FSFI, significantly lower scores for arousal (p=0.021), lubrication (p=0.021), orgasm (p=0.040), pain (p < 0.001), and overall FSFI (p=0.031) were noted in Cu-IUD users. When the results for FSFI domains were considered for Cu-IUD users separately, the only difference to reach statistical significance, using a Bonferroni adjustment, was found to be the pain domain. Finally, we determined that Cu-IUD status made the strongest unique contribution to explaining the dependent variable pain in multiple logistic regression model (β = -0.26, p=0.001). Cu-IUD users have increased sexual pain compared to women with no contraception, which in turn possibly causes decreased sexual arousal, lubrication, and orgasm in these women. Copyright © 2016. Published by Elsevier B.V.

  11. Changes in sexual functioning in women after neuromodulation for voiding dysfunction.

    PubMed

    Yih, Jessica M; Killinger, Kim A; Boura, Judith A; Peters, Kenneth M

    2013-10-01

    Sacral neuromodulation is a well-established treatment for urinary and bowel disorders with potential use for other disorders such as sexual dysfunction. To evaluate changes in sexual functioning in women undergoing neuromodulation for voiding symptoms. Patients enrolled in our prospective, observational neuromodulation database study were evaluated. Data were collected from medical records, and patient-completed Female Sexual Function Index (FSFI) and Interstitial Cystitis Symptom-Problem Indices (ICSI-PI) at baseline, 3, 6, and 12 months post-implant. Patients rated overall change in sexual functioning on scaled global response assessments (GRA) at 3, 6, and 12 months post-implant. We grouped women by baseline FSFI scores: less (score<26) and more sexually functional (score≥26). Data were analyzed with Pearson's Chi-square or Fisher's Exact test and repeated measures. Changes in FSFI and ICSI-PI scores in women grouped by baseline FSFI score<26 and ≥26. Of 167 women evaluated, FSFI scores improved overall from preimplant (mean 13.5±8.5) to 12 months (N=72; mean 15.9±8.9, P=0.004). At baseline and each follow-up point, ICSI-PI scores were similar between groups and improved through time. For patients in the FSFI<26 group there was improvement from baseline to 12-month scores (N=63; 11.9±6.9 to 14.8±8.7; P=0.0006). Improved FSFI domains included desire, orgasm, satisfaction, and pain. Furthermore, of the 74 subjects in this group not sexually active at baseline, 10 became sexually active during follow-up. In the FSFI≥26 group there was slight but statistically significant decline in mean scores between baseline and 12 months (N=9; 27.4±1.1 to 24.5±3.4; P=0.0302); however one had become sexually inactive. A significant decrease was seen in the satisfaction domain. Many factors affect sexual functioning in women; however sexual function may improve along with urinary symptoms after neuromodulation. © 2013 International Society for Sexual Medicine.

  12. A Longitudinal Study of Predictors of Sexual Dysfunction in Men on Active Surveillance for Prostate Cancer

    PubMed Central

    Pearce, Shane M; Wang, Chi-Hsiung E; Victorson, David E; Helfand, Brian T; Novakovic, Kristian R; Brendler, Charles B; Albaugh, Jeffrey A

    2015-01-01

    Aim The aim of this study was to examine the relationship between sexual dysfunction, repeat biopsies and other demographic and clinical factors in men on active surveillance (AS). Methods Patient-reported outcomes (PROs) measures were administered at enrollment and every 6 months to assess quality of life (QOL), psychosocial and urological health outcomes. Using mixed-effects models, we examined the impact of repeat biopsies, total number of cores taken, anxiety, age, and comorbidity on sexual function over the first 24 months of enrolling in AS. Main Outcome Measures PROs included the Expanded Prostate Cancer Index Composite-26 (EPIC-26) Sexual Function (SF) subscale, the American Urological Association-Symptom Index (AUA-SI), and the Memorial Anxiety Scale for Prostate Cancer (MAX-PC). Results At enrollment (n = 195), mean age was 66.5 ± 6.8 with a mean EPIC-26 SF score of 61.4 ± 30.4. EPIC-26 SF scores steadily decreased to 53.9 ± 30.7 at 24 months (P < 0.01). MAX-PC scores also progressively decreased over time (P = 0.03). Factors associated with lower EPIC-26 scores over time included age, unemployed status, diabetes, coronary artery disease, and hypertension (all P < 0.05). Higher prostate-specific antigen (PSA) was associated with a more rapid decline in EPIC-26 SF over time (P = 0.03). In multivariable analysis, age, diabetes, and PSA × time interaction remained significant predictors of diminished sexual function. Anxiety, number of biopsies, and total cores taken did not predict sexual dysfunction or change over time in our cohort. Conclusions Men on AS experienced a gradual decline in sexual function during the first 24 months of enrollment. Older age, PSA × time, and diabetes were all independent predictors of diminished sexual function over time. Anxiety, AUA-SI, the number of cores and the number of biopsies were not predictors of reduced sexual function in men in AS. PMID:26468379

  13. Potent natural aphrodisiacs for the management of erectile dysfunction and male sexual debilities.

    PubMed

    Pratap, Singh Akhand; Rajender, Singh

    2012-01-01

    The area of natural product research is rapidly progressing from traditional medicine to modern medicine having proper scientific basis of its usage. However, identifying the active constituent or the basis of its mechanism holds the key to synthesis of these drugs in the laboratory. Traditional Indian literature such as Ayurveda has listed several plant and animal based resources for treatment of almost every ailment. Erectile dysfunction and male sexual debilities are among the most explored areas in traditional medicine. A number of natural products, mostly plant based, have been claimed to cure erectile dysfunction and related male sexual debilities. These products often are aphrodisiac and have multi-fold effects on male reproductive system. This review aims at compiling the animal and plant based resources which bear promise of treating loss of libido and erectile dysfunction. A special emphasis is paid to find out scientific basis of their usage. The identification of potential resources could help undertake further studies to establish their possible mechanism of action; opening the doors to proper clinical trials for human use.

  14. Clinical Assessment of Tribulus terrestris Extract in the Treatment of Female Sexual Dysfunction

    PubMed Central

    Gama, Carlos RB; Lasmar, Ricardo; Gama, Gustavo F; Abreu, Camila S; Nunes, Carlos P; Geller, Mauro; Oliveira, Lisa; Santos, Alessandra

    2014-01-01

    This is a qualitative–quantitative study based on hospital records of female patients of reproductive age, presenting sexual dysfunction, and treated with 250 mg Tribulus terrestris extract (1 tablet thrice daily for 90 days). Safety monitoring included vital signs, physical examination, laboratory tests, and occurrence of adverse events. Efficacy analysis included results of the Female Sexual Function Index (FSFI), dehydroepiandrosterone (DHEA) levels together with total and free testosterone, and the patient and physician assessments. There was a statistically significant improvement in total FSFI scores (P < 0.0001) post-treatment, with improvement among 106 (88.33%) subjects. There was a statistically significant (P < 0.0001) increase in the level of DHEA, while the levels of both serum testosterone (P = 0.284) and free testosterone decreased (P < 0.0001). Most adverse events recorded were related to the gastrointestinal tract. Physical examination showed no significant changes post-treatment. Based on the results, it is concluded that the T. terrestris extract is safe and effective in the treatment of female sexual dysfunction. PMID:25574150

  15. Historical revolutions in sex therapy: a critical examination of men's sexual dysfunctions and their treatment.

    PubMed

    Berry, Michael D

    2013-01-01

    History, recent and ancient, presents innumerable methods intended to ensure or restore male sexual performance. Although these methods have regularly claimed to be "revolutionary," they have often been remarkably similar, and of questionably efficacy. This article provides a critical account of key historical trends in the treatment of male sexual dysfunctions in order to contextualize and critique the current treatment field. The author uses historical analysis to contextualize contemporary sex therapy techniques, arguing that even clinically verified contemporary revolutions, such as the advent of Viagra and similar drugs, may not present broadly efficacious standalone cures. Using critical historical analysis to illustrate the limitations of single-method treatments, the article argues for the value of comprehensive, biopsychosocial therapy methods. A common tendency--to seek a 'magic bullet' solution to sexual dysfunctions--is apparent throughout history, the author argues. While Viagra differs biomedically from historical treatments, it may appeal to the same logic, raising the question of whether it constitutes a truly revolutionary development in treatment. The article concludes with a set of recommendations regarding the implementation of biopsychosocial practice in sex therapy.

  16. Testosterone/estradiol ratio, is it useful in the diagnosis of erectile dysfunction and low sexual desire?

    PubMed

    Castelló-Porcar, A M; Martínez-Jabaloyas, J M

    2016-12-01

    Erectile dysfunction and low sexual desire are multifactorial diseases. The decrease in testosterone levels is one of the causes, but the effect of estradiol is not well known. Moreover, study has shown that the testosterone/estradiol ratio has more influence over sexuality than does estradiol alone. The aim of the study was to determine whether the balance between testosterone and estradiol has any relation to some aspects of sexual function. It was an ambispective study of 230 patients with urological problems unrelated to sexuality. They underwent a detailed history and hormone study including total, free, bioavailable testosterone and estradiol. They completed the Sexual Health Inventory for Men and questions 11 and 12 of the IIEF15 were used to assess impairment in sexual desire. The T/E ratio was calculated, and the relationship between the different parameters and erectile function and sexual desire were studied by univariate and multivariate analysis. The mean age was 66.32 ± 8.17 years. The percentage of patients with erectile dysfunction was 60.9% (7% severe, 14.3% moderate, 12.6% mild to moderate and 27% mild) and decreased sexual desire was 46.5%. Age, free and biodisponible testosteron were the only variables with a positive linear association with erectile dysfunction and decreased sexual desire. Age was the only independent variable for both, erectile dysfunction and sexual desire, in the multiple linear regression. There was no association between a testosterone/estradiol imbalance and an alteration in erectile function and sexual desire. Consequently, in the clinical study of these patients, it is not necessary to request estradiol in the laboratory analyses.

  17. Sexuality of men with fibromyalgia: what are the factors that cause sexual dysfunction?

    PubMed

    Batmaz, Ibrahim; Sarıyıldız, Mustafa Akif; Dilek, Banu; Inanır, Ahmet; Demircan, Zeynep; Hatipoğlu, Namık; Atar, Murat; Cevik, Remzi

    2013-05-01

    The purpose of the present study is to compare male patients with the fibromyalgia syndrome (FMS) with healthy individuals in terms of the sexual function. For the purposes of this study, 37 sexually active male FMS patients and 30 healthy controls were enrolled. The demographic data of the patients were recorded, and the widespread pain observed in FMS was graded with the help of the visual analogue scale (VAS 0-100 mm). Sexual function was assessed according to the international index of erectile function (IIEF) scoring system. The disease-related quality of life was measured with the help of the Short Form-36 quality of life questionnaire (SF-36 QoL). Levels of anxiety and depression observed in the patients were graded through the Hospital Anxiety and Depression Scale (HADS). Patients with FMS had significantly lower scores in each of the five domains of the IIEF in comparison with the healthy control group (p < 0.001). Patients' age and widespread pain were negatively correlated with the IIEF scores (p < 0.05). The SF-36 scores (physical functioning, role limitations due to physical problems, pain and general health perception) were observed to be positively correlated with the IIEF scores (p < 0.05). No significant relationship has been observed between the scores obtained from the domains of IIEF and the psychological status (p > 0.05). FMS leads to an impairment in the sexual function in male patients, which is especially strongly associated with the age, widespread pain and the quality of life.

  18. The Effects of False Physiological Feedback on Sexual Arousal in Sexually Dysfunctional and Functional Males

    DTIC Science & Technology

    1999-01-01

    aged 18 to 29 years. Besides age, other risk factors included: 1) marital status (non-married men reported significantly higher rates of erectile...etiological factors , their treatment program focuses on the more immediate causes within the couple’s present sexual interactions. Prominent among these...variables while the latter two are secondary factors . Each is explicated below with reference to empiric literature. Schematic Content The present

  19. The effects of false physiological feedback on tumescence and cognitive domains in sexually functional and dysfunctional men.

    PubMed

    Stone, Jay M; Clark, Robert; Sbrocco, Tracy; Lewis, Evelyn L

    2009-08-01

    A false feedback paradigm was used to produce a discrepancy between expected and "actual" tumescence among 57 sexually dysfunctional and 58 sexually functional men randomly assigned to one of four false tumescence feedback conditions: negative (NEG), neutral (NEU), positive (POS), or no (NO) feedback. Participants predicted an erection score before viewing an erotic film and then received false tumescence feedback based on this score. Tumescence and cognitive ratings were obtained before and after the feedback. It was predicted that discrepancies would differ between dysfunctional and functional participants such that functional participants would have the ability to overcome discrepancies, whereas dysfunctional participants would not. As expected, POS decreased tumescence for dysfunctional participants and NO did not influence tumescence for either group. Unexpectedly, NEU decreased tumescence for dysfunctional participants and NEG decreased tumescence for functional participants. Despite tumescence changes, cognitive ratings generally followed the feedback that was given. These results only partially support current models of sexual dysfunction and behavioral regulation. Anxiety, self-focused attention, cognitive interference, and unexpectedness of the feedback could not account for the partial support. However, most feedback that was outside of the realm of the status quo for both functional and dysfunctional participants did decrease tumescence, despite outcome expectancies. These results suggest that both functional and dysfunctional men may be at risk for erectile failure should feedback about their performance be discrepant from what they expect. Prevention and treatment should focus on preparing men for occasional erectile failure and on helping them overcome discrepant feedback.

  20. The association between physical activity and sexual dysfunction in patients with diabetes mellitus of European and South Asian origin: The Oxford Sexual Dysfunction Study.

    PubMed

    Malavige, Lasantha S; Wijesekara, Pabasi; Ranasinghe, Priyanga; Levy, Jonathan C

    2015-11-05

    The present study aims to evaluate the relationship between physical activity and sexual dysfunction amongst an ethnic South Asian population living in the United Kingdom and compare the association with that of the native Caucasian population. Twenty-five general practitioner clinics from eight primary care trusts in the United Kingdom collaborated in the Oxford Sexual Dysfunction Study. In each practice, a sample of diabetic and non-diabetic patients of European/Europid and South Asian origin were invited for the study. Erectile dysfunction (ED) was assessed using a five-item version of the International Index of Erectile Function. Premature ejaculation (PE) was diagnosed using the premature ejaculation diagnostic tool. Libido was assessed by asking participants to grade their desire for sexual activity. Physical activity during the past week was assessed using the short version of the International Physical Activity Questionnaire (IPAQ). A binary logistic regression analysis was performed in all adults, Europids and South Asians with 'presence of ED' as the dichotomous dependent variable (0 = ED absent; 1 = ED present) and age, diabetes status, physical activity, ethnicity, current smoking and use of antihypertensive medications as the independent variables. Sample size was 510, and mean age was 56.9 ± 9.7 years. There were 63.9 % (n = 326) Europid males in the study population. The prevalence of ED was 64.5 % and it was significantly higher in men with diabetes than in those without diabetes (84.4 vs. 49.0 %, p < 0.001). The overall prevalence of PE was 28.8 %, (with diabetes 32.6 %, without diabetes 25.8 %; p = 0.109). Reduced libido was reported by 26.9 % of study participants (with diabetes 32.8 %, without diabetes 22.0 %; p < 0.01). The median (IQR) total physical activity of the study population was 2373 (3612) MET-min/week. In the IPAQ categorical score, 36.8 % (n = 184/434) males were 'highly active', and 17.8 % (n = 89

  1. Success of sildenafil treatment in neurogenic female sexual dysfunction caused by L5-S1 intervertebral disk rupture: a case report.

    PubMed

    Ferrara, Dean; Zaslau, Stanley

    2007-06-01

    Female sexual dysfunction can be founded by disorders of sexual desire, arousal, orgasm, and sexual pain. Physiologic sexual dysfunction can, in many cases, be the result of impaired neurovascular tone to the clitoris and vagina. The vagina and clitoris both contain erectile tissue and phosphodiesterase type 5 (PDE5). Accordingly, the use of sildenafil, a PDE5 inhibitor, has been studied in relation to neurogenic female sexual dysfunction. The present case report addresses neurogenic female sexual dysfunction from the result of a ruptured L5-S1 intervertebral disk. The patient was treated with sildenafil, and her symptoms were recorded using a Female Sexual Function Index score. Discussion of the use of sildenafil in women, with an emphasis on female neurovascular sexual physiology and function, is reviewed.

  2. Network position and sexual dysfunction: implications of partner betweenness for men.

    PubMed

    Cornwell, Benjamin; Laumann, Edward O

    2011-07-01

    This article combines relational perspectives on gender identity with social network structural perspectives on health to understand men's sexual functioning. The authors argue that network positions that afford independence and control over social resources are consistent with traditional masculine roles and may therefore affect men's sexual performance. For example, when a heterosexual man's female partner has more frequent contact with his confidants than he does--which the authors refer to as partner betweenness--his relational autonomy, privacy, and control are constrained. Analyses of data from the National Social Life, Health, and Aging Project (NSHAP) show that about a quarter of men experience partner betweennessa and that these men are 92% more likely to report erectile dysfunction. Partner betweenness is strongest among the youngest men in the sample, which may reflect changing conceptions of masculinity in later life. The authors consider several explanations for these findings and urge additional research on the links between health, gender, and network structure.

  3. EFFICACY TRIAL OF AN INTERNET-BASED INTERVENTION FOR CANCER-RELATED FEMALE SEXUAL DYSFUNCTION

    PubMed Central

    Schover, Leslie R.; Yuan, Ying; Fellman, Bryan M.; Odensky, Evan; Lewis, Pamela E.; Martinetti, Paul

    2013-01-01

    The recent National Comprehensive Cancer Network Survivorship Guideline recommends systematic evaluation and multidisciplinary treatment of cancer-related sexual dysfunctions. Yet, most oncology professionals fail to routinely assess sexual problems and lack expertise to treat them. An internet-based intervention was designed to educate female patients and their partners about cancer-related sexual problems, to describe medical treatment options and how to find expert care, and to provide self-help strategies. A randomized trial assessed efficacy of the intervention when used as self-help versus the same web access plus three supplemental counseling sessions. Survivors of localized breast or gynecological cancer completed online questionnaires at baseline, post-treatment, and 3- and 6-month follow-up, including the Female Sexual Function Index (FSFI); the Menopausal Sexual Interest Questionnaire (MSIQ), the Brief Symptom Inventory-18 (BSI-18) to assess emotional distress, and the Quality of Life in Adult Cancer Survivors Scale (QLACS). Program evaluation ratings were completed post-treatment. Fifty-eight women completed baseline questionnaires (mean age 53 ± 9). Drop-out rates were 22% during treatment and 34% at 6-month follow-up. Linear mixed models for each outcome across time showed improvement in total scores on the FSFI, MSIQ, and QLACS (P<0.001) and BSI-18 (P=0.001). The counseled group improved significantly more on sexuality measures, but changes in emotional distress and quality of life did not differ between groups. Program content and ease of use were rated positively. Research is needed on how best to integrate this intervention into routine clinical practice, particularly how to improve uptake and adherence. PMID:24225972

  4. [Turpentine white emulsion baths in the rehabilation in patients with sexual dysfunctions].

    PubMed

    Karpukhin, I V; Li, A A; Gusev, M E

    2000-01-01

    100 patients with sexual dysfunction (SD) and 20 SD patients took turpentine white emulsion baths and sodium chloride baths, respectively. The turpentine baths were given with step-by-step rise in turpentine concentration from 20 to 50 ml per 200 l of water, temperature 36-37 degrees C, duration of the procedure 10-15 min. The course consisted of 10-12 procedures which were conducted daily or each other day. The turpentine baths were more effective than sodium chloride baths (85 vs 50%, respectively).

  5. Pharmacologic and surgical therapies for sexual dysfunction in male cancer survivors

    PubMed Central

    Kadıoğlu, Ateş; Ortaç, Mazhar

    2015-01-01

    The recent recognition that many men experience sexual dysfunction following their diagnosis and treatment of genitourinary cancers, has led to the development multiple varied strategies that attempt to restore or preserve that function. In this manuscript we review the understanding of why it happens, highlight novel management strategies and discuss the concept of penile rehabilitation (PR) following prostate cancer (PCa) treatment, glans preserving strategies among men diagnosed with penile cancer and address the controversial issue of testosterone therapy in men with PCa. PMID:26816821

  6. Views and Experiences of Malaysian Family Medicine Trainees of Female Sexual Dysfunction.

    PubMed

    Lai, Pauline Siew Mei; Tan, Sing Yee; Liew, Su May

    2016-11-01

    Sociocultural factors have been shown to be important influencers of sexual health and sexuality. Hence, the aim of our study was to explore the views and experiences of family medicine trainees regarding female sexual dysfunction (FSD) with a focus on the barriers and facilitators towards the initiation of conversation on this topic. A qualitative study design involving semi-structured focus group discussions (FGDs) was conducted with 19 family medicine trainees in Malaysia. The conceptual framework used was based on the Theory of Planned Behavior. Thematic approach was used to analyze the data. Participants perceived FSD as being uncommon and unimportant. According to our participants, patients often presented with indirect complaints, and doctors were not proactive in asking about FSD. Three main barriers were identified: doctor factors, perceived patient factors, and system factors. Lack of confidence, knowledge, experience, time, and embarrassment were the key barriers identified at the doctors' level. Lack of awareness, among patients regarding FSD, and local cultural and religious norms were the perceived patient barriers. System barriers were lack of time and privacy. Various facilitators, such as continuous medical education and public forums, were suggested as means to encourage family medicine trainees to initiate discussion on sexual matters during consultations. In conclusion, family medicine trainees found it difficult to initiate conversation on FSD with patients. Interventions to encourage conversation on FSD should target this and other identified barriers.

  7. Sexual dysfunction in women with migraine and tension-type headaches.

    PubMed

    Solmaz, V; Ceviz, A; Aksoy, D; Cevik, B; Kurt, S; Gencten, Y; Erdemir, F

    2016-11-01

    Primary headaches (PHAs) prominently affect the performance and life quality of people. Sexual dysfunction (SD) is an important health problem caused by several factors. This study aimed to compare the sexual function of women who have PHAs. Forty-one female patients who were diagnosed with migraine, 39 female patients who were diagnosed with tension-type headache (TTHA) and 41 healthy subjects were included in study. Sexual function of the cases were evaluated by using the 'Female Sexual Function Index (FSFI)'. Beck Depression Scale was applied to subjects and those who were diagnosed with depression were excluded from the study. SD was detected in both the migraine and TTHA groups. FSFI subgroup scores were statistically significantly lower in the migraine and TTHA groups compared with the control group. No significant differences were detected between the migraine and TTHA groups in terms of FSFI and its components. In addition, no significant differences were detected between the blood prolactin levels or SD and headache. It was concluded that primary headaches (which are chronic diseases) itself may cause SD in female patients with migraine and TTHA independently of factors that may cause development of SD such as comorbid condition, depression, drug use and age.

  8. The assessment of sexual dysfunction in Egyptian women with lower urinary tract symptoms

    PubMed Central

    El Atrash, Gamal; Ali, Mohamed H.; Abdelwahab, Hassan A.; Abdelreheem, Lobna A.; Shamaa, Mostafa

    2014-01-01

    Introduction Female sexual dysfunction (FSD) has been reported in 46% of women with lower urinary tract symptoms (LUTS). FSD is a common health problem that remains under-investigated, especially in Eastern communities, where discussion of the issue is considered a taboo. In this study we determined the prevalence of various subtypes of FSD in relation to LUTS in women in Ismailia, Egypt. Patients and methods This was a case-control study to assess FSD in women with LUTS in comparison to normal women. In all, 101 women patients attending the Urology clinic at our institution were divided into two groups, a study group of 52 with LUTS and a control group of 49 with no LUTS. Validated Arabic versions of the FSD index and the Bristol questionnaire were used to assess the participants, and the data analysed statistically. Results FSD was diagnosed in 75 of the 101 patients (74%); 87 (86%) reported hypoactive sexual desire, 61 (60%) reported sexual arousal disorder, 56 (55%) had lubrication disorders, 65 (64%) complained of orgasmic deficiency, 36 (36%) had satisfaction disorder, and 59 (58%) had sexual pain disorder (e.g., dyspareunia or non-coital genital pain). Arousal, satisfaction, orgasmic and lubrication disorders were more common in the women with LUTS. There was no statistically significant difference in desire disorders between the groups. Conclusions FSD and its subtypes are more prevalent in women with LUTS in this sample of Egyptian women. PMID:26019956

  9. Opioids Increase Sexual Dysfunction in Patients With Non-Cancer Pain.

    PubMed

    Ajo, Raquel; Segura, Ana; Inda, María M; Planelles, Beatriz; Martínez, Luz; Ferrández, Guillermina; Sánchez, Angel; César Margarit; Peiró, Ana-María

    2016-09-01

    Long-term opioid therapy has been found to have a strong impact on the hypothalamic-pituitary-gonadal axis that can be manifested clinically by sexual dysfunction (SD). This event is rarely reported and thus unnoticed and undertreated. To analyze the presence of SD in a large group of patients receiving long-term opioids. A descriptive, cross-sectional pilot study of sexual health was conducted for 2 years in 750 consecutive ambulatory patients with chronic non-cancer pain (CNP) receiving opioids for at least 12 months. Cases that reported SD and matched controls were included. Standardized questionnaires and medical record reviews were used to assess rates of pain at diagnosis, daily morphine equivalent doses, and opioid adverse effects. Sexual function was determined by the Female Sexual Function Index (FSFI; scores = 2-36) and the International Index of Erectile Function erectile function domain (IIEF-EF; scores = 1-30). Thirty-three percent of 33% of 750 patients with CNP recorded SD based on their spontaneous notification at the pain unit. Men reported SD significantly more frequently than women (33% vs 25%, respectively, P < .05), although they reported having a regular partner (84% vs 70%, P = .03) and a sexually active life (69% vs 34%, respectively, P = .00) significantly more often. FSFI scores were significantly influenced by sexual activity in lubrication and arousal. IIEF scores were significantly determined by age in satisfaction with sexual intercourse and overall satisfaction. The morphine equivalent dose was significant higher in men than in women (38%; median = 70 mg/d, interquartile range = 43.1-170, 115.5 ± 110.3 mg/d vs median = 60 mg/d, interquartile range = 30-100.6, 76.67 ± 63.79 mg/d, P = .016) at the same mean intensity of pain (P = .54), which correlated to FSFI scores (r = -0.313, P = .01). SD is prevalent in patients with CNP and higher in men who received a significantly higher mean opioid dose at the same intensity pain

  10. Epidemiology of Sexual Dysfunction in Iran: A Systematic Review and Meta-analysis

    PubMed Central

    Ramezani, Mohammad Arash; Ahmadi, Khodabakhsh; Ghaemmaghami, Afagh; Marzabadi, Esfandiar Azad; Pardakhti, Faezeh

    2015-01-01

    Background: The aim of this study was to determine the cumulative prevalence rate of every sexual dysfunctions (SDs) in Iranian population. Methods: We searched international database such as: PubMed/Medline, Scopus, PsychNET, and Scholar Google and Iranian database such as Iran Psych, IranDoc, IranMedex, and SID. Search duration was between 1990 and 2013. Results: From 449 articles were retrieved, then 11 articles on male with total sample size of 2142 and 8 articles on female with total sample size of 4391 were selected after critical appraisal. For quality assessment check list to evaluate a prevalence article was contained study population, sampling method, sample size, criteria for SD diagnosis, specific rates, study location, and authors list. In male, erectile dysfunction was 56.1%. In female, pooled estimation prevalence of hypoactive sexual desire disorder in complained group was 65.8% (95% confidence interval [CI]: 51.1-80.6%) compared to general population 35% (95% CI: 17.6-52.1%). Sexual arousal disorder in clinical patient was 59.6% (95% CI: 39-80%) against 33.8% (95% CI: 18.3-49.3%) in general population. Orgasmic disorder in complained was 35.5% (95% CI: 16-55%) and in general population was 35.3% (95% CI: 26.8-43.8%). Sexual pain disorder pooled estimation prevalence were 35.2% (95% CI: 14.5-56%) versus 20.1% (95% CI: 6.4-33.8%) in complained and general population consecutively. Conclusions: The rate of SD in Iran was approximately the same of worldwide except orgasmic disorder which was two times more than the worldwide average. PMID:26097672

  11. The evaluation of sexual dysfunction in male patients with migraine and tension type headache.

    PubMed

    Aksoy, Durdane; Solmaz, Volkan; Cevik, Betul; Gencten, Yusuf; Erdemir, Fikret; Kurt, Semiha Gulsum

    2013-05-29

    Erectile dysfunction (ED), defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance, is a common condition. The psychological, hormonal, neurogenic and arterial pathologies, medications, chronic diseases have been reported in the etiology of the ED. This paper aims to study sexual dysfunction in the male patients with migraine and Tension type headache (TTH). 30 migraine cases (Group M), 31 TTH cases (Group T) and 30 control cases (Group C) were included in the study. Patients were evaluated with medical history, physical examination, body mass index (BMI), Beck Depression Inventory, biochemical analysis and hormone profiles. ED was evaluated via International Index of Erectile Function Scale (IIEF). In statistical analysis, variant analysis, post-hoc tukey test, Pearson correlation test, t-test, and fisher's exact chi-square test were used. The patients' mean age was 34.96+/-1.30, 35.54+/-1.52 and 32.26+/-1.38 for group M,T and C, respectively. There was no significant difference between the groups in terms of testosterone levels. Mean IIEF scores was 19.83+/-2.2, 20.39+/-1.35 and 27.83+/-0.34 in groups M,T,C. When M and T groups were compared with group C, there were significant differences, and there was no statistical difference when T and M groups were compared to each other. Beck Depression Scores were not significantly different in groups M, T and C. In this study, it was shown that, migraine and TTH affects the sexual functions negatively in male patients. Chronic diseases may cause sexual disorders in patients because of despair, guilt, and fear of death or pain. Our results suggest that, along with the effect of chronic disease and pain, there must be other complicated factors exist causing the development of SD in patients with migraine and TTH.

  12. Loxapine for Reversal of Antipsychotic-Induced Metabolic Disturbances: A Chart Review.

    PubMed

    Jain, Seema; Andridge, Rebecca; Hellings, Jessica A

    2016-04-01

    Loxapine substitution is a promising option for patients with autism spectrum disorder (ASD) who develop antipsychotic-induced metabolic illness. We performed a chart review of 15 adolescents and adults meeting DSM-IV-TR criteria for ASD, all with antipsychotic-associated weight gain, who received low dose loxapine in an attempt to taper or discontinue the weight gain-associated antipsychotic. Mean weight loss was -5.7 kg, mean BMI reduction was -1.9, and mean triglyceride reduction was -33.7 mg/dl. At chart review, 14 of 15 subjects were rated 2 (Much Improved) or 1 (Very Much Improved) on the Clinical Global Impressions-Improvement scale (CGI-I). Low dose loxapine addition in most cases enabled taper of offending antipsychotics, significantly reversed drug-induced metabolic disturbances and improved irritability.

  13. DRD2 promoter region variation predicts antipsychotic-induced weight gain in first episode schizophrenia.

    PubMed

    Lencz, Todd; Robinson, Delbert G; Napolitano, Barbara; Sevy, Serge; Kane, John M; Goldman, David; Malhotra, Anil K

    2010-09-01

    Many antipsychotic medications carry a substantial liability for weight gain, and one mechanism common to all antipsychotics is binding to the dopamine D2 receptor. We therefore examined the relationship between -141C Ins/Del (rs1799732), a functional promoter region polymorphism in DRD2, and antipsychotic-induced weight gain in 58 first episode schizophrenia patients enrolled in a randomized trial of risperidone versus olanzapine. Carriers of the deletion allele (n=29) were compared with Ins/Ins homozygotes (noncarriers, n=29) in a mixed model encompassing 10 weight measurements over 16 weeks. Deletion allele carriers showed significantly more weight gain after 6 weeks of treatment regardless of assigned medication. Although deletion carriers were prescribed higher doses of olanzapine (but not risperidone), dose did not seem to account for the genotype effects on weight gain. Given earlier evidence that deletion carriers show reduced symptom response to medication, additional study of appropriate treatment options for these patients seems warranted.

  14. Quality of life, depression, and sexual dysfunction in spouses of female patients with fibromyalgia.

    PubMed

    Tutoglu, Ahmet; Boyaci, Ahmet; Koca, Irfan; Celen, Esra; Korkmaz, Nurdan

    2014-08-01

    The aim of this study was to investigate the effects of the quality of life and psychological condition of female patients with fibromyalgia and their spouses on sexual function. A total of 32 female patients diagnosed with fibromyalgia and their spouses were analyzed. Thirty married couples were included in the study as the control group. The demographic data of the fibromyalgia patients were recorded, a visual analog scale was used to evaluate the level of pain, and the Fibromyalgia Impact Questionnaire was used to evaluate the impact of the symptoms on the quality of life of the patients. The quality of life of both the patients and the control group were evaluated using the Short Form 36 (SF-36), and psychological variables were evaluated using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory. Sexual function was assessed using the Female Sexual Function Index for female participants and the International Index of Erectile Function (IIEF) for male participants. The IIEF erectile dysfunction scores were significantly lower in the spouses of female patients with fibromyalgia than in the control group (p < 0.05), and the BDI scores were significantly higher in the spouses of the female patients with fibromyalgia (p < 0.05). Among the SF-36 scores, the emotional and physical roles were significantly lower in the spouses of the female patients with fibromyalgia (p = 0.003 and p = 0.004, respectively). In all spouses of FMS patients and controls, there was a significantly negative correlation between erectile function, the BDI score, and to be married with FMS patient and positive correlations between erectile function and emotional role, social function, mental health, SF-36 pain score, and general health (p < 0.05 for all). In a linear regression model, BDI, to be married with FMS patient and general health were found to affect erectile function (beta regression coefficient = -0.572, SE = 0.082, p = 0.001; beta regression coefficient = -0.332, SE = 1

  15. Levels of estradiol and testosterone are altered in Chinese men with sexual dysfunction.

    PubMed

    Wu, F; Chen, T; Mao, S; Jiang, H; Ding, Q; Xu, G

    2016-09-01

    An estimated 20-30% of adult men have at least one manifestation of sexual dysfunction, the most common of which are premature ejaculation (PE) and erectile dysfunction (ED). Emerging evidence has suggested an association between the regulation of hormones with the processes of erection and ejaculation. In this study, we aim to investigate the relationship between sexual dysfunction, namely, PE and ED, and the levels and ratios of estradiol to testosterone in Chinese men. A retrospective case-control study was performed involving 878 male patients aged from 18 to 74 years (mean: 36 years). The ratio of estradiol to testosterone was significantly higher for subjects with ED (7.45 ± 3.09 × 10(-3) ; p < 0.001), and combined PE and ED (6.66 ± 3.05 × 10(-3) ; p = 0.032) compared with that of the control group (6.01 ± 2.61 × 10(-3) ). The ratio was also significantly higher for ED patients when compared with PE patients (5.26 ± 2.18 × 10(-3) ; p < 0.001). Furthermore, compared with the control group, subjects with PE had similar levels of estradiol (95.47 ± 37.86 pmol/L vs. 94.12 ± 32.32 pmol/L; p = 0.678) but significantly higher levels of testosterone (18.66 ± 6.03 nmol/L vs. 16.82 ± 4.93 nmol/L; p < 0.001). This contrasted with the ED group, which showed similar levels of testosterone (16.96 ± 5.86 nmol/L vs. 16.82 ± 4.93 nmol/L; p = 0.773) and significantly higher levels of estradiol (116.88 ± 40.81 pmol/L vs. 94.12 ± 32.32 pmol/L; p < 0.001) compared with control. Subjects with combined ED and PE also had a significantly higher level of estradiol (104.98 ± 43.99 pmol/L vs. 94.12 ± 32.32 pmol/L; p = 0.014) and similar levels of testosterone (17.30 ± 7.23 nmol/L vs. 16.82 ± 4.93 nmol/L; p = 0.503) compared with control. In conclusion, this study involving Chinese males with sexual dysfunction reports, for the first time, that there is an association between sexual dysfunction

  16. Vitamin D deficiency exacerbates atypical antipsychotic-induced metabolic side effects in rats: involvement of the INSIG/SREBP pathway.

    PubMed

    Dang, Ruili; Jiang, Pei; Cai, Hualin; Li, Huande; Guo, Ren; Wu, Yanqin; Zhang, Lihong; Zhu, Wenye; He, Xin; Liu, Yiping; Xu, Ping

    2015-08-01

    Metabolic syndrome is a major concern in psychotic patients receiving atypical antipsychotics. Recent evidence suggests that sterol regulatory element-binding proteins (SREBPs) and insulin-induced genes (INSIGs) are implicated in the antipsychotic-induced metabolic side-effects. Vitamin D (VD) deficiency, a highly prevalent phenomenon among patients with psychosis, might also predispose individuals to metabolic syndrome Considering that VD has modulating effects on the INSIG/SREBP pathway, it is possible that VD may have a role in the antipsychotic-induced metabolic disturbances involving its effects on the INSIG/SREBP system. Thus, the present study aimed to evaluate the effects of VD deficiency and VD supplementation on antipsychotic-induced metabolic changes in rats. After 4-week administration, clozapine (10mg/kg/d) and risperidone (1mg/kg/d) both caused glucose intolerance and insulin resistance in VD deficient rats, but not in rats with sufficient VD status. Antipsychotic treatments, especially clozapine, elevated serum lipid levels, which were most apparent in VD deficient rats, but alleviated in VD-supplemented rats. Additionally, antipsychotic treatments down-regulated INSIGs and up-regulated SREBPs expression in VD deficient rats, and these effects were attenuated when VD status was more sufficient. Collectively, this study disclose the novel findings that antipsychotic-induced metabolic disturbances is exacerbated by VD deficiency and can be alleviated by VD supplementation, providing new evidence for the promising role of VD in prevention and treatment of metabolic disorders caused by antipsychotic medications. Furthermore, our data also suggest the involvement of INSIG/SREBP pathway in the antipsychotic-induced hyperlipidemia and beneficial effects of VD on lipid profile.

  17. Sexual dysfunction during treatment of major depressive disorder with vilazodone, citalopram, or placebo: results from a phase IV clinical trial.

    PubMed

    Clayton, Anita H; Gommoll, Carl; Chen, Dalei; Nunez, Rene; Mathews, Maju

    2015-07-01

    Sexual dysfunction commonly occurs with major depressive disorder (MDD). Vilazodone, a selective serotonin reuptake inhibitor and 5-HT1A receptor partial agonist antidepressant approved for the treatment of MDD in adults, was evaluated to determine its effects on sexual function. The primary study was a double-blind, randomized, controlled trial comparing vilazodone 20 and 40 mg/day with placebo; citalopram 40 mg/day was an active control (NCT01473381; http://www.clinicaltrials.gov). Post-hoc analyses evaluated change from baseline to week 10 on the Changes in Sexual Functioning Questionnaire (CSFQ); no inferential statistics were performed. CSFQ scores increased for women [1.2 (citalopram) to 3.0 (vilazodone 40 mg)] and men [1.2 (vilazodone 40 mg) to 3.5 (placebo)] in all treatment groups. Greater changes in CSFQ scores were seen in responders [women: 2.33 (citalopram) to 5.06 (vilazodone 40 mg); men: 2.26 (vilazodone 40 mg) to 4.35 (placebo)] versus nonresponders. CSFQ change from baseline was small for patients with normal baseline sexual function; in patients with baseline sexual dysfunction, CSFQ scores improved across groups [women: 2.35 (citalopram) to 4.52 (vilazodone 40 mg); men 2.83 (vilazodone 40 mg) to 6.43 (placebo)]. Across treatment groups, baseline sexual function improved in women and men, MDD responders, and patients with baseline sexual dysfunction.

  18. Sexual dysfunction during treatment of major depressive disorder with vilazodone, citalopram, or placebo: results from a phase IV clinical trial

    PubMed Central

    Gommoll, Carl; Chen, Dalei; Nunez, Rene; Mathews, Maju

    2015-01-01

    Sexual dysfunction commonly occurs with major depressive disorder (MDD). Vilazodone, a selective serotonin reuptake inhibitor and 5-HT1A receptor partial agonist antidepressant approved for the treatment of MDD in adults, was evaluated to determine its effects on sexual function. The primary study was a double-blind, randomized, controlled trial comparing vilazodone 20 and 40 mg/day with placebo; citalopram 40 mg/day was an active control (NCT01473381; http://www.clinicaltrials.gov). Post-hoc analyses evaluated change from baseline to week 10 on the Changes in Sexual Functioning Questionnaire (CSFQ); no inferential statistics were performed. CSFQ scores increased for women [1.2 (citalopram) to 3.0 (vilazodone 40 mg)] and men [1.2 (vilazodone 40 mg) to 3.5 (placebo)] in all treatment groups. Greater changes in CSFQ scores were seen in responders [women: 2.33 (citalopram) to 5.06 (vilazodone 40 mg); men: 2.26 (vilazodone 40 mg) to 4.35 (placebo)] versus nonresponders. CSFQ change from baseline was small for patients with normal baseline sexual function; in patients with baseline sexual dysfunction, CSFQ scores improved across groups [women: 2.35 (citalopram) to 4.52 (vilazodone 40 mg); men 2.83 (vilazodone 40 mg) to 6.43 (placebo)]. Across treatment groups, baseline sexual function improved in women and men, MDD responders, and patients with baseline sexual dysfunction. PMID:26039688

  19. Estimating the prevalence and impact of antidepressant-induced sexual dysfunction in 2 European countries: a cross-sectional patient survey.

    PubMed

    Williams, Valerie S L; Baldwin, David S; Hogue, Susan L; Fehnel, Sheri E; Hollis, Kelly A; Edin, Heather M

    2006-02-01

    Sexual dysfunction is a common side effect of antidepressant treatment, but recognition of the problem is variable. The aim of this study was to estimate the prevalence and impact of sexual dysfunction during antidepressant treatment in 2 European countries. A cross-sectional survey of 502 adults in France and the United Kingdom. All participants were diagnosed with depression and taking a selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI), starting within the previous 3 months. Information was gathered about other medications and conditions known to impair sexual functioning, recent changes in sexual functioning, and the impact of any changes. The Medical Outcomes Study 12-Item Short-Form Health Survey and the Arizona Sexual Experience Scale were administered to measure health status and sexual functioning. Data were collected from June to July of 2002. Applying a prevalence estimate algorithm, 26.6% of the French sample and 39.2% of the U.K. sample were classified as having antidepressant-induced sexual dysfunction; 34.2% of men and 32.5% of women were classified with antidepressant-induced sexual dysfunction. There was no clear pattern of antidepressant-induced sexual dysfunction related to specific antidepressants. Patients with antidepressant-induced sexual dysfunction reported that changes in sexual functioning negatively affected their self-esteem, mood, and relationships with sexual partners. 23.8% of the French sample and 25.2% of the U.K. sample reported that they perceived that their partner was dissatisfied with their sex life. The prevalence of antidepressant-induced sexual dysfunction in this study is similar to previous estimates reported in the literature. The impact of antidepressant-induced sexual dysfunction is substantial and negatively affects quality of life, self-esteem, mood, and relationships with sexual partners.

  20. Assessment and Treatment of Psychiatric Distress, Sexual Dysfunction, Sleep Disturbances, and Pain in Multiple Sclerosis

    PubMed Central

    Schairer, Laura C.; Pasternak, Eliana; Kim, Stella H.; Foley, Frederick W.

    2016-01-01

    Background: Psychiatric distress (depression and anxiety), sexual dysfunction, sleep disturbances, and pain are frequent comorbidities in multiple sclerosis (MS) that have the potential to interfere with functioning and quality of life. Often, patients benefit from a combination of medical and psychotherapeutic interventions. However, the literature suggests that many of these issues have been underdiagnosed or undertreated. To better understand current practices, this study aimed to gain a multidisciplinary perspective on how MS providers assess and treat these five problems. Methods: An online questionnaire was completed by 42 members of the Consortium of Multiple Sclerosis Centers on their assessment procedures, treatment recommendations, and prevalence rates of these issues in their practices. Results: More than 80% of participants reported routinely assessing for depression, anxiety, sleep, and pain, but only slightly more than half ask about sexual dysfunction. Most of these health-care providers endorsed using a general question in their assessments and recommending a pharmaceutical intervention. Conclusions: Health-care providers are aware of the prevalence of these issues in their patients with MS. Promoting the use of validated screening measures and increased research on psychotherapeutic interventions for sleep and pain are two potential avenues for improving patient care. PMID:27999523

  1. Persistent sexual dysfunction and depression in finasteride users for male pattern hair loss: a serious concern or red herring?

    PubMed

    Singh, Meena K; Avram, Marc

    2014-12-01

    The use of finasteride for the treatment of male pattern hair loss has recently been the focus of media and internet attention for potential irreversible sexual dysfunction and severe depression. The purpose of this study was to perform a critical review of the recent studies reporting prolonged sexual dysfunction and depression with the use of finasteride for the treatment of male pattern hair loss. A literature search was performed using PubMed to review the literature pertaining to any potential adverse effects with the use of finasteride and its treatment of male pattern hair loss. The authors conclude that the reports of potential irreversible sexual dysfunction and severe depression do raise concerns about the safety of finasteride; however, these studies are wrought with significant bias. Therefore, larger, randomized, double blind, controlled trials are warranted to further ascertain the true potential risks or confirm long-term safety profile of finasteride use.

  2. Female sexual dysfunction in a healthy Austrian cohort: prevalence and risk factors.

    PubMed

    Ponholzer, Anton; Roehlich, Michaela; Racz, Ursula; Temml, Christian; Madersbacher, Stephan

    2005-03-01

    Data on prevalence and risk factors for female sexual dysfunction (FSD) are rare, particularly from Europe. Aim of our study was therefore to investigate this issue in a cohort of women undergoing a health investigation. A consecutive series of women aged 20-80 years participating in a health-screening project in Vienna underwent a detailed health investigation and completed a 23-item questionnaire on several aspects of FSD including desire, arousal, pain and orgasmic disorders. Prevalence of FSD in different age groups and risk factors for FSD were calculated. A total of 703 women aged 43+/-15 years entered this study. Within the total study population, 22% reported on desire disorders, 35% on arousal disorders, and 39% on orgasmic problems, all of which increased significantly with age. Pain disorders were reported by 12.8% being most frequently in the women aged 20-39 years. In women aged 60-69 years, still 50% reported having at least "occasionally" sexual desire and 30% had more than two sexual intercourses per month. In this age group, 50% stated that a healthy sexual life is at least moderately important to them. Apart from age few risk factors for FSD were identified. Sportive activity was the only correlate to desire- and arousal disorders, psychological stress for orgasmic disorders. This study provides insights into age-specific changes of FSD in apparently healthy women. The importance of this subject is underlined by the high prevalence of FSD particularly in the elderly paralleled by a persisting interest in sexual activity.

  3. Electroencephalographic activity during sexual behavior: a novel approach to the analysis of drug effects on arousal and motivation relevant for sexual dysfunctions.

    PubMed

    Hernández-González, Marisela; Guevara, Miguel Angel; Agmo, Anders

    2014-06-01

    The neurobiological bases of human sexual behavior are only partly understood. The etiology of most human sexual dysfunctions is not understood at all. Nevertheless, substantial progress has been made in the treatment of some male sexual disorders. The prime example should be erectile deficiency, where several efficient and safe treatments are available. Pharmacological treatment for premature ejaculation is also available, although it is still in an early stage. Disorders of sexual desire have attracted much attention when women are affected but far less so when men are concerned. Whereas animal models appropriate for testing treatments for problems with erection and premature ejaculation are available, it is questionable whether such models of the desire disorders have predictive validity. There seems to be many factors involved both in reduced and enhanced sexual desire, most of which are unknown. In this review we present some data suggesting that an electroencephalographic analysis of brain activity during exposure to sexually relevant stimuli in male rats and men and during execution of sexual behaviors in male rats may provide useful information. The effects of a commonly used drug, ethanol, on the electroencephalogram recorded during sexual events in rats and men are also described. Although this approach to the analysis of the central nervous activity associated with sexual desire, arousal and behavior is still in its infancy, the data obtained so far show a remarkable similarity between men and rats. This suggests that animal studies of electroencephalographic responses to drugs in sexual contexts may be useful for predicting effects in the human male.

  4. Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: results from a randomized clinical trial.

    PubMed

    Meston, Cindy M; Lorenz, Tierney A; Stephenson, Kyle R

    2013-09-01

    Women with a history of childhood sexual abuse (CSA) have high rates of depression, posttraumatic stress disorder, and sexual problems in adulthood. We tested an expressive writing-based intervention for its effects on psychopathology, sexual function, satisfaction, and distress in women who have a history of CSA. Seventy women with CSA histories completed five 30-minute sessions of expressive writing, either with a trauma focus or a sexual schema focus. Validated self-report measures of psychopathology and sexual function were conducted at posttreatment: 2 weeks, 1 month, and 6 months. Women in both writing interventions exhibited improved symptoms of depression and posttraumatic stress disorder (PTSD). Women who were instructed to write about the impact of the abuse on their sexual schema were significantly more likely to recover from sexual dysfunction. Expressive writing may improve depressive and PTSD symptoms in women with CSA histories. Sexual schema-focused expressive writing in particular appears to improve sexual problems, especially for depressed women with CSA histories. Both treatments are accessible, cost-effective, and acceptable to patients. © 2013 International Society for Sexual Medicine.

  5. Female sexual dysfunction: A comparative study in drug naive 1st episode of depression in a general hospital of South Asia

    PubMed Central

    Roy, Payel; Manohar, Shivananda; Raman, Rajesh; Sathyanarayana Rao, T. S.; Darshan, M. S.

    2015-01-01

    Background: Women's sexual dysfunction is found to be highly prevalent in western and Indian literature. Limited studies are available on drug naive depression in western literature and in Indian population. Aim: To determine the prevalence rate and symptom profile of female sexual dysfunctions in patients with untreated depression. Design: A cross-sectional study in the psychiatry out-patient department of general hospital in South India. Materials and Methods: Following written informed consent female sexual functioning index (FSFI) and Arizona Sexual Experience Scale (ASEX) – female version and Hamilton Depression Rating Scale (HAMD - 17 item) on 30 cases and 30 controls was administered. Sociodemographic data, pattern and type of sexual dysfunctions were enquired. Data were analyzed using descriptive statistics, contingency co-efficient analysis and stepwise multiple regression. Results: The mean score of HAMD 17 item in study group was 19.13. The study showed that female sexual dysfunction was 70.3% in study group compared to 43.3% in control FSFI scores above 16 in HAMD had dysfunction of 76% with FSFI in study group. With ASEX-F sexual dysfunction was 73.3% in study compared to 20% in control. Scores above 16 in HAMD had 80% of sexual dysfunction with ASEX-F in study group. Conclusion: The study found that ASEX-F co-related better with HAMD 17 item. Following the onset of depression, the incidence of sexual dysfunction started at an early age in women. PMID:26600576

  6. Sexual Dysfunction Related to Drugs: a Critical Review. Part V: α-Blocker and 5-ARI Drugs.

    PubMed

    La Torre, A; Giupponi, G; Duffy, D; Conca, A; Cai, T; Scardigli, A

    2016-01-01

    Sexual dysfunction is a potential side effect of BPH (benign prostatic hyperplasia) and LUTS (lower urinary tract symptoms) drugs: this article is a critical review of the current literature. Many studies have been published on this topic. Methodological flaws limit the conclusions of these studies, mainly because of the lack of diagnostic criteria for ejaculatory and sexual desire dysfunction. Few of these studies are RCTs. The α-blocker (also called α1-adrenergic antagonist, alpha-adrenoceptor antagonist, alpha-blocker or AB) and 5-ARI (also called 5α-reductase inhibitor or testosterone-5-alpha reductase inhibitor) drugs can in particular cause erectile dysfunction, ejaculatory disorders and reduction of sexual desire. The sexual side effect profile of these drugs is different. Among the α-blockers, silodosin appears have the highest incidence of ejaculatory disorders. Persistent sexual side effects after discontinuation of finasteride has recently been reported, however further studies are needed to clarify the true incidence and the significance of this finding. It is desirable that future studies include validated tools to assess and diagnose sexual dysfunction induced by these medications, especially for ejaculation and sexual desire disorders. Only a small amount of research has intentionally set out to investigate sexual dysfunction caused by α-blocker and 5-ARI drugs: studies to specifically assess sexual dysfunction induced by these drugs are needed. Further studies are also needed to assess in the long term the role of combined therapy of phosphodiesterase type 5 inhibitors and α-blockers or 5-ARIs in treating LUTS/BPH. This study was conducted in 2014 using the paper and electronic resources of the library of the "Azienda Provinciale per i Servizi Sanitari (APSS)" in Trento, Italy (http://atoz.ebsco.com/Titles/2793). The library has access to a wide range of databases including DYNAMED, MEDLINE Full Text, CINAHL Plus Full Text, The Cochrane

  7. Female sexual dysfunction among young and middle-aged women in Hong Kong: prevalence and risk factors.

    PubMed

    Zhang, Huiping; Yip, Paul S F

    2012-11-01

    Sexual dysfunction is a serious public health problem that affects women's quality of life. However, there is very little epidemiological data on its incidence in Hong Kong Chinese women. To estimate the prevalence of, and risk factors associated with sexual dysfunction among young and middle-aged women in Hong Kong. The study was part of the ninth Knowledge, Attitude, and Practice survey conducted by the Family Planning Association of Hong Kong in 2007. The dataset comprised 1,510 face-to-face interviews with Hong Kong Chinese women aged 19-49 living in the community. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition classification of sexual dysfunction was used to measure female sexual dysfunction (FSD). At least one form of FSD was reported by 37.9% of the sample. Multivariate analysis showed that having sought medical help for sexual problems (odds ratio [OR] = 4.20), having a partner with erectile dysfunction (OR = 2.44) and premature ejaculation (OR = 2.56), perceiving sex as unimportant to marriage (OR = 1.57), and reporting marital dissatisfaction (OR = 1.45) were all significant risk factors for FSD and its specific components among the sample. However, having liberal attitudes to sex (OR = 0.63) was a protective factor. The prevalence of FSD is lower among Hong Kong Chinese young and middle-aged women than in the United States and some Asian countries. Factors contributing to the risk of FSD span the domains of sexual experience, attitudes to sex, and relationship factors. These findings suggest future directions for the delivery of services addressing the prevention and treatment of FSD. © 2012 International Society for Sexual Medicine.

  8. Prevalence of sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome.

    PubMed

    Trinchieri, Alberto; Magri, Vittorio; Cariani, Lisa; Bonamore, Roberto; Restelli, Antonella; Garlaschi, Maria Cristina; Perletti, Gianpaolo

    2007-06-01

    The aim of this study was to assess the prevalence of sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome. A group of 399 patients with symptoms suggesting prostatitis without urethral discharge attending an outpatient Prostatitis Clinic was considered. All were evaluated by the same urologist according to a protocol comprising medical history, physical and transrectal ultrasound examination. Patients had a urethral swab, a four-specimen study and culture of the seminal fluid. Patients were classified according to NIDDK/NIH on the basis of the results of the microbiologic and microscopic four-specimen study and of the culture of the seminal fluid. Subjective symptoms were scored by CPSI questionnaire and by non validated general assessment questions inquiring loss of libido, quality of erection, premature loss of erection, pain on ejaculation, hemo-spermia, pyo-spermia, premature ejaculation, and presence of semen abnormalities. Of all the patients evaluated, 138 (34%) had erectile and 220 ejaculatory dysfunctions (55%). Loss of libido, premature ejaculation and presence of semen abnormalities were more frequent in subjects younger than 50 years. Rates of impaired erection and of semen abnormalities were significantly higher in patients with bacterial chronic prostatitis with respect to patients with chronic pelvic pain syndrome. Premature ejaculation was more frequent (p = 0.02) in patients with 10-30 leukocytes (36%) or > 30 leukocytes (32%) in VB3 urine than in those with 10 or less leukocytes (22%). Painful ejaculation was significantly associated to the sonographic demonstration of enlargement (p = 0.000), asymmetry (p = 0.001) or inflammatory changes (p = 0.038) of the seminal vesicles, whereas hemo-spermia was significantly associated to asymmetry (p = 0.000) or inflammatory changes (p = 0.013, respectively) of the seminal vesicles. Men with erectile (p = 0.001) and ejaculation dysfunction (p = 0.001) had more severe CPSI scores

  9. Persistent genital arousal and restless genitalia: sexual dysfunction or subtype of vulvodynia?

    PubMed

    Markos, A R; Dinsmore, Wallace

    2013-11-01

    We conducted a literature review of patients' conditions described under persistent genital arousal disorder and restless genital syndrome, vulvodynia and male genital skin pain of unknown aetiology (penoscrotodynia). Our aim is to improve the understanding of the condition, unify nomenclature and promote evidence-based practice. The most prominent symptom in persistent genital arousal disorder and restless genital syndrome is a spontaneous, unwelcomed, intrusive and distressing vulval sensation. There are similarities between the clinical presentation of vulvodynia, penoscrotodynia, persistent genital arousal disorder and restless genital syndrome patients. The aetiology of persistent genital arousal disorder and restless genital syndrome, similar to vulvodynia, could be better explained in terms of neuro-vascular dysfunction, genital peripheral neuropathy and/or dysfunctional micro-vascular arterio-venous shunting. Erythromelalgia lends itself to explain some cases of restless genital syndrome, who have concurrent restless legs syndrome; and therefore draw parallels with the red scrotum syndrome. The published literature supports the concept of classifying restless genital syndrome as a sub-type of vulvodynia rather than sexual dysfunction.

  10. A qualitative evaluation of online chat groups for women completing a psychological intervention for female sexual dysfunction.

    PubMed

    Hucker, Alice; McCabe, Marita P

    2014-01-01

    Because of the embarrassment that can surround female sexual dysfunctions, online interventions offer an anonymous and private treatment alternative. Recently, an online cognitive-behavioral treatment for female sexual dysfunctions was evaluated. Although significant improvements were observed in sexual functioning, the treatment was primarily a behavioral intervention because of difficulties with engaging participants in cognitive therapy over e-mail. To address this limitation, the use of chat groups was incorporated into a new online treatment for female sexual dysfunctions-the PursuingPleasure program. Thirty-eight women participated in the PursuingPleasure chat groups. The goals of the chat groups were to address and overcome challenges as women progressed through PursuingPleasure and to create a social support network where group therapy processes could be used. The chat groups aimed to address misunderstandings, monitor changes, and receive feedback. A qualitative analysis of the chat groups revealed that they helped to facilitate the cognitive-affective aspects of the program, as well as fulfill their other intended functions. This study demonstrates how the use of chat groups in the online treatment of female sexual dysfunctions is a useful addition to Internet-based treatment. Feedback suggests that the chat groups were one of the most helpful aspects of the program, although a small group of women reported finding the groups unhelpful.

  11. Sexual Dysfunction among Females Receiving Psychotropic Medication: A Hospital-based Cross-sectional Study

    PubMed Central

    Shetageri, Veda N.; Bhogale, Govind S.; Patil, N. M.; Nayak, R. B.; Chate, S. S.

    2016-01-01

    Background: Sexual dysfunction (SD) is a known adverse effect of psychotropic medications. Even though sexual difficulties are common among women; very few studies have been carried out in India. Objective: To study the prevalence and nature of SD among females receiving psychotropic medications and to compare the SD among female patients receiving antipsychotics and antidepressants. Materials and Methods: Female investigator conducted a hospital-based cross-sectional study on female patients visiting the psychiatry outpatient department. Patients meeting inclusion criteria were assessed for SD disorder as per Diagnostic and Statistical Manual of Mental Disorders 4th Edition Text Revision. SD severity was measured using Female Sexual Function Index (FSFI) scale. Results: The prevalence of SD in this study was 68.32%. There was more than one SD in 48 (47.52%). FSFI score was significantly low in patients with SD as compared to patients not having SD (P = 0.001). SD was more common in patients who were on combination of antidepressants and benzodiazepines than antidepressant alone or antipsychotic alone. Conclusion: SD was prevalent in more than 50% of female patients on psychotropic drugs. Number of patients on individual psychotropic drugs was so small that a definite conclusion could not be drawn. Study emphasizes the need to carry out similar study on larger number of patients to get better insight into this problem. PMID:27833229

  12. The Global Online Sexuality Survey (GOSS): female sexual dysfunction among Internet users in the reproductive age group in the Middle East.

    PubMed

    Shaeer, Osama; Shaeer, Kamal; Shaeer, Eman

    2012-02-01

    The exact prevalence of female sexual dysfunction (FSD) in the Middle East is exceptionally difficult to measure in light of its sensitive nature and the conservative tinge of the population. The Global Online Sexuality Survey-Arabic-Females (GOSS-AR-F) is a community-based study of female sexuality in the Middle East through an online survey. Prevalence of risk for female sexual dysfunction (rFSD) in the reproductive age group and its vulnerability to various risk factors. GOSS-AR-F was offered via online advertising. The survey is comprised of the Female Sexual Function Index (FSFI) questionnaire among other questions. Out of 2,920 participants, 344 participants completed all survey questions. Average total FSFI score was 23 ± 6.5, with 59.1% of participants suffering rFSD. Age adjusted prevalence of rFSD was 59.5%, standardized to World Health Organ