[Neurobiological foundations underlying normal and disturbed sexuality].

PubMed

Krüger, T H C; Kneer, J

2017-05-01

Sexual functions are regulated by hormonal and neurochemical factors as well as neuronal networks. An understanding of these basic principles is necessary for the diagnostics, counselling and treatment of sexual problems. Description of essential mechanisms of sexual function on a neurochemical and neuronal level. Literature search, selection and discussion of relevant studies. Analogous to the dual control model there are primary inhibitory (e. g. serotonin) and excitatory neurotransmitter systems (e.g. sex steroids and dopamine). Moreover, neuronal structures have been identified that are responsible for processing sexual stimuli. These networks are altered in subjects with sexual disorders or by pharmacological treatment, e. g. antiandrogens and selective serotonin reuptake inhibitors (SSRI) CONCLUSION: Knowledge of the neurobiology of sexuality forms the foundations for the treatment of sexual dysfunctions in psychiatry and other disciplines.

Asexuality: a mixed-methods approach.

PubMed

Brotto, Lori A; Knudson, Gail; Inskip, Jess; Rhodes, Katherine; Erskine, Yvonne

2010-06-01

Current definitions of asexuality focus on sexual attraction, sexual behavior, and lack of sexual orientation or sexual excitation; however, the extent to which these definitions are accepted by self-identified asexuals is unknown. The goal of Study 1 was to examine relationship characteristics, frequency of sexual behaviors, sexual difficulties and distress, psychopathology, interpersonal functioning, and alexithymia in 187 asexuals recruited from the Asexuality Visibility and Education Network (AVEN). Asexual men (n = 54) and women (n = 133) completed validated questionnaires online. Sexual response was lower than normative data and was not experienced as distressing, and masturbation frequency in males was similar to available data for sexual men. Social withdrawal was the most elevated personality subscale; however, interpersonal functioning was in the normal range. Alexithymia was elevated in 12%. Social desirability was also in the normal range. Study 2 was designed to expand upon these quantitative findings with 15 asexuals from Study 1 through in-depth telephone interviews. The findings suggest that asexuality is best conceptualized as a lack of sexual attraction; however, asexuals varied greatly in their experience of sexual response and behavior. Asexuals partnered with sexuals acknowledged having to "negotiate" sexual activity. There were not higher rates of psychopathology among asexuals; however, a subset might fit the criteria for Schizoid Personality Disorder. There was also strong opposition to viewing asexuality as an extreme case of sexual desire disorder. Finally, asexuals were very motivated to liaise with sex researchers to further the scientific study of asexuality.

Translational Perspective on the Role of Testosterone in Sexual Function and Dysfunction.

PubMed

Podlasek, Carol A; Mulhall, John; Davies, Kelvin; Wingard, Christopher J; Hannan, Johanna L; Bivalacqua, Trinity J; Musicki, Biljana; Khera, Mohit; González-Cadavid, Nestor F; Burnett, Arthur L

2016-08-01

The biological importance of testosterone is generally accepted by the medical community; however, controversy focuses on its relevance to sexual function and the sexual response, and our understanding of the extent of its role in this area is evolving. To provide scientific evidence examining the role of testosterone at the cellular and molecular levels as it pertains to normal erectile physiology and the development of erectile dysfunction and to assist in guiding successful therapeutic interventions for androgen-dependent sexual dysfunction. In this White Paper, the Basic Science Committee of the Sexual Medicine Society of North America assessed the current basic science literature examining the role of testosterone in sexual function and dysfunction. Testosterone plays an important role in sexual function through multiple processes: physiologic (stimulates activity of nitric oxide synthase), developmental (establishes and maintains the structural and functional integrity of the penis), neural (development, maintenance, function, and plasticity of the cavernous nerve and pelvic ganglia), therapeutically for dysfunctional regulation (beneficial effect on aging, diabetes, and prostatectomy), and phosphodiesterase type 5 inhibition (testosterone supplement to counteract phosphodiesterase type 5 inhibitor resistance). Despite controversies concerning testosterone with regard to sexual function, basic science studies provide incontrovertible evidence for a significant role of testosterone in sexual function and suggest that properly administered testosterone therapy is potentially advantageous for treating male sexual dysfunction. Published by Elsevier Inc.

Urinary and sexual functions after surgical treatment of penile fracture concomitant with complete urethral disruption.

PubMed

Raheem, Ali Abdel; El-Tatawy, Hassan; Eissa, Ahmed; Elbahnasy, Abdel Hamid; Elbendary, Mohamed

2014-03-28

Penile fracture with concomitant complete urethral disruption is an uncommon urologic disorder. Data about the treatment and outcome measurements of this condition are scarce in the literature. The aim of the present study is to evaluate the long term urinary and sexual functions of patients with penile fracture associated with complete urethral injury after immediate surgical reconstruction. Twelve patients met our inclusion criteria and were included in this retrospective case series study; however, one was lost during follow-up. Patient's medical records were reviewed and all patients were interviewed for clinical evaluation. Urinary function was assessed by history, uroflometry and retrograde urethrography, while, sexual function was assessed by questionnaire (Sexual Health Inventory for Men) and penile Doppler for patients with erectile dysfunction. Patients' mean age was 32.3 ± 7.5 years (range 21-43) and the mean follow-up period was 72.6 ± 45.4 months (range 14-187). Vigorous sexual intercourse was the main cause in 91% of our patients. No serious long term complications was found. Only 1 patient (9%) suffered from anterior urethral stricture, 1 patient (9%) complained of weak erection, 3 patients (27%) had a palpable fibrosis and 2 patients (18%) reported a slight penile curvature during erection. Ninety one percent of all our patients maintained their normal urinary and sexual functions. On the long term follow-up, most of the patients maintained their normal erectile and voiding functions with no harmful long-term complications. We advocate immediate surgical intervention and reconstruction of both corpora cavernous and urethra as a first line treatment for those patients.

The politics of heterosexuality--a missing discourse in cancer nursing literature on sexuality: a discussion paper.

PubMed

Hyde, Abbey

2007-02-01

In this article, a critique of cancer nursing literature on the issue of sexuality is presented, with particular reference to literature on cancers common to women. The paper begins with an account of two competing perspectives on sexuality. The first is a version of sexuality rooted in sexology, underpinned by biomedical science that makes a claim to having identified 'normal' sexuality. The second is a version of sexuality developed within feminist scholarship that tends to reject biological determinism as a basis for understanding sexuality, instead favouring constructionist perspectives, with the socio-political context of sexual relations problematised. The focus of the article then shifts to cancer nursing literature on sexuality that deals primarily with cancers common to women, to appraise the extent to which either of the above perspectives on sexuality is invoked. Within this body of nursing knowledge, I argue that there has largely been an uncritical endorsement of biomedical constructions of sexuality, rooted in orthodox sexology, with a dominant focus on sexual functioning and on sexual rehabilitation for women with cancer. Moreover, in this knowledge base, phallocentric heterosexuality over and above other forms of sexual expression is privileged, and the socio-political context of unequal gender power relations is largely excluded. References to the social sphere as a dimension of nursing care are focused almost exclusively on maintaining normality, and reflect the emphasis on functional restoration. The largely individualistic, uncritical and biocentric emphasis in this literature may serve inadvertently to reinforce and maintain existing gender inequalities in heterosexual relationships. Finally, I consider the difficulties for oncology nurses in dealing with contradictory truth claims or conventional wisdoms about sexuality from the disparate disciplines of which holism is comprised.

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.

Patterns and Predictors of Sexual Function After Liver Donation: the Adult to Adult Living Donor Liver Transplantation Cohort Study (A2ALL)

PubMed Central

DiMartini, AF.; Dew, MA.; Butt, Z.; Simpson, MA.; Ladner, DP.; Smith, AR.; Hill-Callahan, P.; Gillespie, BW.

2015-01-01

Although sexual functioning is an important facet of living donor quality of life, it has not received extensive evaluation in this population. Using data from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study, we examined donor sexual functioning across the donation process from the predonation evaluation to 3 months and 1 year postdonation. Donors (n=208) and a comparison group of non-donors (n=155) completed self-reported surveys with specific questions on sexual desire, satisfaction, orgasm, and (for men) erectile function. Across the three time points, donor sexual functioning was lower at the evaluation phase and 3 months postdonation than at one year postdonation. In the early recovery period, abdominal pain was associated with difficulty reaching orgasm (OR = 3.98, 95% CI 1.30–12.16), concerns over appearance with lower sexual desire (OR = 4.14, 95% CI 1.02–16.79), and not feeling back to normal was associated with dissatisfaction with sexual life (OR 3.58, 95% CI 1.43–8.99). Efforts to educate donors before the surgery and prepare them for the early recovery phase may improve recovery and reduce distress regarding sexual functioning. PMID:25779554

Addressing Sexuality and Pregnancy in Childbirth Education Classes

PubMed Central

Allen, Laura; Fountain, Lily

2007-01-01

A positive, nonjudgmental, and informed approach to sexual health during pregnancy promotes acceptance of the normal functioning of women's bodies. It also encourages the development of close and supportive relationships that are so essential during pregnancy and birth. Common concerns do not need to become problems. Concerns include issues of libido, positioning, and preterm labor or fetal health, as well as myths and cultural attitudes. Childbirth educators can use tools such as the PLISSIT model to approach the topic of sexuality during pregnancy. In addition, opportunities are available in every childbirth class to acknowledge or ignore sexual issues. Perinatal educators who take responsibility for addressing this often-taboo topic can enhance women's feelings of safety and their confidence in normal birth. PMID:18408809

The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gur, Serkan, E-mail: mserkangur@yahoo.com; Ozkan, Ugur; Onder, Hakan

To determine the incidence of erectile dysfunction in patients with common iliac artery (CIA) occlusive disease and the effect of revascularization on erectile function using the sexual health inventory for males (SHIM) questionnaire. All patients (35 men; mean age 57 {+-} 5 years; range 42-67 years) were asked to recall their sexual function before and 1 month after iliac recanalization. Univariate and multivariate analyses were performed to determine variables effecting improvement of impotence. The incidence of impotence in patients with CIA occlusion was 74% (26 of 35) preoperatively. Overall 16 (46%) of 35 patients reported improved erectile function after iliacmore » recanalization. The rate of improvement of impotence was 61.5% (16 of 26 impotent patients). Sixteen patients (46%), including seven with normal erectile function before the procedure, had no change. Three patients (8%) reported deterioration of their sexual function, two of whom (6%) had normal erectile function before the procedure. The median SHIM score increased from 14 (range 4-25) before the procedure to 20 (range 1-25) after the procedure (P = 0.005). The type of recanalization, the age of the patients, and the length of occlusion were related to erectile function improvement in univariate analysis. However, these factors were not independent factors for improvement of erectile dysfunction in multivariate analysis (P > 0.05). Endovascular recanalization of CIA occlusions clearly improves sexual function. More than half of the patients with erectile dysfunction who underwent endovascular recanalization of the CIA experienced improvement.« less

[Sexual life in elderly patients with cardiovascular disease].

PubMed

Karpuz, Hakan

2017-09-01

Sexual activity is an important component of patient and partner quality of life for men and women with cardiovascular disease, including many elderly patients. Older adults desire sexual intimacy when there is a partner and a health status that allows sexual relationships. Older individuals desire to love and enjoy sexual activity in relation to personal circumstances, and when health status allows them to experience close relations, most often within marriage especially in our country. Normal changes occur in the phases of sexual cycle with aging, male erectile dysfunction and female sexual dysfunction increase with age. Elderly patients are often affected by multiple organic diseases which can interfere with sexual function especially cardiovascular disease. Treating those disorders or modifying lifestyle-related risk factors may help prevent sexual dysfunction in the elderly. Sexuality is important for older adults and physicians should give their patient's opportunity to voice their concerns with sexual function and offer them alternatives for evaluation and treatment. Asking about sexual health remains difficult or embarrassing for many physicians; in addition, many patients find it difficult to raise sexual issues with their doctor.

Functional brain correlates of heterosexual paedophilia.

PubMed

Schiffer, Boris; Paul, Thomas; Gizewski, Elke; Forsting, Michael; Leygraf, Norbert; Schedlowski, Manfred; Kruger, Tillmann H C

2008-05-15

Although the neuronal mechanisms underlying normal sexual motivation and function have recently been examined, the alterations in brain function in deviant sexual behaviours such as paedophilia are largely unknown. The objective of this study was to identify paedophilia-specific functional networks implicated in sexual arousal. Therefore a consecutive sample of eight paedophile forensic inpatients, exclusively attracted to females, and 12 healthy age-matched heterosexual control participants from a comparable socioeconomic stratum participated in a visual sexual stimulation procedure during functional magnetic resonance imaging. The visual stimuli were sexually stimulating photographs and emotionally neutral photographs. Immediately after the imaging session subjective responses pertaining to sexual desire were recorded. Principally, the brain response of heterosexual paedophiles to heteropaedophilic stimuli was comparable to that of heterosexual males to heterosexual stimuli, including different limbic structures (amygdala, cingulate gyrus, and hippocampus), the substantia nigra, caudate nucleus, as well as the anterior cingulate cortex, different thalamic nuclei, and associative cortices. However, responses to visual sexual stimulation were found in the orbitofrontal cortex in healthy heterosexual males, but not in paedophiles, in whom abnormal activity in the dorsolateral prefrontal cortex was observed. Thus, in line with clinical observations and neuropsychological studies, it seems that central processing of sexual stimuli in heterosexual paedophiles may be altered by a disturbance in the prefrontal networks, which, as has already been hypothesized, may be associated with stimulus-controlled behaviours, such as sexual compulsive behaviours. Moreover, these findings may suggest a dysfunction (in the functional and effective connectivity) at the cognitive stage of sexual arousal processing.

Prostate Cancer Patient Characteristics Associated With a Strong Preference to Preserve Sexual Function and Receipt of Active Surveillance.

PubMed

Broughman, James R; Basak, Ramsankar; Nielsen, Matthew E; Reeve, Bryce B; Usinger, Deborah S; Spearman, Kiayni C; Godley, Paul A; Chen, Ronald C

2018-04-01

Men with early-stage prostate cancer have multiple options that have similar oncologic efficacy but vary in terms of their impact on quality of life. In low-risk cancer, active surveillance is the option that best preserves patients' sexual function, but it is unknown if patient preference affects treatment selection. Our objectives were to identify patient characteristics associated with a strong preference to preserve sexual function and to determine whether patient preference and baseline sexual function level are associated with receipt of active surveillance in low-risk cancer. In this population-based cohort of men with localized prostate cancer, baseline patient-reported sexual function was assessed using a validated instrument. Patients were also asked whether preservation of sexual function was very, somewhat, or not important. Prostate cancer disease characteristics and treatments received were abstracted from medical records. A modified Poisson regression model with robust standard errors was used to compute adjusted risk ratio (aRR) estimates. All statistical tests were two-sided. Among 1194 men, 52.6% indicated a strong preference for preserving sexual function. Older men were less likely to have a strong preference (aRR = 0.98 per year, 95% confidence interval [CI] = 0.97 to 0.99), while men with normal sexual function were more likely (vs poor function, aRR = 1.59, 95% CI = 1.39 to 1.82). Among 568 men with low-risk cancer, there was no clear association between baseline sexual function or strong preference to preserve function with receipt of active surveillance. However, strong preference may differnetially impact those with intermediate baseline function vs poor function (Pinteraction = .02). Treatment choice may not always align with patients' preferences. These findings demonstrate opportunities to improve delivery of patient-centered care in early prostate cancer.

Female sexual function and fertility after ileal pouch-anal anastomosis.

PubMed

Hor, Thevy; Lefevre, Jeremie H; Shields, Conor; Chafai, Najim; Tiret, Emmanuel; Parc, Yann

2016-03-01

A potential complication in women after ileal pouch-anal anastomosis (IPAA) is sexual impairment and reduced fertility. The aim was to evaluate sexual function and fertility after IPAA. All female patients who underwent an IPAA between 2004 and 2013 were retrospectively included. Sexual function, fertility, and continence were explored by the female sexual function index (FSFI), telephonic interview, and Wexner's score. Among 127 women included, 93 responded to the questionnaires (73.2%). Seventy five were sexually active, and 48 (64%) had normal sexual function (FSFI > 26). In univariate analysis, there was a significant relationship between ulcerative colitis (p = 0.0161), age > 40 years (p = 0.01311), number of bowel movements (p = 0.0238), nocturnal pouch activity (p = 0.0094), use of loperamide (p = 0.0283), and existence of sexual dysfunction. After multivariate analysis, age and nocturnal pouch activity were associated with a worse sexual function (p = 0.0235, OR = 3.3 (1.2-9.9) and p = 0.0094, OR = 4.1 (1.4-13.5)). Of 16 patients who wished to have children, 10 (63%) became pregnant without recourse to in vitro fertilization, of whom 3 had two or more pregnancies. In total, there were 13 children born after IPAA. The mean time between the first pregnancy and surgery was 24.8 ± 22 months. At 12 and 24 months after cessation of contraception, 57 and 67% had at least one pregnancy. While sexual function is impaired in a limited number of patients, the impact of surgery can be regarded as modest. Age and nocturnal pouch activity were some independent factors of worse sexual function. The risk of infertility should not preclude consideration of IPAA as a treatment option.

Subclinical Hypothyroidism is not a Risk Factor for Female Sexual Dysfunction in Korean Middle-Aged Women.

PubMed

Hong, Hyeri; Lee, Hee Jun; Kim, Sun Min; Jeon, Myung Jae; Shin, Dong Wook; Choi, Ho-Chun; Lee, Hyejin; Yun, Jae Moon; Cho, Belong; Lee, Seung Mi

2015-07-01

Previous studies have suggested that subclinical hypothyroidism is associated with the risk of anxiety or depression and can affect quality of life. However, there is a paucity of information regarding the relationship between subclinical hypothyroidism and female sexual dysfunction. The study population consisted of sexually active middle-aged women (≥40 years old) who visited the center for health promotion and optimal aging at Seoul National University Hospital for a health check-up between 2010 and 2011. Sexual function was evaluated by the female sexual function index (FSFI) questionnaire, and female sexual dysfunction was defined as a FSFI score of ≤26.55. FSFI scores and female sexual dysfunction frequencies were compared between cases with subclinical hypothyroidism and healthy controls. Nonparametric methods were used for statistical analysis. A total of 1086 women were included, and the frequency of subclinical hypothyroidism and female sexual dysfunction was 138 (12.7%) and 741 (68.2%), respectively. The total FSFI score and the scores in each domain were not different between the two groups (median total FSFI score (interquartile range): 23.8 (20.2-27.5) for normal thyroid status vs. 24.4 (20.6-27.6) for subclinical hypothyroidism, p=n.s.). The frequency of female sexual dysfunction was not different between the two groups, either (68.4% for normal thyroid status vs. 67.4% for subclinical hypothyroidism, p=n.s.). These findings were consistent even after adjustment for confounding variables. Subclinical hypothyroidism is not a risk factor for sexual dysfunction in middle-aged women.

Penile vascular evaluation and sexual function before and after radical retropubic prostatectomy: 5-year follow-up.

PubMed

Dubbelman, Yvette D; Wildhagen, Mark F; Dohle, Gert R

2008-09-01

Sexual dysfunction is common after surgery for prostate cancer. The aetiology of changes in sexual potency after radical prostatectomy is probably multifactorial, including neurogenic, vascular and psychosexual factors. A prospective study was designed to investigate haemodynamic and psychosexual changes before and after radical retropubic prostatectomy (RRP) for organ-confined prostate cancer. Penile haemodynamic evaluation and an assessment of sexual excitement were performed preoperatively and 3 months after RRP by colour Doppler ultrasonography (CDU) with visual erotic stimulation combined with a single intracavernous injection of a mixture of papaverine/phentolamine. Questionnaires on sexual function [International Index of Erectile Function (IIEF)], general health and quality of life were sent to the patients preoperative, 3 months and 5 years after operation. Forty-eight men participated in the study. Mean age was 62.6 years (range 55-69). CDU did not show any significant reduction in mean peak systolic flow velocity and mean resistance index. From the men who preoperatively had normal arterial inflow 18% developed arteriogenic insufficiency. Some form of veno-occlusive insufficiency and low resistance indices were already present in the majority of normal potent men preoperatively. Surgical technique did not influence penile arterial blood flow after the operation. Three months and 5 years postoperatively, there was a highly significant reduction in erectile function, intercourse satisfaction, overall satisfaction, orgasmic function and sexual desire. However, with respect to the outcome at 3 months there was a significant improvement of orgasmic function 5 years after operation, especially after a bilateral nerve sparing procedure. Erections sufficient for vaginal penetration (questions 3 and 4 of the IIEF, score >or=8) improved from 2% to 11% 3 months and 5 years after RRP respectively. Total IIEF score was significantly better after a bilateral nerve-sparing procedure compared with non-nerve sparing. No structural vascular changes were observed 3 months after operation. Vascular factors appear to be less important in the aetiology of ED after RRP. There seems to be a trend of a better improvement of sexual function over time, especially orgasmic function, in patients with bilateral nerve-sparing surgery.

The use of magnetic resonance imaging for studying female sexual function: A review.

PubMed

Vaccaro, Christine M

2015-04-01

Many would agree that there are two quintessential sexual organs in the female: the clitoris and the brain. Using non-invasive techniques of magnetic resonance imaging (MRI), investigators have gained insight into the mental and physical factors involved in female sexual function. Since only the external clitoral glans is easily accessible for direct measurement, the complete anatomy of the clitoris (including the internal components-paired corpora, crura, and bulbs) has only recently been described, with MRI providing the most sensitive way of distinguishing among the various soft tissue planes. Average sizes of clitoral structures and average distances between the clitoral complex and other pelvic landmarks have been measured. These measurements have been correlated with female sexual function: a longer distance between the clitoral complex and the vaginal lumen correlates with poorer sexual function, consistent with prior imaging studies. However, whether clitoral size influences function is debatable, so further studies are needed. Physiological investigations have demonstrated that female arousal disorder is unlikely to be due to inadequate genital engorgement. Some consider the brain to be the ultimate sexual organ, and several recent studies have used functional MRI (fMRI) to reveal sexual excitability in the brain. The normal sexual response requires deactivation of the frontal lobe and activation of the instinctual limbic system of the midbrain. As MR technology continues to improve, the mysteries of female sexuality will be further unraveled. © 2015 Wiley Periodicals, Inc.

Long-term follow-up of children who underwent severe hypospadias repair using an online survey with validated questionnaires.

PubMed

Fraumann, Sarah A; Stephany, Heidi A; Clayton, Douglass B; Thomas, John C; Pope, John C; Adams, Mark C; Brock, John W; Tanaka, Stacy T

2014-06-01

Few studies of hypospadias repair in childhood have used validated questionnaires to investigate outcomes of cosmesis, urinary function, and sexual function in adulthood. We sought to investigate long-term outcomes in adult patients who had undergone severe hypospadias repair as children using an existing web-based application available to multiple institutions in order to develop an online patient survey of previously validated questionnaires. Patients aged 18 years or older who underwent severe hypospadias repair between 1992 and 1997 at our institution were contacted to complete an online survey. Through medical chart reviews, we analyzed the location of meatus, type of repair, and complications. The online survey included questions about penile appearance, and validated questionnaires to assess urinary and sexual function. Of 58 patients who met the inclusion criteria, we contacted 19, and 13 completed the survey. Fifty-nine percent had complications, with an average of 2.2 procedures per patient. Most (85.0%) were satisfied with penile appearance, although 38.0% had residual penile curvature. Hypospadias patients had mean lower orgasmic function than normal controls. Mean scores for urinary function and other domains of sexual function were similar to normal controls. Although the majority of adult patients were satisfied with the outcomes of penile appearance, urinary function, and sexual function, our online survey suggests decreased lower orgasmic function as measured by validated questionnaire. An online survey accessible to multiple institutions with validated questionnaires may facilitate assessment of long-term hypospadias results. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Sexual function and behavior in social phobia.

PubMed

Bodinger, Liron; Hermesh, Haggai; Aizenberg, Dov; Valevski, Avi; Marom, Sofi; Shiloh, Roni; Gothelf, Doron; Zemishlany, Zvi; Weizman, Abraham

2002-10-01

Social phobia is a type of performance and interpersonal anxiety disorder and as such may be associated with sexual dysfunction and avoidance. The aim of the present study was to evaluate sexual function and behavior in patients with social phobia compared with mentally healthy subjects. Eighty subjects participated in the study: 40 consecutive, drug-free outpatients with social phobia (DSM-IV) attending an anxiety disorders clinic between November 1997 and April 1999 and 40 mentally normal controls. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Liebowitz Social Anxiety Scale were used to quantitatively and qualitatively assess sexual function and behavior. Men with social phobia reported mainly moderate impairment in arousal, orgasm, sexual enjoyment, and subjective satisfaction domains. Women with social phobia reported severe impairment in desire, arousal, sexual activity, and subjective satisfaction. In addition, compared with controls, men with social phobia reported significantly more frequent paid sex (p < .05), and women with social phobia reported a significant paucity of sexual partners (p < .05). Patients with social phobia exhibit a wide range of sexual dysfunctions. Men have mainly performance problems, and women have a more pervasive disorder. Patients of both genders show difficulties in sexual interaction. It is important that clinicians be aware of this aspect of social phobia and initiate open discussions of sexual problems with patients.

Exploring gay couples' experience with sexual dysfunction after radical prostatectomy: a qualitative study.

PubMed

Hartman, Mary-Ellen; Irvine, Jane; Currie, Kristen L; Ritvo, Paul; Trachtenberg, Lianne; Louis, Alyssa; Trachtenberg, John; Jamnicky, Leah; Matthew, Andrew G

2014-01-01

This exploratory study examines the experience of three gay couples managing sexual dysfunction as a result of undergoing a radical prostatectomy. Semi-structured interviews were conducted as part of a larger study at an urban hospital in Toronto, Ontario, Canada. Interview transcripts were transcribed verbatim, and analyzed using interpretative phenomenological analysis. The authors clustered 18 subordinate themes under 3 superordinate themes: (a) acknowledging change in sexual experience (libido, erectile function, sexual activity, orgasmic function); (b) accommodating change in sexual experience (strategies: emphasizing intimacy, embracing plan B, focus on the other; barriers: side-effect concerns, loss of naturalness, communication breakdown, failure to initiate, trial and failure, partner confounds); and (c) accepting change in sexual experience (indicators: emphasizing health, age attributions, finding a new normal; barriers: uncertain outcomes, treatment regrets). Although gay couples and heterosexual couples share many similar challenges, we discovered that gay men have particular sexual roles and can engage in novel accommodation practices, such as open relationships, that have not been noted in heterosexual couples. All couples, regardless of their level of sexual functioning, highlighted the need for more extensive programming related to sexual rehabilitation. Equitable rehabilitative support is critical to assist homosexual couples manage distress associated with prostatectomy-related sexual dysfunction.

Clitoral therapy device for treatment of sexual dysfunction in irradiated cervical cancer patients.

PubMed

Schroder, Maryann; Mell, Loren K; Hurteau, Jean A; Collins, Yvonne C; Rotmensch, Jacob; Waggoner, Steven E; Yamada, S Diane; Small, William; Mundt, Arno J

2005-03-15

The purpose of this pilot study was to evaluate the efficacy of the clitoral therapy device (Eros Therapy) in alleviating sexual dysfunction in irradiated cervical cancer patients. Eligible patients had a history of cervical cancer treated with radiotherapy and self-reported sexual dysfunction of sexual arousal and/or orgasmic disorders. Patients used the noninvasive, nonpharmacologic clitoral therapy device using a hand-held, battery-powered vacuum to cause clitoral engorgement four times weekly for 3 months during foreplay and self-stimulation. Study instruments included the Female Sexual Function Index, Derogatis Interview for Sexual Functioning, and Dyadic Adjustment Scale. The outcome evaluation was performed at 3 months. Between 2001 and 2002, 15 women were enrolled and 13 completed the study. The median patient age and radiotherapy-enrollment interval was 43.5 years and 2 years, respectively. At baseline, all patients reported symptoms of sexual arousal and/or orgasmic disorders, and some also had sexual desire and pain disorders. At 3 months, statistically significant improvements were seen in all domains tested, including sexual desire, arousal, lubrication, orgasm, sexual satisfaction, and reduced pain. The median Female Sexual Function Index total score increased from 17 to 29.4 (maximal score, 36; p <0.001). The median Derogatis Interview for Sexual Functioning total raw score increased from 46 to 95 (maximal score, 118; p <0.001). At baseline, the Derogatis Interview for Sexual Functioning total T-score corresponded to the bottom 10th percentile of normal sexual functioning. At 3 months, the total T-score placed the patients at the normalcy cutoff. Gynecologic examinations revealed improved mucosal color and moisture and vaginal elasticity and decreased bleeding and ulceration. Our results from this pilot study suggest that the clitoral therapy device may alleviate sexual dysfunction in irradiated cervical cancer patients. A randomized, controlled trial is warranted to assess the full benefits of this approach.

Autism-spectrum disorders in adolescence and adulthood: focus on sexuality.

PubMed

Turner, Daniel; Briken, Peer; Schöttle, Daniel

2017-11-01

The combination of the core symptoms, characterizing individuals with autism-spectrum disorder (ASD), can lead to problems in romantic relationships and sexual functioning. The purpose of this article is to review studies on sexuality in individuals with ASD published since January 2016. Individuals with ASD and especially women show a higher diversity in sexual orientation in comparison with the non-ASD population. Furthermore, ASD women are more frequently in a relationship and usually report more previous sexual experiences. Up to now, sexual education programs specifically addressing the needs of the ASD population were scarce, which was criticized by patients, their parents, and caregivers. With the development of the Tackling Teenage Training program, a psychoeducational intervention designed specifically for ASD individuals was introduced, leading to significant improvements in psychosexual functioning and knowledge. Such programs are needed because a considerable rate of problematic sexual behaviors, including public masturbation and paraphilic sexual interests were found in the ASD population. Just like their typically developing counterparts, individuals with ASD show the whole range of normal-to-problematic sexual behaviors. Improving sexual knowledge could lead to less inappropriate sexual behaviors and could improve sexual health as part of a healthy and satisfying life.

Aging and sexuality.

PubMed

Yee, Lesley

2010-10-01

Sexuality has become a medical issue in association with aging. This is due to a number of factors, including increasing age of survival, a positive societal construct that promotes sexuality as important for quality of life as we age, and the medicalisation of sexuality with the advent of prescription medications to treat sexual dysfunction. This article reviews the factors surrounding aging and sexuality and also considers special situations with age, such as institutionalised care and the possibility of elder abuse. Normal physiological changes with aging affect both genders in terms of sexual desire and performance. Other medical conditions increase with age, and these and their treatments will impact on sexuality and the way it can be expressed. Medical practitioners require an understanding of these changes in order to find ways to optimise sexual function in older patients.

Sexual response of male Drosophila to honey bee queen mandibular pheromone: implications for genetic studies of social insects.

PubMed

Croft, Justin R; Liu, Tom; Camiletti, Alison L; Simon, Anne F; Thompson, Graham J

2017-02-01

Honey bees secrete a queen mandibular pheromone that renders workers reproductively altruistic and drones sexually attentive. This sex-specific function of QMP may have evolved from a sexually dimorphic signaling mechanism derived from pre-social ancestors. If so, there is potential for pre-social insects to respond to QMP, and in a manner that is comparable to its normal effect on workers and drones. Remarkably, QMP applied to female Drosophila does induce worker-like qualities [Camiletti et al. (Entomol Exp Appl 147:262, 2013)], and we here extend this comparison to examine the effects of bee pheromone on male fruit flies. We find that male Drosophila melanogaster consistently orient towards a source of queen pheromone in a T-maze, suggesting a recruitment response comparable to the pheromone's normal effect on drones. Moreover, exposure to QMP renders male flies more sexually attentive; they display intensified pre-copulatory behavior towards conspecific females. We can inhibit this sexual effect through a loss-of-olfactory-function mutation, which suggests that the pheromone-responsive behavioral mechanism is olfactory-driven. These pheromone-induced changes to male Drosophila behavior suggest that aspects of sexual signaling are conserved between these two distantly related taxa. Our results highlight a role for Drosophila as a genetically tractable pre-social model for studies of social insect biology.

Sexuality changes in prostate cancer patients receiving antihormonal therapy combining the antiandrogen flutamide with medical (LHRH agonist) or surgical castration.

PubMed

Rousseau, L; Dupont, A; Labrie, F; Couture, M

1988-02-01

The results of a written questionnaire with 44 patients (pilot study) indicated that before the beginning of treatment for advanced prostatic cancer, most subjects had an active sexual life, as illustrated by a normal erotic imagery, an adequate sexual desire and a normal frequency of intercourse. More than three-quarters (80%) of subjects had at least one coitus a week. Slightly more than 50% were able to easily achieve an erection by erotic imagery or by a preferred sexual fantasy; 50% never experienced erectile problems. When compared with their previous sexual functioning, 70% of subjects noticed during the antiandrogenic treatment a major reduction in their interest for sexual intercourse which was maintained in only 18% of patients. It became impossible for 57% to induce an erection by erotic imagery. However, 19% claimed an ability to maintain an erection during sexual activity, as compared to 56% before treatment, but erections usually lacked full rigidity. Twenty-two percent of patients mentioned having nocturnal or morning erections. Despite this dramatic decrease in sexual activity in most patients, complete antiandrogen blockade left sexual activity in approximately 20% of patients. Due to the treatment's excellent tolerance, the findings suggest that such combined androgen blockade could be beneficial for the treatment of sex offenders.

Examining the sexual function and related attitudes among aged women: A cross- sectional study

PubMed Central

Jamali, Safieh; Rahmanian, Afifeh; Javadpour, Shohreh

2016-01-01

Background: Sexual function and its subsequent satisfaction are among the most important aspects of women’s life. However, this instinct could be influenced by some factors such as diseases, drug using, aging, and hormonal and physiologic changes associated with menopause, and sexual behavior. Objective: The aim of this study was to describe the prevalence rates of sexual dysfunction, and related attitudes among aged women in Jahrom, Iran. Materials and Methods: This cross-sectional study was conducted on 746 postmenopausal women aged between 50 and 89 years old who had referred to obstetric and gynecologic clinic in Jahrom, from April to October 2014. Female Sexual Function Index questionnaire was used order to assess the sexual function. The cases were classified into three categories according to the attitude scores: negative (17-32), medium (33-38), and positive (39-48). One-way ANOVA test was used to determine the relationship between FSFI and attitude scores. Results: The participants’ mean±SD age was 60.10±6.89 years and the total mean score of FSFI was 19.31±8.5. In addition, 81.5% of the women had sexual dysfunction (FSFI< 26.55) and only 147 women (18.5%) had normal sexual function (FSFI> 26.55). Almost 62.1% the women displayed a negative attitude towards sexuality and only 18.8% women had positive attitude. Feeling of dyspareunia (p= 0.02), lubrication (p< 0.0001), orgasm (p= 0.002) and satisfaction (p= 0.002) were significantly different between three categories of attitudes regarding sexuality, respectively Conclusion: Our data showed that sexual disorders were highly prevalent among postmenopausal women. The most affected problems were arousal, dyspareunia, and lubrication. More than half of the women had negative attitude towards sexual function consequently this could affect their sexual function. So, it seems screening of sexual dysfunction for finding the causes in women should be the main sexual health program. Also, it would be important to emphasis the role of physicians and experts on education and counseling in this subject. PMID:27141546

Sex/gender differences in the brain and cognition in schizophrenia.

PubMed

Mendrek, Adrianna; Mancini-Marïe, Adham

2016-08-01

The early conceptualizations of schizophrenia have noted some sex/gender differences in epidemiology and clinical expression of the disorder. Over the past few decades, the interest in differences between male and female patients has expanded to encompass brain morphology and neurocognitive function. Despite some variability and methodological shortcomings, a few patterns emerge from the available literature. Most studies of gross neuroanatomy show more enlarged ventricles and smaller frontal lobes in men than in women with schizophrenia; finding reflecting normal sexual dimorphism. In comparison, studies of brain asymmetry and specific corticolimbic structures, suggest a disturbance in normal sexual dimorphism. The neurocognitive findings are somewhat consistent with this picture. Studies of cognitive functions mediated by the lateral frontal network tend to show sex differences in patients which are in the same direction as those observed in the general population, whereas studies of processes mediated by the corticolimbic system more frequently reveal reversal of normal sexual dimorphisms. These trends are faint and future research would need to delineate neurocognitive differences between men and women with various subtypes of schizophrenia (e.g., early versus late onset), while taking into consideration hormonal status and gender of tested participants. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

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.

Prevalence and related factors for anorgasmia among reproductive aged women in Hesarak, Iran

PubMed Central

Najafabady, Mitra Tadayon; Salmani, Zahra; Abedi, Parvin

2011-01-01

INTRODUCTION: Orgasmic dysfunction in women is characterized by persistent or recurrent delay in or absence of orgasm following a normal sexual excitement phase. Research has shown that almost two thirds of women have concerns about their sexual relationship. Sexual dysfunction has many problems for couples; some researchers found that up to 67% of divorces related to sexual disorders. OBJECTIVE: The aim of this cross‐sectional study was to assess the prevalence and related factors of anorgasmia among reproductive age Iranian women. METHODS: This study was conducted in 2006–7 in Hesarak, Karaj, Iran. A total of 1200 women were randomly recruited to the study. Sexual satisfaction questions were prepared according to the Enrich Sexual Satisfaction Questionnaire. Orgasms were assessed according to the relevant questions in the Female Sexual Function Index (FSFI) questionnaire. The data were analyzed using SPSS version 11; Chi‐square, Mann–Whitney and independent t‐test were used for statistical purposes. RESULTS: This study showed that the prevalence of anorgasmia among Iranian women in Hesarak, Karaj, was 26.3%. There was a significant difference between the anorgasmic and normal orgasm groups regarding the women's age, age at marriage, duration of marriage and education during puberty (p<0.05). Some psychological factors, e.g. anxiety, fatigue, pain, feeling of guilt, anti‐masculine feelings and embarrassment in sexual relationships were higher in the anorgasmic group (p<0.001). DISCUSSION: The results of this study showed that the prevalence of anorgasmia in Hesarak is high and most of the anorgasmic women were highly unsatisfied with their sexual relationship compared to the normal orgasm group. CONCLUSION: The prevalence of anorgasmia among Iranian women in Hesarak, Karaj, is high and some socio‐demographic and psychological factors have a strong relationship with anorgasmia. PMID:21437441

Sexual function and erection capability among young men with spina bifida.

PubMed

Sandler, A D; Worley, G; Leroy, E C; Stanley, S D; Kalman, S

1996-09-01

In a study of sexual function and erection capability, 15 young men with spina bifida were interviewed, underwent physical examination, and completed two consecutive night recordings of penile tumescence and rigidity with the Rigi-Scan (Dacomed Inc.). Eleven reported erections with stimulation. Rigi-Scan data showed that two subjects (both with lesions at the sacral level) had normal numbers and durations of erections, that seven others had abnormally brief and infrequent nocturnal erections, and that six had none. Ten subjects had at least 'some' glans sensation on physical examination. Self-reported erection capability was related to motor level and glans sensation. The number of nocturnal erections was related to sensory level. The study suggests that lower motor and sensory levels are associated with greater potential sexual function in males with spina bifida.

Sexuality after a cancer diagnosis: A population‐based study

PubMed Central

Wardle, Jane; Steptoe, Andrew; Fisher, Abigail

2016-01-01

BACKGROUND This study explored differences in sexual activity, function, and concerns between cancer survivors and cancer‐free controls in a population‐based study. METHODS The data were from 2982 men and 3708 women who were 50 years old or older and were participating in the English Longitudinal Study of Ageing. Sexual well‐being was assessed with the Sexual Relationships and Activities Questionnaire, and cancer diagnoses were self‐reported. RESULTS There were no differences between cancer survivors and controls in levels of sexual activity (76.0% vs 78.5% for men and 58.2% vs 55.5% for women) or sexual function. Men and women with cancer diagnoses were more dissatisfied with their sex lives than controls (age‐adjusted percentages: 30.9% vs 19.8% for men [P = .023] and 18.2% vs 11.8% for women [P = .034]), and women with cancer were more concerned about levels of sexual desire (10.2% vs 7.1%; P = .006). Women diagnosed < 5 years ago were more likely to report difficulty with becoming aroused (55.4% vs 31.8%; P = .016) and achieving orgasm (60.6% vs 28.3%; P < .001) and were more concerned about sexual desire (14.8% vs 7.1%; P = .007) and orgasmic experience (17.6% vs 7.1%; P = .042) than controls, but there were no differences in men. CONCLUSIONS Self‐reports of sexual activity and functioning in older people with cancer are broadly comparable to age‐matched, cancer‐free controls. There is a need to identify the causes of sexual dissatisfaction among long‐term cancer survivors despite apparently normal levels of sexual activity and function for their age. The development of interventions addressing low sexual desire and problems with sexual functioning in women is also important and may be particularly relevant for cancer survivors after treatment. Cancer 2016;122:3883–3891. © 2016 American Cancer Society. PMID:27531631

Sexuality after a cancer diagnosis: A population-based study.

PubMed

Jackson, Sarah E; Wardle, Jane; Steptoe, Andrew; Fisher, Abigail

2016-12-15

This study explored differences in sexual activity, function, and concerns between cancer survivors and cancer-free controls in a population-based study. The data were from 2982 men and 3708 women who were 50 years old or older and were participating in the English Longitudinal Study of Ageing. Sexual well-being was assessed with the Sexual Relationships and Activities Questionnaire, and cancer diagnoses were self-reported. There were no differences between cancer survivors and controls in levels of sexual activity (76.0% vs 78.5% for men and 58.2% vs 55.5% for women) or sexual function. Men and women with cancer diagnoses were more dissatisfied with their sex lives than controls (age-adjusted percentages: 30.9% vs 19.8% for men [P = .023] and 18.2% vs 11.8% for women [P = .034]), and women with cancer were more concerned about levels of sexual desire (10.2% vs 7.1%; P = .006). Women diagnosed < 5 years ago were more likely to report difficulty with becoming aroused (55.4% vs 31.8%; P = .016) and achieving orgasm (60.6% vs 28.3%; P < .001) and were more concerned about sexual desire (14.8% vs 7.1%; P = .007) and orgasmic experience (17.6% vs 7.1%; P = .042) than controls, but there were no differences in men. Self-reports of sexual activity and functioning in older people with cancer are broadly comparable to age-matched, cancer-free controls. There is a need to identify the causes of sexual dissatisfaction among long-term cancer survivors despite apparently normal levels of sexual activity and function for their age. The development of interventions addressing low sexual desire and problems with sexual functioning in women is also important and may be particularly relevant for cancer survivors after treatment. Cancer 2016;122:3883-3891. © 2016 American Cancer Society. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder

PubMed Central

Schöttle, Daniel; Briken, Peer; Tüscher, Oliver; Turner, Daniel

2017-01-01

Like nonaffected adults, individuals with autism spectrum disorders (ASDs) show the entire range of sexual behaviors. However, due to the core symptoms of the disorder spectrum, including deficits in social skills, sensory hypo- and hypersensitivities, and repetitive behaviors, some ASD individuals might develop quantitatively above-average or nonnormative sexual behaviors and interests. After reviewing the relevant literature on sexuality in high-functioning ASD individuals, we present novel findings on the frequency of normal sexual behaviors and those about the assessment of hypersexual and paraphilic fantasies and behaviors in ASD individuals from our own study. Individuals with ASD seem to have more hypersexual and paraphilic fantasies and behaviors than general-population studies suggest. However, this inconsistency is mainly driven by the observations for male participants with ASD. This could be due to the fact that women with ASD are usually more socially adapted and show less ASD symptomatology. The peculiarities in sexual behaviors in ASD patients should be considered both for sexual education and in therapeutic approaches. PMID:29398933

Amyloid beta precursor protein regulates male sexual behavior.

PubMed

Park, Jin Ho; Bonthius, Paul J; Tsai, Houng-Wei; Bekiranov, Stefan; Rissman, Emilie F

2010-07-28

Sexual behavior is variable between individuals, ranging from celibacy to sexual addictions. Within normal populations of individual men, ranging from young to middle aged, testosterone levels do not correlate with libido. To study the genetic mechanisms that contribute to individual differences in male sexual behavior, we used hybrid B6D2F1 male mice, which are a cross between two common inbred strains (C57BL/6J and DBA/2J). Unlike most laboratory rodent species in which male sexual behavior is highly dependent upon gonadal steroids, sexual behavior in a large proportion of these hybrid male mice after castration is independent of gonadal steroid hormones and their receptors; thus, we have the ability to discover novel genes involved in this behavior. Gene expression arrays, validation of gene candidates, and transgenic mice that overexpress one of the genes of interest were used to reveal genes involved in maintenance of male sexual behavior. Several genes related to neuroprotection and neurodegeneration were differentially expressed in the hypothalamus of males that continued to mate after castration. Male mice overexpressing the human form of one of these candidate genes, amyloid beta precursor protein (APP), displayed enhanced sexual behavior before castration and maintained sexual activity for a longer duration after castration compared with controls. Our results reveal a novel and unexpected relationship between APP and male sexual behavior. We speculate that declining APP during normal aging in males may contribute to the loss of sexual function.

Embryology and anatomy of the vulva: the female orgasm and women's sexual health.

PubMed

Puppo, Vincenzo

2011-01-01

Sexual health is vital to overall well-being. Orgasm is a normal psycho-physiological function of human beings and every woman has the right to feel sexual pleasure. The anatomy of the vulva and of the female erectile organs (trigger of orgasm) is described in human anatomy textbooks. Female sexual physiology was first described in Dickinson's textbook in 1949 and subsequently by Masters and Johnson in 1966. During women's sexual response, changes occur in the congestive structures that are essential to the understanding of women's sexual response and specifically of their orgasm. Female and male external genital organs arise from the same embryologic structures, i.e. phallus, urogenital folds, urogenital sinus and labioscrotal swellings. The vulva is formed by the labia majora and vestibule, with its erectile apparatus: clitoris (glans, body, crura), labia minora, vestibular bulbs and corpus spongiosum. Grafenberg, in 1950, discovered no "G-spot" and did not report an orgasm of the intraurethral glands. The hypothetical area named "G-spot" should not be defined with Grafenberg's name. The female orgasm should be a normal phase of the sexual response cycle, which is possible to achieve by all healthy women with effective sexual stimulation. Knowledge of the embryology, anatomy and physiology of the female erectile organs are important in the field of women's sexual health. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

A Simple Laparoscopic Procedure to Restore a Normal Vaginal Length After Colpohysterectomy With Large Upper Colpectomy for Cervical and/or Vaginal Neoplasia.

PubMed

Leblanc, Eric; Bresson, Lucie; Merlot, Benjamin; Puga, Marco; Kridelka, Frederic; Tsunoda, Audrey; Narducci, Fabrice

2016-01-01

Colpohysterectomy is sometimes associated with a large upper colpectomy resulting in a shortened vagina, potentially impacting sexual function. We report on a preliminary experience of a laparoscopic colpoplasty to restore a normal vaginal length. Patients with shortened vaginas after a laparoscopic colpohysterectomy were considered for a laparoscopic modified Davydov's procedure to create a new vaginal vault using the peritoneum of the rectum and bladder. From 2010 to 2014, 8 patients were offered this procedure, after informed preoperative consent. Indications were 2 extensive recurrent vaginal intraepithelial neoplasias grade 3 and 6 radical hysterectomies for cervical cancer. Mean vaginal length before surgery was 3.8 cm (standard deviation, 1.6). Median operative time was 50 minutes (range, 45-90). Blood loss was minimal (50-100 mL). No perioperative complications occurred. Median vaginal length at discharge was 11.3 cm (range, 9-13). Sexual intercourse could be resumed around 10 weeks after surgery. At a median follow-up of 33.8 months (range, 2.4-51.3), 6 patients remained sexually active but 2 had stopped. Although this experience is small, this laparoscopic modified Davydov's procedure seems to be an effective procedure, adaptable to each patient's anatomy. If the initial postoperative regular self-dilatation is carefully observed, vaginal patency is durably restored and enables normal sexual function. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Quality of life, self-esteem, fatigue, and sexual function in young men after cancer: a controlled cross-sectional study.

PubMed

Greenfield, Diana M; Walters, Stephen J; Coleman, Robert E; Hancock, Barry W; Snowden, John A; Shalet, Stephen M; DeRogatis, Leonard R; Ross, Richard J M

2010-03-15

Androgen deficiency is increasingly recognized in young male cancer survivors; however, its impact on quality of life (QOL) is not established. The authors investigated the relationship between androgen levels, QOL, self-esteem, fatigue, and sexual function in young male cancer survivors compared with control subjects. A cross-sectional, observational study of 176 male cancer survivors and 213 male controls aged 25 to 45 years was performed. Subjects completed 3 QOL scales (Medical Outcomes Study 36-Item Short-Form Health Survey version 2, the 12-item General Health Questionnaire [GHQ-12], and Aging Male Scale), and measures of self-esteem (Rosenberg Self-Esteem Scale), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), and sexual function (Derogatis Interview for Sexual Functioning-II Self-Report-Male). Cancer survivors had lower scores for all components of the Short-Form Health Survey, Aging Male Scale, and Functional Assessment of Chronic Illness Therapy-Fatigue, and for 4 of 5 subsections of the Derogatis Interview for Sexual Functioning than controls. The majority of these differences remained after adjusting by linear regression analysis. Levels of psychiatric disorder or self-esteem did not differ between the 2 groups. In cancer survivors, those with androgen deficiency (serum testosterone < or = 10 nmol/L) had lower scores than those without for all components of the Short-Form Health Survey, the General Health Questionnaire, Functional Assessment of Chronic Illness Therapy-Fatigue, and the Derogatis Interview for Sexual Functioning. Serum testosterone only weakly correlated with health measures. Young male cancer survivors self-report a marked impairment in QOL, energy levels, and quality of sexual functioning, and this was exacerbated in those with androgen deficiency. However, psychological distress was not elevated, self-esteem was normal, and sexual relationships were not impaired. The relationship with testosterone is complex, and appears dependent on a threshold level rather than direct correlation. Interventional trials are needed to determine whether testosterone replacement would improve QOL in young male cancer survivors.

Sexual Violence Against Adolescent Girls: Labeling It to Avoid Normalization.

PubMed

Barbara, Giussy; Collini, Federica; Cattaneo, Cristina; Facchin, Federica; Vercellini, Paolo; Chiappa, Laura; Kustermann, Alessandra

2017-11-01

Violence against women is a pervasive complex phenomenon that destroys women's feelings of love, trust, and self-esteem. In this commentary, we specifically focus on sexual violence against adolescent girls, whose impact is particularly harmful since it may lead to impaired mental health, social functioning, and neurodevelopment. Between 12% and 25% of adolescent girls throughout the world experience sexual violence, very often perpetrated by a family member or a friend. Moreover, for an alarming proportion of girls, the first sexual experience is coerced. In this article, we review the multiple negative effects of sexual violence against adolescent girls. We also report data derived from our practice in a public Italian referral Centre for Sexual and Domestic Violence (SVSeD) and address the importance of a multidisciplinary clinical approach with adolescent victims of sexual violence.

Seminal characteristics and sexual behavior in men of different age groups: is there an aging effect?

PubMed

Zavos, Panayiotis M; Kaskar, Khalied; Correa, Juan R; Sikka, Suresh C

2006-05-01

To assess the seminal characteristics as well as the sexual behavior of men of various age groups to establish the presence of an aging effect on those characteristics. Semen samples were collected from men (n = 792) undergoing in vitro fertilization or intrauterine insemination in cases of female factor infertility only. Samples were collected using a seminal collection device at intercourse and evaluated manually according to World Health Organization (WHO) standards. Men were divided into four groups according to their ages: (i) 20-30, (ii) 31-40, (iii) 41-50 and (iv) 51-60 years, and their seminal characteristics and responses to a sexual behavior questionnaire were compared. The data showed statistically significant differences in the seminal characteristics tested, most notably in the sperm concentration, motility, grade of motility, hypo-osmotic swelling and normal sperm morphology. Furthermore, the decline in normal sperm morphology with age was more pronounced when using strict criteria rather than WHO standards. There were also differences in total sperm count, total motile sperm and total functional sperm fraction (assessed by both WHO and strict criteria). Significant differences were also observed in the sexual behavior patterns in older men in terms of the number of years they have been trying to conceive, sexual frequency and sexual satisfaction. The data clearly illustrate an aging effect on semen characteristics and sexual behavior in men as they age. It is suggested that the aging effect be taken into consideration when proposing normal standard values for semen characteristics in routine semen analysis as outlined by WHO standards.

Brain activation by visual erotic stimuli in healthy middle aged males.

PubMed

Kim, S W; Sohn, D W; Cho, Y-H; Yang, W S; Lee, K-U; Juh, R; Ahn, K-J; Chung, Y-A; Han, S-I; Lee, K H; Lee, C U; Chae, J-H

2006-01-01

The objective of the present study was to identify brain centers, whose activity changes are related to erotic visual stimuli in healthy, heterosexual, middle aged males. Ten heterosexual, right-handed males with normal sexual function were entered into the present study (mean age 52 years, range 46-55). All potential subjects were screened over 1 h interview, and were encouraged to fill out questionnaires including the Brief Male Sexual Function Inventory. All subjects with a history of sexual arousal disorder or erectile dysfunction were excluded. We performed functional brain magnetic resonance imaging (fMRI) in male volunteers when an alternatively combined erotic and nonerotic film was played for 14 min and 9 s. The major areas of activation associated with sexual arousal to visual stimuli were occipitotemporal area, anterior cingulate gyrus, insula, orbitofrontal cortex, caudate nucleus. However, hypothalamus and thalamus were not activated. We suggest that the nonactivation of hypothalamus and thalamus in middle aged males may be responsible for the lesser physiological arousal in response to the erotic visual stimuli.

Sexual Self-Concept and General Health in Rheumatoid Arthritis Patients

PubMed Central

Saadat, Seyed Hassan; Ramezani, Arash; Ahmadi, Khodabakhsh

2015-01-01

Background: There are several studies regarding sexual dysfunction in chronic diseases such as diabetes and renal failure; however, no significant study has been done on Iranian rheumatoid arthritis (RA) patients. Objectives: In this study, we aimed to identify and compare sexual dysfunction between RA patients and the normal population. Patients and Methods: In this case-control study, two groups of females (87 RA patients and 89 controls) were randomly selected from the rheumatology clinic of Baqiyatallah Hospital, Tehran, Iran. General health questionnaire (GHQ-28) and multidimensional sexual self-concept questionnaire (MSSCQ) were used to evaluate RA patients. We used SPSS for statistical analysis mainly by the t-test and chi-square test. P values less than 0.05 were considered significant. Results: In the GHQ-28 evaluation, RA patients had lower social function; however somatization rated higher in normal patients (P < 0.05). Sexual health was lower in the RA population (P < 0.05). No significant difference was found in sexual desire. Except sexual pain, other sexual health parameters were lower in RA patients. The scores were as follow: sensation 13.6 ± 4.4 vs. 12.2 ± 4.5, P = 0.024; lubrication 6.9 ± 2.1 vs. 6.2 ± 2.1, P = 0.017; orgasm 10.4 ± 2.8 vs. 9.5 ± 3.2, P = 0.37; pain 10.1 ± 2.2 vs. 10.8 ± 1.9, P = 0.013; enjoyment 23.8 ± 5.8 vs. 21.3 ± 7.5, P = 0.009 and partner related 8.5 ± 1.7 vs. 7.6 ± 2.4, P = 0.005. Furthermore, the concern of losing their sexual partner was higher in the normal population. Conclusions: Our study demonstrated that almost all GHQ and MSSCQ parameters were lower in RA patients, which indicates lower quality sexual life in RA patients. We recommend further consideration for the treatment and care of these patients. PMID:26568849

Functional and aesthetic results in hypospadias repair with Hinderer's techniques.

PubMed

Hinderer, U T

2000-01-01

In his editorial to the first issue of Aesthetic Plastic Surgery in 1976, the Managing Editor, Dr. Blair Rogers lays special emphasis on the publication of papers and reports dealing with the increasing role of Aesthetic Plastic Surgery as the final step in the overall rehabilitation of Reconstructive Surgery patients. In genitourinary malformations-hypospadias and epispadias-without any doubt a satisfactory sexual and urinary functional result is essential. However, also a normal aesthetic appearance, resembling a circumcised penis, and with the meatus at the tip of the glans, is becoming increasingly important, notably since the second half of the last century. An abnormal aesthetic appearance affects the patient's body image and has a negative influence on his self-esteem and sexual behaviour. Psychological stress is brought on from genital comparison with school-mates, in adulthood in gym changing rooms and, specifically, in sexual relations. In these days of greater sexual freedom, the knowledge of male genital anatomy and aesthetic appearance has considerably improved. Penile hypoplasia creates a psychological impact perhaps only comparable with that of female mammary hypoplasia. It is therefore unsurprising that not only normal aesthetic appearance after hypospadias surgery is essential, but also the demand for penile lengthening and girth augmentation has progressively increased over these past recent years.

Neural Control and Physiology of Sexual Function: Effect of Spinal Cord Injury.

PubMed

Krassioukov, Andrei; Elliott, Stacy

2017-01-01

Objective: To present the current understanding of normal anatomy, physiology, sexual physiology, pathophysiology and the consequential sexual changes and dysfunctions following a spinal cord injury (SCI). Methods: Narrative review of the latest literature. Results: Peripheral innervations of the pelvis involve 3 sets of efferent neurons coordinated though the pelvic plexus (somatic, thoracolumbar sympathetic, and sacral parasympathetic), and these are under cerebral descending excitatory and inhibitory control. SCI, depending on the level of lesion and completeness, can alter this cerebral control, affecting the psychological and reflexogenic potential for genital arousal and also ejaculation and orgasm. During arousal, nitric oxide is the main neurotransmitter for smooth muscle relaxation in both male and female erectile tissue. In men, erection, ejaculation, and orgasm are under separate neurological control and can be individually affected by SCI. Conclusions: Since sexual function is rated amongst the highest priorities by individuals living with SCI, methods employed to affect the neurological changes to maximize sexual neurophysiology prior to initiating medical therapies including paying attention to sexual sensate areas and visceral signals with mindfulness techniques, practicing body mapping, and sexual stimulation of sensate areas to encourage neuroplasticity. Attention should be paid to the biopsychosocial sexual contexts within which persons with SCI live to maximize their sexual and fertility rehabilitation.

Neural Control and Physiology of Sexual Function: Effect of Spinal Cord Injury

PubMed Central

Elliott, Stacy

2017-01-01

Objective: To present the current understanding of normal anatomy, physiology, sexual physiology, pathophysiology and the consequential sexual changes and dysfunctions following a spinal cord injury (SCI). Methods: Narrative review of the latest literature. Results: Peripheral innervations of the pelvis involve 3 sets of efferent neurons coordinated though the pelvic plexus (somatic, thoracolumbar sympathetic, and sacral parasympathetic), and these are under cerebral descending excitatory and inhibitory control. SCI, depending on the level of lesion and completeness, can alter this cerebral control, affecting the psychological and reflexogenic potential for genital arousal and also ejaculation and orgasm. During arousal, nitric oxide is the main neurotransmitter for smooth muscle relaxation in both male and female erectile tissue. In men, erection, ejaculation, and orgasm are under separate neurological control and can be individually affected by SCI. Conclusions: Since sexual function is rated amongst the highest priorities by individuals living with SCI, methods employed to affect the neurological changes to maximize sexual neurophysiology prior to initiating medical therapies including paying attention to sexual sensate areas and visceral signals with mindfulness techniques, practicing body mapping, and sexual stimulation of sensate areas to encourage neuroplasticity. Attention should be paid to the biopsychosocial sexual contexts within which persons with SCI live to maximize their sexual and fertility rehabilitation. PMID:29339872

Reversal of normal cerebral sexual dimorphism in schizophrenia: evidence and speculations.

PubMed

Mendrek, Adrianna

2007-01-01

Sex differences in epidemiology, clinical course and symptomatology of schizophrenia have been widely documented, but still relatively little is known about the brain sexual dimorphism in this psychiatric disorder. While some neuroanatomical and neuropsychological studies have reported existence of differences between male and female patients in a direction of normal sexual dimorphism, others did not find any effect. A few recent reports point to a peculiar disturbance of normal sexual dimorphism in brain regions implicated in the processing of emotions, including amygdala, orbitofrontal cortex and anterior cingulate. Prompted by these findings we compared cerebral activations between the sexes during performance of two emotion processing tasks and found overall much more extensive and intense cerebral activations in men than in women with schizophrenia. Moreover, the pattern of obtained sex differences in cerebral activation in patients differed significantly from what has been observed in the general population. Based on these preliminary structural and functional neuroimaging data, as well as some clinical reports, it is hypothesized in the present paper that schizophrenia is characterized by a reversed (or at least seriously disturbed) cerebral sexual dimorphism. It is further argued that this phenomenon stems from masculinization and/or un-feminization of females and feminizations and/or un-masculinization of males by sex steroid hormones, such as estrogen and testosterone, during both organizational and activational stages of neurodevelopment.

Quality of life and female sexual function after skinning vulvectomy with split-thickness skin graft in women with vulvar intraepithelial neoplasia or vulvar Paget disease.

PubMed

Lavoué, V; Lemarrec, A; Bertheuil, N; Henno, S; Mesbah, H; Watier, E; Levêque, J; Morcel, K

2013-12-01

Vulvar intraepithelial neoplasia (VIN) and vulvar Paget disease are managed with either vulvectomy, destructive treatments (laser, antimitotic drugs) or immunostimulants. All these options are associated with functional complications. The purpose of this study was to evaluate the surgical technique consisting of skinning vulvectomy with split-thickness skin graft, and its effect on overall quality of life and sexual function. A retrospective study was conducted on thirteen patients who underwent skinning vulvectomy with split-thickness skin graft between 1999 and 2009. Overall quality of life and sexual function were assessed with the Medical Outcome Study Short Form 36 (MOS SF-36) and Female Sexual Function Index (FSFI), respectively. The median age of patients was 54 (range: 33-77) years. Three patients had Paget disease and 10 patients had VIN lesions. The excision margins were clear in 46% of cases. The incidence of occult cancer was 31%. The mean follow-up period was 77 (±35) months. Four patients experienced a relapse of their intraepithelial disease. The mean disease-free survival was 58 (±44) months. There was no significant difference in MOS SF-36 scores between the study population and the general population. The patients assessed with the FSFI regained normal sexual function after the surgical procedure. Skinning vulvectomy with split-thickness skin graft is a feasible technique yielding good results in terms of quality of life and sexual function. It enables occult cancer to be diagnosed in patients with VIN or Paget disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

Hypochlorite Oxidation of Select Androgenic Steroids

EPA Science Inventory

Steroid hormones are vital for regulation of various biological functions including sexual development. Elevated concentrations of natural and synthetic androgenic steroids have been shown to adversely affect normal development in indigenous aqueous species. Androgens and their s...

The effects of citalopram and fluoxetine on sexual behavior in healthy men: evidence of delayed ejaculation and unaffected sexual desire. A randomized, placebo-controlled, double-blind, double-dummy, parallel group study.

PubMed

Madeo, Bruno; Bettica, Paolo; Milleri, Stefano; Balestrieri, Antonio; Granata, Antonio R M; Carani, Cesare; Rochira, Vincenzo

2008-10-01

Selective serotonin reuptake inhibitors (SSRIs) are known to induce delayed orgasm and delayed ejaculation, while their effect on other aspects of sexual function, such as sexual motivation, arousal, and erectile function are unclear. In order to evaluate the effect of chronic administration of two SSRIs, citalopram and fluoxetine, on normal sexual function, we studied the parameters of male sexual behavior, erectile function, and ejaculation on 48 healthy male volunteers, aged 29.5 +/- 4.9, in a randomized, placebo-controlled, double-blind, double-dummy study. Methods. The subjects were randomized to receive placebo (16 subjects), or fluoxetine (20 mg/day) (16 subjects) or citalopram (20 mg/day) for the first week, and 40 mg/day in the following 3 weeks (16 subjects). Sexual function was investigated at the screening and at the end of the study by means of test of penile erection (TPE) and masturbation ejaculation latency time (MELT) performed during visual erotic stimulation, and at each visit by self-filled questionnaires (International Index Erectile Function [IIEF-15] and Golombock Rust Inventory of Sexual Satisfaction [GRISS]). All the erectile parameters, evaluated by means of RigiScan Plus during TPE, were not significantly different when both fluoxetine and citalopram were compared with placebo. A delay in the ejaculation time was observed both during citalopram and during fluoxetine treatment when compared with placebo, reaching a statistical significance only with citalopram. During the treatment with citalopram and fluoxetine, the IIEF-15 score of all items decreased except for those items related to sexual desire; however, the scores were significantly lower only for the citalopram treatment. The treatment with citalopram or with fluoxetine was confirmed to delay ejaculation, but was significant only for citalopram. Citalopram and fluoxetine did not affect sexual desire. Citalopram and fluoxetine did not directly affect penile erection as objectively assessed by RigiScan, although an impairment in the subjective assessment of erectile function was observed, but was significant only for citalopram, and it was thought to be a possible consequence of the delayed ejaculation perceived as a trouble.

Measures of clinical health among female-to-male transgender persons as a function of sexual orientation.

PubMed

Meier, S Colton; Pardo, Seth T; Labuski, Christine; Babcock, Julia

2013-04-01

The present study examined the sexual orientation classification system that was used in the DSM-IV-TR for categorizing those who met the Gender Identity Disorder diagnostic criteria in order to determine the extent to which female-to-male transgender persons (FTMs) differ on psychological variables as a function of sexual orientation. Participants were 605 self-identified FTMs from 19 different countries (83 % U.S.) who completed an internet survey assessing their sexual orientation, sexual identity, symptoms of depression and anxiety, stress (Depression Anxiety Stress Scales), social support (Multidimensional Scale of Perceived Social Support), and health related quality of life (SF-36v2 Health Survey). Over half the sample (52 %) reported sexual attractions to both men and women. The most common sexual identity label reported was "queer." Forty percent of FTMs who had begun to transition reported a shift in sexual orientation; this shift was associated with testosterone use. Overall, FTMs ranged from normal to above average on all psychological measures. FTMs did not significantly differ by sexual attraction on any mental health variables, except for anxiety. FTMs attracted to both men and women reported more symptoms of anxiety than those attracted to men only. Results from the present study did not support a sexual orientation classification system in FTMs with regard to psychological well-being.

Plasma Concentration of Prolactin, Testosterone Might Be Associated with Brain Response to Visual Erotic Stimuli in Healthy Heterosexual Males

PubMed Central

Seo, Younghee; Kim, Ji-Woong; Choi, Jeewook

2009-01-01

Objective Many studies have showed that excess or lack of sexual hormones, such as prolactin and testosterone, induced the sexual dysfunction in humans. Little, however, is known about the role of sexual hormones showing normal range in, especially, the basal state unexposed to any sexual stimulation. We hypothesized sexual hormones in the basal state may affect sexual behavior. Methods We investigated the association of the sexual hormones level in the basal hormonal state before visual sexual stimulation with the sexual response-related brain activity during the stimulation. Twelve heterosexual men were recorded the functional MRI signals of their brain activation elicited by passive viewing erotic (ERO), happy-faced (HA) couple, food and nature pictures. Both plasma prolacitn and testosterone concentrations were measured before functional MR scanning. A voxel wise regression analyses were performed to investigate the relationship between the concentration of sexual hormones in basal state and brain activity elicited by ERO minus HA, not food minus nature, contrast. Results The plasma concentration of prolactin in basal state showed positive association with the activity of the brain involving cognitive component of sexual behavior including the left middle frontal gyrus, paracingulate/superior frontal/anterior cingulate gyri, bilateral parietal lobule, right angular, bilateral precuneus and right cerebellum. Testosterone in basal state was positively associated with the brain activity of the bilateral supplementary motor area which related with motivational component of sexual behavior. Conclusion Our results suggested sexual hormones in basal state may have their specific target regions or network associated with sexual response. PMID:20046395

Plasma concentration of prolactin, testosterone might be associated with brain response to visual erotic stimuli in healthy heterosexual males.

PubMed

Seo, Younghee; Jeong, Bumseok; Kim, Ji-Woong; Choi, Jeewook

2009-09-01

Many studies have showed that excess or lack of sexual hormones, such as prolactin and testosterone, induced the sexual dysfunction in humans. Little, however, is known about the role of sexual hormones showing normal range in, especially, the basal state unexposed to any sexual stimulation. We hypothesized sexual hormones in the basal state may affect sexual behavior. We investigated the association of the sexual hormones level in the basal hormonal state before visual sexual stimulation with the sexual response-related brain activity during the stimulation. Twelve heterosexual men were recorded the functional MRI signals of their brain activation elicited by passive viewing erotic (ERO), happy-faced (HA) couple, food and nature pictures. Both plasma prolacitn and testosterone concentrations were measured before functional MR scanning. A voxel wise regression analyses were performed to investigate the relationship between the concentration of sexual hormones in basal state and brain activity elicited by ERO minus HA, not food minus nature, contrast. The plasma concentration of prolactin in basal state showed positive association with the activity of the brain involving cognitive component of sexual behavior including the left middle frontal gyrus, paracingulate/superior frontal/anterior cingulate gyri, bilateral parietal lobule, right angular, bilateral precuneus and right cerebellum. Testosterone in basal state was positively associated with the brain activity of the bilateral supplementary motor area which related with motivational component of sexual behavior. Our results suggested sexual hormones in basal state may have their specific target regions or network associated with sexual response.

Characteristics of Men Who Report Persistent Sexual Symptoms After Finasteride Use for Hair Loss.

PubMed

Basaria, Shehzad; Jasuja, Ravi; Huang, Grace; Wharton, Whitney; Pan, Hong; Pencina, Karol; Li, Zhuoying; Travison, Thomas G; Bhawan, Jag; Gonthier, Renaud; Labrie, Fernand; Dury, Alain Y; Serra, Carlo; Papazian, Allen; O'Leary, Michael; Amr, Sami; Storer, Thomas W; Stern, Emily; Bhasin, Shalender

2016-12-01

Some men who use finasteride for hair loss report persistent sexual and other symptoms after discontinuing finasteride therapy. To determine whether these persistent symptoms after discontinuation of finasteride use are due to androgen deficiency, decreased peripheral androgen action, or persistent inhibition of steroid 5α-reductase (SRD5A) enzymes. Finasteride users, who reported persistent sexual symptoms after discontinuing finasteride (group 1); age-matched finasteride users who did not report sexual symptoms (group 2); and healthy men who had never used finasteride (group 3). Sexual function, mood, affect, cognition, hormone levels, body composition, functional magnetic resonance imaging (fMRI) response to sexually and affectively valenced stimuli, nucleotide sequences of androgen receptor (AR), SRD5A1, and SRD5A2; expression levels of androgen-dependent genes in skin. Academic medical center. Symptomatic finasteride users were similar in body composition, strength, and nucleotide sequences of AR, SRD5A1, and SRD5A2 genes to asymptomatic finasteride users and nonusers. Symptomatic finasteride users had impaired sexual function, higher depression scores, a more negative affectivity balance, and more cognitive complaints than men in groups 2 and 3 but had normal objectively assessed cognitive function. Testosterone, dihydrotestosterone, 5α-androstane-3α,17β-diol-glucuronide, testosterone to dihydrotestosterone and androsterone glucuronide to etiocholanolone glucuronide ratios, and markers of peripheral androgen action and expression levels of AR-dependent genes in skin did not differ among groups. fMRI blood oxygen level-dependent responses to erotic and nonerotic stimuli revealed abnormal function in brain circuitry linked to sexual arousal and major depression. We found no evidence of androgen deficiency, decreased peripheral androgen action, or persistent peripheral inhibition of SRD5A in men with persistent sexual symptoms after finasteride use. Symptomatic finasteride users revealed depressed mood and fMRI findings consistent with those observed in depression.

Characteristics of Men Who Report Persistent Sexual Symptoms After Finasteride Use for Hair Loss

PubMed Central

Basaria, Shehzad; Jasuja, Ravi; Huang, Grace; Wharton, Whitney; Pan, Hong; Pencina, Karol; Li, Zhuoying; Travison, Thomas G.; Bhawan, Jag; Gonthier, Renaud; Labrie, Fernand; Dury, Alain Y.; Serra, Carlo; Papazian, Allen; O'Leary, Michael; Amr, Sami; Storer, Thomas W.; Stern, Emily

2016-01-01

Context: Some men who use finasteride for hair loss report persistent sexual and other symptoms after discontinuing finasteride therapy. Objective: To determine whether these persistent symptoms after discontinuation of finasteride use are due to androgen deficiency, decreased peripheral androgen action, or persistent inhibition of steroid 5α-reductase (SRD5A) enzymes. Participants: Finasteride users, who reported persistent sexual symptoms after discontinuing finasteride (group 1); age-matched finasteride users who did not report sexual symptoms (group 2); and healthy men who had never used finasteride (group 3). Outcomes: Sexual function, mood, affect, cognition, hormone levels, body composition, functional magnetic resonance imaging (fMRI) response to sexually and affectively valenced stimuli, nucleotide sequences of androgen receptor (AR), SRD5A1, and SRD5A2; expression levels of androgen-dependent genes in skin. Setting: Academic medical center. Results: Symptomatic finasteride users were similar in body composition, strength, and nucleotide sequences of AR, SRD5A1, and SRD5A2 genes to asymptomatic finasteride users and nonusers. Symptomatic finasteride users had impaired sexual function, higher depression scores, a more negative affectivity balance, and more cognitive complaints than men in groups 2 and 3 but had normal objectively assessed cognitive function. Testosterone, dihydrotestosterone, 5α-androstane-3α,17β-diol-glucuronide, testosterone to dihydrotestosterone and androsterone glucuronide to etiocholanolone glucuronide ratios, and markers of peripheral androgen action and expression levels of AR-dependent genes in skin did not differ among groups. fMRI blood oxygen level-dependent responses to erotic and nonerotic stimuli revealed abnormal function in brain circuitry linked to sexual arousal and major depression. Conclusions: We found no evidence of androgen deficiency, decreased peripheral androgen action, or persistent peripheral inhibition of SRD5A in men with persistent sexual symptoms after finasteride use. Symptomatic finasteride users revealed depressed mood and fMRI findings consistent with those observed in depression. PMID:27662439

A normal ano-genital exam: sexual abuse or not?

PubMed

Hornor, Gail

2010-01-01

Sexual abuse is a problem of epidemic proportions in the United States. Pediatric nurse practitioners (PNPs) are at the forefront of providing care to children and families. The PNP is in a unique position to educate patients and families regarding sexual abuse and dispel common myths associated with sexual abuse. One such myth is that a normal ano-genital examination is synonymous with the absence of sexual abuse. This article will provide primary care providers, including PNPs, with a framework for understanding why a normal ano-genital examination does not negate the possibility of sexual abuse/assault. Normal ano-genital anatomy, changes that occur with puberty, and physical properties related to the genitalia and anus will be discussed. Photos will provide visualization of both normal variants of the pre-pubertal hymen and genitalia as well as changes that occur with puberty. Implications for practice for PNPs will be discussed.

Animal models of physiologic markers of male reproduction: genetically defined infertile mice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chubb, C.

The present report focuses on novel animal models of male infertility: genetically defined mice bearing single-gene mutations that induce infertility. The primary goal of the investigations was to identify the reproductive defects in these mutant mice. The phenotypic effects of the gene mutations were deciphered by comparing the mutant mice to their normal siblings. Initially testicular steroidogenesis and spermatogenesis were investigated. The physiologic markers for testicular steroidogenesis were steroid secretion by testes perifused in vitro, seminal vesicle weight, and Leydig cell histology. Spermatogenesis was evaluated by the enumeration of homogenization-resistant sperm/spermatids in testes and by morphometric analyses of germ cellsmore » in the seminiferous epithelium. If testicular function appeared normal, the authors investigated the sexual behavior of the mice. The parameters of male sexual behavior that were quantified included mount patency, mount frequency, intromission latency, thrusts per intromission, ejaculation latency, and ejaculation duration. Females of pairs breeding under normal circumstances were monitored for the presence of vaginal plugs and pregnancies. The patency of the ejaculatory process was determined by quantifying sperm in the female reproductive tract after sexual behavior tests. Sperm function was studied by quantitatively determining sperm motility during videomicroscopic observation. Also, the ability of epididymal sperm to function within the uterine environment was analyzed by determining sperm capacity to initiate pregnancy after artificial insemination. Together, the experimental results permitted the grouping of the gene mutations into three general categories. They propose that the same biological markers used in the reported studies can be implemented in the assessment of the impact that environmental toxins may have on male reproduction.« less

Meta-analysis of Results of Testosterone Therapy on Sexual Function Based on International Index of Erectile Function Scores.

PubMed

Corona, Giovanni; Rastrelli, Giulia; Morgentaler, Abraham; Sforza, Alessandra; Mannucci, Edoardo; Maggi, Mario

2017-12-01

The interpretation of available clinical evidence related to the effect of testosterone (T) treatment (TTh) on sexual function has been inconsistent, in part due to the use of different and self-reported measures to assess outcomes. The International Index of Erectile Function (IIEF) is the most frequently used validated tool to assess male sexual function. To perform a meta-analysis of available data evaluating the effect of TTh on male sexual function using IIEF as the primary outcome. An extensive Medline, Embase, and Cochrane search was performed including all placebo-controlled randomized clinical trials enrolling men comparing the effect of TTh on sexual function. Out of 137 retrieved articles, 14 were included in the study enrolling 2298 participants, with a mean follow-up of 40.1 wk and mean age of 60.2±6.5 yr. Using IIEF-erectile function domain (IIEF-EFD) as the outcome, we found that TTh significantly improved erectile function compared with placebo (mean difference=2.31 [1.41;3.22] IIEF-EFD score, p<0.0001). Patients with more severe hypogonadism (total T<8 nmol/l) reported greater changes in final IIEF-EFD score when compared with those with a milder T deficiency (total T<12 nmol/l; 1.47 [0.90;2.03] and 2.95 [1.86;4.03] for total T<12 nmol/l and <8 nmol/l, respectively, Q=5.61, p=0.02). The magnitude of the effect was lower in the presence of metabolic derangements, such as diabetes and obesity. Other aspects of sexual function, as evaluated by IIEF subdomains, were also improved with TTh including libido, intercourse satisfaction, orgasm, and overall sexual satisfaction. TTh significantly improves erectile function and other sexual parameters as measured by IIEF in hypogonadal men. These results argue that sexual dysfunction should be considered a hallmark manifestation of T deficiency, since those symptoms can be significantly improved with normalization of serum T. In addition, these results suggest that TTh alone may be considered a reasonable treatment for hypogonadal men with milder degrees of erectile dysfunction, whereas the addition of other treatments, such as phosphodiesterase type 5 inhibitors, may be more appropriate for men with more severe erectile dysfunction. We investigated the effect of testosterone treatment on sexual function by performing a meta-analysis of all available studies that used the most frequently used assessment tool, the International Index of Erectile Function. We found that testosterone treatment significantly improves erectile dysfunction, as well as other aspects of sexual function, in men with testosterone deficiency. This treatment may be all that is required for hypogonadal men with milder erectile dysfunction; however, additional treatments may be necessary in more severe cases. Copyright © 2017. Published by Elsevier B.V.

Different patterns of sexual dysfunctions associated with psychiatric disorders and psychopharmacological treatment. Results of an investigation by semistructured interview of schizophrenic and neurotic patients and methadone-substituted opiate addicts.

PubMed

Teusch, L; Scherbaum, N; Böhme, H; Bender, S; Eschmann-Mehl, G; Gastpar, M

1995-05-01

Little is known about sexual dysfunctions associated with psychiatric disorders and psychopharmacological treatment. In the present study schizophrenic patients (n = 45, mostly under neuroleptic treatment), neurotic patients (n = 50, mostly treated without medication), methadone-substituted opiate addicts (n = 37), and normal controls (n = 41) were included. They were interviewed with the aid of a sex-differentiated semistructured questionnaire on sexual function. All the methadone-substituted opiate addicts and nearly all the schizophrenic patients suffered from dysfunctions in at least one criterion. The three clinical groups differed significantly from the controls in sexual interest, emotional arousal, physiological arousal (erectile function/vaginal lubrication), performance (ejaculatory function/vaginism, dyspareunia), and orgasm satisfaction. Characteristic patterns of dysfunction were found in the male patients. The schizophrenic patients had significantly more dysfunctions of interest, physiological arousal, performance, and orgasm than the controls. Emotional arousal, erectile and ejaculatory functions, and orgasm satisfaction were impaired more frequently in the male schizophrenics than in the neurotic patients. Reduced sexual interest, emotional arousal, and orgasm satisfaction were reported more frequently by the methadone-substituted opiate addicts than by the neurotic men. Emotional arousal was even more frequently reduced than in the schizophrenic men. There was no correlation between sexual dysfunction and particular neuroleptics or neuroleptic or methadone dosage. The results are compared with the literature and suggestions made for further investigations.

Effects of mother-son incest and positive perceptions of sexual abuse experiences on the psychosocial adjustment of clinic-referred men.

PubMed

Kelly, Robert J; Wood, Jeffrey J; Gonzalez, Lauren S; MacDonald, Virginia; Waterman, Jill

2002-04-01

The primary objective was to examine the long-term impact of mother-son incest and positive initial perceptions of sexual abuse experiences on adult male psychosocial functioning. Sixty-seven clinic-referred men with a history of sexual abuse participated. The participants completed self-report measures regarding their current psychosocial functioning and described the nature of their sexual and physical abuse experiences during childhood. Seventeen men reported mother-son incest, and these men endorsed more trauma symptoms than did other sexually abused men, even after controlling for a history of multiple perpetrators and physical abuse. Mother-son incest was likely to be subtle, involving behaviors that may be difficult to distinguish from normal caregiving (e.g., genital touching), despite the potentially serious long-term consequences. Twenty-seven men recalled positive or mixed initial perceptions of the abuse, including about half of the men who had been abused by their mothers. These men reported more adjustment problems than did men who recalled purely negative initial perceptions. Mother-son incest and positive initial perceptions of sexual abuse experiences both appear to be risk factors for more severe psychosocial adjustment problems among clinic-referred men.

Pharmacologic management of sexual dysfunction: benefits and limitations.

PubMed

Segraves, Robert Taylor

2003-03-01

What is the current knowledge concerning the pharmacologic treatment of human sexual dysfunction? A number of interventions, including oral phophodiesterase inhibitors and intracorporeal agents with vasodilatory effects, are available to treat male erectile disorder. Serotonergic drugs have been shown to be effective in the treatment of rapid ejaculation. Various lines of research suggest that high dosages of androgenic agents may eventually have a role in the treatment of decreased libido in females. There may be a role for phophodiesterase inhibitors in the treatment of a subgroup of women with arousal disorders. Normal sexual function involves successful integration of biological, psychological, and interpersonal influences. Clinical psychiatry with its biopsychosocial model should incorporate the treatment of human sexual dysfunction within its purview.

The use of children's drawings in the evaluation and treatment of child sexual, emotional, and physical abuse.

PubMed

Peterson, L W; Hardin, M; Nitsch, M J

1995-05-01

Primary care physicians can be instrumental in the initial identification of potential sexual, emotional, and physical abuse of children. We reviewed the use of children's artwork as a method of communicating individual and family functioning. A quantitative method of analyzing children's artwork provides more reliability and validity than some methods used previously. A new scoring system was developed that uses individual human figure drawings and kinetic family drawings. This scoring system was based on research with 842 children (341 positively identified as sexually molested, 252 positively not sexually molested but having emotional or behavioral problems, and 249 "normal" public school children). This system is more comprehensive than previous systems of assessment of potential abuse.

Types of Sexual Transference and Countertransference in Psychotherapeutic Work with Children and Adolescents

ERIC Educational Resources Information Center

Alvarez, Anne

2010-01-01

The question of normal sexuality begins to arise in the treatment of severely sexually abused or sexually offending patients. The author suggests that it is an interesting and delicate moment during the process of recovery when less perverse, more normal sexuality appears mixed with, or even disguised by, the more habitual perverse fantasies.…

Deletion of the Ttf1 gene in differentiated neurons disrupts female reproduction without impairing basal ganglia function.

PubMed

Mastronardi, Claudio; Smiley, Gregory G; Raber, Jacob; Kusakabe, Takashi; Kawaguchi, Akio; Matagne, Valerie; Dietzel, Anja; Heger, Sabine; Mungenast, Alison E; Cabrera, Ricardo; Kimura, Shioko; Ojeda, Sergio R

2006-12-20

Thyroid transcription factor 1 (TTF1) [also known as Nkx2.1 (related to the NK-2 class of homeobox genes) and T/ebp (thyroid-specific enhancer-binding protein)], a homeodomain gene required for basal forebrain morphogenesis, remains expressed in the hypothalamus after birth, suggesting a role in neuroendocrine function. Here, we show an involvement of TTF1 in the control of mammalian puberty and adult reproductive function. Gene expression profiling of the nonhuman primate hypothalamus revealed that TTF1 expression increases at puberty. Mice in which the Ttf1 gene was ablated from differentiated neurons grew normally and had normal basal ganglia/hypothalamic morphology but exhibited delayed puberty, reduced reproductive capacity, and a short reproductive span. These defects were associated with reduced hypothalamic expression of genes required for sexual development and deregulation of a gene involved in restraining puberty. No extrapyramidal impairments associated with basal ganglia dysfunction were apparent. Thus, although TTF1 appears to fulfill only a morphogenic function in the ventral telencephalon, once this function is satisfied in the hypothalamus, TTF1 remains active as part of the transcriptional machinery controlling female sexual development.

Personal and environmental factors contributing to participation in romantic relationships and sexual activity of young adults with cerebral palsy.

PubMed

Wiegerink, Diana J H G; Stam, Henk J; Ketelaar, Marjolijn; Cohen-Kettenis, Peggy T; Roebroeck, Marij E

2012-01-01

To study determinants of romantic relationships and sexual activity of young adults with cerebral palsy (CP), focusing on personal and environmental factors. A cohort study was performed with 74 young adults (46 men; 28 women) aged 20-25 years (SD 1.4) with CP (49% unilateral CP, 76% GMFCS level I, 85% MACS level I). All participants were of normal intelligence. Romantic relationships, sexual activity (outcome measures), personal and environmental factors (associated factors) were assessed. Associations were analyzed using logistic regression analyses. More females than males with CP were in a current romantic relationship. Self-esteem, sexual esteem and feelings of competence regarding self-efficacy contributed positively to having current romantic relationships. A negative parenting style contributed negatively. Age and gross motor functioning explained 20% of the variance in experience with intercourse. In addition, sexual esteem and taking initiative contributed significantly to intercourse experience. For young adults with CP personal factors (20-35% explained variances) seem to contribute more than environmental factors (9-12% explained variances) to current romantic relationships and sexual experiences. We advice parents and professionals to focus on self-efficacy, self-esteem and sexual self-esteem in development of young adults with CP. [ • The severity of gross motor functioning contributed somewhat to sexual activities, but not to romantic relationships.• High self-efficacy, self-esteem and sexual self-esteem can facilitate involvement in romantic and sexual relationships for young adults with CP.

A comparison of incest offenders based on victim age.

PubMed

Firestone, Philip; Dixon, Kristopher L; Nunes, Kevin L; Bradford, John M

2005-01-01

The purpose of the present study was to compare incest offenders (IOs) whose victims include infants or toddlers to IOs with adolescent victims on several variables commonly examined in the sexual offender literature. Participants were 48 men whose youngest victim was less than 6 years of age (younger-victim incest offenders; YVs); and 71 men whose youngest victim was 12 to 16 years of age (older-victim incest offenders (OVs). In general, YVs showed more emotional disturbance and pathology than OVs. Compared with OVs, YVs had a greater history of substance abuse and more current problems with alcohol. In addition, YVs reported significantly poorer sexual functioning and were significantly more psychiatrically disturbed. YVs were also more likely to have a male victim, to have victimized a nephew/niece or grandson/granddaughter, and to have denied their offense(s). It was evident that both the YVs and OVs demonstrated clinically significant difficulty with normal sexual functioning and exhibited deviant sexual arousal.

Human face processing is tuned to sexual age preferences

PubMed Central

Ponseti, J.; Granert, O.; van Eimeren, T.; Jansen, O.; Wolff, S.; Beier, K.; Deuschl, G.; Bosinski, H.; Siebner, H.

2014-01-01

Human faces can motivate nurturing behaviour or sexual behaviour when adults see a child or an adult face, respectively. This suggests that face processing is tuned to detecting age cues of sexual maturity to stimulate the appropriate reproductive behaviour: either caretaking or mating. In paedophilia, sexual attraction is directed to sexually immature children. Therefore, we hypothesized that brain networks that normally are tuned to mature faces of the preferred gender show an abnormal tuning to sexual immature faces in paedophilia. Here, we use functional magnetic resonance imaging (fMRI) to test directly for the existence of a network which is tuned to face cues of sexual maturity. During fMRI, participants sexually attracted to either adults or children were exposed to various face images. In individuals attracted to adults, adult faces activated several brain regions significantly more than child faces. These brain regions comprised areas known to be implicated in face processing, and sexual processing, including occipital areas, the ventrolateral prefrontal cortex and, subcortically, the putamen and nucleus caudatus. The same regions were activated in paedophiles, but with a reversed preferential response pattern. PMID:24850896

Sexual dysfunction and infertility as late effects of cancer treatment

PubMed Central

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

2014-01-01

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. PMID:26217165

Fertility and sexuality in the spinal cord injury patient.

PubMed

Stoffel, J T; Van der Aa, F; Wittmann, D; Yande, S; Elliott, S

2018-06-14

After a spinal cord injury, patients have different perceptions of sexuality, sexual function, and potential for fertility. These changes can greatly impact quality of life over a lifetime. The purpose of this workgroup was to identify common evidence based or expert opinion themes and recommendations regarding treatment of sexuality, sexual function and fertility in the spinal cord injury population. As part of the SIU-ICUD joint consultation of Urologic Management of the Spinal Cord Injury (SCI), a workgroup and comprehensive literature search of English language manuscripts regarding fertility and sexuality in the spinal cord injury patient were formed. Articles were compiled, and recommendations in the chapter are based on group discussion and follow the Oxford Centre for Evidence-based Medicine system for levels of evidence (LOEs) and grades of recommendation (GORs). Genital arousal, ejaculation, and orgasm are significantly impacted after spinal cord injury in both male and female SCI patients. This may have a more significant impact on potential for fertility in male spinal cord injury patients, particularly regarding ability of generate erection, semen quantity and quality. Female patients should be consulted that pregnancy is still possible after injury and a woman should expect resumption of normal reproductive function. As a result, sexual health teaching should be continued in women despite injury. Pregnancy in a SCI may cause complications such as autonomic dysreflexia, so this group should be carefully followed during pregnancy. By understanding physiologic changes after injury, patients and care teams can work together to achieve goals and maximize sexual quality of life after the injury.

Evaluation and Tests

MedlinePlus

... may also ask if your bladder control and sexual function are normal. You will also be asked if you are suffering from any other illnesses and if you are taking medications. The physician will then perform a physical exam to test for loss of vibratory sensation. ...

Surgical treatment of Peyronie's disease.

PubMed

Carson, Culley C

2006-02-01

Peyronie's disease is a sexually debilitating disease causing significant penile deformity and erectile dysfunction as well as psychological stress for many men. The incidence of Peyronie's disease appears to be increasing and urologists are being called upon more frequently to treat this debilitating condition. Urologists have an opportunity to help men suffering from Peyronie's disease to improve their lives and the lives of their partners. Appropriate treatment should be individualized and tailored to the patient's expectations, disease history, physical exam findings, and coital function. After medical therapy is considered and the Peyronie's disease has stabilized, surgical correction is an excellent option for patients with functional impairment from their Peyronie's disease. Surgical outcomes are excellent with expected return to normal sexual function following Peyronie's disease treatment.

Sexual function in adult patients with classic bladder exstrophy: A multicenter study.

PubMed

Park, Weon; Zwink, Nadine; Rösch, Wolfgang H; Schmiedeke, Eberhard; Stein, Raimund; Schmidt, Dominik; Noeker, Meinolf; Jenetzky, Ekkehart; Reutter, Heiko; Ebert, Anne-Karoline

2015-06-01

The bladder exstrophy-epispadias complex (BEEC) comprises a spectrum of congenital anomalies that represents the severe end of urorectal malformations, and has a profound impact on continence as well as sexual and renal functions. The relation between severity of BEEC and its associated functional impairments, on one hand, and the resulting restrictions in quality of life and potential psychopathology determine the patients' outcome. It is important for improving further outcome to identify BEEC-related sources of distress in the long term. Genital function and sexuality becomes an important issue for adolescent and adult BEEC individuals. Hence, the present study focused on sexual function and psychological adaption in patients with BEEC. In a multicenter study 52 patients (13 females, 39 males) with classic bladder exstrophy (BE) with their bladders in use were assessed by a self-developed questionnaire about sexual function, and psychosexual and psychosocial outcome. The patients were born between 1948 and 1994 (median age 31 years). Twelve of 13 (92%) females and 25 of 39 (64%) males with classic BE had answered the questions on sexual function. Of these, 50% females and 92% males answered that they masturbated. Females had sexual intercourse more frequently. Six (50%) females affirmed dyspareunia whereas only two (8%) males reported pain during erection. Eight (67%) females specified having orgasms. Eighteen (72%) males were able to ejaculate. Two males and none of the females lived in a committed partnership (Figure). Two (15%) females and 13 (33%) males answered all psychosocial questions. The majority of these patients had concerns about satisfactory sexuality and lasting, happy partnerships. A minority of patients of both sexes were willing to answer psychosocial questions. Sexual activity and relationships of many adult BE patients seems to be impaired. Not surprisingly, sexual activity and awareness were different in males and females even in a multi-organ anomaly. To date, one of the main goals of the medical treatment of BEEC/BE patients is to enable normal sexual life and fertility. However, only a few outcome studies have focused on these issues with contradicting results, most of them not using standardized outcome measures. In accordance with other studies, our female BE patients have dyspareunia and most of our male BE patients were able to ejaculate. But the question of normal force of ejaculation, ejaculated volume, or semen analysis remains unanswered. Despite partial confirmation of previous findings, there is inconsistency referring to the outcome measured by the available studies. This might in part be explained by the fact that, other than this study, most previous studies are the result of single-institution experience. Thus, selection bias in the patient sampling due to different a clinical collective in different hospitals may be the consequence. Furthermore, patients' honesty and self-reflection in answering difficult questions regarding their sexual and cosmetic impairments is questionable. In addition, studies include a wide range of age groups and are connected with this life period. Fears and condition-specific anxieties might change over time. Hence, the strengths of this study are the nationwide and treating physician-independent data acquisition as well as the large sample size of adult patients with a very rare congenital malformation. Unfortunately, more detailed analyses on sexual function and current psychosocial situation, for example correlation of data with clinical symptoms such as continence status, was not possible as data were mainly not answered by patients. To improve the quality of life of patients with BEEC/BE, treatment and follow-up should emphasize physical but also psychological care in these patients. Physicians should further re-evaluate their preconceptions and should take care of the patients throughout their lives. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Secondary traumatization in parents following the disclosure of extrafamilial child sexual abuse: initial effects.

PubMed

Manion, I G; McIntyre, J; Firestone, P; Ligezinska, M; Ensom, R; Wells, G

1996-11-01

Disclosure or discovery of extrafamilial sexual abuse (ESA) has the potential to traumatize the entire family system. Little controlled research has examined the initial reactions of parents to this type of trauma. The present study evaluated the adjustment of 93 parents (63 mothers and 30 fathers) within 3 months of the disclosure of ESA. Parents' functioning was compared to that of a nonclinical comparison group of 136 parents (74 mothers, 62 fathers). Parent adjustment was assessed using self-report measures of psychological distress, parent competence, family functioning, marital functioning, life stressors, and environmental support. Results revealed that mothers of sexually abused children, in comparison to mothers of nonabused children, experienced greater overall emotional distress, poorer family functioning, and lower satisfaction in their parenting role. Fathers of sexually abused children also experienced greater overall emotional distress relative to comparison fathers but their level of distress remained below that of mothers. Standard and hierarchical multiple regressions on maternal self-reports revealed that mothers' satisfaction with their parenting role and their perceived level of environmental support predicted their emotional functioning. Abuse-related variables did not contribute to the prediction of emotional functioning. These results emphasize the need to expand our focus beyond the child victims to the traumatized families and to normalize the potential for all close family members to be vulnerable to experience adjustment difficulties following ESA.

Health-Related Quality of Life in Men with Erectile Dysfunction

PubMed Central

Litwin, Mark S; Nied, Robert J; Dhanani, Nasreen

1998-01-01

OBJECTIVE To assess health-related quality of life (HRQOL) in men with erectile dysfunction. DESIGN Descriptive survey with general and disease-specific measures. The instrument contained three established, validated HRQOL measures, a validated comorbidity checklist, and sociodemographics. The RAND 36-Item Health Survey 1.0 (SF-36) was used to assess general HRQOL. Sexual function and sexual bother were assessed using the UCLA Prostate Cancer Index. The marital interaction scale from the Cancer Rehabilitation Evaluation System Short Form (CARES-SF) was used to assess each patient's relationship with his sexual partner. SETTING Urology clinics at a university medical center and the affiliated Veterans Affairs (VA) Medical Center. PARTICIPANTS Thirty-five (67%) of 54 consecutive university patients presenting for erectile dysfunction and 22 (42%) of 52 VA patients who were awaiting a previously prescribed vacuum erection device participated. MAIN RESULTS The university respondents scored slightly lower than population normals in social function, role limitations due to emotional problems, and emotional well-being. The VA respondents scored lower than expected in all eight domains. Scores for the VA population were significantly lower than those for the university population in physical function, role limitations due to physical problems, bodily pain, and social function. A significant correlation was seen between marital interaction and sexual function (r = −.33, p = .01) but not between marital interaction and sexual bother (r = −.15, p = .26) in the total sample. Sexual function also correlated significantly with general health perceptions (r = .34, p = .01), role limitations due to physical problems (r = .29, p = .03), and role limitations due to emotional problems (r = .30, p = .03). Sexual bother did not correlate with any of the general HRQOL domains. Affluent men reported better sexual function (p = .03). CONCLUSIONS The emotional domains of the SF-36 are associated with more profound impairment than are the physical domains in men with erectile dysfunction. Erectile dysfunction and the bother it causes are discrete domains of HRQOL and distinct from each other in these patients. With increased attention to patient-centered medical outcomes, greater emphasis has been placed on such variables as HRQOL. This should be particularly true for a patient-driven symptom, such as erectile dysfunction. PMID:9541372

Role of the different sexuality domains on the sexual function of women with premature ovarian failure.

PubMed

Benetti-Pinto, Cristina Laguna; Soares, Patrícia Magda; Giraldo, Helena Patrícia Donovan; Yela, Daniela Angerame

2015-03-01

Women with premature ovarian failure (POF) often manifest complaints involving different aspects of sexual function (SF), regardless of using hormone therapy. SF involves a complex interaction between physical, psychological, and sociocultural aspects. There are doubts about the impact of different complaints on the global context of SF of women with POF. To evaluate the percentage of influence of each of the sexuality domains on the SF in women with POF. Cross-sectional study with 80 women with POF, matched by age to 80 women with normal gonadal function. We evaluated SF through the "Female Sexual Function Index" (FSFI), a comparison between the POF and control groups using the Mann-Whitney test. Component exploratory factor analysis was used to assess the proportional influence of each domain on the composition of the overall SF for women in the POF group. SF was evaluated using FSFI. Exploratory Factor Analysis for components was used to evaluate the role of each domain on the SF of women with POF. The FSFI score was significantly worse for women with POF, with a decrease in arousal, lubrication, orgasm, satisfaction, and dyspareunia. Exploratory factor analysis of SF showed that the domain with greater influence in the SF was arousal, followed by desire, together accounting for 41% of the FSFI. The domains with less influence were dyspareunia and lubrication, which together accounted for 25% of the FSFI. Women with POF have impaired SF, determined mainly by changes in arousal and desire. Aspects related to lubrication and dyspareunia complaints have lower determination coefficient in SF. These results are important in adapting the approach of sexual disorders in this group of women. © 2014 International Society for Sexual Medicine.

Sexual self-esteem in mothers of normal and mentally-retarded children.

PubMed

Tavakolizadeh, Jahanshir; Amiri, Mostafa; Nejad, Fahimeh Rastgoo

2017-06-01

Sexual self-esteem is negatively influenced by the stressful experiences in lifetime. This study compared the sexual self-esteem and its components in mothers with normal and mentally-retarded children in Qaen city, in 2014. A total of 120 mothers were selected and assigned into two groups of 60 samples based on convenient sampling method and randomized multiple stage sampling. Both groups completed sexual self-esteem questionnaire. The data were analyzed employing t-test through SPSS software version15. The results showed that the rate of sexual self-esteem in mothers of mentally-retarded children decreased significantly compared with that of mothers with normal children (p<0.05). Moreover, the mean scores of all components of sexual self-esteem including skill and experience, attractiveness, control, moral judgment, and adaptiveness in mothers of mentally-retarded children were significantly less than those of mothers with normal children (p <0.05). Therefore, it is recommended that self-esteem, especially the sexual one, be taught to mothers of mentally-retarded children by specialists.

Normal Psychosexual Development

ERIC Educational Resources Information Center

Rutter, Michael

1971-01-01

Normal sexual development is reviewed with respect to physical maturation, sexual interests, sex drive", psychosexual competence and maturity, gender role, object choice, children's concepts of sexual differences, sex role preference and standards, and psychosexual stages. Biologic, psychoanalytic and psychosocial theories are briefly considered.…

Sexual function and practice in elderly men of lower socioeconomic status.

PubMed

Cogen, R; Steinman, W

1990-08-01

Normal aging plus certain prevalent diseases are believed to render many elderly men impotent. Recent studies have suggested that educated middle-class and upper-class elderly men continue sexual activity, despite erectile dysfunction, by employing alternative practices such as mutual masturbation and oral sex. Few elderly men of lower socioeconomic background have been included in these studies, however. Using physician-administered interviews, 87 men attending an urban Veterans Administration geriatric clinic were studied to determine (1) the prevalence of erectile dysfunction, and (2) the sexual practices and attitudes of this group. Of the 87 men, 28% reported complete loss of erectile function, while 31% had frequent difficulties achieving vaginal intromission. Unlike economically advantaged groups, only 29% used mutual masturbation and 16% used oral sex. Attitudes toward these practices were negative. With one exception, men unable to perform coitus ceased all heterosexual activities.

Sexual function and fecundity after treatment for testicular tumors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bracken, R.B.; Johnson, D.E.

Questionnaires were mailed to patients who had undergone either radiotherapy, lymphadenectomy, or a combination of both as treatment for malignant disease of the testis in an attempt to define the effects of their therapy on sexual function, ejaculation, and fecundity. The forms returned by 29 patients with seminoma treated with irradiation alone indicated that little change had occurred in their sexual performance or sex drive. Diminished semen volume was reported by 10 patients but was severe in only 1. Two of 3 patients who desired children after therapy were successful. In patients with nonseminomatous testis tumor treated surgically, 42 ofmore » 50 reported a significant decrease in semen volume, but 7 of 12 who desired children following therapy were successful. The physiology of ejaculation is reviewed, and comments are offered on the means by which retroperitoneal lymphadenectomy may disrupt normal ejaculation.« less

Sexual satisfaction in the elderly female population: A special focus on women with gynecologic pathology.

PubMed

Ratner, Elena S; Erekson, Elisabeth A; Minkin, Mary Jane; Foran-Tuller, Kelly A

2011-11-01

SEXUAL FUNCTION IN AGING WOMEN: Sexuality is an integral part of human expressions. Mental health plays a major role in sexuality. Several psychological interventions are proposed to increase the sexual quality of life in older women with diverse gynecologic pathology. A biopsychosocial approach utilizing brief strategies can be easily implemented in clinics to help women of all ages increase their sexual quality of life. THE IMPACT OF FEMALE PELVIC FLOOR DISORDERS ON SEXUAL FUNCTION IN OLDER WOMEN: Female pelvic floor disorders include urinary incontinence, pelvic organ prolapse, and fecal incontinence. These disorders increase dramatically with increasing age. Urinary incontinence has been demonstrated to have a negative impact on a woman's sexual function. Among sexually active older women with urinary incontinence, 22% report being moderately or extremely worried that sexual activity would cause urine loss. An increased prevalence of sexual distress [9% (6/76) vs. 1.3% (2/216), p=0.005] has been reported in sexually active women over 40 years old with urinary incontinence. Treatment of urinary incontinence can improve sexual function in older women. Among sexually active women (N=53) who underwent midurethral slings procedures for the correction of urinary incontinence, increased coital frequency, decrease fear of incontinence with coitus, decreased embarrassment due to incontinence was reported six months after surgery. Pelvic organ prolapse, a hernia of the vagina resulting in a visible vaginal bulge, has also been associated with a negative impact on sexual function. Women with advanced pelvic organ prolapse (POP-Q stage III or IV) have been demonstrated to have decreased body image reporting that they are more self-conscious about their appearance [adjusted odds ratio (AOR) 4.7; 95% confidence interval (CI) 2.9, 51], feel less feminine (AOR 4.0; 95% CI 1.2, 15) and less sexually attractive (AOR 4.6; 95% CI 1.4, 17) compared with women who have normal pelvic support. Both vaginal and abdominal approaches to surgical correction of pelvic organ prolapse have been demonstrated to improve sexual function. MENTAL HEALTH: Mental health plays a major role in older woman's sexuality. Sexual interest and satisfaction is tied to emotional expressivity, women's self-worth, feelings of depression and loneliness as well as cognitive function. Research has shown that both general practitioners and specialists lack training in sexual assessments. Behavioral health specialists, such as a psychologist, can play an integral role in helping to facilitate communication between the patient and the provider. A main focus of communication training is to facilitate open and genuine conversation between the provider and the patient. Providers are encouraged to ask open ended questions while patients are encouraged to discuss symptoms while coping with an internal state of anxiety. Despite the known prevalence of sexual dysfunction among older women, few studied empirically based interventions have been published with these women. This speaks to the general assumption among medical professionals that having the "sex talk" in older women with gynecological pathology is not important or relevant. A biopsychosocial approach utilizing some of the aforementioned brief strategies can be easily implemented in comprehensive gynecology clinics in order to help women of all ages increase their sexual quality of life. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Sexual satisfaction in the elderly female population: A special focus on women with gynecologic pathology

PubMed Central

Ratner, Elena S.; Erekson, Elisabeth A.; Minkin, Mary Jane; Foran-Tuller, Kelly A.

2013-01-01

Sexual function in aging women Sexuality is an integral part of human expressions. Mental health plays a major role in sexuality. Several psychological interventions are proposed to increase the sexual quality of life in older women with diverse gynecologic pathology. A biopsychosocial approach utilizing brief strategies can be easily implemented in clinics to help women of all ages increase their sexual quality of life. The impact of female pelvic floor disorders on sexual function in older women Female pelvic floor disorders include urinary incontinence, pelvic organ prolapse, and fecal incontinence. These disorders increase dramatically with increasing age. Urinary incontinence has been demonstrated to have a negative impact on a woman’s sexual function. Among sexually active older women with urinary incontinence, 22% report being moderately or extremely worried that sexual activity would cause urine loss. An increased prevalence of sexual distress [9% (6/76) vs. 1.3% (2/216), p=0.005] has been reported in sexually active women over 40 years old with urinary incontinence. Treatment of urinary incontinence can improve sexual function in older women. Among sexually active women (N=53) who underwent midurethral slings procedures for the correction of urinary incontinence, increased coital frequency, decrease fear of incontinence with coitus, decreased embarrassment due to incontinence was reported six months after surgery. Pelvic organ prolapse, a hernia of the vagina resulting in a visible vaginal bulge, has also been associated with a negative impact on sexual function. Women with advanced pelvic organ prolapse (POP-Q stage III or IV) have been demonstrated to have decreased body image reporting that they are more self-conscious about their appearance [adjusted odds ratio (AOR) 4.7; 95% confidence interval (CI) 2.9, 51], feel less feminine (AOR 4.0; 95% CI 1.2, 15) and less sexually attractive (AOR 4.6; 95% CI 1.4, 17) compared with women who have normal pelvic support. Both vaginal and abdominal approaches to surgical correction of pelvic organ prolapse have been demonstrated to improve sexual function. Mental health Mental health plays a major role in older woman’s sexuality. Sexual interest and satisfaction is tied to emotional expressivity, women’s self-worth, feelings of depression and loneliness as well as cognitive function. Research has shown that both general practitioners and specialists lack training in sexual assessments. Behavioral health specialists, such as a psychologist, can play an integral role in helping to facilitate communication between the patient and the provider. A main focus of communication training is to facilitate open and genuine conversation between the provider and the patient. Providers are encouraged to ask open ended questions while patients are encouraged to discuss symptoms while coping with an internal state of anxiety. Despite the known prevalence of sexual dysfunction among older women, few studied empirically based interventions have been published with these women. This speaks to the general assumption among medical professionals that having the “sex talk” in older women with gynecological pathology is not important or relevant. A biopsychosocial approach utilizing some of the aforementioned brief strategies can be easily implemented in comprehensive gynecology clinics in order to help women of all ages increase their sexual quality of life. PMID:21943557

A large multicenter outcome study of female genital plastic surgery.

PubMed

Goodman, Michael P; Placik, Otto J; Benson, Royal H; Miklos, John R; Moore, Robert D; Jason, Robert A; Matlock, David L; Simopoulos, Alex F; Stern, Bernard H; Stanton, Ryan A; Kolb, Susan E; Gonzalez, Federico

2010-04-01

Female Genital Plastic Surgery, a relatively new entry in the field of Cosmetic and Plastic Surgery, has promised sexual enhancement and functional and cosmetic improvement for women. Are the vulvovaginal aesthetic procedures of Labiaplasty, Vaginoplasty/Perineoplasty ("Vaginal Rejuvenation") and Clitoral Hood Reduction effective, and do they deliver on that promise? For what reason do women seek these procedures? What complications are evident, and what effects are noted regarding sexual function for women and their partners? Who should be performing these procedures, what training should they have, and what are the ethical considerations? This study was designed to produce objective, utilizable outcome data regarding FGPS. 1) Reasons for considering surgery from both patient's and physician's perspective; 2) Pre-operative sexual functioning per procedure; 3) Overall patient satisfaction per procedure; 4) Effect of procedure on patient's sexual enjoyment, per procedure; 5) Patient's perception of effect on her partner's sexual enjoyment, per procedure; 6) Complications. This cross-sectional study, including 258 women and encompassing 341 separate procedures, comes from a group of twelve gynecologists, gynecologic urologists and plastic surgeons from ten centers in eight states nationwide. 104 labiaplasties, 24 clitoral hood reductions, 49 combined labiaplasty/clitoral hood reductions, 47 vaginoplasties and/or perineoplasties, and 34 combined labiaplasty and/or reduction of the clitoral hood plus vaginoplasty/perineoplasty procedures were studied retrospectively, analyzing both patient's and physician's perception of surgical rationale, pre-operative sexual function and several outcome criteria. Combining the three groups, 91.6% of patients were satisfied with the results of their surgery after a 6-42 month follow-up. Significant subjective enhancement in sexual functioning for both women and their sexual partners was noted (p = 0.0078), especially in patients undergoing vaginal tightening/perineal support procedures. Complications were acceptable and not of major consequence. While emphasizing that these female genital plastic procedures are not performed to correct "abnormalities," as there is a wide range of normality in the external and internal female genitalia, both parous and nulliparous, many women chose to modify their vulvas and vaginas. From the results of this large study pooling data from a diverse group of experienced genital plastic surgeons, outcome in both general and sexual satisfaction appear excellent.

Functional Analysis of Developmentally Regulated Genes chs7 and sec22 in the Ascomycete Sordaria macrospora.

PubMed

Traeger, Stefanie; Nowrousian, Minou

2015-04-14

During sexual development, filamentous ascomycetes form complex, three-dimensional fruiting bodies for the generation and dispersal of spores. In previous studies, we identified genes with evolutionary conserved expression patterns during fruiting body formation in several fungal species. Here, we present the functional analysis of two developmentally up-regulated genes, chs7 and sec22, in the ascomycete Sordaria macrospora. The genes encode a class VII (division III) chitin synthase and a soluble N-ethylmaleimide-sensitive-factor attachment protein receptor (SNARE) protein, respectively. Deletion mutants of chs7 had normal vegetative growth and were fully fertile but showed sensitivity toward cell wall stress. Deletion of sec22 resulted in a reduced number of ascospores and in defects in ascospore pigmentation and germination, whereas vegetative growth was normal in the mutant. A SEC22-EGFP fusion construct under control of the native sec22 promoter and terminator regions was expressed during different stages of sexual development. Expression of several development-related genes was deregulated in the sec22 mutant, including three genes involved in melanin biosynthesis. Our data indicate that chs7 is dispensable for fruiting body formation in S. macrospora, whereas sec22 is required for ascospore maturation and germination and thus involved in late stages of sexual development. Copyright © 2015 Traeger and Nowrousian.

Functional Analysis of Developmentally Regulated Genes chs7 and sec22 in the Ascomycete Sordaria macrospora

PubMed Central

Traeger, Stefanie; Nowrousian, Minou

2015-01-01

During sexual development, filamentous ascomycetes form complex, three-dimensional fruiting bodies for the generation and dispersal of spores. In previous studies, we identified genes with evolutionary conserved expression patterns during fruiting body formation in several fungal species. Here, we present the functional analysis of two developmentally up-regulated genes, chs7 and sec22, in the ascomycete Sordaria macrospora. The genes encode a class VII (division III) chitin synthase and a soluble N-ethylmaleimide-sensitive-factor attachment protein receptor (SNARE) protein, respectively. Deletion mutants of chs7 had normal vegetative growth and were fully fertile but showed sensitivity toward cell wall stress. Deletion of sec22 resulted in a reduced number of ascospores and in defects in ascospore pigmentation and germination, whereas vegetative growth was normal in the mutant. A SEC22-EGFP fusion construct under control of the native sec22 promoter and terminator regions was expressed during different stages of sexual development. Expression of several development-related genes was deregulated in the sec22 mutant, including three genes involved in melanin biosynthesis. Our data indicate that chs7 is dispensable for fruiting body formation in S. macrospora, whereas sec22 is required for ascospore maturation and germination and thus involved in late stages of sexual development. PMID:25873638

Long-Term Quality of Life Outcome After Proton Beam Monotherapy for Localized Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coen, John J., E-mail: jcoen@partners.org; Paly, Jonathan J.; Niemierko, Andrzej

Objectives: High-dose external radiation for localized prostate cancer results in favorable clinical outcomes and low toxicity rates. Here, we report long-term quality of life (QOL) outcome for men treated with conformal protons. Methods: QOL questionnaires were sent at specified intervals to 95 men who received proton radiation. Of these, 87 men reported 3- and/or 12-month outcomes, whereas 73 also reported long-term outcomes (minimum 2 years). Symptom scores were calculated at baseline, 3 months, 12 months, and long-term follow-up. Generalized estimating equation models were constructed to assess longitudinal outcomes while accounting for correlation among repeated measures in an individual patient. Menmore » were stratified into functional groups from their baseline questionnaires (normal, intermediate, or poor function) for each symptom domain. Long-term QOL changes were assessed overall and within functional groups using the Wilcoxon signed-rank test. Results: Statistically significant changes in all four symptom scores were observed in the longitudinal analysis. For the 73 men reporting long-term outcomes, there were significant change scores for incontinence (ID), bowel (BD) and sexual dysfunction (SD), but not obstructive/irritative voiding dysfunction (OID). When stratified by baseline functional category, only men with normal function had increased scores for ID and BD. For SD, there were significant changes in men with both normal and intermediate function, but not poor function. Conclusions: Patient reported outcomes are sensitive indicators of treatment-related morbidity. These results quantitate the long-term consequences of proton monotherapy for prostate cancer. Analysis by baseline functional category provides an individualized prediction of long-term QOL scores. High dose proton radiation was associated with small increases in bowel dysfunction and incontinence, with more pronounced changes in sexual dysfunction.« less

Human face processing is tuned to sexual age preferences.

PubMed

Ponseti, J; Granert, O; van Eimeren, T; Jansen, O; Wolff, S; Beier, K; Deuschl, G; Bosinski, H; Siebner, H

2014-05-01

Human faces can motivate nurturing behaviour or sexual behaviour when adults see a child or an adult face, respectively. This suggests that face processing is tuned to detecting age cues of sexual maturity to stimulate the appropriate reproductive behaviour: either caretaking or mating. In paedophilia, sexual attraction is directed to sexually immature children. Therefore, we hypothesized that brain networks that normally are tuned to mature faces of the preferred gender show an abnormal tuning to sexual immature faces in paedophilia. Here, we use functional magnetic resonance imaging (fMRI) to test directly for the existence of a network which is tuned to face cues of sexual maturity. During fMRI, participants sexually attracted to either adults or children were exposed to various face images. In individuals attracted to adults, adult faces activated several brain regions significantly more than child faces. These brain regions comprised areas known to be implicated in face processing, and sexual processing, including occipital areas, the ventrolateral prefrontal cortex and, subcortically, the putamen and nucleus caudatus. The same regions were activated in paedophiles, but with a reversed preferential response pattern. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Prevalence of sexual dysfunction among females in a university community in Enugu, Nigeria.

PubMed

Nwagha, U I; Oguanuo, T C; Ekwuazi, K; Olubobokun, T O; Nwagha, T U; Onyebuchi, A K; Ezeonu, P O; Nwadike, K

2014-01-01

Female sexual dysfunction is a common, condition that significantly reduces the quality-of-life of the affected persons. Unfortunately, because of the veil of secrecy that shrouds discussions on human sexuality, there has been limited research on this topic in some sociocultural settings. The aim was to determine the prevalence and some sociodemographic factors associated with sexual dysfunction in females in a university community at the University of Nigeria, Enugu Campus, Enugu State, Nigeria. This is a cross-sectional study involving 500 females recruited randomly in a tertiary institution in Nigeria. A self-administered structured pretested questionnaire on sexual activity was administered (the Female Sexual Function Index [FSFI]). Statistical analysis was performed using SPSS software package (Version 17.0, Chicago, IL, USA). Multiple logistic regression was used to determine the relationship between the sociodemographic factors, and the total FSFI scores dichotomized as normal and reduced sexual function. In addition, multiple linear regression was used to determine the relationship between the six different domains scores and the continuous values of the total score. For all, calculations, P < 0.05 was considered as statistically significant at 95% confidence interval (CI). The prevalence of female sexual dysfunction (FSFI score ≤ 26.50) was 53.3%. The highest prevalence occurred in the 41-50 years age group (73.3%; 66/90), married and living together 56.4% (123/218) and had postsecondary education (56.1%; 137/244). Only age significantly predicted female sexual function (P = 0.007; 95% CI; 0.691-0.943). Marital status, religion, ethnic group, and educational qualification had no significant effect (P < 0.05). The total FSFI significantly increase as desire increases (P = 0.002; 95% CI = 0.817-3.573). Female sexual dysfunction is common in the university environment, with the highest prevalence occurring in 41-50 years age group.

Sex steroids effects in normal endocrine pancreatic function and diabetes.

PubMed

Morimoto, Sumiko; Jiménez-Trejo, Francisco; Cerbón, Marco

2011-01-01

Traditionally the role of sexual steroid hormones was focused primarily on reproductive organs: the breast, female reproductive tract (uterus, mammary gland, and ovary), and male reproductive tract (testes, epididymis and prostate), however our current understanding of tissue-specific effects of sex steroids has elucidated new aspects in its functionality. Recent data have shown that many other tissues are targets of those hormones in addition to classical reproductive organs. The pancreas (which performs both endocrine and exocrine functions), has proven to be an extragonadal target of sexual steroid hormone action. The endocrine pancreas has a pivotal role on carbohydrate homeostasis and deterioration in function produces diabetes. Diabetes is a metabolic disorder that has high prevalence worldwide, particularly in developing countries. It has been shown that steroid hormones have an important role in susceptibility and development of diabetes in animal models, in humans its role is less clear, however the most evident effect is on the perimenopausal women, in this stage the decrease in gonadal steroids produces an increase on susceptibility to develop diabetes mellitus; in men, hypoandrogenism is associated with an increased prevalence of insulin resistance. This review focused on the effects of sexual steroids on pancreatic function and diabetes.

Sacrifice of accessory pudendal arteries in normally potent men during robot-assisted radical prostatectomy does not impact potency.

PubMed

Box, Geoffrey N; Kaplan, Adam G; Rodriguez, Esequiel; Skarecky, Douglas W; Osann, Kathryn E; Finley, David S; Ahlering, Thomas E

2010-01-01

Whether or not sacrificing accessory pudendal arteries (APAs) during radical prostatectomy affects potency has been an ongoing source of concern. Herein, we present our potency results relative to sacrificing APAs in normally pre-potent men following robot-assisted radical prostatectomy (RARP). The distribution of APAs and clinical characteristics were prospectively recorded in 200 consecutive patients undergoing RARP with a cautery-free technique. Sexual function was assessed using the International Index of Erectile Function 5-item questionnaire (IIEF-5). All APAs were sacrificed due to stapling the dorsal vein complex. Postoperatively, potency was defined by an affirmative answer to the following two questions: "Were erections adequate for penetration?" and "were the erections satisfactory?" Postoperative IIEF-5 scores and quality of erections (% of preoperative firmness: 0%, 25%, 50%, 75%, 100%) were also obtained. Subgroup analysis of patients age < or =65 years with IIEF-5 score of 22-25 was performed. Eighty patients (40%) had APAs. Preoperatively, there was no association with having an APA and normal/abnormal sexual function. Preoperatively, 58/200 were < or =65 years with self-administered IIEF-5 scores of 22-25. Postoperatively, 53/58 (91%) were potent at 24 months follow-up. Nineteen of 58 patients had a sacrificed APA; 39 patients had no APA. Eighteen of 19 (95%) patients with sacrificed APAs were potent vs. 35/39 (90%) with no APA present (P = 0.53). Multivariate analysis showed no significant correlation between sacrificing an APA and time of potency recovery, quality of postoperative erections (94% vs. 90% P = 0.80) or mean IIEF-5 score (22.4 vs. 20.8, P = 0.13). We found no correlation between the presence or absence of APAs and preoperative sexual function. Furthermore, after sacrificing all APAs, we found no correlation with potency return, time to return of potency, quality of erections, or mean IIEF-5 scores at 24 months.

Stimuli eliciting sexual arousal in males who offend adult women: an experimental study.

PubMed

Kolárský, A; Madlafousek, J; Novotná, V

1978-03-01

The sexually arousing effects of short film scenes showing a naked actress's seductive behavior were phalloplethysmographically measured in 14 sexual deviates. These were males who had offended adult women, predominantly exhibitionists. Controls were 14 normal men. Deviates responded positively to the scenes and differentiated strong and weak seduction scenes similarly to normals. Consequently, the question arises of why deviates avoid their victim's erotic cooperation and why they do not offend their regular sexual partners. Post hoc analysis of five scenes which elicited a strikingly higher response in deviates than in normals suggested that these scenes contained reduced seductive behavior but unrestrained presentation of the genitals. This finding further encourages the laboratory study of stimulus conditions for abnormal sexual arousal which occurs during the sexual offense.

Normal male childhood and adolescent sexual interactions: implications for sexual orientation of the individual with intersex.

PubMed

Lee, Peter A; Houk, Christopher P

2005-03-01

Data provided by 24 adult men, 20 heterosexual and four homosexual, concerning parental, religious, geographic and explicit sexual innuendos, comments and childhood experiences are presented and discussed in an attempt to consider some of the multiple factors impacting the development of sexual orientation. All of the study subjects were normally developed males and were presumed to have been exposed to normal male levels of androgens prenatally. Since the experiences and perceptions reported are conditioned by a unique social environment that has been superimposed on a normal male typical prenatal CNS differentiation, the experiences of these men suggest that affirmation of masculinity, and openness in the realm of social and sexual interaction, may enhance the formation of a heterosexual orientation. Conversely, sexually explicit feedback with critical implications occurred commonly among the homosexual men, which they interpreted as implying an insufficient masculinity. Both innate factors and social influences impact sexual orientation; in some instances males appear to have been homosexual from early childhood onward, while in other cases there appears to have been some degree of conditioning and choice in sexual orientation. Regarding the intersexed male, this suggests that social interactions, particularly those provided by parents, have a major influence on the development of sexual orientation in the child, while all persons involved in these children's lives and particularly those who nurture must be prepared for any sexual orientation that develops.

Labeling Same-Sex Sexuality in a Tolerant Society That Values Normality: The Dutch Case.

PubMed

van Lisdonk, Jantine; Nencel, Lorraine; Keuzenkamp, Saskia

2017-10-16

Studies have pointed to a trend in Western societies toward the normalization of homosexuality and emerging "post-gayness" among young people, who no longer consider their sexual identity meaningful in defining themselves. This article takes a closer look at the Dutch case where tolerance is regarded as a national virtue, while society remains heteronormative. In 38 interviews with Dutch same-sex-attracted young people, we investigated the labels they used to describe their sexual orientation to reveal what they can tell us about normalization, tolerance, and heteronormativity. In their labeling strategies, participants de-emphasized their sexual identity, othered, and reinforced the hetero/homo binary. They preferred labels without connotations to gender expression. While post-gay rhetoric was ideologically appealing, its use was not an outcome of their sexual orientation having become insignificant; it rather enabled them to produce normality. We discuss the findings against the backdrop of "Dutch tolerance," which rests on an ideology of normality.

Comparison of Behavioral and Sexual Problems between Intellectually Disabled and Normal Adolescent Boys during Puberty in Yazd, Iran

PubMed Central

Akrami, Leila; Davudi, Maryam

2014-01-01

Objective: To compare sexual and behavioral puberty problems between intellectually disabled (ID) and normal boys in Yazd, Iran. Methods: In the present study, 65 intellectually disabled and 65 normal boys were included. The Child Behavior Check List (CBCL) was used to investigate behavioral problems. In order to study sexual problems, a questionnaire that was designed by the researchers was applie. Results: Anxiety, depression, social problems, attention problems, aggressiveness, and sexual problems were more frequent in intellectually disabled boys than in normal boys. On the other hand, regarding somatic complaints, withdrawal, thought problems, internalizing, delinquent behavior, and externalizing there was no difference between the two groups. Conclusion: Behavioral and sexual problems are more common in adolescent boys with intellectual disability (ID) than in normal boys during the puberty period. Therefore, puberty is an important period for intellectually disabled boys and their families; this should be taken into consideration by psychologists and clinicians. PMID:25053959

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.

[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.

Development of self-image and its components during a one-year follow-up in non-referred adolescents with excess and normal weight.

PubMed

Mäkinen, Mauno; Marttunen, Mauri; Komulainen, Erkki; Terevnikov, Viacheslav; Puukko-Viertomies, Leena-Riitta; Aalberg, Veikko; Lindberg, Nina

2015-01-01

The proportion of overweight and obese youths is high. The present study aimed to investigate the development of self-image and its components during a one-year follow-up among non-referred adolescents with excess and normal weight. Furthermore, we separately analyzed the data for girls and boys. Altogether 86 8(th) grades (41 girls and 45 boys) with a relative weight of 26% or more above the median and 91 controls (43 girls and 48 boys) with normal weight participated the follow-up. The Offer Self-Image Questionnaire, Revised (OSIQ-R) was used to assess self-image at baseline and on follow-up. In the OSIQ-R, a low total raw score implies positive adjustment, while a high raw score implies poor adjustment and a negative self-image. The study design was doubly correlated (pairs and time), and a linear mixed model was used in the statistical analysis. In OSIQ-R total scores, a comparative improvement was observed in girls with normal weight. Among these girls, significant change scores compared to zero were seen in impulse control, social functioning, vocational attitudes, self-confidence, self-reliance, body image, sexuality, and ethical values. In girls with excess weight, none of the change scores compared to zero were statistically significant. When the girls with normal and excess weight were compared, the difference in change scores was largest in sexuality and vocational attitudes. Change scores compared to zero were significant in sexuality and idealism for boys with excess weight, and in impulse control, mental health, self-reliance, and sexuality for normal weight boys. When the boys with excess and normal weight were compared, no statistically significant differences emerged in change scores. In mid-adolescent girls, the influence of overweight and obesity on the development of self-image is substantial. Weight management programs directed at overweight adolescent girls should include psychological interventions aiming to diminish self-image distress, especially that associated with feelings, attitudes, and behavior towards the opposite sex, as well as future career plans.

Sexual activity and aging.

PubMed

Ni Lochlainn, Mary; Kenny, Rose Anne

2013-08-01

Sexuality is an important component of emotional and physical intimacy that men and women experience throughout their lives. Research suggesting that a high proportion of men and women remain sexually active well into later life refutes the prevailing myth that aging and sexual dysfunction are inexorably linked. Age-related physiological changes do not render a meaningful sexual relationship impossible or even necessarily difficult. Many of these physiological changes are modifiable. There are various therapeutic options available to patients to achieve maximum sexual capacity in old age. This article reviews the prevalence of sexual activity among older adults, the problems these adults encounter with sexual activity, and the role of the health care professional in addressing these problems. The physiological sex-related changes that occur as part of the normal aging process in men and women are reviewed, as well as the effect of age-related physical and psychological illness on sexual function. The attitudes and perceptions of the media and general public toward sexual activity and aging are summarized. An understanding of the sexual changes that accompany the aging process may help general practitioners and other doctors to give practical and useful advice on sexuality as well as refute the misconception that aging equates to celibacy. A thorough awareness of this aspect of older people's quality of life can raise meaningful expectations for aging patients. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Theoretical perspectives accounting for adolescent homosexuality.

PubMed

Savin-Williams, R C

1988-03-01

Few topics in sexology elicit such a diversity of opinions and emotions as the question of etiology of homosexuality. Views frequently carry with them implicit or explicit messages concerning the psychologic health of this sexual orientation. Theories of sexual development usually portray adolescence as a critical time in the life course because of changes in: 1) anatomy and physiology; 2) psychologic functioning: the reawakening, renewal, and reliving of previously established sexual relations and drives; and/or 3) social conditions: an increased exposure and adherence to societal messages concerning appropriate and inappropriate social and sexual behaviors and relationships. This paper provides a brief overview of several major theories--evolutionary biology, psychoanalysis, and social processes--as they relate to the development of sexual orientation. In addition, an ethologic perspective that synthesizes various etiologic theories, as they relate to homosexuality during adolescence, is briefly reviewed. In these discussions, the issue of whether homosexuality is a normal or abnormal developmental state during adolescence is also addressed.

Neurokinin B is critical for normal timing of sexual maturation but dispensable for adult reproductive function in female mice.

PubMed

True, Cadence; Nasrin Alam, Sayeda; Cox, Kimberly; Chan, Yee-Ming; Seminara, Stephanie B

2015-04-01

Humans carrying mutations in neurokinin B (NKB) or the NKB receptor fail to undergo puberty due to decreased secretion of GnRH. Despite this pubertal delay, many of these patients go on to achieve activation of their hypothalamic-pituitary-gonadal axis in adulthood, a phenomenon termed reversal, indicating that NKB signaling may play a more critical role for the timing of pubertal development than adult reproductive function. NKB receptor-deficient mice are hypogonadotropic but have no defects in the timing of sexual maturation. The current study has performed the first phenotypic evaluation of mice bearing mutations in Tac2, the gene encoding the NKB ligand, to determine whether they have impaired sexual development similar to their human counterparts. Male Tac2-/- mice showed no difference in the timing of sexual maturation or fertility compared with wild-type littermates and were fertile. In contrast, Tac2-/- females had profound delays in sexual maturation, with time to vaginal opening and first estrus occurring significantly later than controls, and initial abnormalities in estrous cycles. However, cycling recovered in adulthood and Tac2-/- females were fertile, although they produced fewer pups per litter. Thus, female Tac2-/- mice parallel humans harboring NKB pathway mutations, with delayed sexual maturation and activation of the reproductive cascade later in life. Moreover, direct comparison of NKB ligand and receptor-deficient females confirmed that only NKB ligand-deficient animals have delayed sexual maturation, suggesting that in the absence of the NKB receptor, NKB may regulate the timing of sexual maturation through other tachykinin receptors.

Impact of estrogen receptor α gene and oxytocin receptor gene polymorphisms on female sexuality

PubMed Central

Armeni, Anastasia K; Assimakopoulos, Konstantinos; Marioli, Dimitra; Koika, Vassiliki; Michaelidou, Euthychia; Mourtzi, Niki; Iconomou, Gregoris

2017-01-01

Over the past decades, research attention has increasingly been paid to the neurobiological component of sexual behavior. The aim of the present study was to investigate the correlation of estrogen receptor α (ERA) gene polymorphism (rs2234693-PvuII) (T→C substitution) and oxytocin receptor gene polymorphism (rs53576) (G→A substitution) with sexuality parameters of young, healthy women. One hundred thirty-three Greek heterosexual women, students in higher education institutions, 20–25 years of age, sexually active, with normal menstrual cycles (28–35 days), were recruited in the study. Exclusion criteria were chronic and/or major psychiatric diseases, use of oral contraceptive pills (OCs), polycystic ovary syndrome (PCOS), thyroid diseases as well as drugs that are implicated in hypothalamus–pituitary–gonadal axis. T allele (wildtype) of rs2234693 (PvuII) polymorphism of ERA gene was correlated with increased levels of arousal and lubrication, whereas A allele (polymorphic) of rs53576 (OXTR) polymorphism was correlated with increased arousal levels. The simultaneous presence of both T allele of rs2234693 (PvuII) and A allele of rs53576 (OXTR) polymorphisms (T + A group) was correlated with increased arousal, orgasm levels as well as female sexual function index full score. To our knowledge, this is the first study to investigate the interaction between ERA and OXTR with regard to sexual function in women. Female sexuality is a complex behavioral trait that encompasses both biological and psychological components. It seems that variability in female sexual response stems from genetic variability that characterizes endocrine, neurotransmitter and central nervous system influences. PMID:28069897

Residual neurological function after sacral root resection during en-bloc sacrectomy: a systematic review.

PubMed

Zoccali, Carmine; Skoch, Jesse; Patel, Apar S; Walter, Christina M; Maykowski, Philip; Baaj, Ali A

2016-12-01

Sacrectomy is a highly demanding surgery representing the main treatment for primary tumors arising in the sacrum and pelvis. Unfortunately, it is correlated with loss of important function depending on the resection level and nerve roots sacrificed. The current literature regarding residual function after sacral resection comes from several small case series. The goal of this review is to appraise residual motor function and gait, sensitivity, bladder, bowel, and sexual function after sacrectomies, with consideration to the specific roots sacrificed. An exhaustive literature search was conducted. All manuscripts published before May 2015 regarding residual function after sacrectomy were considered; if a clear correlation between root level and functioning was not present, the paper was excluded. The review identified 15 retrospective case series, totaling 244 patients; 42 patients underwent sacrectomies sparing L4/L4, L4/L5 and L5/L5; 45 sparing both L5 and one or both S1 roots; 8 sparing both S1 and one S2; 48 sparing both S2; 11 sparing both S2 and one S3, 54 sparing both S3, 9 sparing both S3 and one or both S4, and 27 underwent unilateral variable resection. Patients who underwent a sacrectomy maintained functionally normal ambulation in 56.2 % of cases when both S2 roots were spared, 94.1 % when both S3 were spared, and in 100 % of more distal resections. Normal bladder and bowel function were not present when both S2 were cut. When one S2 root was spared, normal bladder function was present in 25 % of cases; when both S2 were spared, 39.9 %; when one S3 was spared, 72.7 %; and when both S3 were spared, 83.3 %. Abnormal bowel function was present in 12.5 % of cases when both S1 and one S2 were spared; in 50.0 % of cases when both S2 were spared; and in 70 % of cases when one S3 was spared; if both S3 were spared, bowel function was normal in 94 % of cases. When even one S4 root was spared, normal bladder and bowel function were present in 100 % of cases. Unilateral sacral nerve root resection preserved normal bladder function in 75 % of cases and normal bowel function in 82.6 % of cases. Motor function depended on S1 root involvement. Total sacrectomy is associated with compromising important motor, bladder, bowel, sensitivity, and sexual function. Residual motor function is dependent on sparing L5 and S1 nerve roots. Bladder and bowel function is consistently compromised in higher sacrectomies; nevertheless, the probability of maintaining sufficient function increases progressively with the roots spared, especially when S3 nerve roots are spared. Unilateral resection is usually associated with more normal function. To the best of our knowledge, this is the first comprehensive literature review to analyze published reports of residual sacral nerve root function after sacrectomy.

Female Sexual Dysfunction in the Late Postpartum Period Among Women with Previous Gestational Diabetes Mellitus.

PubMed

Sargin, Mehmet Akif; Yassa, Murat; Taymur, Bilge Dogan; Taymur, Bulent; Akca, Gizem; Tug, Niyazi

2017-04-01

To compare the status of female sexual dysfunction (FSD) between women with a history of previous gestational diabetes mellitus (GDM) and those with follow-up of a healthy pregnancy, using the female sexual function index (FSFI) questionnaire. Cross-sectional study. Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey, from September to December 2015. Healthy sexually active adult parous females were included. Participants were asked to complete the validated Turkish versions of the FSFI and Hospital Anxiety and Depression Scale (HADS) questionnaires. Student's t-test was used for two-group comparisons of normally distributed variables and quantitative data. Mann-Whitney U-test was used for two-group comparisons of non-normally distributed variables. Pearson's chi-squared test, the Fisher-FreemanHalton test, Fisher's exact test, and Yates' continuity correction test were used for comparison of qualitative data. The mean FSFI scores of the 179 participants was 23.50 ±3.94. FSFI scores and scores of desire, arousal, lubrication, orgasm, satisfaction, and pain were not statistically significantly different (p>0.05), according to a history of GDM and types of FSD (none, mild, severe). HADS scores and anxiety and depression types did not statistically significantly differ according to the history of GDM (p>0.05). An association could not be found in FSFI scores between participants with both the history of previous GDM and with healthy pregnancy; subclinical sexual dysfunction may be observed in the late postpartum period among women with a history of previous GDM. This may adversely affect their sexual health.

Neurological bypass for sensory innervation of the penis in patients with spina bifida.

PubMed

Overgoor, Max L E; Kon, Moshe; Cohen-Kettenis, Peggy T; Strijbos, Saskia A M; de Boer, Niels; de Jong, Tom P V M

2006-09-01

Most male patients with spina bifida have normal sexual desires. During puberty they begin to realize that they can achieve erection and sexual intercourse but without any sensation in the penis. We hypothesized that restored sensation in the penis would greatly contribute to their quality of life and sexual health. In this prospective study we investigated the outcome of a new operative neurological bypass procedure in patients with spina bifida. In 3 patients who were 17, 18 and 21 years old with a spinal lesion at L5, L4 and L3-L4, respectively, the sensory ilioinguinal nerve (L1) was cut distal in the groin and joined by microneurorrhaphy to the divided ipsilateral dorsal nerve of the penis (S2-4) at the base of the penis. All patients underwent preoperative and postoperative neurological and psychological evaluations. By 15 months postoperatively all patients had achieved excellent sensation on the operated side of the glans penis. They were unequivocally positive about the results and the penis had become more integrated into the body image. In 2 patients masturbation became more meaningful and 1 became more sexually active with and without his partner. The newly designed neurological bypass procedure in patients with spina bifida resulted in excellent sensibility in the glans penis. The new sensation appeared to contribute to the quality of the patient sexuality and sexual functioning as well as to the feeling of being a more normal and complete individual who is more conscious of the penis. This new operation might become standard treatment in patients with spina bifida in the future.

Physiological changes in female genital sensation during sexual stimulation.

PubMed

Gruenwald, Ilan; Lowenstein, Lior; Gartman, Irena; Vardi, Yoram

2007-03-01

A normal sexual response in the female depends on the integrity of afferent sensory input from the genital region. So far genital sensation has been investigated only during a non-excitatory state, and the sensory physiological changes, which occur during the sexual cycle in this region, are still obscured. To investigate the sensory status of the female genital region during sexual arousal and orgasm. Genital sensory thresholds measured by Quantitative Sensory Testing (vibratory and thermal) were compared in a non-excitatory vs. excitatory state in normal sexually functioning females. Eleven healthy female volunteers were recruited and attended three separate visits. During each session only one anatomical site, either clitoris or vagina was tested for either vibratory or thermal stimuli. A psychophysical method of limits was employed for threshold determination of warm or vibratory stimuli. In each session, all women were tested at baseline, immediately after arousal, after orgasm and three more measurements - 5, 10, and 20 minutes during the recovery state. A significant decrease in clitoral vibratory sensation threshold was observed between the baseline and the arousal phases (P = 0.003). Comparison of vibratory sensation between baseline and following orgasm at the clitoral and vaginal region showed a significant difference (P < 0.001) for both regions. These changes were not significant for thermal threshold sensation at the clitoral region (P = 0.6). This is the first time that genital sensation has been measured during the excitatory phase of the female sexual cycle. This normative data may serve as a baseline for further investigations of the sensory input of the genital organs during intercourse in pathological states.

The development of a sensory substitution system for the sexual rehabilitation of men with chronic spinal cord injury.

PubMed

Borisoff, Jaimie F; Elliott, Stacy L; Hocaloski, Shea; Birch, Gary E

2010-11-01

Sexual health is often severely impacted after spinal cord injury (SCI). Current research has primarily addressed male erection and fertility, when in fact pleasure and orgasm are top priorities for functional recovery. Sensory substitution technology operates by communicating input from a lost sensory pathway to another intact sensory modality. It was hypothesized that through training and neuroplasticity, mapped tongue sensations would be interpreted as sensory perceptions arising from insensate genitalia, and improve the sexual experience. To report the development of a sensory substitution system for the sexual rehabilitation of men with chronic SCI. Subjects performed sexual self-stimulation while using a novel sensory substitution device that mapped the stroking motion of the hand to a congruous flow of electrocutaneous sensations on the tongue. Three questionnaires, along with structured interviews, were used to rate the perceived sexual sensations following each training session. Subjects completed 20 sessions over approximately 8 weeks of training. Each subject reported an increased level of sexual pleasure soon after training with the device. Each subject also reported specific perceptions of cutaneous-like sensations below their lesion that matched their hand motion. Later sessions, while remaining pleasurable and interesting, were inconsistent, and no subject reported an orgasmic feeling during a session. The subjects were all interested in continuing training with the device at home, if possible, in the future. This study is the first to show that sensory substitution is a possible therapeutic avenue for sexual rehabilitation in people lacking normal genital sexual sensations. However more research, for instance on frequency and duration of training, is needed in order to induce functional lasting neuroplasticity. In the near term, SCI rehabilitation should more fully address sexuality and the role of neuroplasticity for promoting the maximal potential for sexual pleasure and orgasm. © 2010 International Society for Sexual Medicine.

Constitutive luteinizing hormone receptor signaling causes sexual dysfunction and Leydig cell adenomas in male mice.

PubMed

Hai, Lan; Hiremath, Deepak S; Paquet, Marilène; Narayan, Prema

2017-05-01

The luteinizing hormone receptor (LHCGR) is necessary for fertility, and genetic mutations cause defects in reproductive development and function. Activating mutations in LHCGR cause familial male-limited precocious puberty (FMPP). We have previously characterized a mouse model (KiLHRD582G) for FMPP that exhibits the same phenotype of precocious puberty, Leydig cell hyperplasia, and elevated testosterone as boys with the disorder. We observed that KiLHRD582G male mice became infertile by 6 months of age, although sperm count and motility were normal. In this study, we sought to determine the reason for the progressive infertility and the long-term consequences of constant LHCGR signaling. Mating with superovulated females showed that infertile KiLHRD582G mice had functional sperm and normal accessory gland function. Sexual behavior studies revealed that KiLHRD582G mice mounted females, but intromission was brief and ejaculation was not achieved. Histological analysis of the reproductive tract showed unique metaplastic changes resulting in pseudostratified columnar epithelial cells with cilia in the ampulla and chondrocytes in the penile body of the KiLHRD582G mice. The infertile KiLHRD582G exhibited enlarged sinusoids and a decrease in smooth muscle content in the corpora cavernosa of the penile body. However, collagen content was unchanged. Leydig cell adenomas and degenerating seminiferous tubules were seen in 1-year-old KiLHRD582G mice. We conclude that progressive infertility in KiLHRD582G mice is due to sexual dysfunction likely due to functional defects in the penis. © The Authors 2017. Published by Oxford University Press on behalf of Society for the Study of Reproduction. All rights reserved. For permissions, please journals.permissions@oup.com.

A randomized trial of a minimal intervention for sexual concerns after cancer: a comparison of self-help and professionally delivered modalities.

PubMed

Perz, Janette; Ussher, Jane M

2015-09-09

Information and discussion of sexual changes with a health professional is a high priority for many cancer patients in order to assist with sexual changes and ensure that sexual intimacy does not cease post-cancer. The PLISSIT model is widely recommended as a framework for providing sexual information and support, allowing for the discussion of sexual changes at various levels of increasing intensity. The aim of the present study is to evaluate the early stages of the PLISSIT model by examining the relative efficacy of written information provision about cancer related sexual changes, and information provision accompanied by a single session of counselling, for people with cancer and their partners, across a range of cancer types. Eighty-eight people with cancer and 53 partners across a range of sexual and non-sexual cancers, took part in a randomised trial which adopted mixed method analysis to examine changes in psychological wellbeing, quality of life, relationship satisfaction and communication, and sexual functioning, following written information provision about cancer related sexual changes (self-help condition; SH), or written information accompanied by a single session of counselling (health professional condition; HP). Ratings of the usefulness and efficacy of the SH and HP interventions, collected through analysis of Likert scales, open ended survey items and interviews, indicated that both conditions were found to be useful and efficacious by the majority of participants, serving to increase awareness of sexuality, improve couple communication about sex, and help in the management of sexual changes, through the exploration of non-coital sexual practices. In contrast, the quantitative analysis of standardized instruments found no significant improvements in psychological wellbeing, quality of life, relationship satisfaction and communication, or sexual functioning. There were significant reductions in self-silencing in the HP condition, and a trend towards increases in sexual satisfaction across both conditions. These results offer support for the early stages of the PLISSIT model, in terms of normalization and increased awareness of sexual changes after cancer, increased couple communication about sexual changes, and legitimation of exploration of a range of non-coital sexual practices and intimacy. However, more complex and intensive interventions are needed to address sexual functioning and psychological wellbeing. The findings provide support for the proposition that providing permission to discuss sexuality should be the core feature underpinning all stages of interventions designed to provide sexuality information and support for people with cancer and their partners, and also demonstrate the potential importance of limited information and specific suggestions. This study was registered in the Australian New Zealand Clinical Trials Registry. ( ACTRN12615000399594 ) on 29 April 2015.

Sexuality and Young Children.

ERIC Educational Resources Information Center

Honig, Alice Sterling

2000-01-01

Describes normal aspects of sexuality during the early years, including masturbation and children's fanciful sexual ideas. Presents inappropriately mature sexual knowledge as a danger sign of abuse. Discusses whether and what teachers/caregivers should tell children about sexuality, and notes the importance of teaching staff about sexual identity…

Antecedents of cell aging research.

PubMed

Hayflick, L

1989-01-01

Our observation that normal human and animal cells have a limited capacity to divide and function in vitro overturned a dogma held since the turn of the century. The dogma held that cultured normal cells are immortal and gerontologists interpreted this to mean that aging, therefore, could not be the result of intracellular events. We concluded that longevity and aging do result from intracellular events, and, in the subsequent 30 years, the validity of our finding has been widely confirmed. Other major findings have been made: (a) The number of population doublings and functional events that a cultured normal cell can undergo is inversely proportional to donor age and, probably, directly proportional to species longevity; (b) the limit on cell division and function also occurs in vivo when normal cells are transplanted seriatim; (c) as cell doublings or functional events reach their limit, changes occur in hundreds of variables from the molecular to the whole cell. Most importantly, many of these changes are identical to those seen in intact humans and animals as they age; (d) WI-38, the first widely distributed normal human cell strain has retained its memory of population doubling level during 27 years of cryogenic storage. This is the longest time that any normal human cell has ever been preserved. Evidence that longevity is determined by genetic events is overwhelming but evidence that age changes are the result of gene expression is not. Normal age changes must be distinguished from disease. Because few feral animals ever become old, natural selection could not have favored the development of a genetically programmed aging process. In the 2 or 3 million years of human existence, too few old humans existed to have provided a selective advantage favoring the development of a genetic program that would determine age changes. The selective advantage of maintaining physiological vigor for as long as possible in order to insure maximum reproductive success may be the essential indirect determinant of longevity. Natural selection has provided sexually mature animals with extraordinary reserve capacities in virtually all organs. After sexual maturation, animals continue to function by utilizing the reserve capacity that evolved to insure that they would attain reproductive success. The magnitude of reserve capacity is the essential element in determining postdevelopmental longevity. Thus "Why do we age?" may be the wrong question. The right question may be "Why do we live as long as we do?"

Sexual Dimorphism and Aging in the Human Hyppocampus: Identification, Validation, and Impact of Differentially Expressed Genes by Factorial Microarray and Network Analysis.

PubMed

Guebel, Daniel V; Torres, Néstor V

2016-01-01

Motivation: In the brain of elderly-healthy individuals, the effects of sexual dimorphism and those due to normal aging appear overlapped. Discrimination of these two dimensions would powerfully contribute to a better understanding of the etiology of some neurodegenerative diseases, such as "sporadic" Alzheimer. Methods: Following a system biology approach, top-down and bottom-up strategies were combined. First, public transcriptome data corresponding to the transition from adulthood to the aging stage in normal, human hippocampus were analyzed through an optimized microarray post-processing (Q-GDEMAR method) together with a proper experimental design (full factorial analysis). Second, the identified genes were placed in context by building compatible networks. The subsequent ontology analyses carried out on these networks clarify the main functionalities involved. Results: Noticeably we could identify large sets of genes according to three groups: those that exclusively depend on the sex, those that exclusively depend on the age, and those that depend on the particular combinations of sex and age (interaction). The genes identified were validated against three independent sources (a proteomic study of aging, a senescence database, and a mitochondrial genetic database). We arrived to several new inferences about the biological functions compromised during aging in two ways: by taking into account the sex-independent effects of aging, and considering the interaction between age and sex where pertinent. In particular, we discuss the impact of our findings on the functions of mitochondria, autophagy, mitophagia, and microRNAs. Conclusions: The evidence obtained herein supports the occurrence of significant neurobiological differences in the hippocampus, not only between adult and elderly individuals, but between old-healthy women and old-healthy men. Hence, to obtain realistic results in further analysis of the transition from the normal aging to incipient Alzheimer, the features derived from the sexual dimorphism in hippocampus should be explicitly considered.

Sexual Dimorphism and Aging in the Human Hyppocampus: Identification, Validation, and Impact of Differentially Expressed Genes by Factorial Microarray and Network Analysis

PubMed Central

Guebel, Daniel V.; Torres, Néstor V.

2016-01-01

Motivation: In the brain of elderly-healthy individuals, the effects of sexual dimorphism and those due to normal aging appear overlapped. Discrimination of these two dimensions would powerfully contribute to a better understanding of the etiology of some neurodegenerative diseases, such as “sporadic” Alzheimer. Methods: Following a system biology approach, top-down and bottom-up strategies were combined. First, public transcriptome data corresponding to the transition from adulthood to the aging stage in normal, human hippocampus were analyzed through an optimized microarray post-processing (Q-GDEMAR method) together with a proper experimental design (full factorial analysis). Second, the identified genes were placed in context by building compatible networks. The subsequent ontology analyses carried out on these networks clarify the main functionalities involved. Results: Noticeably we could identify large sets of genes according to three groups: those that exclusively depend on the sex, those that exclusively depend on the age, and those that depend on the particular combinations of sex and age (interaction). The genes identified were validated against three independent sources (a proteomic study of aging, a senescence database, and a mitochondrial genetic database). We arrived to several new inferences about the biological functions compromised during aging in two ways: by taking into account the sex-independent effects of aging, and considering the interaction between age and sex where pertinent. In particular, we discuss the impact of our findings on the functions of mitochondria, autophagy, mitophagia, and microRNAs. Conclusions: The evidence obtained herein supports the occurrence of significant neurobiological differences in the hippocampus, not only between adult and elderly individuals, but between old-healthy women and old-healthy men. Hence, to obtain realistic results in further analysis of the transition from the normal aging to incipient Alzheimer, the features derived from the sexual dimorphism in hippocampus should be explicitly considered. PMID:27761111

Neuropsychological performance of sexual assaulters and pedophiles.

PubMed

Scott, M L; Cole, J K; McKay, S E; Golden, C J; Liggett, K R

1984-10-01

Persons who had been arrested for sexual assault were administered the Luria-Nebraska Neuropsychological Battery and the results compared to a group of normal controls. The sexual assaulters performed significantly worse on 7 of the 14 scales of the battery. The data were then broken down into three groups: (1) those who had forcibly assaulted postpubescent victims, (2) those subjects who had sexually molested a prepubescent child, and (3) normal controls. A discriminant analysis correctly classified 68% of the subjects on the basis of their neuropsychological performance alone.

Voiding and sexual dysfunctions after pelvic fracture urethral injuries treated with either initial cystostomy and delayed urethroplasty or immediate primary urethral realignment.

PubMed

Aşci, R; Sarikaya, S; Büyükalpelli, R; Saylik, A; Yilmaz, A F; Yildiz, S

1999-08-01

The aim of this study is to evaluate the effects of the different immediate treatment modalities on the sexual and voiding functions in pelvic fracture urethral injuries. The records of 38 male patients with traumatic posterior urethral injuries were reviewed, 18 of whom were treated by initial suprapubic cystostomy and delayed repair (Group 1), and 20 by primary urethral realignment (Group 2). Types of pelvic fractures and urethral injuries were classified according to surgical and radiological findings. Long-term voiding functions were determined by the patient questionnaire, residual urine and uroflow. Sexual functions were also determined by the patient questionnaire and a penile duplex ultrasound study. Mean follow-ups of Groups 1 and 2 were 37 and 39 months, respectively. Membranous urethral disruption extending to the urogenital diaphragm was the most frequent urethral injury (type 3), with incidences of 66.7% and 77.7%, respectively. There were no statistically significant differences in mean age, incidence of pelvic fracture types and urethral injury types between groups (p > 0.05). After the immediate treatments, 16.7% and 55% of the patients regained normal urination, and stricture developed in 83.3% and 45% of the patients, respectively. In 44.4% of the patients in Group 1 and 10% in Group 2, urethral strictures required open urethroplasty (p < 0.05). Erectile impotence before urethroplasty in 17.6% and 20%, anejaculation after urethroplasty in 17.6% and 15% and incontinence in 5.6% and 10% of the patients were found in Groups 1 and 2, respectively (p > 0.05). However, 88.8% and 90% of patients eventually achieved normal urination with complete continence. Sexual and voiding dysfunction after pelvic fracture posterior urethral injury seem to be the result of the injury itself, not of the immediate treatment modalities. In urethral disruption injuries, primary urethral realignment seems more favourable than suprapubic cystostomy and delayed repair.

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.

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

Regional gray matter growth, sexual dimorphism, and cerebral asymmetry in the neonatal brain.

PubMed

Gilmore, John H; Lin, Weili; Prastawa, Marcel W; Looney, Christopher B; Vetsa, Y Sampath K; Knickmeyer, Rebecca C; Evans, Dianne D; Smith, J Keith; Hamer, Robert M; Lieberman, Jeffrey A; Gerig, Guido

2007-02-07

Although there has been recent interest in the study of childhood and adolescent brain development, very little is known about normal brain development in the first few months of life. In older children, there are regional differences in cortical gray matter development, whereas cortical gray and white matter growth after birth has not been studied to a great extent. The adult human brain is also characterized by cerebral asymmetries and sexual dimorphisms, although very little is known about how these asymmetries and dimorphisms develop. We used magnetic resonance imaging and an automatic segmentation methodology to study brain structure in 74 neonates in the first few weeks after birth. We found robust cortical gray matter growth compared with white matter growth, with occipital regions growing much faster than prefrontal regions. Sexual dimorphism is present at birth, with males having larger total brain cortical gray and white matter volumes than females. In contrast to adults and older children, the left hemisphere is larger than the right hemisphere, and the normal pattern of fronto-occipital asymmetry described in older children and adults is not present. Regional differences in cortical gray matter growth are likely related to differential maturation of sensory and motor systems compared with prefrontal executive function after birth. These findings also indicate that whereas some adult patterns of sexual dimorphism and cerebral asymmetries are present at birth, others develop after birth.

Neutral and selection-driven decay of sexual traits in asexual stick insects

PubMed Central

Schwander, Tanja; Crespi, Bernard J.; Gries, Regine; Gries, Gerhard

2013-01-01

Environmental shifts and lifestyle changes may result in formerly adaptive traits becoming non-functional or maladaptive. The subsequent decay of such traits highlights the importance of natural selection for adaptations, yet its causes have rarely been investigated. To study the fate of formerly adaptive traits after lifestyle changes, we evaluated sexual traits in five independently derived asexual lineages, including traits that are specific to males and therefore not exposed to selection. At least four of the asexual lineages retained the capacity to produce males that display normal courtship behaviours and are able to fertilize eggs of females from related sexual species. The maintenance of male traits may stem from pleiotropy, or from these traits only regressing via drift, which may require millions of years to generate phenotypic effects. By contrast, we found parallel decay of sexual traits in females. Asexual females produced altered airborne and contact signals, had modified sperm storage organs, and lost the ability to fertilize their eggs, impeding reversals to sexual reproduction. Female sexual traits were decayed even in recently derived asexuals, suggesting that trait changes following the evolution of asexuality, when they occur, proceed rapidly and are driven by selective processes rather than drift. PMID:23782880

A randomized trial of internet-based versus traditional sexual counseling for couples after localized prostate cancer treatment.

PubMed

Schover, Leslie R; Canada, Andrea L; Yuan, Ying; Sui, Dawen; Neese, Leah; Jenkins, Rosell; Rhodes, Michelle M

2012-01-15

After treatment for prostate cancer, multidisciplinary sexual rehabilitation involving couples appears more promising than traditional urologic treatment for erectile dysfunction (ED). The authors of this report conducted a randomized trial comparing traditional or internet-based sexual counseling with waitlist (WL) control. Couples were randomized adaptively to a 3-month WL, a 3-session face-to-face format (FF), or an internet-based format (WEB1). A second internet-based group (WEB2) was added to examine the relation between web site use and outcomes. At baseline, post-WL, post-treatment, and 6-month, and 12-month follow-up assessments, participants completed the International Index of Erectile Function (IIEF), the Female Sexual Function Index (FSFI), the Brief Symptom Inventory-18 to measure emotional distress, and the abbreviated Dyadic Adjustment Scale. Outcomes did not change during the WL period. Of 115 couples that were randomized to FF or WEB1 and 71 couples in the WEB2 group, 34% dropped out. Neither drop-outs nor improvements in outcomes differed significantly between the 3 treatment groups. In a linear mixed-model analysis that included all participants, mean ± standard deviation IIEF scores improved significantly across time (baseline, 29.7 ± 17.9; 12 months, 36.2 ± 22.4; P < .001). FSFI scores also improved significantly (baseline, 15.4 ± 8.5; 12 months, 18.2 ± 10.7; P = .034). Better IIEF scores were associated with finding an effective medical treatment for ED and normal female sexual function at baseline. In the WEB2 group, IIEF scores improved significantly more in men who completed >75% of the intervention. An internet-based sexual counseling program for couples was as effective as a brief, traditional sex therapy format in producing enduring improvements in sexual outcomes after prostate cancer. Copyright © 2011 American Cancer Society.

Half a Man: The Symbolism and Science of Paraplegic Impotence in World War II America.

PubMed

Linker, Beth; Laemmli, Whitney

2015-01-01

At the conclusion of the Second World War, more than 600,000 men returned to the United States with long-term disabilities, profoundly destabilizing the definitions, representations, and experiences of male sexuality in America. By examining an oft-neglected 1950 film, The Men, along with medical, personal, and popular accounts of impotence in paralyzed World War II veterans, this essay excavates the contours of that change and its attendant anxieties. While previous scholarship on film and sexuality in the postwar period has focused on women's experiences, we broaden the analytical lens to provide a fuller picture of the various meanings of male sexuality, especially disabled heterosexuality. In postwar America, the paralyzed veteran created a temporary fissure in conventional discussions of the gendered body, a moment when the "normality" and performative features of the male body could not be assumed but rather had to be actively defined. To many veterans, and to the medical men who treated them, sexual reproduction--not function-became the ultimate signifier of remasculinization.

Clinical report--the evaluation of sexual behaviors in children.

PubMed

Kellogg, Nancy D

2009-09-01

Most children will engage in sexual behaviors at some time during childhood. These behaviors may be normal but can be confusing and concerning to parents or disruptive or intrusive to others. Knowledge of age-appropriate sexual behaviors that vary with situational and environmental factors can assist the clinician in differentiating normal sexual behaviors from sexual behavior problems. Most situations that involve sexual behaviors in young children do not require child protective services intervention; for behaviors that are age-appropriate and transient, the pediatrician may provide guidance in supervision and monitoring of the behavior. If the behavior is intrusive, hurtful, and/or age-inappropriate, a more comprehensive assessment is warranted. Some children with sexual behavior problems may reside or have resided in homes characterized by inconsistent parenting, violence, abuse, or neglect and may require more immediate intervention and referrals.

Screening for erectile dysfunction in men with lifelong premature ejaculation--Is the Sexual Health Inventory for Men (SHIM) reliable?

PubMed

McMahon, Chris G

2009-02-01

Some men with premature ejaculation (PE) and normal erectile function record contradictory response/s to The Sexual Health Inventory for Men (SHIM) and may be incorrectly categorized as suffering from erectile dysfunction (ED). The aim of this study was to evaluate the frequency of false positive SHIM diagnosis of ED in men with lifelong PE. SHIM, stopwatch intravaginal ejaculation latency time (IELT). A prospective observational study of men with normal erectile function and lifelong PE, diagnosed using the ISSM definition of lifelong PE, was conducted. The SHIM was self-administered at Visit 1. Mean per subject stopwatch IELT was determined from four subsequent intercourse attempts. Seventy-eight subjects with a mean age of 33.2 +/- 8.3 years and a geometric mean IELT of 15.9 +/- 2.3 seconds were enrolled. The mean SHIM score for all subjects was 20.4 +/- 6.0. Fifty-two subjects (66.7%) have SHIM scores of >21 (mean 24.3 +/- 1.1), consistent with normal erectile function, and a geometric mean IELT of 18.3 +/- 2.2 seconds. Twenty-six subjects (33.3%) had SHIM scores <22 (mean 12.7 +/- 3.7), consistent with a false positive diagnosis of ED, and a geometric mean IELT of 10.5 +/- 2.3 seconds. The incidence of false positive SHIM diagnosis of ED (SHIM < 22) was inversely related to the IELT. Although the geometric mean IELT for subjects with SHIM scores <22 was significantly less than that of all subjects and subjects with SHIM scores >21, there were no significant differences between the geometric mean IELT or the IELT distribution of all subjects vs. the normal erectile function IELT (SHIM > 21) cohort. This study demonstrates a 33.3% false positive SHIM diagnosis of ED in men with PE. This is likely to limit subject recruitment in clinical trials by exclusion of subjects with low-range IELTs but is unlikely to result in significantly different baseline IELTs or IELT distributions.

The struggle towards 'the New Normal': a qualitative insight into psychosexual adjustment to prostate cancer.

PubMed

Hanly, Narelle; Mireskandari, Shab; Juraskova, Ilona

2014-07-30

Despite the growing body of literature which highlights the potential for significant and enduring side-effects of prostate cancer treatment, there is limited research exploring the experience of living with the treatment-induced side-effects such as sexual dysfunction, and their repercussions for men and their partners. The aim of this qualitative study was to explore factors influencing psychosexual adjustment, self-perception, and unmet information and support needs of prostate cancer patients and their partners. Twenty-one men, recruited via a prostate cancer support group newsletter, participated in face-to-face semi-structured interviews, which were subjected to thematic analysis. The qualitative analysis revealed three inter-connected main themes which contributed to men's psychosexual adjustment: i) Psychosexual impact, ii) Communication and support, and iii) Integration process. Men reported distressing sexual and urinary difficulties, tainted self-perception and altered intimate relationships. Receiving adequate information and support, and having good communication with their doctors and partners facilitated better adjustment to prostate cancer treatment. Coming to terms with the significant impact of treatment had involved making lifestyle changes, coping with emotional struggles and striving to accept and integrate their post-treatment "new normal" self and sexual life. The importance of adequate communication with health professionals and partners, especially regarding treatment effects on sexual function and rehabilitation options, was highlighted as a key factor facilitating the adjustment process. Prostate cancer patients would benefit from improved access to timely and tailored information and decision-making resources, ongoing multidisciplinary care, and support groups, as well as appropriate referrals for sexual and psychological counselling.

Sexual activity of young men is not related to their anthropometric parameters.

PubMed

Rurik, Imre; Varga, Attila; Fekete, Ferenc; Ungvári, Timea; Sándor, János

2014-09-01

Many articles have been written about the deterioration of male sexual function, mainly in relation to metabolic diseases and aging. With younger men, unless they have a complaint, sexual issues are rarely discussed during medical consultations. No articles could be found about anthropometric parameters as factors potentially influencing sexual performance. The aim of this study was to find the anthropometric parameters with the closest correlation with sexual activity. Main outcome measures included self-reported weekly intercourses, age, body weight and height, body mass index (BMI), and waist circumference. Data for 531 heterosexual men aged 20-54 years were collected in three andrological centers. Past and recent morbidity, medications, and some lifestyle elements were recorded; anthropometric parameters were measured; and andrological examination was performed. The average weekly number of intercourses was asked confidentially. The mean weekly coital frequency (±SD) was 2.55 ± 1.08. The highest self-reported weekly coital frequency was recorded for men between the ages of 25 and 29 (3.02 ± 1.27). Coital frequency was higher among men with a height of less than 175 cm (2.69 ± 1.24), weight of less than 78 kg (2.74 ± 1.18), normal BMI (2.74 ± 1.16), normal waist circumference (2.69 ± 1.19), and no metabolic disease (2.57 ± 1.11). Logistic regression described an inverse, statistically significant association between age and coital frequency, with the following odds ratios for coital frequency (ORcf ): ORcf≥2  = 0.932, P < 0.001; ORcf≥2.5  = 0.935, P < 0.001; ORcf≥3  = 0.940, P < 0.001; ORcf≥3.5  = 0.965, P = 0.041. Among men who reported a coital frequency of more than 3.5 times a week, waist circumference (ORcf≥3.5  = 0.986, P = 0.066) showed borderline association with lower sexual activity, while lesser height (ORcf≥3.5  = 0.951, P = 0.005) was associated with higher activity. In this study's age range, none of the examined anthropometric parameters was perfectly correlated with sexual activity. Obesity and metabolic diseases can cause all types of sexual function to deteriorate in older age, whereas their effects may not yet be prominent at younger ages (below 45 years). Health promotion for all ages should focus on prevention of obesity so as to improve quality of life and sexual health. © 2014 International Society for Sexual Medicine.

Robotic radical prostatectomy in overweight and obese patients: oncological and validated-functional outcomes.

PubMed

Wiltz, Aimee L; Shikanov, Sergey; Eggener, Scott E; Katz, Mark H; Thong, Alan E; Steinberg, Gary D; Shalhav, Arieh L; Zagaja, Gregory P; Zorn, Kevin C

2009-02-01

To determine the impact of body mass index (BMI) on perioperative functional and oncological outcomes in patients undergoing robotic laparoscopic radical prostatectomy (RLRP) when stratified by BMI. Data were collected prospectively for 945 consecutive patients undergoing RLRP. Patients were evaluated with the UCLA-PCI-SF36v2 validated-quality-of-life questionnaire preoperatively and postoperatively to 24 months. Patients were stratified by BMI as normal weight (BMI < 25 kg/m(2)), overweight (BMI = 25 to < 30 kg/m(2)) and obese (BMI > or = 30 kg/m(2)) for outcomes analysis. Preoperatively, obese men had a significantly greater percentage of medical comorbidities (P < .01) as well as a baseline erectile dysfunction (lower mean baseline Sexual Health Inventory for Men score [P = .01] and UCLA-PCI-SF36v2 sexual function domain scores [P = .01]). Mean operative time was significantly longer in obese patients when compared with normal and overweight men (234 minutes vs 217 minutes vs 214 minutes; P = .0003). Although overall complication rates were comparable between groups, a greater incidence of case abortion caused by pneumoperitoneal pressure with excessive airway pressures was noted in obese men. Urinary continence and potency outcomes were significantly lower for obese men at both 12 and 24 months (all P < .05). In this series, obese men experienced a longer operative time, particularly during the initial robotic experience. As such, surgeons early in their RLRP learning curve should proceed cautiously with surgery in these technically more difficult patients or reserve such cases until the learning curve has been surmounted. These details, including inferior urinary and sexual outcomes, should be discussed with obese patients during preoperative counseling.

Do we have a moral responsibility to compensate for vulnerable groups? A discussion on the right to health for LGBT people.

PubMed

Ekmekci, Perihan Elif

2017-09-01

Vulnerability is a broad concept widely addressed in recent scholarly literature. Lesbian, gay, bisexual, and transgender (LGBT) people are among the vulnerable populations with significant disadvantages related to health and the social determinants of health. Medical ethics discourse tackles vulnerability from philosophical and political perspectives. LGBT people experience several disadvantages from both perspectives. This article aims to justify the right to health for LGBT people and their particular claims regarding healthcare because they belong to a vulnerable group. Rawls' theory of justice and Norman Daniels' normal functioning approach will be discussed in this context. Despite the fact that the right to health can be justified by Daniels' normal functioning approach, there is still a theoretical gap in justifying the right to health for particular vulnerable populations such as LGBT peopleand discussing society's duty to compensate for these disadvantages. In search of solid theoretical grounds for the justification of the right to health for LGBT people, the present author takes the opportunity to utilize Daniels' flexible definition of normal functioning to show that normal functioning not only varies by age but also by different states of human existence, including sexual orientation and gender identity, and to propose replacing the life span approach with normal states of human existence.

Attachment insecurities and women's sexual function and satisfaction: the mediating roles of sexual self-esteem, sexual anxiety, and sexual assertiveness.

PubMed

Brassard, Audrey; Dupuy, Emmanuelle; Bergeron, Sophie; Shaver, Phillip R

2015-01-01

We examined the potential role of three mediators--sexual self-esteem, sexual anxiety, and sexual assertiveness--of the association between romantic attachment insecurities (anxiety and avoidance) and two aspects of women's sexual functioning: sexual function and sexual satisfaction. A sample of 556 women aged 18 to 30 agreed to complete an online series of validated questionnaires assessing attachment insecurities and several aspects of sexual functioning. Lower sexual self-esteem and higher sexual anxiety mediated the associations between attachment anxiety and lower sexual function and satisfaction. Lower sexual self-esteem and higher sexual anxiety also partially mediated the links between attachment-related avoidance and the two sexual functioning variables. Sexual assertiveness, however, did not mediate these associations. A significant interaction between attachment anxiety and avoidance was also found to predict sexual satisfaction, with women high in avoidance and low in anxiety being the least satisfied. Results are discussed in terms of theoretical and clinical implications.

SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients.

PubMed

Montejo-González, A L; Llorca, G; Izquierdo, J A; Ledesma, A; Bousoño, M; Calcedo, A; Carrasco, J L; Ciudad, J; Daniel, E; De la Gandara, J; Derecho, J; Franco, M; Gomez, M J; Macias, J A; Martin, T; Perez, V; Sanchez, J M; Sanchez, S; Vicens, E

1997-01-01

The authors analyzed the incidence of sexual dysfunction (SD) with different selective serotonin reuptake inhibitors (SSRIs; fluoxetine, fluvoxamine, paroxetine, and sertraline) and hence the qualitative and quantitative changes in SD throughout time in a prospective and multicenter study. Outpatients (192 women and 152 men; age = 39.6 +/- 11.4 years) under treatment with SSRIs were interviewed with an SD questionnaire designed for this purpose by the authors and that included questions about the following: decreased libido, delayed orgasm or anorgasmia, delayed ejaculation, inability to ejaculate, impotence, and general sexual satisfaction. Patients with the following criteria were included: normal sexual function before SSRI intake, exclusive treatment with SSRIs or treatment associated with benzodiazepines, previous heterosexual or self-erotic current sexual practices. Excluded were patients with previous sexual dysfunction, association of SSRIs with neuroleptics, recent hormone intake, and significant medical illnesses. There was a significant increase in the incidence of SD when physicians asked the patients direct questions (58%) versus when SD was spontaneously reported (14%). There were some significant differences among different SSRIs: paroxetine provoked more delay of orgasm or ejaculation and more impotence than fluvoxamine, fluoxetine and sertraline (chi 2, p < .05). Only 24.5% of the patients had a good tolerance of their sexual dysfunction. Twelve male patients who suffered from premature ejaculation before the treatment preferred to maintain delayed ejaculation, and their sexual satisfaction, and that of their partners, clearly improved. Sexual dysfunction was positively correlated with dose. 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's. In only 5.8% of patients, the dysfunction disappeared completely within 6 months, but 81.4% showed no improvement at all by the end of this period. Twelve of 15 patients experienced total improvement when the treatment was changed to moclobemide (450-600 mg/day), and 3 of 5 patients improved when treatment was changed to amineptine (200 mg/day).

[Correlation between premature ejaculation diagnostic tool and International Index of Erectile Function-15 in different types of premature ejaculation].

PubMed

Li, Chao; Zhang, Xian-Sheng; Tang, Dong-Dong; Gao, Jing-Jing; Huang, Yuan-Yuan; Gao, Pan; Liu, Wei-Qun; Liang, Chao-Zhao

2016-09-01

To investigate the correlation between the premature ejaculation diagnostic tool (PEDT) and International Index of Erectile Function-15 (IIEF-15) in different types of premature ejaculation (PE). We performed a cross-section survey among 352 PE patients received in the andrology clinic from December 2014 to December 2015 and 104 healthy men from the health examination center using basic demographic information (as on age, height, weight, education status, occupation, income, etc.), PEDT results, and IIEF-15 scores of the subjects. The PE patients had remarkably higher PEDT and lower IIEF-15 scores than the healthy men (P<0.01). The PEDT score of the PE patients was negatively correlated with their total IIEF-15 score as well as with the scores in the domains of erectile function, sexual intercourse satisfaction, and overall satisfaction after adjusted for age (P<0.01). The patients with acquired PE (APE) showed a lower IIEF-15 score than those with lifelong PE (LPE) (P<0.01). The PEDT score of the APE patients was correlated negatively with the total IIEF-15 score (r=－0.391, P<0.01) and the scores in the domains of erectile function (r=－0.362, P<0.01) and overall satisfaction (r=－0.621, P<0.01), but not correlated with intercourse satisfaction, sexual orgasm, or sexual desire. The PEDT score of the LPE group was correlated negatively with intercourse satisfaction (r=－0.286, P<0.05) but not correlated with either the total IIEF-15 score or the scores in the domains of erectile function, overall satisfaction, sexual orgasm, or sexual desire. PE patients have a higher PEDT score and a lower IIEF-15 score than normal males. The PEDT score of APE patients is significantly correlated with the total IIEF-15 score, while that of LPE patients is correlated not with the total IIEF-15 score but with intercourse satisfaction.

Correlates of sexual-risk behaviors among young black MSM: implications for clinic-based counseling programs.

PubMed

Crosby, Richard A; Mena, Leandro; Ricks, JaNelle M

2017-06-01

This study applied an 8-item index of recent sexual-risk behaviors to young Black men who have sex with men (YBMSM) and evaluated the distribution for normality. The distribution was tested for associations with possible antecedents of sexual risk. YBMSM (N = 600), aged 16-29 years, were recruited from a sexually transmitted infection clinic, located in the southern US. Men completed an extensive audio computer-assisted self-interview. Thirteen possible antecedents of sexual risk, as assessed by the index, were selected for analyses. The 8-item index formed a normal distribution with a mean of 4.77 (SD = 1.77). In adjusted analyses, not having completed education beyond high school was associated with less risk, as was having sex with females. Conversely, meeting sex partners online was associated with greater risk, as was reporting that sex partners were drunk during sex. The obtained normal distribution of sexual-risk behaviors suggests a corresponding need to "target and tailor" clinic-based counseling and prevention services for YBMSM. Avoiding sex when partners are intoxicated may be an especially valuable goal of counseling sessions.

Sequelae in male rabbits following developmental exposure to p,p'-DDT or a mixture of p,p'-DDT and vinclozolin: cryptorchidism, germ cell atypia, and sexual dysfunction.

PubMed

Veeramachaneni, D N R; Palmer, J S; Amann, R P; Pau, K-Y F

2007-01-01

Rabbit does (7-9 per group) were treated daily per orum from gestation day 15 through post-natal week 4 to provide per kg body wt 25 micaromol (low) or 250 micromol (high) p,p'-DDT or a mixture of DDT and vinclozolin (12.5 and 125 micromol each). Developmental as well as post-pubertal reproductive sequelae of male progeny were studied. Testicular descent in some pups was impaired by DDT. Serum LH or testosterone was not affected. FSH was lower in mixture- but not in DDT-exposed rabbits. Lack of sexual interest, penile erection and ejaculation were observed in some mixture rabbits. Sperm counts were unaffected, but morphologically normal spermatozoa were fewer; nuclear and acrosomal morphogenesis was disrupted. Atypical germ cells resembling carcinoma in situ were found. Also considering data for vinclozolin [Veeramachaneni DNR, Palmer JS, Amann RP, Kane CM, Higuchi TT, Pau K-YF. Disruption of sexual function, FSH secretion, and spermiogenesis in rabbits following developmental exposure to vinclozolin, a fungicide. Reproduction 2006;131:805-16], we concluded that DDT causes cryptorchidism and germ cell atypia, vinclozolin permanently disrupts FSH secretion and sexual function, and the mixture causes the full spectrum of dysgenesis.

Multicenter Study of Sexual Functioning in Spouses/Partners of Persons With Traumatic Brain Injury.

PubMed

Sander, Angelle M; Maestas, Kacey Little; Pappadis, Monique R; Hammond, Flora M; Hanks, Robin A

2016-05-01

To investigate sexual functioning and its predictors in spouses/partners of persons with traumatic brain injury (TBI). Inception cohort survey. Community. Persons (N=70) with complicated mild to severe TBI admitted to 1 of 6 participating TBI Model Systems inpatient rehabilitation units and their spouses/partners who were both living in the community and assessed 1 year after injury. Not applicable. Derogatis Interview for Sexual Functioning Self-Report; Global Sexual Satisfaction Index. Twenty percent of spouses/partners of persons with TBI reported sexual dysfunction, and 44% reported dissatisfaction with sexual functioning. Sixty-two percent of spouses/partners reported a decrease in sexual activity during the year postinjury, 34% reported a decrease in sexual drive or desire, and 34% indicated that sexuality was less important in comparison to preinjury. The sexual functioning of spouses/partners of persons with TBI was highly associated with the sexual functioning of the person with TBI. Age of spouses/partners and sexual functioning in persons with the TBI were significant predictors of spouses'/partners' sexual functioning, even after controlling for sex of partners and the physical, cognitive, participation, and sexual functioning of the persons with injury. Greater sexual dysfunction in spouses/partners was associated with older age and with poorer sexual functioning in the person with injury. Rehabilitation professionals should provide education on the potential impact of TBI on sexual functioning for both persons with TBI and their spouses/partners, and integrate the assessment of sexual functioning into their clinical assessment, making appropriate referrals for therapy. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Challenging stereotypes: sexual functioning of single adults with high functioning autism spectrum disorder.

PubMed

Byers, E Sandra; Nichols, Shana; Voyer, Susan D

2013-11-01

This study examined the sexual functioning of single adults (61 men, 68 women) with high functioning autism and Asperger syndrome living in the community with and without prior relationship experience. Participants completed an on-line questionnaire assessing autism symptoms, psychological functioning, and various aspects of sexual functioning. In general participants reported positive sexual functioning. Participants without prior relationship experience were significantly younger and more likely to be male and identify as heterosexual. They reported significantly higher sexual anxiety, lower sexual arousability, lower dyadic desire, and fewer positive sexual cognitions. The men reported better sexual function than did the women in a number of areas. These results counter negative societal perceptions about the sexuality of high functioning individuals on the autism spectrum.

Sexual assault and rape perpetration by college men: the role of the big five personality traits.

PubMed

Voller, Emily K; Long, Patricia J

2010-03-01

A sample of 521 college men completed the Revised NEO Personality Inventory and an expanded version of the Sexual Experiences Survey to examine whether variation in the Big Five personality traits in a normal, college population provides any insight into the nature of sexual assault and rape perpetrators. Rape perpetrators reported lower levels of Agreeableness and Conscientiousness when compared to both sexual assault perpetrators and nonperpetrators, and lower levels of Extraversion when compared to nonperpetrators. Rape perpetrators also endorsed lower levels of tendermindedness, excitement-seeking, warmth, positive emotions, feelings, altruism, competence, and dutifulness, and higher levels of vulnerability. Contrary to expectation, overall personality profiles followed remarkably comparable patterns for sexual assault and nonperpetrators, suggesting that sexual assault perpetrators were more similar to nonperpetrators than to rape perpetrators. Findings suggest that individuals who perpetrate sexual offenses, particularly rape, differ from nonperpetrators on dimensions of normal personality. Clinical and research implications are discussed.

Sexual Functioning After Childhood Abuse: The Influence of Post-Traumatic Stress Disorder and Trauma Exposure.

PubMed

Bornefeld-Ettmann, Pia; Steil, Regina; Lieberz, Klara A; Bohus, Martin; Rausch, Sophie; Herzog, Julia; Priebe, Kathlen; Fydrich, Thomas; Müller-Engelmann, Meike

2018-04-01

Impairments in sexual functioning and sexual satisfaction are very common in women who have experienced childhood sexual abuse (CSA). A growing body of literature suggests a high prevalence of sexual distress in patients with post-traumatic stress disorder (PTSD). However, the influence of sexual trauma exposure per se and the influence of PTSD symptoms on impairments in sexual functioning remain unclear. The aim of this study was to investigate the influence of sexual trauma exposure and PTSD on sexual functioning and sexual satisfaction by comparing 3 groups of women. Women with PTSD after CSA (N = 32), women with a history of CSA and/or physical abuse but without PTSD (trauma controls [TC]; N = 32), and healthy women (N = 32) were compared with regards to self-reported sexual functioning and sexual satisfaction. Trauma exposure was assessed with the Childhood Trauma Questionnaire, and PTSD was assessed with the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Sexual functioning was assessed with the Sexual Experience and Behavior Questionnaire, and sexual satisfaction was assessed with the questionnaire Resources in Sexuality and Relationship. PTSD patients had significantly lower sexual functioning in some aspects of sexual experience (sexual aversion, sexual pain, and sexual satisfaction) but did not significantly differ in sexual arousal and orgasm from the other 2 groups. TC and healthy women did not significantly differ from each other on the measures of sexual functioning or sexual satisfaction. Results suggest that the development of PTSD has a greater impact on sexual functioning than does the experience of a traumatic event. This emphasizes the importance to address possible sexual distress and sexual satisfaction in women with PTSD by administering specific diagnostic instruments and by integrating specific interventions targeting sexual problems into a trauma-specific treatment. The study is the first comparing PTSD patients and TC with healthy women with regards to sexual functioning. Limitations are selection and size of the samples, the assessment of sexual functioning by self-report measures only, and lack of consideration of other potentially relevant factors influencing sexuality. The findings suggest that the experience of sexual abuse does not necessarily lead to sexual impairment, whereas comparably low levels of sexual functioning seem to be prominent in PTSD patients after CSA. Further research is needed on how to improve treatment for this patient group. Bornefeld-Ettmann P, Steil R, Lieberz KA, et al. Sexual Functioning After Childhood Abuse: The Influence of Post-Traumatic Stress Disorder and Trauma Exposure. J Sex Med 2018;15:529-538. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Experiences of Sexuality Six Years After Stroke: A Qualitative Study.

PubMed

Nilsson, Marie I; Fugl-Meyer, Kerstin; von Koch, Lena; Ytterberg, Charlotte

2017-06-01

Little is known about the long-term consequences of stroke on sexuality, and studies on how individuals with stroke communicate with health care professionals about information and/or interventions on sexuality are even sparser. To explore experiences of sexuality 6 years after stroke, including communication with health care professionals concerning sexuality. This qualitative study was based on data collected by semistructured interviews with 12 informants 43 to 81 years old 6 years after stroke. Interviews were recorded and transcribed verbatim and thematic analysis was performed. The analysis resulted in the following three themes. Not exclusively negative experiences in sexuality after stroke: Most informants experienced some change in their sexual life from before their stroke. Decreased sexual interest and function were ascribed to decreased sensibility, post-stroke pain, or fatigue. Some informants reported positive changes in sexuality, which were attributed to feelings of increased intimacy. Individual differences and variability on how to handle sexuality after stroke: Different strategies were used to manage unwanted negative changes such as actively trying to adapt by planning time with the partner and decreasing pressure or stress. Open communication about sexuality with one's partner also was described as important. Strikingly, most informants with negative experiences of sexual life attributed these to age or a stage in life and not to the stroke or health issues. Furthermore, they compared themselves with others without stroke but with changes in sexuality, thus achieving a sense of normality. Communication and counseling concerning sexuality-many unmet needs: Experiences of communication with health care professionals varied. Very few informants had received any information or discussed sexuality with health care professionals during the 6 years since the stroke, although such needs were identified by most informants. When encountering individuals with previous stroke, there is a need for vigilance concerning individual experiences of stroke on sexuality to avoid under- or overestimating the impact and to raise the subject, which currently might be seldom. Individuals with long-term diverse consequences of stroke and with different sociodemographic backgrounds were interviewed. Because most individuals in the present study had retained functioning, this could decrease transferability to populations with more severe sequelae after stroke. The individuals in the present study had different experiences of sexuality after stroke. The results point to the importance of acknowledging sexual rehabilitation as part of holistic person-centered stroke rehabilitation. Nilsson MI, Fugl-Meyer K, von Koch L, Ytterberg C. Experiences of Sexuality Six Years After Stroke: A Qualitative Study. J Sex Med 2017;14:797-803. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Physiological stress responses predict sexual functioning and satisfaction differently in women who have and have not been sexually abused in childhood

PubMed Central

Meston, Cindy M.; Lorenz, Tierney A.

2012-01-01

Physiological responses to sexual stimuli may contribute to the increased rate of sexual problems seen in women with childhood sexual abuse (CSA) histories. We compared two physiological stress responses as predictors of sexual function and satisfaction, sympathetic nervous system (SNS) activation and cortisol in women with (CSA, N = 136) and without CSA histories (NSA, N = 102). In CSA survivors, cortisol response to sexual stimuli did not significantly predict sexual functioning; however, in NSA women, cortisol increases were associated with poorer sexual functioning, and decreases with higher functioning. For women with CSA histories, lower SNS activity was associated with poorer sexual functioning. For CSA survivors with low lifetime trauma, lower SNS activity was associated with higher sexual satisfaction; for women with high lifetime trauma, the reverse was true. Decreased SNS activity during sexual stimuli predicted higher sexual functioning in NSA women with low lifetime exposure to traumatic events, but lower sexual functioning in those with high exposure. Differences between women with and without CSA histories in the association between cortisol and SNS response and sexual functioning and satisfaction suggests that CSA causes disruptions in both short and long-term stress responses to sexual stimuli that perpetuate into adulthood. PMID:24748915

The relationships between sex hormones and sexual function in middle-aged and older European men.

PubMed

O'Connor, Daryl B; Lee, David M; Corona, Giovanni; Forti, Gianni; Tajar, Abdelouahid; O'Neill, Terence W; Pendleton, Neil; Bartfai, Gyorgy; Boonen, Steven; Casanueva, Felipe F; Finn, Joseph D; Giwercman, Aleksander; Han, Thang S; Huhtaniemi, Ilpo T; Kula, Krzysztof; Labrie, Fernand; Lean, Michael E J; Punab, Margus; Silman, Alan J; Vanderschueren, Dirk; Wu, Frederick C W

2011-10-01

Limited data are available exploring the associations between sex hormones, multiple domains of sexual functioning, and sexual function-related distress in nonpatient samples in Europe. The aim of the study was to investigate the relationships between serum testosterone (T), estradiol (E2), and dihydrotestosterone (DHT) and sexual function in a multicenter population-based study of aging in men. Using stratified random sampling, 2838 men aged 40-79 yr completed the European Male Ageing Study-Sexual Function Questionnaire and provided a blood sample for hormone measurements. T, E2, and DHT were measured using gas chromatography-mass spectrometry. We conducted a community-based population survey in eight European centers. Self-reported sexual function (overall sexual function, sexual function-related distress, erectile dysfunction, masturbation) was measured. Total and free T, but not E2 or DHT, was associated with overall sexual function in middle-aged and older men. E2 was the only hormone associated with sexual function-related distress such that higher levels were related to greater distress. Free T levels were associated with masturbation frequency and erectile dysfunction in the fully adjusted models, such that higher T was associated with less dysfunction and greater frequency. Moreover, there was a T threshold for the relationship between total T, sexual function, and erectile dysfunction. At T concentrations of 8 nmol/liter or less, T was associated with worse sexual functioning, whereas at T levels over 8 nmol/liter, the relationship came to a plateau. These findings suggest that different hormonal mechanisms may regulate sexual functioning (T) vs. the psychological aspects (E2) of male sexual behavior. Moreover, there was a T threshold for overall sexual function such that at levels greater than 8 nmol/liter the relationship between T and sexual function did not become stronger.

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

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.

[Andrological status of adolescents and its connection to anthropometric and hormonal descriptions in the students of technical college group].

PubMed

Lutov, Iu V; Seliatitskaia, V G; Epanchintseva, E A; Riabichenko, T I

2014-01-01

The purpose of this investigation was to study the interrelation of andrological status with anthropometric and hormonal descriptions for age-specific features discovery of male sexual system pathological states at technical college students. 147 adolescents aged 15-17 years old were examined. Only 41 of them were found to have no abnormalities in their genital system development; in 35 adolescents sexual development was delayed; and 97 adolescents were found to have various andrological diseases (varicocele, phimosis, gynecomastia, testicular asymmetry, etc.) or clinical signs for development of these diseases. In 26 adolescences delayed sexual development was combined with the andrological pathology. The normal andrological status was usually accompanied with the highest frequency of low values of anthropometric indicators and indices that reflect the influence of various hormonal systems on the bodily constitution, as well as expressed anthropometricheterogeneity. In adolescents with andrological pathology or clinical signs for its development, in all anthropometric parameters the higher values were seen more frequently than low values against the background of highest group anthropometric homogeneity. Summative anthropometric characteristics of the adolescents group with delayed sexual development were between those of the adolescents groups with normal andrological status and andrological pathology The number of correlational relationships of anthropometric and hormonal indicators with the levels of cortisol and dehydroepiandrosteronesulphate was the lowest in the group of adolescents with normal andrological status as compared to their peers with delayed sexual development and andrological pathology. Only in the group of adolescents with normal andrological status the correlation analysis of data showed physiological influence of sexual hormones on anthropometric indicators. Thus, lower influence of sexual system hormones during this ontogenesis stage contributes to slowing down the process of sexual maturation both with the development of andrological pathology in adolescents.

Sexual Abuse and Sexual Functioning in a Chronic Pelvic Pain Sample

ERIC Educational Resources Information Center

Randolph, Mary E.; Reddy, Diane M.

2006-01-01

Sexual abuse, particularly childhood sexual abuse, has been linked to chronic pelvic pain and to sexual dysfunction, though the sexual functioning of survivors of sexual abuse has not been studied in a chronic pain population. Sixty-three women with chronic pelvic pain completed measures of sexual function, sexual abuse, and pain. Using an index…

Sexual Patterns at Different Ages

ERIC Educational Resources Information Center

Kaplan, Helen S.; Sager, Clifford J.

1971-01-01

When not understood as normal consequences of growth and aging, sexual fluctuations can be the source of personal and marital distress. Discussed are sexual behavior norms as they change from infancy to old age. (Author/CJ)

Sexual side effects of serotonergic antidepressants: mediated by inhibition of serotonin on central dopamine release?

PubMed

Bijlsma, Elisabeth Y; Chan, Johnny S W; Olivier, Berend; Veening, Jan G; Millan, Mark J; Waldinger, Marcel D; Oosting, Ronald S

2014-06-01

Antidepressant-induced sexual dysfunction adversely affects the quality of life of antidepressant users and reduces compliance with treatment. Animal models provide an instructive approach for examining potential sexual side effects of novel drugs. This review discusses the stability and reproducibility of our standardized test procedure that assesses the acute, subchronic and chronic effects of psychoactive compounds in a 30 minute mating test. In addition, we present an overview of the effects of several different (putative) antidepressants on male rat sexual behavior, as tested in our standardized test procedure. By comparing the effects of these mechanistically distinct antidepressants (paroxetine, venlafaxine, bupropion, buspirone, DOV 216,303 and S32006), this review discusses the putative mechanism underlying sexual side effects of antidepressants and their normalization. This review shows that sexual behavior is mainly inhibited by antidepressants that increase serotonin neurotransmission via blockade of serotonin transporters, while those that mainly increase the levels of dopamine and noradrenaline are devoid of sexual side effects. Those sexual disturbances cannot be normalized by simultaneously increasing noradrenaline neurotransmission, but are normalized by increasing both noradrenaline and dopamine neurotransmission. Therefore, it is hypothesized that the sexual side effects of selective serotonin reuptake inhibitors may be mediated by their inhibitory effects on dopamine signaling in sex brain circuits. Clinical development of novel antidepressants should therefore focus on compounds that simultaneously increase both serotonin and dopamine signaling. © 2013 Elsevier Inc. All rights reserved.

EXERCISE IMPROVES SEXUAL FUNCTION IN WOMEN TAKING ANTIDEPRESSANTS: RESULTS FROM A RANDOMIZED CROSSOVER TRIAL

PubMed Central

Lorenz, Tierney Ahrold; Meston, Cindy May

2014-01-01

Background In laboratory studies, exercise immediately before sexual stimuli improved sexual arousal of women taking antidepressants [1]. We evaluated if exercise improves sexual desire, orgasm, and global sexual functioning in women experiencing antidepressant-induced sexual side effects. Methods Fifty-two women who were reporting antidepressant sexual side effects were followed for 3 weeks of sexual activity only. They were randomized to complete either three weeks of exercise immediately before sexual activity (3×/week) or 3 weeks of exercise separate from sexual activity (3×/week). At the end of the first exercise arm, participants crossed to the other. We measured sexual functioning, sexual satisfaction, depression, and physical health. Results Exercise immediately prior to sexual activity significantly improved sexual desire and, for women with sexual dysfunction at baseline, global sexual function. Scheduling regular sexual activity significantly improved orgasm function; exercise did not increase this benefit. Neither regular sexual activity nor exercise significantly changed sexual satisfaction. Conclusions Scheduling regular sexual activity and exercise may be an effective tool for the behavioral management of sexual side effects of antidepressants. PMID:24754044

Exercise improves sexual function in women taking antidepressants: results from a randomized crossover trial.

PubMed

Lorenz, Tierney Ahrold; Meston, Cindy May

2014-03-01

In laboratory studies, exercise immediately before sexual stimuli improved sexual arousal of women taking antidepressants [1]. We evaluated if exercise improves sexual desire, orgasm, and global sexual functioning in women experiencing antidepressant-induced sexual side effects. Fifty-two women who were reporting antidepressant sexual side effects were followed for 3 weeks of sexual activity only. They were randomized to complete either three weeks of exercise immediately before sexual activity (3×/week) or 3 weeks of exercise separate from sexual activity (3×/week). At the end of the first exercise arm, participants crossed to the other. We measured sexual functioning, sexual satisfaction, depression, and physical health. Exercise immediately prior to sexual activity significantly improved sexual desire and, for women with sexual dysfunction at baseline, global sexual function. Scheduling regular sexual activity significantly improved orgasm function; exercise did not increase this benefit. Neither regular sexual activity nor exercise significantly changed sexual satisfaction. Scheduling regular sexual activity and exercise may be an effective tool for the behavioral management of sexual side effects of antidepressants

Drug-induced sexual dysfunction.

PubMed

Aldridge, S A

1982-01-01

Commonly used drugs that may cause sexual dysfunction are reviewed. The anatomy and physiology of the normal sexual response are reviewed. The influence of drugs on neurogenic, hormonal, and vascular mechanisms may result in diminished libido, impotence, ejaculatory and orgasmic difficulties, inhibited vaginal lubrication, menstrual irregularities, and gynecomastia in men or painful breast enlargement in women. Parasympatholytic agents, which interfere with cholinergic transmission, may affect erectile potency, while adrenergic inhibiting agents may interfere with ejaculatory control. Central nervous system depressants or sedating drugs, drugs producing hyperprolactinemia, and antiandrogenic drugs also may affect the normal sexual response. Drugs such as antihypertensive and antipsychotic agents may induce sexual dysfunction that can result in patient noncompliance. Usually, drug-induced side effects are reversible with discontinuation of the offending agent.

The inhibitory effects of nicotine on physiological sexual arousal in nonsmoking women: results from a randomized, double-blind, placebo-controlled, cross-over trial.

PubMed

Harte, Christopher B; Meston, Cindy M

2008-05-01

Extensive research suggests that long-term cigarette smoking is an independent risk factor for the introduction of sexual dysfunction in men. However, results of limited data investigating this relationship in women are mixed. No studies have examined the acute effects of tobacco or nicotine on physiological sexual response in women. Controlled experimental studies examining acute effects of isolated nicotine intake on female physiological sexual responses are necessary in order to help elucidate tobacco's potential role in the development and/or maintenance of sexual impairment in women. To examine whether isolated nicotine intake acutely affects sexual arousal responses in nonsmoking women. Twenty-five sexually functional women (mean age = 20 years) each with less than 100 direct exposures to nicotine completed two counterbalanced conditions in which they were randomized to received either nicotine gum (6 mg) or placebo gum, both administered double-blind and matched for appearance, taste, and consistency, approximately 40 minutes prior to viewing an erotic film. Physiological (changes in vaginal pulse amplitude via vaginal photoplethysmography) and subjective (continuous self-report) sexual responses to erotic stimuli were examined, as well as changes in mood. Nicotine significantly reduced genital responses to the erotic films (P = 0.05), corresponding to a 30% attenuation in physiological sexual arousal. This occurred in 11 of 18 women with valid physiological assessments. Nicotine had no significant effect on continuous self-report ratings of sexual arousal (P = 0.45), or on mood (all Ps > 0.05). Acute nicotine intake significantly attenuates physiological sexual arousal in healthy nonsmoking women. Our findings provide support to the hypothesis that nicotine may be the primary pharmacological agent responsible for genital hemodynamic disruption, thereby facilitating a cascade of biochemical and vascular events which may impair normal sexual arousal responses.

Quantity vs. quality: an exploration of the predictors of posttreatment sexual adjustment for women affected by early stage cervical and endometrial cancer.

PubMed

Juraskova, Ilona; Bonner, Carissa; Bell, Melanie L; Sharpe, Louise; Robertson, Rosalind; Butow, Phyllis

2012-11-01

Women with early stage cervical and endometrial cancer may experience complex posttreatment changes to their sexual function, but clinical practice and past research have focused more on the quantity than the perceived quality of sexual life. The aims of this prospective study were to explore the following: (i) the relative importance of quantity vs. quality of sexual life over the first year posttreatment; (ii) the psychological and sexual predictors of overall sexual function; and (iii) the relationship between sexual function and quality of life (QoL). Fifty-three cancer patients completed standardized measures at baseline, with follow-up at 6 and 12 months posttreatment. Analyses were based on prespecified linear mixed models with overall sexual function and QoL as outcomes, and quality and quantity of sexual life, anxiety, and depression as the main predictors of interest. Radiotherapy, age, and relationship satisfaction were controlled for as potential confounders. Derogatis Sexual Functioning Inventory subscales to assess quantity (Drive) and quality (Satisfaction) of sexual life, and overall sexual function (Global Sexual Satisfaction Index); Functional Assessment of Cancer Therapy--General to assess QoL; Hospital Anxiety and Depression Scale to assess psychological distress; and Relationship Satisfaction Interaction Scale to assess relationship satisfaction. The models demonstrated that: (i) overall sexual function was predicted more strongly by the perceived quality than the quantity of sexual interactions, (ii) a small change in perceived quality had a large impact on overall sexual function, and (iii) overall sexual function was a predictor of QoL. This study found that quality rather than quantity of sexual life is the best predictor of overall sexual function among women treated for early stage cervical and endometrial cancer, indicating the importance of including quality indices in posttreatment sexual assessment in clinical practice and research studies. © 2012 International Society for Sexual Medicine.

Sexual Assertiveness Mediates the Associations Between Partner Facilitative Responses and Sexual Outcomes in Women With Provoked Vestibulodynia.

PubMed

McNicoll, Gabrielle; Corsini-Munt, Serena; O Rosen, Natalie; McDuff, Pierre; Bergeron, Sophie

2017-10-03

Provoked vestibulodynia (PVD) is a recurrent idiopathic vulvo-vaginal pain associated with negative sexual and psychological consequences. Facilitative partner responses to pain are currently receiving empirical attention because they are positively associated with women's sexual outcomes. However, the mechanisms through which facilitative responses to pain are associated with these outcomes have not been examined. One potential mechanism is sexual assertiveness, which has been found to be associated with better sexual function and satisfaction in women with PVD. The present study examined whether women's sexual assertiveness mediated the association between women's perception of facilitative partner responses and women's sexual function and satisfaction. Women (N = 140) with PVD symptomatology completed self-reported questionnaires evaluating their perception of their partners' facilitative responses, and their own sexual assertiveness, sexual function, and sexual satisfaction. Dependent measures were sexual function measured by the Female Sexual Function Index and sexual satisfaction assessed by the Global Measure of Sexual Satisfaction Scale. Results indicated that women's higher sexual assertiveness mediated the association between their greater perceived facilitative partner responses and their improved sexual function and satisfaction. Findings suggest a potential mechanism through which partner responses may be associated with women's sexual outcomes.

Vaginal reconstruction with sigmoid colon in patients with congenital absence of vagina and menses retention: a report of treatment experience in 22 young women.

PubMed

Yang, Bin; Wang, Ning; Zhang, Shulan; Wang, Mingqian

2013-01-01

We evaluated the surgical feasibility, sexual satisfaction and complications of vaginal reconstruction with sigmoid colon in patients with congenital absence of vagina and menses retention. Retrospective analysis of surgical techniques and long-term postoperative follow-up was performed for 22 patients who underwent vaginal reconstruction with sigmoid colon at a single hospital between 1977 and 2011 to treat congenital absence of vagina with menses retention. All patients achieved satisfactory sexual function after marriage. No patients experienced enterospastic abdominal pain during sexual intercourse. The neovaginas accommodated two or more fingers and had depths >10 cm. The mucous membranes were soft and flexible, and secretions of the sigmoid mucosa provided adequate and acceptable lubrication. No patient required vaginal stents, and none developed vaginal stenosis or reported pain with vaginal expansion. Fifteen of the 22 patients underwent hysterectomies due to cervical agenesis; seven retained their uterus and had onset of normal menses postoperatively. Two patients became pregnant 1 year after marriage; one achieved 38-week gestation, underwent cesarean section due to premature rupture of membranes, and delivered a healthy boy. The other experienced natural incomplete abortion and underwent curettage at her local hospital. This study confirms that sigmoid colon vaginal reconstruction is a good choice for treating congenital absence of vagina and menses retention and results in the closest approximation to the physical function of a normal female vagina. Reproductive ability can be retained in many cases for patients with a well-developed uterus and cervix.

Neural activation-based sexual orientation and its correlation with free testosterone level in postoperative female-to-male transsexuals: preliminary study with 3.0-T fMRI.

PubMed

Kim, Gwang-Won; Kim, Seok-Kwun; Jeong, Gwang-Woo

2016-03-01

The purpose of this study was to evaluate the brain activation pattern associated with sexual orientation and its correlation with the level of the free testosterone (free T) in postoperative female-to-male (FtM) transsexuals using a 3.0-Tesla functional magnetic resonance imaging (fMRI). Eleven postoperative FtM transsexuals with sex reassignment surgery underwent fMRI on a 3.0-T MR scanner. Brain activity was measured while viewing erotic male and female nude pictures. The average level of free T in the FtM transsexuals was in the normal range of heterosexual men. The brain areas with predominant activities during viewing female nude pictures in contrast to male pictures included the hippocampus, parahippocampal gyrus, anterior cingulate gyrus, putamen, amygdala, hypothalamus, and insula (p < 0.005). The free T levels were positively correlated with the BOLD signal changes in the parahippocampal gyrus (Spearman's rho = 0.91, p < 0.001), hippocampus (rho = 0.90, p < 0.001), insula (rho = 0.68, p < 0.05), putamen (rho = 0.66, p < 0.05), and amygdala (rho = 0.64, p < 0.05). Compared to FtM transsexuals with deficient level of free T, the FtM transsexuals with normal range of free T showed significantly higher activities in the parahippocampal gyrus, hippocampus, insula, putamen, and amygdala during viewing female nude pictures (p < 0.005). This study revealed the specific brain activation pattern associated with sexual orientation and its correlation with free T in the postoperative FtM transsexuals. These findings are applicable in understanding the neural mechanism on sexual arousal in FtM transsexuals and their sexual orientation in connection with the free T levels.

Reaction to cutaneous (tickle) and sexual pleasure by normal and dermapathic subjects.

PubMed

Ruggieri, V; Milizia, M; Angeli, F

1985-12-01

We examined separately tickle perception and pleasure and anxiety during sexual sequence of 40 dermapathic (20 men and 22 women) and 39 normal subjects (20 men and 19 women) aged between 35 and 40 yr. The dermapathic patients have an inhibitory attitude towards tactile perception of tickling and high anxiety during the sexual sequence. Furthermore, they show positive association of anxiety and pleasure unlike the control group for whom the correlation between the two emotions is negative.

Predictors of Genital Pain in Young Women

PubMed Central

Farmer, Melissa A.; Meston, Cindy M.

2010-01-01

Despite the high prevalence of genital pain in healthy young adult women, limited research has addressed genital pain during intercourse using contemporary models of multidimensional sexual function. The objectives of this study were threefold: (1) to identify differences in sexual functioning in women who experience genital pain compared to pain free women; (2) to identify predictors of sexual functioning in women with and without genital pain; and (3) to identify predictors of sexual satisfaction in women with and without genital pain. Sexually active female undergraduates (n = 651) were administered the Female Sexual Function Index and the Derogatis Sexual Functioning Inventory. We evaluated the sexual factors that impact the sexual function of women with any pain (including high and low pain groups) versus women with no history of pain. Women with genital pain reported greater rates of sexual dysfunction as compared to pain-free women; however, sexual functioning in the high versus low pain groups was distinguished primarily by vaginal lubrication. Women in the high pain group showed negative correlations between domains of sexual satisfaction and genital pain frequency and intensity that were not found in the low pain group. For pain-free women, intercourse played a strong role in sexual satisfaction, whereas non-intercourse sexual behavior was central to sexual satisfaction in women who reported pain. The evaluation of levels of genital pain may provide insight into the mechanisms underlying the impairment of sexual function, sexual behavior, and sexual satisfaction. PMID:17674182

Immunological Development and Cardiovascular Function Are Normal in Annexin VI Null Mutant Mice

PubMed Central

Hawkins, Tim E.; Roes, Jürgen; Rees, Daryl; Monkhouse, Jayne; Moss, Stephen E.

1999-01-01

Annexins are calcium-binding proteins of unknown function but which are implicated in important cellular processes, including anticoagulation, ion flux regulation, calcium homeostasis, and endocytosis. To gain insight into the function of annexin VI, we performed targeted disruption of its gene in mice. Matings between heterozygous mice produced offspring with a normal Mendelian pattern of inheritance, indicating that the loss of annexin VI did not interfere with viability in utero. Mice lacking annexin VI reached sexual maturity at the same age as their normal littermates, and both males and females were fertile. Because of interest in the role of annexin VI in cardiovascular function, we examined heart rate and blood pressure in knockout and wild-type mice and found these to be identical in the two groups. Similarly, the cardiovascular responses of both sets of mice to septic shock were indistinguishable. We also examined components of the immune system and found no differences in thymic, splenic, or bone marrow lymphocyte levels between knockout and wild-type mice. This is the first study of annexin knockout mice, and the lack of a clear phenotype has broad implications for current views of annexin function. PMID:10567528

MRI-based morphometric characterizations of sexual dimorphism of the cerebrum of ferrets (Mustela putorius).

PubMed

Sawada, Kazuhiko; Horiuchi-Hirose, Miwa; Saito, Shigeyoshi; Aoki, Ichio

2013-12-01

The present study aimed to characterize cerebral morphology in young adult ferrets and its sexual dimorphism using high-field MRI and MRI-based morphometry. Ex vivo short TR/TE (typical T1-weighted parameter setting for conventional MRI) and T2W (long TR/TE) MRI with high spatial resolution at 7-tesla could visualize major subcortical and archicortical structures, i.e., the caudate nucleus, lentiform nucleus, amygdala and hippocampus. In particular, laminar organization of the olfactory bulb was identifiable by short TR/TE-MRI. The primary and secondary sulci observable in the adult ferret were distinguishable on either short TR/TE- or T2W-MRI, and the cortical surface morphology was reproduced well by 3D-rendered images obtained by short TR/TE-MRI. The cerebrum had a significantly lower volume in females than in males, which was attributed to region-specific volume reduction in the cerebral cortex and subcortical white matter in females. A sexual difference was also detected, manifested by an overall reduction in normalized signal ratios of short TR/TE-MRI in all cerebral structures examined in females than in males. On the other hand, an alternating array of higher and lower short TR/TE-MRI intensity transverse zones throughout the cortex, which was reminiscent of the functional cortical areas, was revealed by maximum intensity projection (MIP) in 3D. The normalized signal ratio of short TR/TE-MRI, but not T2W-MRI in the cortex, was negatively correlated with the density of myelin-basic protein immunoreactive fibers (males, r=-0.440; females, r=-0.481). The present results suggest that sexual differences in the adult ferret cerebrum are characterized by reduced volumes of the cerebral cortex and subcortical white matter in females, and by overall reductions in physiochemical characteristics, as obtained by short TR/TE-MRI, in females. It should be noted that short TR/TE-MRI-based MIP delineated functional cortical areas related to myeloarchitecture in 3D. Such an approach makes possible conventional investigation of the functional organization of the cerebral cortex and its abnormalities using high-field MRI. Copyright © 2013 Elsevier Inc. All rights reserved.

Daily affect and female sexual function.

PubMed

Kalmbach, David A; Pillai, Vivek

2014-12-01

The specific affective experiences related to changes in various aspects of female sexual function have received little attention as most prior studies have focused instead on the role of clinical mood and anxiety disorders and their influence on sexual dysfunction. We sought to understand the transaction between daily affect and female sexual function in effort to provide a more nuanced understanding of the interplay between affective and sexual experiences. The present study used a 2-week daily diary approach to examine same-day and temporal relations between positive and negative affect states and sexual function in young women. We examined the unique relations between positive (i.e., joviality, serenity, self-assurance) and negative (i.e., fear, sadness, hostility) affects and female sexual response (i.e., desire, subjective arousal, vaginal lubrication, orgasmic function, and sexual pain) while controlling for higher order sexual distress, depression, and anxiety, as well as age effects and daily menstruation. Analyses revealed different aspects of both positive and negative affects to be independently related to sexual response indices. Specifically, results indicated that joviality was related to same-day sexual desire and predicted increased desire the following day. This latter relation was partially mediated by sexual activity. Further, greater sexual desire predicted next-day calmness, which was partially mediated by sexual activity. Notably, fear was related to same-day subjective arousal, lubrication, orgasmic function, and vaginal pain, whereas poorer orgasmic function predicted greater next-day sadness. These findings describe the manner in which changes in affect correspond to variations in female sexual function, thus highlighting the inextricability of mental and sexual health. Further, these findings may offer insight into the progression of normative levels of affect and sexual function as they develop into comorbid depression, anxiety, and sexual dysfunction. © 2014 International Society for Sexual Medicine.

Sibling Sexual Abuse: An Empirical Analysis of Offender, Victim, and Event Characteristics in National Incident-Based Reporting System (NIBRS) Data, 2000-2007

ERIC Educational Resources Information Center

Krienert, Jessie L.; Walsh, Jeffrey A.

2011-01-01

Sibling sexual abuse is identified as the most common form of familial sexual abuse. Extant literature is plagued by definitional inconsistencies, data limitations, and inadequate research methodology. Trivialized as "normal" sexual exploration, sibling sexual abuse has been linked to psychosocial/psychosexual dysfunction. Research has relied on…

The relation between sexual interest and personality characteristics in men: an eye-tracking study.

PubMed

Tsujimura, A; Miyagawa, Y; Takada, S; Nagahara, A; Matsuoka, Y; Takao, T; Nakayama, J; Matsushita, M; Nonomura, N; Okuyama, A

2010-01-01

There is a large individual deviation for men, which may be caused by a difference in personality characteristics, in sexual interest in response to sexual stimuli. In this study, we investigate whether attention to the sexual region in a video depends on the personality characteristics of men, assessing this with an eye-tracking system. The study included 30 healthy males with a normal psychological state, who viewed a sexual video in which the sexual region had been designated. Visual attention was measured across the designated region according to gaze duration. Ten types of personality characteristics were evaluated as a T-score by a questionnaire. By Pearson's correlation coefficient, the relations between gaze duration at the sexual region and T-scores of paranoia, psychasthenia and social introversion were found to be statistically significant. By multivariate stepwise regression analysis, only social introversion was negatively associated with the sexual region. Even normal variation of personality characteristics can affect the viewing period of the sexual region. This is the first report showing that subjects with a high degree of paranoia, psychasthenia and particularly social introversion have a tendency to view the sexual region for a shorter duration.

As the wheel turns: a centennial reflection on Freud's Three Essays on the Theory of Sexuality.

PubMed

Person, Ethel Spector

2005-01-01

Freud's theories of psychosexual development, while highly original, were anchored in the explosion of scientific studies of sex in the nineteenth century. Most of these studies were based on masturbation, homosexuality, and deviance, with little attention given to normal sexuality. Around the turn of the century, the narrow interest in pathological sexuality and sexual physiology gradually gave way to a broader interest in normal sexuality. It was in the context of these expanding studies of sexuality that Freud proposed the first psychological view of sexuality, a theory that defined sex as being at the interface between soma and psyche. Libido theory, which Freud developed, is a theory of drives and conflicts. For Freud, libido was the major force in personality development, and he posited sexual conflicts as the heart of neuroses, sexual fixations as the essence of perversions. This article traces the way Freud's libido theory has served as one of the mainsprings in the development of psychoanalytic theory. It also addresses the major revisions that have taken place in libido theory, with a focus primarily on object relations theory, and the impact of culture on the way sex and sexual mores are parsed.

Current hormonal contraceptive use predicts female extra-pair and dyadic sexual behavior: evidence based on Czech National Survey data.

PubMed

Klapilová, Kateřina; Cobey, Kelly D; Wells, Timothy; Roberts, S Craig; Weiss, Petr; Havlíček, Jan

2014-01-10

Data from 1155 Czech women (493 using oral contraception, 662 non-users), obtained from the Czech National Survey of Sexual Behavior, were used to investigate evolutionary-based hypotheses concerning the predictive value of current oral contraceptive (OC) use on extra-pair and dyadic (in-pair) sexual behavior of coupled women. Specifically, the aim was to determine whether current OC use was associated with lower extra-pair and higher in-pair sexual interest and behavior, because OC use suppresses cyclical shifts in mating psychology that occur in normally cycling women. Zero-inflated Poisson (ZIP) regression and negative binomial models were used to test associations between OC use and these sexual measures, controlling for other relevant predictors (e.g., age, parity, in-pair sexual satisfaction, relationship length). The overall incidence of having had an extra-pair partner or one-night stand in the previous year was not related to current OC use (the majority of the sample had not). However, among the women who had engaged in extra-pair sexual behavior, OC users had fewer one-night stands than non-users, and tended to have fewer partners, than non-users. OC users also had more frequent dyadic intercourse than non-users, potentially indicating higher commitment to their current relationship. These results suggest that suppression of fertility through OC use may alter important aspects of female sexual behavior, with potential implications for relationship functioning and stability.

Sexual Function, Satisfaction, and Use of Aids for Sexual Activity in Middle-Aged Adults with Long-Term Physical Disability

PubMed Central

Smith, Amanda E.; McMullen, Kara; Jensen, Mark P.

2015-01-01

Background: Sexuality is an important aspect of quality of life in individuals with disabilities, yet little is known about what factors contribute to sexual satisfaction as these individuals age. Method: Middle-aged adults with physical disabilities completed a cross-sectional survey that included measures of sexual activity, function, and satisfaction. Results: Consistent with studies of able-bodied adults, sexual function was the strongest predictor of satisfaction. However, depression also predicted sexual satisfaction for women. Use of aids for sexual activity varied by disability type and was generally associated with better function. Lowest levels of sexual satisfaction were reported by men with SCI. Conclusion: Depression may negatively impact sexual satisfaction in women, beyond contributions of sexual dysfunction, and effective use of sexual aids may improve function in this population. PMID:26363589

Implicit and Explicit Associations with Erotic Stimuli in Sexually Functional and Dysfunctional Men.

PubMed

van Lankveld, Jacques; Odekerken, Ingrid; Kok-Verhoeven, Lydia; van Hooren, Susan; de Vries, Peter; van den Hout, Anja; Verboon, Peter

2015-08-01

Although conceptual models of sexual functioning have suggested a major role for implicit cognitive processing in sexual functioning, this has thus far, only been investigated in women. The aim of this study was to investigate the role of implicit cognition in sexual functioning in men. Men with (N = 29) and without sexual dysfunction (N = 31) were compared. Participants performed two single-target implicit association tests (ST-IAT), measuring the implicit association of visual erotic stimuli with attributes representing, respectively, valence ('liking') and motivation ('wanting'). Participants also rated the erotic pictures that were shown in the ST-IAT on the dimensions of valence, attractiveness, and sexual excitement to assess their explicit associations with these erotic stimuli. Participants completed the International Index of Erectile Functioning for a continuous measure of sexual functioning. Unexpectedly, compared with sexually functional men, sexually dysfunctional men were found to show stronger implicit associations of erotic stimuli with positive valence than with negative valence. Level of sexual functioning, however, was not predicted by explicit nor implicit associations. Level of sexual distress was predicted by explicit valence ratings, with positive ratings predicting higher levels of sexual distress. Men with and without sexual dysfunction differed significantly with regard to implicit liking. Research recommendations and implications are discussed. © 2015 International Society for Sexual Medicine.

Mood disorders and sexual functioning in women with functional hypothalamic amenorrhea.

PubMed

Dundon, Carolyn M; Rellini, Alessandra H; Tonani, Silvia; Santamaria, Valentina; Nappi, Rosella

2010-11-01

To investigate the sexual function of women with functional hypothalamic amenorrhea (FHA) and to test the mediating effects of depression and anxiety on the sexual functioning of women with FHA. In this cross-sectional study, participants completed questionnaires on sexual function, depression, and anxiety. Tertiary care university hospital. Women with (n=41) and without (n=39) FHA recruited from a gynecologic endocrinology unit. None. The McCoy Female Sexuality Questionnaire assessed sexual function, and the Zung Scale measured depression and anxiety. Women with FHA experienced more sexual function problems and significantly higher depression and anxiety compared to women without menstrual dysfunction. In addition, depression offered a significant explanation for the sexual problems experienced by women with FHA. The psychologic symptoms that contribute to the onset of FHA partially mediate the relationship between FHA and sexual dysfunction. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Masturbation, sexuality, and adaptation: normalization in adolescence.

PubMed

Shapiro, Theodore

2008-03-01

During adolescence the central masturbation fantasy that is formulated during childhood takes its final form and paradoxically must now be directed outward for appropriate object finding and pair matching in the service of procreative aims. This is a step in adaptation that requires a further developmental landmark that I have called normalization. The path toward airing these private fantasies is facilitated by chumship relationships as a step toward further exposure to the social surround. Hartmann's structuring application of adaptation within psychoanalysis is used as a framework for understanding the process that simultaneously serves intrapsychic and social demands and permits goals that follow evolutionary principles. Variations in the normalization process from masturbatory isolation to a variety of forms of sexual socialization are examined in sociological data concerning current adolescent sexual behavior and in case examples that indicate some routes to normalized experience and practice.

The effect of sexual health education program on women sexual function in Iran.

PubMed

Behboodi Moghadam, Zahra; Rezaei, Elham; Khaleghi Yalegonbadi, Fariba; Montazeri, Ali; Arzaqi, Syed Masood; Tavakol, Zeinab; Yari, Fatemeh

2015-01-01

Sexual dysfunction is the most common disorder in women. According to the WHO, sexual education programs are considered as a need. Therefore, this study was designed to investigate the effect of educational program on sexual function in women with sexual dysfunction. This randomized trial, was conducted in 2013 on 90 married women by convenient sampling in Qazvin, central Iran. The demographic, Female Sexual Function Index (FSFI), and Beck's Depression Inventory (BDI) questionnaires were completed during structured interviews. After completing the sample size, subjects were divided randomly into two groups by using the table of random numbers (educational and control groups), then respectively received an educational intervention in the four sessions with one week interval and routine program offered by the center and following-up was done with refilling questionnaires 8 weeks after intervention. Sexual function improved after sex educational programs in all dimensions (sexual desire (P=0.006), sexual exciting (P=0.006), vaginal moisture (P=0.002), sexual satisfaction (P=0.011), and total score of sexual function (P=0.001). Considering the importance role of sexual function in family strength, health, and development, it can be claimed that educational sex programs can help practitioners to improve sexual function of married women with sexual dysfunction.

Sexual Function and Pessary Management among Women Using a Pessary for Pelvic Floor Disorders.

PubMed

Meriwether, Kate V; Komesu, Yuko M; Craig, Ellen; Qualls, Clifford; Davis, Herbert; Rogers, Rebecca G

2015-12-01

Pessaries are commonly used to treat pelvic floor disorders, but little is known about the sexual function of pessary users. We aimed to describe sexual function among pessary users and pessary management with regard to sexual activity. This is a secondary analysis of a randomized trial of new pessary users, where study patients completed validated questionnaires on sexual function and body image at pessary fitting and 3 months later. Women completed the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire, International Urogynecological Association Revised (PISQ-IR), a validated measure that evaluates the impact of pelvic floor disorders on sexual function, a modified female body image scale (mBIS), and questions regarding pessary management surrounding sexual activity. Of 127 women, 54% (68/127) were sexually active at baseline and 42% (64/114) were sexually active at 3 months. Sexual function scores were not different between baseline and 3 months on all domains except for a drop of 0.15 points (P = 0.04) for sexually active women, and a drop of 0.34 points for non-sexually active women (P = 0.02) in the score related to the sexual partner. Total mBIS score did not change (P = 0.07), but scores improved by 0.2 points (P = 0.03) in the question related to self-consciousness. Pessary satisfaction was associated with improved sexual function scores in multiple domains and improved mBIS scores. The majority (45/64, 70%) of sexually active women removed their pessary for sex, with over half stating their partner preferred removal for sex (24/45, 53%). Many women remove their pessary during sex for partner considerations, and increased partner concerns are the only change seen in sexual function in the first 3 months of pessary use. Pessary use may improve self-consciousness and pessary satisfaction is associated with improvements in sexual function and body image. © 2015 International Society for Sexual Medicine.

Sexual functioning in obese adults enrolling in a weight loss study.

PubMed

Ostbye, Truls; Kolotkin, Ronette L; He, Hong; Overcash, Francine; Brouwer, Rebecca; Binks, Martin; Syrjala, Karen L; Gadde, Kishore M

2011-01-01

The authors assessed sexual functioning among treatment-seeking obese men (n = 91) and women (n = 134) using the comprehensive validated Sexual Functioning Questionnaire. Scores were lower for women than for men, indicating reduced sexual functioning. Men's scores fell between those of a group of cancer survivors and a general population group, whereas women generally had lower scores than both of these groups. Increasing body mass index was associated with decreasing sexual functioning only for arousal and behavior. Sexual functioning was also reduced on most subscales for individuals who reported sexual inactivity in the past month.

Harassment and Mental Distress Among Adolescent Female Students by Sexual Identity and BMI or Perceived Weight Status.

PubMed

Johns, Michelle Marie; Lowry, Richard; Demissie, Zewditu; Robin, Leah

2017-08-01

Sexual minority girls (lesbian/bisexual) and girls with overweight/obesity experience high rates of discrimination and mental distress. This study explored whether BMI or perceived weight status might compound sexual minority girls' risk for harassment and mental distress. Data on female students from the national 2015 Youth Risk Behavior Survey (n = 7,006) were analyzed. Logistic regression was used to examine differences in bullying, harassment, and mental distress across sexual identity/BMI groups: heterosexual/normal-weight, heterosexual/overweight, sexual minority/normal-weight, and sexual minority/overweight. Procedures were repeated with four analogous groups created from sexual identity and perceived weight. Across sexual identity/BMI groups, being overweight increased heterosexual females' odds of being bullied or experiencing suicidal thoughts and behaviors. Regardless of weight status, sexual minority females had greater odds for each outcome than heterosexual females. Sexual minority females who perceived themselves as overweight had greater odds of suicidality than all other sexual minority/perceived weight groups. Double jeopardy may exist for sexual minority female students who perceive themselves as overweight. Professional development with school staff on how to create a positive climate for sexual minorities and those with overweight/obesity and addressing positive identity and body image within school-based suicide prevention efforts may be important to the well-being of adolescent girls. © 2017 The Obesity Society.

Has dopamine a physiological role in the control of sexual behavior? A critical review of the evidence.

PubMed

Paredes, Raúl G; Agmo, Anders

2004-06-01

The role of dopaminergic systems in the control of sexual behavior has been a subject of study for at least 40 years. Not surprisingly, reviews of the area have been published at variable intervals. However, the earlier reviews have been summaries of published research rather than a critical analysis of it. They have focused upon the conclusions presented in the original research papers rather than on evaluating the reliability and functional significance of the data reported to support these conclusions. During the last few years, important new knowledge concerning dopaminergic systems and their behavioral functions as well as the possible role of these systems in sexual behavior has been obtained. For the first time, it is now possible to integrate the data obtained in studies of sexual behavior into the wider context of general dopaminergic functions. To make this possible, we first present an analysis of the nature and organization of sexual behavior followed by a summary of current knowledge about the brain structures of crucial importance for this behavior. We then proceed with a description of the dopaminergic systems within or projecting to these structures. Whenever possible, we also try to include data on the electrophysiological actions of dopamine. Thereafter, we proceed with analyses of pharmacological data and release studies, both in males and in females. Consistently throughout this discussion, we make an effort to distinguish pharmacological effects on sexual behavior from a possible physiological role of dopamine. By pharmacological effects, we mean here drug-induced alterations in behavior that are not the result of the normal actions of synaptically released dopamine in the untreated animal. The conclusion of this endeavor is that pharmacological effects of dopaminergic drugs are variable in both males and females, independently of whether the drugs are administered systemically or intracerebrally. We conclude that the pharmacological data basically reinforce the notion that dopamine is important for motor functions and general arousal. These actions could, in fact, explain most of the effects seen on sexual behavior. Studies of dopamine release, in both males and females, have focused on the nucleus accumbens, a structure with at most a marginal importance for sexual behavior. Since accumbens dopamine release is associated with all kinds of events, aversive as well as appetitive, it can have no specific effect on sexual behavior but promotes arousal and activation of non-specific motor patterns. Preoptic and paraventricular nucleus release of dopamine may have some relationship to mechanisms of ejaculation or to the neuroendocrine consequences of sexual activity or they can be related to other autonomic processes associated with copulation. There is no compelling indication in existing experimental data that dopamine is of any particular importance for sexual motivation. There is experimental evidence showing that it is of no importance for sexual reward.

Correlates of sexual risk behaviors among young Black MSM: implications for clinic-based counseling programs

PubMed Central

Crosby, Richard A.; Mena, Leandro; Ricks, JaNelle

2018-01-01

This study applied an 8-item index of recent sexual risk behaviors to young Black men who have sex with men (YBMSM) and evaluated the distribution for normality. The distribution was tested for associations with possible antecedents of sexual risk. YBMSM (N=600), ages 16–29 years, were recruited from an STI clinic, located in the Southern United States. Men completed an extensive audio-computer assisted self-interview. Thirteen possible antecedents of sexual risk, as assessed by the index, were selected for analyses. The 8-item index formed a normal distribution with a mean of 4.77 (sd=1.77). In adjusted analyses, not having completed education beyond high school was associated with less risk, as was having sex with females. Conversely, meeting sex partners online was associated with greater risk, as was reporting that sex partners were drunk during sex. The obtained normal distribution of sexual risk behaviors suggests a corresponding need to “target and tailor” clinic-based counseling and prevention services for YBMSM. Avoiding sex when partners are intoxicated may be an especially valuable goal of counseling sessions. PMID:27875903

The Skinny on Sexual Risk: The Effects of BMI on STI Incidence and Risk

PubMed Central

Arnold, Anna; Lewis, Jessica B.; Magriples, Urania; Ickovics, Jeannette R.

2011-01-01

Few studies examine the influence of body mass index (BMI) on sexual risk. The purpose of this study was to determine whether BMI among 704 young mothers (ages 14–25) related to STI incidence and sexual risk. We examined the effect of BMI groups (normal weight, overweight, and obese) at 6 months postpartum on STI incidence and risky sex (e.g., unprotected sex, multiple partners, risky and casual partner) at 12 months post-partum. At 6 months postpartum, 31% of participants were overweight and 40% were obese. Overweight women were more likely to have an STI (OR = 1.79, 95% CI = 1.11–2.89, P < .05) and a risky partner (OR = 1.64, 95% CI = 1.01–2.08, P < .05) at 12 months postpartum compared to normal weight women. However, obese women were less likely to have an STI than normal weight women (OR = .57, 95% CI = .34–.96, P < .01). BMI related to STI incidence and sexual risk behavior. Integrated approaches to weight loss and sexual risk prevention should be explored. PMID:20976536

School-Based Primary School Sexuality Education for Migrant Children in Beijing, China

ERIC Educational Resources Information Center

Liu, Wenli; Su, Yufen

2014-01-01

In May 2007, Beijing Normal University launched a programme of school-based sexuality education for migrant children in Xingzhi Primary School in Beijing. Over the past seven years, the project team has developed a school-based sexuality education curriculum using the "International Technical Guidance on Sexuality Education" published by…

Young women's genital self-image and effects of exposure to pictures of natural vulvas.

PubMed

Laan, Ellen; Martoredjo, Daphne K; Hesselink, Sara; Snijders, Nóinín; van Lunsen, Rik H W

2017-12-01

Many women have doubts about the normality of the physical appearance of their vulvas. This study measured genital self-image in a convenience sample of college-educated women, and assessed whether exposure to pictures of natural vulvas influenced their genital self-image. Forty-three women were either shown pictures of natural vulvas (N = 29) or pictures of neutral objects (N = 14). Genital self-image was measured before and after exposure to the pictures and two weeks later. Sexual function, sexual distress, self-esteem and trait anxiety were measured to investigate whether these factors influenced genital self-image scores after vulva picture exposure. A majority of the participants felt generally positively about their genitals. Having been exposed to pictures of natural vulvas resulted in an even more positive genital self-image, irrespective of levels of sexual function, sexual distress, self-esteem and trait anxiety. In the women who had seen the vulva pictures, the positive effect on genital self-image was still present after two weeks. The results of this study seem to indicate that even in young women with a relatively positive genital self-image, exposure to pictures of a large variety of natural vulvas positively affects genital self-image. This finding may suggest that exposure to pictures of natural vulvas may also lead to a more positive genital self-image in women who consider labiaplasty.

Shaping Sexual Knowledge: A Cultural History of Sex Education in Twentieth Century Europe. Routledge Studies in the Social History of Medicine

ERIC Educational Resources Information Center

Sauerteig, Lutz, Ed.; Davidson, Roger, Ed.

2012-01-01

The history of sex education enables us to gain valuable insights into the cultural constructions of what different societies have defined as 'normal' sexuality and sexual health. Yet, the history of sex education has only recently attracted the full attention of historians of modern sexuality. "Shaping Sexual Knowledge: A Cultural History of…

[Male sexuality in the elderly].

PubMed

Rinnab, L; Schrader, A J; Schrader, M; Zengerling, F

2012-10-01

Male sexuality in the elderly is an important issue with a growing relevance. In contrast to the assumption of an asexual state when becoming older, recent representative surveys show that the majority of men maintain sexual desires and fantasies into old age. Sexual activity primarily depends on the availability of a partner and on maintaining intimacy and sexuality in the face of changes in the sexual response cycle and increasing comorbidity. This review aims to clarify the normal aging process, the sexual behavior of aging males and the prevalence of sexual dysfunction.

Childhood Sexual Abuse Moderates the Association between Sexual Functioning and Sexual Distress in Women

PubMed Central

Stephenson, Kyle R.; Hughan, Corey P.; Meston, Cindy M.

2012-01-01

Objective To assess the degree to which a history of CSA moderates the association between sexual functioning and sexual distress in women. Method Women with (n = 105, M age = 33.71, 66.1% Caucasian) and without (n = 71, M age = 32.63, 74.7% Caucasian) a history of CSA taking part in a larger clinical trial completed self-report questionnaires at intake including the Sexual Satisfaction Scale for Women (SSS-W), the Female Sexual Function Index (FSFI), and the Trauma History Questionnaire (THQ). Results Desire, arousal, lubrication, and orgasm interacted with sexual abuse status in predicting sexual distress such that sexual functioning was more weakly associated with distress for women with a history of CSA. This disconnect was more pronounced for women who were abused by a family member. Conclusion CSA status serves as an important moderator of the association between sexual functioning and sexual distress in women. Specifically, women with a history of CSA show higher levels of distress in the context of good sexual functioning as compared to women without a history of CSA. Possible explanations and clinical implications are discussed. PMID:22391416

Brain Activation in Response to Visually Evoked Sexual Arousal in Male-to-Female Transsexuals: 3.0 Tesla Functional Magnetic Resonance Imaging

PubMed Central

Oh, Seok-Kyun; Kim, Gwang-Won; Yang, Jong-Chul; Kim, Seok-Kwun; Kang, Heoung-Keun

2012-01-01

Objective This study used functional magnetic resonance imaging (fMRI) to contrast the differential brain activation patterns in response to visual stimulation with both male and female erotic nude pictures in male-to-female (MTF) transsexuals who underwent a sex reassignment surgery. Materials and Methods A total of nine healthy MTF transsexuals after a sex reassignment surgery underwent fMRI on a 3.0 Tesla MR Scanner. The brain activation patterns were induced by visual stimulation with both male and female erotic nude pictures. Results The sex hormone levels of the postoperative MTF transsexuals were in the normal range of healthy heterosexual females. The brain areas, which were activated by viewing male nude pictures when compared with viewing female nude pictures, included predominantly the cerebellum, hippocampus, putamen, anterior cingulate gyrus, head of caudate nucleus, amygdala, midbrain, thalamus, insula, and body of caudate nucleus. On the other hand, brain activation induced by viewing female nude pictures was predominantly observed in the hypothalamus and the septal area. Conclusion Our findings suggest that distinct brain activation patterns associated with visual sexual arousal in postoperative MTF transsexuals reflect their sexual orientation to males. PMID:22563262

Physiologic measures of sexual function in women: a review.

PubMed

Woodard, Terri L; Diamond, Michael P

2009-07-01

To review and describe physiologic measures of assessing sexual function in women. Literature review. Studies that use instruments designed to measure female sexual function. Women participating in studies of female sexual function. Various instruments that measure physiologic features of female sexual function. Appraisal of the various instruments, including their advantages and disadvantages. Many unique physiologic methods of evaluating female sexual function have been developed during the past four decades. Each method has its benefits and limitations. Many physiologic methods exist, but most are not well-validated. In addition there has been an inability to correlate most physiologic measures with subjective measures of sexual arousal. Furthermore, given the complex nature of the sexual response in women, physiologic measures should be considered in context of other data, including the history, physical examination, and validated questionnaires. Nonetheless, the existence of appropriate physiologic measures is vital to our understanding of female sexual function and dysfunction.

What couples say about their recovery of sexual intimacy after prostatectomy: toward the development of a conceptual model of couples' sexual recovery after surgery for prostate cancer.

PubMed

Wittmann, Daniela; Carolan, Marsha; Given, Barbara; Skolarus, Ted A; Crossley, Heather; An, Lawrence; Palapattu, Ganesh; Clark, Patricia; Montie, James E

2015-02-01

Interventions designed to help couples recover sexual intimacy after prostatectomy have not been guided by a comprehensive conceptual model. We examined a proposed biopsychosocial conceptual model of couples' sexual recovery that included functional, psychological, and relational aspects of sexuality, surgery-related sexual losses, and grief and mourning as recovery process. We interviewed 20 couples preoperatively and 3 months postoperatively. between 2010 and 2012. Interviews were analyzed with Analytic Induction qualitative methodology, using NVivo software. Paired t-tests described functional assessment data. Study findings led to a revised conceptual model. Couples' experiences were assessed through semi-structured interviews; male participants' sexual function was assessed with the Expanded Prostate Cancer Index Composite and female participants' sexual function with the Female Sexual Function Index. Preoperatively, 30% of men had erectile dysfunction (ED) and 84% of partners were postmenopausal. All valued sexual recovery, but worried about cancer spread and surgery side effects. Faith in themselves and their surgeons led 90% of couples to overestimate erectile recovery. Postoperatively, most men had ED and lost confidence. Couples' sexual activity decreased. Couples reported feeling loss and grief: cancer diagnosis was the first loss, followed by surgery-related sexual losses. Couples' engagement in intentional sex, patients' acceptance of erectile aids, and partners' interest in sex aided the recovery of couples' sexual intimacy recovery. Unselfconscious sex, not returning to erectile function baseline, was seen as the end point. Survey findings documented participants' sexual function losses, confirming qualitative findings. Couples' sexual recovery requires addressing sexual function, feelings about losses, and relationship simultaneously. Perioperative education should emphasize the roles of nerve damage in ED and grief and mourning in sexual recovery. © 2014 International Society for Sexual Medicine.

Factors affecting sexual function: A comparison between women with gynecological or rectal cancer and healthy controls.

PubMed

Li, Chia-Chun; Rew, Lynn; Chen, Lynn

2015-03-01

This study had two purposes: (i) to explore differences in sexual function between women with gynecological or rectal cancer after related pelvic-area treatments and women without cancer; and (ii) to investigate the relationships among body image, anxiety and depression, sexual relationship power, sexual self-schema, and female sexual function. The participants (n = 139) were recruited through Internet cancer support groups and women's health organizations in the USA. Six structured questionnaires were mailed, and the data were analyzed using descriptive and inferential statistics. The results showed that women with gynecological or rectal cancer had significantly worse sexual function than women without cancer. Having gynecological/rectal cancer and a negative sexual self-schema were significantly related to poor sexual function. Furthermore, sexual self-schema moderated the relationship between sexual relationship power and female sexual function. Healthcare providers could give more attention to sexual issues in women who have undergone treatment for gynecological or rectal cancer, especially for those with a negative sexual self-schema and high sexual relationship power, which might improve these women's quality of life. © 2014 Wiley Publishing Asia Pty Ltd.

Factors Associated With Specific Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Sexual Dysfunctions in Breast Cancer Survivors: A Study of Patients and Their Partners.

PubMed

Hummel, Susanna B; Hahn, Daniela E E; van Lankveld, Jacques J D M; Oldenburg, Hester S A; Broomans, Eva; Aaronson, Neil K

2017-10-01

Many women develop sexual problems after breast cancer (BC) treatment. Little is known about BC survivors with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) sexual dysfunction and their partners, and the factors associated with their sexual functioning. To evaluate (i) patient-related and clinical factors associated with (a) specific DSM-IV sexual dysfunctions and (b) level of sexual functioning and sexual distress as reported by BC survivors and (ii) the association between the sexual functioning of BC survivors and that of their partners. We analyzed baseline data from a study of the efficacy of online cognitive-behavioral therapy for sexual dysfunction in BC survivors. Women completed self-report questionnaires assessing sexual functioning, sexual distress, relationship intimacy, marital functioning, menopausal symptoms, body image, and psychological distress. Their partners completed questionnaires assessing sexual functioning. The study included 169 BC survivors and 67 partners. The most prevalent female sexual dysfunctions were hypoactive sexual desire disorder (HSDD; 83%), sexual arousal disorder (40%), and dyspareunia (33%). Endocrine therapy was associated with HSDD (P = .003), and immunotherapy was associated with dyspareunia (P = .009). Older age was associated with lower sexual distress (P < .001). Depressive symptoms were highest in women with sexual arousal disorder (P = .004). An indication for erectile disorder was present in two thirds of partners. Lower overall partner sexual satisfaction was associated with lower overall BC survivor sexual functioning (P = .001), lower female arousal (P = .002), and lower female sexual satisfaction (P = .001). Poorer male erectile function was related to higher female sexual pain (P = .006). Partners of women who underwent breast reconstruction reported marginally significantly better orgasmic functioning (P = .012) and overall sexual functioning (P = .015) than partners of women who had undergone breast-conserving treatment. BC survivors and their partners experience sexual problems after BC treatment. This suggests that not only the BC survivor but also her partner could benefit from sexual counseling. This is the first study focusing on BC survivors with a DSM-IV sexual dysfunction and their partners. The results cannot necessarily be generalized to women experiencing milder sexual problems or who have no interest in receiving sexual counseling. Endocrine therapy and immunotherapy are relevant risk factors for HSDD and dyspareunia in BC survivors. The sexual functioning of women and their partners is affected, underscoring the importance of involving both partners in sexual counseling after BC treatment. Hummel SB, Hahn DEE, van Lankveld JJDM, et al. Factors Associated With Specific Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Sexual Dysfunctions in Breast Cancer Survivors: A Study of Patients and Their Partners. J Sex Med 2017;14:1248-1259. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The association between sexual satisfaction and body image in women.

PubMed

Pujols, Yasisca; Seal, Brooke N; Meston, Cindy M

2010-02-01

Although sexual functioning has been linked to sexual satisfaction, it only partially explains the degree to which women report being sexually satisfied. Other factors include quality of life, relational variables, and individual factors such as body image. Of the few studies that have investigated the link between body image and sexual satisfaction, most have considered body image to be a single construct and have shown mixed results. The present study assessed multiple body image variables in order to better understand which aspects of body image influence multiple domains of sexual satisfaction, including sexual communication, compatibility, contentment, personal concern, and relational concern in a community sample of women. Women between the ages of 18 and 49 years in sexual relationships (N = 154) participated in an Internet survey that assessed sexual functioning, five domains of sexual satisfaction, and several body image variables. Body image variables included the sexual attractiveness, weight concern, and physical condition subscales of the Body Esteem Scale, the appearance-based subscale of the Cognitive Distractions During Sexual Activity Scale, and body mass index. Total score of the Sexual Satisfaction Scale for Women was the main outcome measure. Sexual functioning was measured by a modified Female Sexual Function Index. Consistent with expectations, correlations indicated significant positive relationships between sexual functioning, sexual satisfaction, and all body image variables. A multiple regression analysis revealed that sexual satisfaction was predicted by high body esteem and low frequency of appearance-based distracting thoughts during sexual activity, even after controlling for sexual functioning status. Several aspects of body image, including weight concern, physical condition, sexual attractiveness, and thoughts about the body during sexual activity predict sexual satisfaction in women. The findings suggest that women who experience low sexual satisfaction may benefit from treatments that target these specific aspects of body image.

Sexual Dysfunctions in Men and Women with Inflammatory Bowel Disease: The Influence of IBD-Related Clinical Factors and Depression on Sexual Function.

PubMed

Bel, Linda G J; Vollebregt, Anna M; Van der Meulen-de Jong, Andrea E; Fidder, Herma H; Ten Hove, Willem R; Vliet-Vlieland, Cornelia W; Ter Kuile, Moniek M; de Groot, Helena E; Both, Stephanie

2015-07-01

Inflammatory bowel disease (IBD) is likely to have an impact on sexual function because of its symptoms, like diarrhea, fatigue, and abdominal pain. Depression is commonly reported in IBD and is also related to impaired sexual function. This study aimed to evaluate sexual function and its association with depression among patients with IBD compared with controls. IBD patients registered at two hospitals participated. The control group consisted of a general practitioner practice population. The web-based questionnaire included the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men. Other variables evaluated were depression, disease activity, IBD-related quality of life, body image, and fatigue. In total, 168 female and 119 male patients were available for analysis (response rate 24%). Overall, patients with IBD did not significantly differ in prevalence of sexual dysfunctions from controls: female patients 52%, female controls 44%, male patients and male controls both 25%. However, men and women with an active disease scored significantly lower than patients in remission and controls, indicating impaired sexual functioning during disease activity. Significant associations were found between active disease, fatigue, depressive mood, quality of life, and sexual function for both male and female patients. The association between disease activity and sexual function was totally mediated by depression. Male and female IBD patients with an active disease show impaired sexual function relative to patients in remission and controls. Depression is the most important determinant for impaired sexual function in IBD. © 2015 International Society for Sexual Medicine.

Sexual function and bother after radical prostatectomy or radiation for prostate cancer: multivariate quality-of-life analysis from CaPSURE. Cancer of the Prostate Strategic Urologic Research Endeavor.

PubMed

Litwin, M S; Flanders, S C; Pasta, D J; Stoddard, M L; Lubeck, D P; Henning, J M

1999-09-01

To measure the effect of treatment choice (pelvic irradiation [XRT] versus radical prostatectomy [RP] with or without nerve sparing) on sexual function and sexual bother during the first 2 years after treatment. We studied sexual function and sexual bother in 438 men recently diagnosed with early-stage prostate cancer and treated with XRT or RP with or without nerve sparing. Outcomes were assessed with the University of California, Los Angeles Prostate Cancer Index, a validated health-related quality-of-life instrument that includes these two domains. To minimize the influence of other factors, we adjusted for age, comorbidity, general health, and previous treatment for erectile dysfunction. All subjects were drawn from CaPSURE, a national, longitudinal data base. Sexual function improved over time during the first year in all treatment groups; however, during the second year, sexual function began to decline in the XRT group. Older patients who received XRT showed substantial declines in sexual function throughout the 2 years, and older patients who underwent RP experienced a return of very low baseline sexual function. Sexual function was improved by the use of nerve-sparing procedures or erectile aids. Alterations in sexual bother were ameliorated by many factors, including age, general health perceptions, and sexual function. Patients undergoing XRT or RP with or without nerve sparing all showed comparable rates of improvement in sexual function during the first year after treatment for early-stage prostate cancer. However, in the second year after treatment, patients treated with XRT began to show declining sexual function; patients treated with RP did not.

Evaluation of sexual function in women with type 2 diabetes mellitus.

PubMed

Fatemi, Seyedeh Seddigeh; Taghavi, Seyed Morteza

2009-01-01

Sexual health is an important, but often neglected, component of diabetes care. In contrast to erectile dysfunction among men with diabetes, female sexual dysfunction has not been well studied among diabetic women. The aim of this study was to assess the prevalence of sexual dysfunction in women with type 2 diabetes compared to that in an age-matched control group. In all, 50 married women with type 2 diabetes attending the outpatient endocrine clinic of Ghaem Hospital between April 2007 and March 2008 were selected. Fasting plasma glucose and glycosylated haemoglobin were measured and sexual function was assessed by questionnaire. Scores in each domain of sexual function were compared with those of 40 non-diabetic controls. Sexual function scores for the sexual drive, arousal, vaginal lubrication, orgasm and overall satisfaction domains were all lower in the diabetic women (p value < 0.05). Duration of diabetes and age correlated negatively with all domains of sexual function. There was no significant relationship between sexual function and body mass index (BMI), glycaemic control, education or employment status. Diabetes significantly impairs the sexual performance of diabetic women. Determinants of sexual function include age and duration of diabetes.

A Review of the Literature on Inappropriate Sexual Contact Between Children: Description, Family Dynamics, and Effects.

ERIC Educational Resources Information Center

Brown, MaryLynne

This paper reviews the research literature from 1972 to 1990 relative to inappropriate sexual contact between children. Because of the difficulty in making a clear comparison between studies, the normal child sexual development literature was reviewed to establish a baseline for determining the nature of inappropriate sexual interactions between…

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

PubMed Central

Meston, Cindy M.

2010-01-01

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.” PMID:15927143

What couples say about their recovery of sexual intimacy after prostatectomy: toward the development of a conceptual model of couples’ sexual recovery after surgery for prostate cancer

PubMed Central

Wittmann, Daniela; Carolan, Marsha; Given, Barbara; Skolarus, Ted A.; Crossley, Heather; An, Lawrence; Palapattu, Ganesh; Clark, Patricia; Montie, James E.

2015-01-01

Introduction Interventions designed to help couples recover sexual intimacy after prostatectomy have not been guided by a comprehensive conceptual model. Aim We examined a proposed biopsychosocial conceptual model of couples’ sexual recovery that included functional, psychological and relational aspects of sexuality, surgery-related sexual losses, and grief and mourning as recovery process. Methods We interviewed twenty couples pre-operatively and 3-months post-operatively. between 2010 and 2012. Interviews were analyzed with Analytic Induction qualitative methodology, using NVivo software. Paired t-tests described functional assessment data. Study findings led to a revised conceptual model. Main Outcome Measures Couples’ experiences were assessed through semi-structured interviews; male participants’ sexual function was assessed with the Expanded Prostate Cancer Index Composite and female participants’ sexual function with the Female Sexual Function Index. Results Pre-operatively, 30% of men had erectile dysfunction (ED), 84% of partners were post-menopausal. All valued sexual recovery, but worried about cancer spread and surgery side-effects. Faith in themselves and their surgeons led 90% of couples to overestimate erectile recovery. Post-operatively, most men had ED and lost confidence. Couples’ sexual activity decreased. Couples reported feeling loss and grief: cancer diagnosis was the first loss, followed by surgery-related sexual losses. Couples’ engagement in intentional sex, patients’ acceptance of erectile aids and partners’ interest in sex aided the recovery of couples’ sexual intimacy recovery. Unselfconscious sex, not return to erectile function baseline, was seen as the endpoint. Survey findings documented participants’ sexual function losses, confirming qualitative findings. Conclusions Couples’ sexual recovery requires addressing sexual function, feelings about losses and relationship simultaneously. Peri-operative education should emphasize the roles of nerve damage in ED and grief and mourning in sexual recovery. PMID:25358901

Improved sexual and urinary function in women with sacral nerve stimulation.

PubMed

Gill, Bradley C; Swartz, Mia A; Firoozi, Farzeen; Rackley, Raymond R; Moore, Courtenay K; Goldman, Howard B; Vasavada, Sandip P

2011-01-01

  Urinary and sexual function improve following sacral nerve stimulation (SNS) for refractory overactive bladder. No significant associations between these changes have been found. Whether improvements in sexual function are independent of or secondary to improvements in urinary function remains unclear. The aim of this study was to analyze changes in urinary and sexual function in a homogeneous sample of patients undergoing SNS for urge urinary incontinence and subsequently identify associations between the two.   A prospective database was created. Enrollees underwent a full history and physical examination at the first office visit. Multiple-day voiding diaries with validated and investigator-designed questionnaires were administered at baseline and follow-up as standard implantation procedures and to assess changes in urinary and sexual function, respectively. Analyses were completed using data from patients who were sexually active at baseline and follow-up.   Statistically significant improvements in urinary and sexual function occurred according to multiple metrics. Patient global impression scales categorized all patients' urinary conditions as improved, with most being less severe. Validated urinary symptom and quality of life scores improved significantly. After treatment, most patients were incontinent less often with sexual activity and felt less restricted from sexual activity by fear of incontinence. Validated quantification of sexual function demonstrated significant improvements in overall sexual function, arousal, and satisfaction. No significant associations between changes in urinary and sexual function were noted; however, trends appeared to exist between the two.   Improved sexual function was not significantly associated with improved urinary function after SNS despite apparent trends between the two. Larger samples are required to definitively demonstrate this conclusion. © 2011 International Neuromodulation Society.

Dyadic sexual communication in pre-menopausal women with self-reported dyspareunia and their partners: associations with sexual function, sexual distress and dyadic adjustment.

PubMed

Pazmany, Els; Bergeron, Sophie; Verhaeghe, Johan; Van Oudenhove, Lukas; Enzlin, Paul

2015-02-01

While there is increasing interest in studying aspects of communication processes in sex research, the association between dyadic sexual communication and relationship and sexuality outcomes has not yet been examined in pre-menopausal women with dyspareunia. To examine the associations between dyadic sexual communication and pain, sexual distress, sexual function and dyadic adjustment in women with self-reported dyspareunia and their male partners. Pre-menopausal women (n=38; M age=24.92, SD=6.12) with self-reported dyspareunia from a community sample and their partners (n=38; M age=26.71, SD=6.59) completed an online survey. The Actor-Partner Interdependence Model was used in order to investigate both actor and partner effects. Both members of the couple completed: (i) the Dyadic Sexual Communication Scale and (ii) the Dyadic Adjustment Scale; women also completed (iii) the Female Sexual Function Index, (iv) the Female Sexual Distress Scale, and (v) a Visual Analogue Scale on pain during intercourse; and men also completed (vi) the International Index of Erectile Functioning. Controlling for relationship duration, women's better dyadic sexual communication was significantly associated with their higher levels of sexual function (P=0.028), lower levels of sexual distress (P=0.003) and higher levels of dyadic adjustment (P=0.005), but not with their pain or men's sexual function or dyadic adjustment. Controlling for relationship duration, men's better dyadic sexual communication was associated with their higher levels of dyadic adjustment (P=0.027) but not with their sexual function, nor with women's sexual function or dyadic adjustment. These findings contribute to the theoretical knowledge on interaction processes in couples with dyspareunia and suggest that it may be important to enhance open and direct communication about sexual matters in couples with dyspareunia. © 2014 International Society for Sexual Medicine.

Sexual Anatomy and Function in Women With and Without Genital Mutilation: A Cross-Sectional Study.

PubMed

Abdulcadir, Jasmine; Botsikas, Diomidis; Bolmont, Mylène; Bilancioni, Aline; Djema, Dahila Amal; Bianchi Demicheli, Francesco; Yaron, Michal; Petignat, Patrick

2016-02-01

Female genital mutilation (FGM), the partial or total removal of the external genitalia for non-medical reasons, can affect female sexuality. However, only few studies are available, and these have significant methodologic limitations. To understand the impact of FGM on the anatomy of the clitoris and bulbs using magnetic resonance imaging and on sexuality using psychometric instruments and to study whether differences in anatomy after FGM correlate with differences in sexual function, desire, and body image. A cross-sectional study on sexual function and sexual anatomy was performed in women with and without FGM. Fifteen women with FGM involving cutting of the clitoris and 15 uncut women as a control group matched by age and parity were prospectively recruited. Participants underwent pelvic magnetic resonance imaging with vaginal opacification by ultrasound gel and completed validated questionnaires on desire (Sexual Desire Inventory), body image (Questionnaire d'Image Corporelle [Body Image Satisfaction Scale]), and sexual function (Female Sexual Function Index). Primary outcomes were clitoral and bulbar measurements on magnetic resonance images. Secondary outcomes were sexual function, desire, and body image scores. Women with FGM did not have significantly decreased clitoral glans width and body length but did have significantly smaller volume of the clitoris plus bulbs. They scored significantly lower on sexual function and desire than women without FGM. They did not score lower on Female Sexual Function Index sub-scores for orgasm, desire, and satisfaction and on the Questionnaire d'Image Corporelle but did report significantly more dyspareunia. A larger total volume of clitoris and bulbs did not correlate with higher Female Sexual Function Index and Sexual Desire Inventory scores in women with FGM compared with uncut women who had larger total volume that correlated with higher scores. Women with FGM have sexual erectile tissues for sexual arousal, orgasm, and pleasure. Women with sexual dysfunction should be appropriately counseled and treated. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Female Sexual Victimization Among College Students: Assault Severity, Health Risk Behaviors, and Sexual Functioning.

PubMed

Turchik, Jessica A; Hassija, Christina M

2014-09-01

The purpose of the present study was to examine the relationship between college women's sexual victimization experiences, health risk behaviors, and sexual functioning. A sample of 309 college women at a mid-sized Midwestern university completed measures assessing sexual victimization, sexual risk taking, substance use behaviors, sexual desire, sexual functioning, prior sexual experiences, and social desirability. Severity of sexual victimization was measured using a multi-item, behaviorally specific, gender-neutral measure, which was divided into four categories based on severity (none, sexual contact, sexual coercion, rape). Within the sample, 72.8% (n = 225) of women reported at least one experience of sexual victimization since age 16. Results from MANCOVAs and a multinomial logistic regression, controlling for social desirability and prior sexual experience, revealed that sexual victimization among female students was related to increased drug use, problematic drinking behaviors, sexual risk taking, sexual dysfunction, and dyadic sexual desire. In addition, findings indicated that women exposed to more severe forms of sexual victimization (i.e., rape) were most likely to report these risk-taking behaviors and sexual functioning issues. Implications for sexual assault risk reduction programming and treatment are discussed. © The Author(s) 2014.

Implicit and Explicit Associations with Erotic Stimuli in Women with and Without Sexual Problems.

PubMed

van Lankveld, Jacques J D M; Bandell, Myrthe; Bastin-Hurek, Eva; van Beurden, Myra; Araz, Suzan

2018-02-20

Conceptual models of sexual functioning have suggested a major role for implicit cognitive processing in sexual functioning. The present study aimed to investigate implicit and explicit cognition in sexual functioning in women. Gynecological patients with (N = 38) and without self-reported sexual problems (N = 41) were compared. Participants performed two Single-Target Implicit Association Tests (ST-IAT), measuring the implicit association of visual erotic stimuli with attributes representing, respectively, valence and motivation. Participants also rated the erotic pictures that were shown in the ST-IATs on the dimensions of valence, attractiveness, and sexual excitement, to assess their explicit associations with these erotic stimuli. Participants completed the Female Sexual Functioning Index and the Female Sexual Distress Scale for continuous measures of sexual functioning, and the Hospital Anxiety and Depression Scale to assess depressive symptoms. Compared to nonsymptomatic women, women with sexual problems were found to show more negative implicit associations of erotic stimuli with wanting (implicit sexual motivation). Across both groups, stronger implicit associations of erotic stimuli with wanting predicted higher level of sexual functioning. More positive explicit ratings of erotic stimuli predicted lower level of sexual distress across both groups.

Sexual self-schema and depressive symptoms after prostate cancer.

PubMed

Hoyt, Michael A; Carpenter, Kristen M

2015-04-01

The years following prostate cancer treatment are characterized by changes in sexual functioning and risk for depressive symptoms. Sexual self-schema (SSS) is a cognitive generalization about sexual aspects of the self that are associated with sexual behavior, affect, and the processing of sexually relevant information. This study tested if men's SSS moderates the impact of sexual morbidity on depressive symptoms. Men (N = 66) treated for localized prostate cancer in the preceding 2 years were assessed at T1 and 4 months later (T2). Questionnaires included the Center for Epidemiologic Studies Depression Scale, Sexual Self-schema Scale for Men, Sexual Experience Scale, and Expanded Prostate Cancer Index Composite. Regressions controlled for age, sexual activity, and T1 depressive symptoms revealed no significant effect of SSS on depressive symptoms; however, better sexual functioning was related to fewer depressive symptoms (B = -0.25, p < 0.05). Results showed significant interactions between SSS and sexual outcomes. Among men with high SSS, poor sexual functioning was associated with increased depressive symptoms; loss of sexual function was particularly distressing. There was no significant effect of sexual functioning. Among men with high SSS, there was an inverse relationship between sexual engagement and depressive symptoms. Among men with lower SSS, greater frequency of sexual behavior was associated with increased depressive symptoms. SSS may be an important individual difference in determining the impact of sexual morbidity on psychological adjustment. Men high on SSS are more vulnerable to psychological consequences of lower sexual functioning and less engagement in sexual activities. Copyright © 2014 John Wiley & Sons, Ltd.

Effects of aqueous extract of Musa paradisiaca root on testicular function parameters of male rats.

PubMed

Yakubu, Musa Toyin; Oyeyipo, Theo Oyetayo; Quadri, Ayodeji Luqman; Akanji, Musbau Adewumi

2013-01-01

There is an age-long claim that the Musa paradisiaca root is used to manage reproductive dysfunction, most especially sexual dysfunction (as an aphrodisiac), but there are no data in the open scientific literature that have refuted or supported this claim and the effects of M. paradisiaca root on the testes. Therefore, this study was aimed at investigating the effect of oral administration of the aqueous extract of M. paradisiaca root on the testicular function parameters of male rat testes. Sexually matured male albino rats (138.67±5.29 g) were randomly assigned into four groups, A, B, C, and D, that respectively received 0.5 mL (3.6 mL/kg body weight) of distilled water and 25, 50, and 100 mg/kg body weight of the extract, orally, once daily, for 14 days. The extract significantly increased (p<0.05) the testes-body weight ratio, total protein, sialic acid, glycogen, cholesterol, activities of alkaline phosphatase, γ-glutamyltransferase, acid phosphatase, and the concentration of testicular testosterone. In contrast, the extract decreased the concentrations of both luteinizing and follicle-stimulating hormones in the serum of the animals. The results revealed that oral administration of M. paradisiaca root extract at doses of 25, 50, and 100 mg/kg body weight enhanced the testosterone-dependent normal functioning of the testes. Overall, the aqueous extract of M. paradisiaca stimulated the normal functioning of the testes and exhibited both androgenic and anabolic properties. The results may explain the rationale behind the folkloric beneficial effect of the plant in the management of reproductive dysfunction.

Effect of environmental contaminants on mammalian testis.

PubMed

Manfo, Faustin P T; Nantia, Edouard A; Mathur, Premendu P

2014-01-01

Exposure of humans and wildlife to pollutants released in the environment is a centre of attention nowadays. Many of these chemicals (generally referred to as environmental pollutants) have been shown to interfere with normal hormonal signalling and biological functions, leading to reproductive disorders or infertility, which has been a matter of concern within the recent decades. The present paper reviews adverse effects of these toxicants on mammalian testes, with emphasis on alteration of steroidogenesis, spermatogenesis, and histopathological effects. From the publications reviewed, it appears that environmental toxicants, especially heavy metals and organic chemicals of synthetic and microbiological origins, disrupt hormone production and action in the mammalian testes. Endocrine disruption leads to disorders of testicular function and thereby compromises the normal phenotypic development of male sexual characteristics, initiation and maintenance of spermatogenesis. The toxicants also induce impairment of testicular cells function, testicular histology, and sperm cells function directly. The release of the toxicants in the environment is still ongoing, despite alarming quantities that already exist in the atmosphere. If appropriate measures are not taken, their impact on the male reproductive function and especially on testicular function will be more serious.

Conflicts Within the Family and Within the Couple as Contextual Factors in the Determinism of Male Sexual Dysfunction.

PubMed

Boddi, Valentina; Fanni, Egidia; Castellini, Giovanni; Fisher, Alessandra Daphne; Corona, Giovanni; Maggi, Mario

2015-12-01

The deterioration of a couple's relationship has been previously associated with impairment in male sexual function. Besides a couple's dystonic relationship, other stressors can unfavorably influence dyadic intimacy. A largely neglected etiopathogenetic factor affecting couple sexuality is the frustration caused by conflicts within the family. To evaluate the possible associations between male sexual dysfunction (SD) and conflictual relationships within the couple or the family. A consecutive series of 3,975 men, attending the Outpatient Clinic for SD for the first time, was retrospectively studied. Conflicts within the family and within the couple were assessed using two standard questions: "Are there any conflicts at home," and "Do you have a difficult relationship with your partner?" respectively, rating 0 = normal relationships, 1 = occasional quarrels, and 2 = frequent quarrels or always. Several clinical, biochemical, and psychological (Middlesex Hospital Questionnaire) parameters were studied. Among the 3,975 patients studied, we observed a high prevalence of conflicts within the family and within the couple (32% vs. 21.2%). When compared with the rest of the sample, subjects reporting both type of conflicts showed a higher prevalence of psychiatric comorbidities. Hence, all data were adjusted for this parameter and for age. Family and couple conflicts were significantly associated with free floating anxiety, depression symptoms, and with a higher risk of subjective (self-reported) and objective (peak systolic velocity at the penile color Doppler ultrasound <35 mm/sec2) erectile dysfunction and hypoactive sexual desire. Female sexual function parameters, as reported by the patient, retained a significant association with both type of conflicts. This study indicates that the presence of often unexplored issues, like conflicts within the family or within the couple, can represent an important contextual factor in the determinism of male SD. © 2015 International Society for Sexual Medicine.

Sexual Functioning in Experienced Meditators.

PubMed

Dascalu, Iulia; Brotto, Lori A

2017-11-21

Given evidence of the benefits of mindfulness for women's sexual difficulties, we investigated the relationship between meditation experience and women's sexual function. Women (N = 450) answered online survey questions about meditation experience, sexual function and desire, interoceptive awareness, health and mood. Women who meditated scored higher than nonmeditators on measures of sexual function and desire, however there was no significant correlation between frequency/length of meditation experience and either of these domains. Global mental health was a significant predictor of both increased sexual function and desire in women who meditate. These findings suggest that, compared to women with no meditation experience, women who meditate to any extent have, on average, improved sexual function associated with better overall mental health.

Sexual Dimorphism and Allometric Effects Associated With the Wing Shape of Seven Moth Species of Sphingidae (Lepidoptera: Bombycoidea)

PubMed Central

de Camargo, Nícholas Ferreira; Corrêa, Danilo do Carmo Vieira; de Camargo, Amabílio J. Aires; Diniz, Ivone Rezende

2015-01-01

Sexual dimorphism is a pronounced pattern of intraspecific variation in Lepidoptera. However, moths of the family Sphingidae (Lepidoptera: Bombycoidea) are considered exceptions to this rule. We used geometric morphometric techniques to detect shape and size sexual dimorphism in the fore and hindwings of seven hawkmoth species. The shape variables produced were then subjected to a discriminant analysis. The allometric effects were measured with a simple regression between the canonical variables and the centroid size. We also used the normalized residuals to assess the nonallometric component of shape variation with a t-test. The deformations in wing shape between sexes per species were assessed with a regression between the nonreduced shape variables and the residuals. We found sexual dimorphism in both wings in all analyzed species, and that the allometric effects were responsible for much of the wing shape variation between the sexes. However, when we removed the size effects, we observed shape sexual dimorphism. It is very common for females to be larger than males in Lepidoptera, so it is expected that the shape of structures such as wings suffers deformations in order to preserve their function. However, sources of variation other than allometry could be a reflection of different reproductive flight behavior (long flights in search for sexual mates in males, and flight in search for host plants in females). PMID:26206895

Rapid adaptation to mammalian sociality via sexually selected traits

PubMed Central

2013-01-01

Background Laboratory studies show that the components of sexual selection (e.g., mate choice and intrasexual competition) can profoundly affect the development and fitness of offspring. Less is known, however, about the total effects of sexual selection on offspring in normal social conditions. Complex social networks, such as dominance hierarchies, regulate the opportunity for mating success, and are often missing from laboratory studies. Social selection is an extended view of sexual selection that incorporates competition during sexual and nonsexual interactions, and predicts complex evolutionary dynamics. Whether social selection improves or constrains offspring fitness is controversial. Results To identify fitness consequences of social selection, wild-derived mice that had bred under laboratory conditions for eight generations were re-introduced to naturalistic competition in enclosures for three consecutive generations (promiscuous line). In parallel, a control lineage bred in cages under random mate assignment (monogamous line). A direct competition experiment using second-generation animals revealed that promiscuous line males had greater reproductive success than monogamous line males (particularly during extra-territorial matings), in spite of higher mortality and equivalent success in social dominance and sperm competition. There were no major female fitness effects (though promiscuous line females had fewer litters than monogamous line females). This result suggested that selection primarily acted upon a sexually attractive male phenotype in the promiscuous line, a hypothesis we confirmed in female odor and mating preference trials. Conclusions We present novel evidence for the strength of sexual selection under normal social conditions, and show rapid male adaptation driven largely by sexual trait expression, with tradeoffs in survivorship and female fecundity. Re-introducing wild-derived mice to competition quickly uncovers sexually selected phenotypes otherwise lost in normal colony breeding. PMID:23577674

Sex after seventy: a pilot study of sexual function in older persons.

PubMed

Smith, Lizette J; Mulhall, John P; Deveci, Serkan; Monaghan, Niall; Reid, M C

2007-09-01

Limited information is available regarding sexual functioning among adults aged 70 years and older. To assess sexual functioning among older men and women, and ascertain patient-physician communication patterns about sexual functioning. Prospective participants were approached prior to scheduled appointments with their primary care physician. In-depth sexual histories were obtained along with data on their demographic, medical, psychological, and cognitive status. Sexual functioning was assessed using standardized questionnaires, and simple yes/no questions were administered to ascertain information regarding patient-physician communication practices about sex. Of the 74 eligible patients approached, 50 (68%) participated. The participants had a mean age +/- standard deviation (SD) of 81 +/- 6 years and most (56%) were women. Eighteen percent of the women and 41% of the men were sexually active. The most commonly reported sexual activity was intercourse for men and masturbation for women. Among the women, the most commonly cited reason for being sexually inactive was "no desire," whereas for most men, it was "erectile dysfunction." Sexual function scores for women were low across each category (lubrication, desire, orgasm, arousal, pain, and satisfaction.) For men, low sexual function scores were found in the domains of erectile function, orgasm, and overall satisfaction, but not desire. Only 4% of the women (vs. 36% of men) reported initiating a discussion about sexual function with their physician in the past year, whereas 7% of the women (vs. 32% of men) reported that their physician inquired about the topic in the preceding year. Finally, 32% of the women (vs. 86% of men) felt that physicians should initiate discussions about sexual function. In this study of older adults, a minority reported current sexual activity. Among sexually inactive women, most did not wish to resume activity, whereas desire for sexual activity remained high among men, despite substantial problems with erectile dysfunction.

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…

Sexual Functioning, Beliefs About Sexual Functioning and Quality of Life of Women with Infertility Problems.

PubMed

Agustus, Prathibha; Munivenkatappa, Manjula; Prasad, Padmini

2017-01-01

The study was conducted in the background of paucity of studies examining the sexual and psychosocial functioning of women with infertility. The study explored sexual functioning in women with infertility problems, their beliefs about sexuality and their quality of life. A single group exploratory design with non-probability purposive sampling was used. A total of 30 participants diagnosed with primary infertility were included in the study. The data were obtained by individual administration of the following tools: Semi-structured interview schedule, Female Sexual Functioning Inventory, Sexual Dysfunctional Beliefs Questionnaire, World Health Organization Quality of Life Scale - BREF Version and General Health Questionnaire-12. The data obtained were analyzed using descriptive statistics and non-parametric tests. About half of the participants had sexual dysfunction. Pain-related problems were most commonly reported (50%). Factors contributing to dysfunction included inadequate knowledge about sex, sexual stimulation and sexual communication. Along with inadequate self-image, negative childhood experiences, financial difficulties and marital discord in parents influenced the perception of self. Majority of the women had dysfunctional beliefs about sexuality (56%), and greater beliefs were found to be in the domain of sexual conservatism. The overall quality of life was poor, and 56% of women experienced psychological distress. There was significant positive correlation between sexual conservatism and experience of pain and overall sexual functioning. Women with infertility bear dysfunctional beliefs and suffer from problems in sexual functioning, have low quality of life and high psychological distress.

Accuracy of 30-Day Recall for Components of Sexual Function and the Moderating Effects of Gender and Mood

PubMed Central

Lin, Li; Dombeck, Carrie B.; Broderick, Joan E.; Snyder, Denise C.; Williams, Megan S.; Fawzy, Maria R.; Flynn, Kathryn E.

2013-01-01

Introduction Despite the ubiquity of 1-month recall periods for measures of sexual function, there is limited evidence for how well recalled responses correspond to individuals’ actual daily experiences. Aim To characterize the correspondence between daily sexual experiences and 1-month recall of those experiences. Methods Following a baseline assessment of sexual functioning, health, and demographic characteristics, 202 adults from the general population (101 women, 101 men) were recruited to complete daily assessments of their sexual function online for 30 days and a single recall measures of sexual function at day 30. Main Outcome Measures At the baseline and 30-day follow-ups, participants answered items asking about sexual satisfaction, sexual activities, interest, interfering factors, orgasm, sexual functioning, and use of therapeutic aids during the previous 30 days. Participants also completed a measure of positive and negative affect at follow-up. The main outcome measures were agreement between the daily and 1-month recall versions of the sexual function items. Results Accuracy of recall varied depending on the item and on the gender and mood of the respondent. Recall was better (low bias and higher correlations) for sexual activities, vaginal discomfort, erectile function, and more frequently used therapeutic aids. Recall was poorer for interest, affectionate behaviors (eg, kissing), and orgasm-related items. Men more than women overestimated frequency of interest and masturbation. Concurrent mood was related to over- or underreporting for 6 items addressing the frequency of masturbation and vaginal intercourse, erectile function, and orgasm. Conclusions A 1-month recall period seems acceptable for many aspects of sexual function in this population, but recall for some items was poor. Researchers should be aware that concurrent mood can have a powerful biasing effect on reports of sexual function. PMID:23802907

Bariatric surgery is associated with reduced depressive symptoms and better sexual function in obese female patients: a one-year follow-up study.

PubMed

Assimakopoulos, Konstantinos; Karaivazoglou, Katerina; Panayiotopoulos, Spiros; Hyphantis, Thomas; Iconomou, Gregoris; Kalfarentzos, Fotis

2011-03-01

Bariatric surgery is an effective treatment for obesity; few studies, however, have investigated its impact on patients' sexuality. We aimed to determine bariatric surgery's effect on female patients' body mass index (BMI), anxiety and depressive symptoms, and sexual function and delineate predictors of treatment outcomes. Fifty-nine obese female bariatric candidates were administered the Hospital Anxiety and Depression Scale and the Female Sexual Function Index 1 week before surgery (T1) and 1 year after (T2). Statistical analysis revealed significant reductions in BMI (p < 0.001), depression (p < 0.001), and sexual pain levels (p = 0.014) and significant improvements in sexual desire (p = 0.005), arousal (p = 0.001), lubrication (p = 0.003), satisfaction (p = 0.012), and total sexual function (p = 0.003) postoperatively. Postoperative total sexual function was independently predicted by baseline sexual function and low baseline BMI. Bariatric surgery is an effective way to reduce weight, manage depression, and improve sexual function in female obese patients.

Alexithymia, negative emotions, and sexual behavior in heterosexual university students from Italy.

PubMed

Scimeca, Giuseppe; Bruno, Antonio; Pandolfo, Gianluca; Micò, Umberto; Romeo, Vincenzo M; Abenavoli, Elisabetta; Schimmenti, Adriano; Zoccali, Rocco; Muscatello, Maria R A

2013-01-01

Alexithymia is a construct which denotes thought characterized by pragmatic content, an inability to recognize and verbally express emotion, a difficulty in distinguishing between feelings and bodily sensations, and a limitation in fantasy life. Research has revealed a role for alexithymia in different kinds of sexual dysfunctions; it was also associated with reduced frequency of penile-vaginal intercourse but not with sexual behaviors-like masturbation-which do not include an emotional interaction in normal individuals. The aim of this research was to further investigate the association between alexithymia scores and sexual behavior in a sample of normal individuals, taking into account the role of gender differences and the possible effect of negative emotions (depression, anxiety, and anger). Participants were 300 university students (142 men and 158 women); sexual behavior was measured by the Sex and the Average Woman (or Man) Scale while alexithymia was measured with the Toronto Alexithymia Scale. The findings of the study showed that higher alexithymia scores were associated with lower levels of sexual satisfaction and higher levels of sexual detachment for females, and with sexual shyness and sexual nervousness for both genders. Results also suggested that the correlations between alexithymia scores and sexual behavior are partially influenced by the effect of negative emotions. Overall, it seems that the same detachment which denotes the alexithymic interpersonal style also characterizes sexual behavior.

[EFFECTIVENESS OF VAGINOPLASTY WITH ACELLULAR DERMAL MATRIX AND MIXED PARTICLES GRAFT].

PubMed

Zhou, Yu; Li, Qiang; Ll, Senkai; Zhou, Chuande; Li, Fengyong; Cao, Yujiao; Zhang, Siya; Wei, Shuyi; Zhao, Yang

2015-06-01

To evaluate the effectiveness or acellular dermal matrix (ADM) with autologous buccal micro mucosa and micro skin graft in vaginoplasty. A retrospective analysis was made on the clinical data of 67 patients with vaginal agenesis treated between July 2006 and June 2013. ADM and mixed particles were used in 20 cases (ADM group) and mixed particles graft in 47 cases (control group) in vaginoplasty. There was no significant difference in age between 2 groups (t=0.233, P=0.816). The depth, diameter, and volume of neovagina, epithelization time, stent needing time, and female sexual function index (FSFI) score were compared between 2 groups. There was no significant difference in operation time and amount of bleeding between 2 groups (t = -1.922, P = 0.059; t = 0.398, P = 0.692). The patients were followed up 11-38 months (mean, 16.08 months). Fifteen cases in ADM group and 29 cases in control group had sexual life after operation. Bleeding after operation occurred in 6 cases (2 in ADM group and 4 in control group). No stenosis was observed. Difference in epithelization time was not statistically significant (t = -1.938, P = 0.057). However, the stent needing time of ADM group was significantly shorter than that of control group (t = 7.020, P = 0.000). The neovagina was ideal in wetness degree, smoothness, flexibility, and hairlessness during follow-up. The depth, diameter, and volume of vagina had no significant difference between 2 groups (P > 0.05) at last follow-up, which were close to normal vagina. The other patients had normal sexual function except 1 patient whose FSFI score was less than 23; no statistically significant difference was found in FSFI score between 2 groups (P > 0.05). On the basis of mixed particles grafting, the ADM could improve trestle structure for resisting contracture. The effectiveness is better than merely mixed particles graft. The procedure has satisfactory anatomical and functional results.

The effect of vilazodone on sexual function during the treatment of major depressive disorder.

PubMed

Clayton, Anita H; Kennedy, Sidney H; Edwards, John B; Gallipoli, Susan; Reed, Carol R

2013-10-01

  Sexual dysfunction is common in major depressive disorder (MDD), and many serotonergic antidepressants adversely affect sexual function. Vilazodone, a novel serotonin (5-HT) reuptake inhibitor and 5-HT1A partial agonist approved for MDD, exerts its effects at the 5-HT transporter and at both presynaptic and postsynaptic 5-HT1A receptors. This mechanism may limit sexual dysfunction.   To summarize effects of vilazodone (40 mg/day, with food) on sexual function in adults with MDD.   Data sources were three Phase III studies: two 8-week, placebo-controlled studies (NCT00285376 and NCT00683592) and a 52-week open-label study (NCT00644358). Sexual function was assessed by analyzing changes from baseline to end of treatment (EOT) using validated measures.   Arizona Sexual Experience Scale or Changes in Sexual Functioning Questionnaire.   Population included 869 patients (vilazodone, 436; placebo, 433) from placebo-controlled studies and 599 patients from the open-label study. Sexual dysfunction prevalence was high (50%, men; 68%, women) before treatment and declined during treatment in vilazodone and placebo groups, indicating improvement on average. At EOT, stable/improved sexual function was observed in ≥91% of patients in placebo-controlled studies; treatment group differences in sexual dysfunction at EOT were not statistically significant for either sex. Differences vs. placebo in changes from baseline of sexual function scores were small and were generally not statistically significant; effect sizes (Cohen's D) were generally of low magnitude. In the placebo-controlled studies, 8.0% of vilazodone-treated patients and 0.9% of placebo-treated patients reported ≥1 sexual-function-related treatment-emergent adverse event (P<0.001).   Half of men and two thirds of women with MDD had sexual dysfunction at baseline; sexual function improved on average in both vilazodone and placebo groups. Results suggest that vilazodone may have a small adverse impact on sexual function in adults with MDD relative to the high prevalence of sexual dysfunction at baseline. © 2012 International Society for Sexual Medicine.

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 style and dysfunctional sexual beliefs as predictors of sexual coercion proclivity, suggesting avenues for further research. PMID:26185675

The Relationship Between Body Image and Sexual Function in Middle-Aged Women.

PubMed

Afshari, Poorandokht; Houshyar, Zeinab; Javadifar, Nahid; Pourmotahari, Fatemeh; Jorfi, Maryam

2016-11-01

An individual's social and marital function, interpersonal relationships, and quality of life may, sometimes be affected by negative body image. This study is aimed at determining the relationship between body image and sexual function in middle-aged women. In this cross-sectional study, 437 middle-aged women, who were referred to various public healthcare centers in Ahvaz, Iran during 2014-2015, were selected. The Female Sexual Function Index (FSFI) and Body Shape Questionnaire (BSQ) were used for data collection. Chi-square, one-way analysis of variance, Spearman's correlation test, and logistic regression analysis were performed for statistical analysis. Approximately 58% of the participants expressed satisfaction with their body image, 35% were mildly dissatisfied, and 7% were moderately dissatisfied with their body image. Body image had a significant negative relationship with sexual satisfaction and sexual function (p=0.005). Furthermore, there was a significant relationship between body image and sexual desire (p=0.022), pain (p=0.001), sexual arousal (p<0.0005), sexual orgasm (p=0.001), and sexual satisfaction (p<0.0005). As the results indicated, body image is an important aspect of sexual health. In this study, women with a positive body image had higher sexual function valuation, compared to women with a negative body image. Also, body shape satisfaction was a predictor of sexual function.

Beliefs About Appearance, Cognitive Distraction and Sexual Functioning in Men and Women: A Mediation Model Based on Cognitive Theory.

PubMed

Silva, Elizabet; Pascoal, Patrícia M; Nobre, Pedro

2016-09-01

Dysfunctional beliefs about body appearance and cognitive distraction from body appearance during sexual activity have been associated with sexual problems, particularly in women. However, there are no studies examining the interplay between these dimensions and the mechanisms by which they affect sexual functioning. To examine the mediating role of cognitive distraction with body appearance on the relation between beliefs about appearance and sexual functioning. The study sample consisted of 426 heterosexual participants (129 men and 297 women) involved in an exclusive dyadic committed relationship who answered an online questionnaire. The Body Appearance Cognitive Distraction Scale, the Beliefs About Appearance Scale, the International Index of Erectile Function, and the Female Sexual Function Index. The findings indicated that cognitive distraction with body appearance fully mediated the relation between beliefs about appearance and sexual functioning in men and women. The results support the role of beliefs about appearance and cognitive distraction based on body appearance in predicting sexual functioning, reaffirming the role of cognitive models in explaining sexual functioning in men and women. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

"Normal" and "Inappropriate" Childhood Sexual Behaviours: Findings from a Delphi Study of Professionals in the United Kingdom

ERIC Educational Resources Information Center

Vosmer, Susanne; Hackett, Simon; Callanan, Margie

2009-01-01

This paper presents the results of a three-stage Delphi study examining the current level of consensus among 24 professionals in the United Kingdom regarding definitions of and distinctions between normal, inappropriate and sexually abusive behaviours in children under 10 years, as well as factors influencing their views. Although firm conclusions…

Labeling of sexual assault and its relationship with sexual functioning: the mediating role of coping.

PubMed

Kelley, Erika L; Gidycz, Christine A

2015-01-01

Little research has examined the relationship between women's labeling of their sexual assault experiences and sexual functioning, as well as identification of variables that may mediate the labeling-trauma outcome relationship. The purpose of this study was to fill this gap in the literature, by examining the potential mediating role of coping strategies in response to sexual assault in the relationship between labeling and sexual functioning. The sample included 135 college women with a history of adolescent/early adulthood sexual assault. Labeling was not bivariately related to sexual functioning outcomes; however, anxious coping mediated the relationships between labeling and both sexual lubrication and sexual satisfaction. This suggests that correlational analyses between labeling and trauma outcomes may not capture the complexity of this relationship, as it may be more indirect. Furthermore, results suggest that labeling is part of the coping process in response to sexual assault; some women who consider their experience to be sexual assault may engage in anxious coping efforts, contributing to difficulties with sexual lubrication and sexual dissatisfaction. Victims actively working to integrate their sexual assault experience with prior beliefs and self-concept may benefit from treatment focused on decreasing anxious coping, especially as it relates to sexual functioning. © The Author(s) 2014.

Sexual Assault Disclosure and Sexual Functioning: The Role of Trauma Symptomatology.

PubMed

Staples, Jennifer M; Eakins, Danielle; Neilson, Elizabeth C; George, William H; Davis, Kelly Cue; Norris, Jeanette

2016-10-01

Previous research has demonstrated that a history of adult sexual assault (ASA) is associated with negative outcomes, including trauma symptomatology and fear of sexual intimacy. Disclosing sexual assault might be protective against such negative outcomes. To examine the indirect effect of trauma symptomatology on the association between disclosing ASA and current sexual functioning. Participants included 652 women 21 to 30 years old with a history of ASA recruited from the community. Participants completed self-report measurements on a computer. Separate models were performed, with sexual functioning divided into sexual desire, orgasm, and pain during sex. ASA disclosure was indirectly associated with sexual orgasm and pain during sex by trauma symptomatology. However, there was no indirect effect of trauma symptomatology on the relation between ASA disclosure and sexual desire. Disclosing experiences of ASA could serve a protective function by lessening trauma symptomatology, thereby mitigating impacts on aspects of sexual functioning, such as orgasm and pain. Published by Elsevier Inc.

Predictors of sexual functioning and satisfaction 1 year following traumatic brain injury: a TBI model systems multicenter study.

PubMed

Sander, Angelle M; Maestas, Kacey Little; Nick, Todd G; Pappadis, Monique R; Hammond, Flora M; Hanks, Robin A; Ripley, David L

2013-01-01

To investigate predictors of sexual functioning 1 year following traumatic brain injury (TBI). Prospective cohort study. Community. A total of 255 persons with TBI (187 males; 68 females) who had been treated at 1 of 6 TBI Model Systems inpatient rehabilitation units and were living in the community. Derogatis Interview for Sexual Functioning-Self-Report (DISF-SR); Global Satisfaction With Sexual Functioning (Global Sexual Satisfaction Index); Participation Assessment With Recombined Tools-Objective; Patient Health Questionnaire-9. Older age, female gender, and more severe injury were associated with greater sexual dysfunction 1 year following injury. As age increased from 24 to 49 years, the odds of sexual impairment increased more than 3-fold (95% confidence interval: 1.82-5.88). Females had a 2.5 increase in odds of sexual impairment compared with males (95% confidence interval: 1.23-5.26). Greater social participation was predictive of better sexual functioning. Dissatisfaction with sexual functioning was predicted by older age and depression. Older persons and females appear to be at greater risk for sexual dysfunction after TBI and may benefit from specialized assessment and treatment services. Relationships were identified between social participation and sexual function and between depression and sexual satisfaction that may serve as clinical indicators for further assessment and intervention. Further research is needed to elucidate these relationships and identify effective clinical approaches.

Sexual functioning of men and women with severe obesity before bariatric surgery.

PubMed

Steffen, Kristine J; King, Wendy C; White, Gretchen E; Subak, Leslee L; Mitchell, James E; Courcoulas, Anita P; Flum, David R; Strain, Gladys; Sarwer, David B; Kolotkin, Ronette L; Pories, Walter; Huang, Alison J

2017-02-01

Obesity may impair sexual function through multiple mechanisms, but little is known about sexual dysfunction among adults with severe obesity seeking bariatric procedures. To describe sexual function and associated factors before bariatric surgery. Ten U.S. clinical facilities. Before bariatric surgery, 2225 of 2458 Longitudinal Assessment of Bariatric Surgery-2 study participants (79% female, median age 45 years and median body mass index 46 kg/m 2 ) completed a survey about sexual function over the past month. Mixed effects ordinal logistic regression models were used to identify factors independently related to 4 domains of sexual function. One third of women (34%) and one quarter of men (25%) were not sexually active, alone or with a partner, in the past month. Twenty-six percent of women and 12% of men reported no sexual desire. Physical health limited sexual activity at least moderately in 38% of women and 44% of men. About one half of the women (49%) and the men (54%) were moderately or very dissatisfied with their sexual life. Among women, older age, being Caucasian, urinary incontinence, depressive symptoms, and antidepressant medication use were associated with poorer sexual function in multiple domains. In men, older age, not being married, depressive symptoms, and antidepressant medication use were associated with poorer sexual function in multiple domains. Before bariatric surgery, approximately one half of women and men with severe obesity are dissatisfied with their sexual life. Older age, severity of depressive symptoms, and antidepressant medication use are associated with poorer sexual function in both sexes. Copyright © 2016. Published by Elsevier Inc.

The relationship between sexual functioning and depressive symptomatology in postpartum women: a pilot study.

PubMed

Chivers, Meredith L; Pittini, Richard; Grigoriadis, Sophie; Villegas, Laura; Ross, Lori E

2011-03-01

Previous research on postpartum sexuality has primarily focused on the impact of physical factors on the resumption and frequency of sexual intercourse; fewer studies have focused on the impact of psychological factors on women's sexual functioning. The aim of this study is to assess current sexual functioning and sexual behavior in women with and without symptoms of postpartum depression using validated measures of postpartum depression and sexual functioning. Women attending postpartum appointments were consecutively recruited over a 12-month period and completed questionnaires assessing sexual functioning, current sexual behavior, and mental health. The Female Sexual Function Index (FSFI), the Edinburgh Postnatal Depression Scale (EPDS), and items assessing current sexual behaviors. A total of 77 women returned completed questionnaire packages (mean postpartum weeks: 13, range 3-24). Of these, 57 women (74%) had engaged in sexual activity with a partner in the 4 weeks prior to completing the questionnaire. The mean FSFI score was 23.0 (range 6-34), with 37 women (65%) scoring in the range associated with clinical sexual dysfunction. Women with elevated EPDS scores had significantly lower total FSFI, arousal, orgasm, and satisfaction FSFI subscale scores (all P values <0.005) than nondepressed women, suggesting more problematic sexual functioning. Desire, lubrication, and pain FSFI subscale scores were not significantly associated with depression status. A substantial proportion of women experience sexual problems in the postpartum period; these problems are particularly pronounced among women with symptoms of postpartum depression. Longitudinal research is needed to better understand the relationship between sexual dysfunction and depression among postpartum women, and to identify implications for prevention and treatment of both conditions. © 2010 International Society for Sexual Medicine.

Questionnaires in the assessment of sexual function in women with urinary incontinence and pelvic organ prolapse.

PubMed

Mestre, M; Lleberia, J; Pubill, J; Espuña-Pons, M

2015-04-01

Integrating sexual health in clinical practice is important. In women with pelvic floor disorders, the evaluation of the anatomical defects, lower urinary tract function and the anorectal function often receives more attention than the sexual function. Review of Medline using defined search terms to identify articles related to sexual health assessment in urogynecology and manual analyses was performed. Only articles published in English or Spanish were included. Only 50% of women attending urogynecological clinics are sexually active. Of those, 60% present with some sort of sexual sexual dysfunction (FSD). Questionnaires and sexuality scales would facilitate discussion of sexual matters between the Health Care professionals and the women, and may increase the likelihood of FSD being diagnosed. The Pelvic Organ Prolapse Incontinence Sexual Questionnaire (PISQ) and the PISQ-IR (IUGA-Revised) are the only female sexual function specific questionnaires currently validated and developed specifically to assess sexual function in women with urinary incontinence and/or pelvic organ prolapse. Furthermore, the PISQ-IR also allows evaluation of the outcomes of women who are not sexually active when requiring urogynecologic care. PISQ-IR is also designed for international validation. In order to use the PISQ-IR in Spain, a proper interpretation and validation of the questionnaire is needed. The evaluation of sexual function through specific questionnaires facilitates the identification of the sexual dysfunctions associated to the pelvic floor disorders. The inclusion of sexuality questionnaires as an outcome measure allows to analyze the impact in the sexual life of women treated for an urogynecological problem. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Attachment, Sexual Assertiveness, and Sexual Outcomes in Women with Provoked Vestibulodynia and Their Partners: A Mediation Model.

PubMed

Leclerc, Bianca; Bergeron, Sophie; Brassard, Audrey; Bélanger, Claude; Steben, Marc; Lambert, Bernard

2015-08-01

Provoked vestibulodynia (PVD) is a prevalent women's sexual pain disorder, which is associated with sexual function difficulties. Attachment theory has been used to understand adult sexual outcomes, providing a useful framework for examining sexual adaptation in couples confronted with PVD. Research to date indicates that anxious and avoidant attachment dimensions correlate with worse sexual outcomes in community and clinical samples. The present study examined the association between attachment, pain, sexual function, and sexual satisfaction in a sample of 101 couples in which the women presented with PVD. The actor-partner interdependence model was used in order to investigate both actor and partner effects. This study also examined the role of sexual assertiveness as a mediator of these associations via structural equation modeling. Women completed measures of pain intensity and both members of the couple completed measures of romantic attachment, sexual assertiveness, sexual function, and satisfaction. Results indicated that attachment dimensions did not predict pain intensity. Both anxious and avoidant attachment were associated with lower sexual satisfaction. Only attachment avoidance predicted lower sexual function in women. Partner effects indicated that higher sexual assertiveness in women predicted higher sexual satisfaction in men. Finally, women's sexual assertiveness was found to be a significant mediator of the relationship between their attachment dimensions, sexual function, and satisfaction. Findings highlight the importance of examining how anxious and avoidant attachment may lead to difficulties in sexual assertiveness and to less satisfying sexual interactions in couples where women suffer from PVD.

Relationship between female sexual difficulties and mental health in patients referred to two public and private settings in Tehran, Iran.

PubMed

Azar, Mahyar; Noohi, Sima; Shafiee Kandjani, Ali Reza

2007-09-01

Sexual difficulty has various effects on patients suffering from this condition that can impact on interpersonal and marital relationships. Sexual function may be adversely affected by stress of any kind and emotional disorders. There have been limited studies focusing on the mental health of those suffering from this problem. To determine the relationship between sexual difficulties and mental health in female patients seeking help in psychiatric clinics. The study was based on the case-control design methodology in which the case group consisted of 165 outpatients of two psychiatric clinics, who were diagnosed with different mental disorders such as depression, anxiety, phobia, aggression, and somatic complaints (33 subjects for each type of disorder). The 33 subjects in the control group were chosen among the patients' relatives and visitors who had no history of either seeking psychiatric help or taking psychiatric drugs. The subjects of both case and control groups were selected based on a convenience sampling method. Moreover, the data were collected based on two techniques of "interview" and "questionnaire;" the latter was of three different subcategories, each dealt with demographic characteristics, sexual difficulties, and a Symptom Check-List-90-Revised. Assessing female sexual difficulties associated with mental health and differences between women with and without psychiatric problems. The obtained results indicated that there was a significant difference between the prevalence of sexual difficulties (e.g., sexual desire and orgasm disorders) in the case group and that of the control group. It was also revealed that there was a significant difference between the depressed, aggressive, as well as those with somatic complaints, and their control group counterparts. In Iran, sexual difficulties seem to be more frequent in those seeking psychiatric help in clinics than in those within the normal population.

The Association Between Sexual Satisfaction and Body Image in Women

PubMed Central

Pujols, Yasisca; Meston, Cindy M.; Seal, Brooke N.

2010-01-01

Introduction Although sexual functioning has been linked to sexual satisfaction, it only partially explains the degree to which women report being sexually satisfied. Other factors include quality of life, relational variables, and individual factors such as body image. Of the few studies that have investigated the link between body image and sexual satisfaction, most have considered body image to be a single construct and have shown mixed results. Aim The present study assessed multiple body image variables in order to better understand which aspects of body image influence multiple domains of sexual satisfaction, including sexual communication, compatibility, contentment, personal concern, and relational concern in a community sample of women. Methods Women between the ages of 18 and 49 years in sexual relationships (N = 154) participated in an Internet survey that assessed sexual functioning, five domains of sexual satisfaction, and several body image variables. Main Outcome Measures Body image variables included the sexual attractiveness, weight concern, and physical condition subscales of the Body Esteem Scale, the appearance-based subscale of the Cognitive Distractions During Sexual Activity Scale, and body mass index. Total score of the Sexual Satisfaction Scale for Women was the main outcome measure. Sexual functioning was measured by a modified Female Sexual Function Index. Results Consistent with expectations, correlations indicated significant positive relationships between sexual functioning, sexual satisfaction, and all body image variables. A multiple regression analysis revealed that sexual satisfaction was predicted by high body esteem and low frequency of appearance-based distracting thoughts during sexual activity, even after controlling for sexual functioning status. Conclusion Several aspects of body image, including weight concern, physical condition, sexual attractiveness, and thoughts about the body during sexual activity predict sexual satisfaction in women. The findings suggest that women who experience low sexual satisfaction may benefit from treatments that target these specific aspects of body image. PMID:19968771

[Richard Freiherr v. Krafft-Ebing and Sigmund Freud--discourse on the "normality" and "perversion" of human sexuality at the close of the 19th century and the beginning of the 20th century].

PubMed

Kapfhammer, Hans-Peter

2015-01-01

Sexuality has been defined a central feature of personal identity since the epoch of enlightenment and has gradually become a decisive issue also in societal and political terms. A major transfer from religion and religious institutions to medicine and medical experts and later on to neuropsychiatrists has to be underlined in the primary position to assess "normal" and "deviant" manifestations of sexuality. Richard Freiherr von Krafft-Ebing and Sigmund Freund play an eminent role in this "discourse on sexuality" (M. Foucault) during the nineteenth and beginning twentieth century on the way to modern sexology. Within this overarching context Krafft-Ebing's and Freud's theoretical conceptualizations of sexuality and perversion will be sketched and basic clinical and societal implications there out will be discussed.

Sexual function of women suffering from anorexia nervosa and bulimia nervosa.

PubMed

Gonidakis, Fragiskos; Kravvariti, Vasilliki; Varsou, Eleftheria

2015-01-01

The cross-sectional study aimed at examining the sexual function of young adult women suffering from eating disorders. The authors interviewed 53 women (26 with anorexia nervosa and 27 with bulimia nervosa) and 58 female students. Each participant was administered the Female Sexual Function Index, the Eating Attitudes Test, the Body Shape Questionnaire, and the Beck Depression Inventory. Comparisons among the 3 groups showed that patients with anorexia nervosa scored lower in each Female Sexual Function Index subscale than did healthy controls. There was no significant difference between bulimia nervosa and healthy controls. Sexual functionality of patients with anorexia nervosa was correlated only with body mass index (r = 0.5, p =.01). Sexual functionality of patients with bulimia nervosa was correlated only with the Beck Depression Inventory (r = -0.4, p =.03) Patients with anorexia nervosa had more disturbed sexual function than did controls. Sexual function can be related to the level of starvation and symptoms of depression.

The androgen receptor governs the execution, but not programming, of male sexual and territorial behaviors

PubMed Central

Juntti, Scott A; Tollkuhn, Jessica; Wu, Melody V; Fraser, Eleanor J; Soderborg, Taylor; Tan, Stella; Honda, Shin-Ichiro; Harada, Nobuhiro; Shah, Nirao M

2010-01-01

SUMMARY Testosterone and estrogen are essential for male behaviors in vertebrates. How these two signaling pathways interact to control masculinization of the brain and behavior remains to be established. Circulating testosterone activates the androgen receptor (AR) and also serves as the source of estrogen in the brain. We have used a genetic strategy to delete AR specifically in the mouse nervous system. This approach permits us to determine the function of AR in sexually dimorphic behaviors in males while maintaining circulating testosterone levels within the normal range. We find that AR mutant males exhibit masculine sexual and territorial displays, but they have striking deficits in specific components of these behaviors. Taken together with the surprisingly limited expression of AR in the developing brain, our findings indicate that testosterone acts as a precursor to estrogen to masculinize the brain and behavior, and signals via AR to control the levels of male behavioral displays. PMID:20435002

Aphrodisiac activity of 50% ethanolic extracts of Myristica fragrans Houtt. (nutmeg) and Syzygium aromaticum (L) Merr. & Perry. (clove) in male mice: a comparative study

PubMed Central

Tajuddin; Ahmad, Shamshad; Latif, Abdul; Qasmi, Iqbal Ahmad

2003-01-01

Background Spices are considered as sexual invigorators in the Unani System of Medicine. In order to explore the sexual function improving effect of Myristica fragrans Houtt. (nutmeg) and Syzygium aromaticum (L) Merr. & Perry. (clove) an experimental study was conducted in normal male mice. Methods The extracts (50% ethanolic) of nutmeg and clove were administered (500 mg/kg; p.o.) to different groups of male Swiss mice. Mounting behaviour, mating performance, and general short term toxicity of the test drugs were determined and compared with the standard drug Penegra (Sildenafil citrate). Results The extracts of the nutmeg and clove were found to stimulate the mounting behaviour of male mice, and also to significantly increase their mating performance. The drugs were devoid of any conspicuous general short term toxicity. Conclusion The extracts (50% ethanolic) of nutmeg and clove enhanced the sexual behaviour of male mice. PMID:14567759

Factors Affecting Sexual Function in Midlife Women: Results from the Midlife Women's Health Study.

PubMed

Smith, Rebecca L; Gallicchio, Lisa; Flaws, Jodi A

2017-09-01

The objective of this study was to estimate the importance of risk factors affecting sexual function in sexually active midlife women. A cohort of 780 women undergoing the menopausal transition was surveyed each year for up to 7 years. Data were collected from sexually active women on sexual function, including frequencies of enjoyment, arousal, orgasm, passion for partner, satisfaction with partner, pain, lack of lubrication, fantasizing, and sexual activity. Data were also collected on a large number of potential risk factors for sexual dysfunction, including behaviors (smoking and alcohol use), health status (overall and frequency of different disorders), and demographic information (race, education, income, etc.). Height and weight were measured at an annual clinic visit; serum hormone concentrations were assayed using blood samples donated annually. Data on individual outcomes were examined with ordinal logistic regression models using individual as a random effect. An overall sexual function score was constructed from individual outcome responses, and this score was examined with linear regression. All factors with univariate associations of p < 0.1 were considered in multivariate model building with stepwise addition. A total of 1,927 women-years were included in the analysis. Women with much more physical work than average had higher sexual function scores and higher rates of enjoyment, passion, and satisfaction. Higher family income was associated with lower sexual function score and more frequent dry sex. Married women had significantly lower sexual function scores, as did those with frequent irritability or vaginal dryness. A higher step on the Ladder of Life was associated with a higher sexual function score and higher frequency of sexual activity. The factors associated with sexual outcome in menopausal women are complex and vary depending on the sexual outcome.

Toward a definition of "hypersexuality" in children and adolescents.

PubMed

Adelson, Stewart; Bell, Robinette; Graff, Adam; Goldenberg, David; Haase, Elizabeth; Downey, Jennifer I; Friedman, Richard C

2012-09-01

Recent psychiatric literature has used the term "hypersexuality" to denote pathologically increased sexual behavior in children and adolescents. Various patterns of increased sexuality have been described in youth, including sexuality that is excessive, developmentally precocious, compulsive, aggressive, or otherwise socially inappropriate. Such "hypersexual" behavior in children and adolescents is associated with a variety of factors. Social factors include sexual abuse, physical abuse, life stress, and impaired family relationships. Psychiatric factors include emotional and behavioral problems in general, posttraumatic stress disorder and dissociative symptoms in particular, and possibly bipolar disorder. Despite the importance of increased sexual behavior in youth as a possible sign of these problems, there is currently no uniform definition in psychiatric literature of the term "hypersexuality" applied to children and adolescents. The usefulness of this term depends upon the degree to which it can be defined, measured, and distinguished from non-pathological juvenile sexual behavior. Research instruments are described that may be useful in measuring levels of sexual behavior in children and adolescents. Elements of a definition of juvenile hypersexuality are proposed based upon current knowledge about children and adolescents' sexuality in both normal development and a variety of conditions in which it is increased. Care is warranted in distinguishing between normal and abnormal sexual behavior in youth because of the variety of factors that can affect its measurement.

[Biogenic amines in the epiphysis and hypothalamus under normal conditions and following ovariectomy].

PubMed

Grishchenko, V I; Koliada, L D; Demidenko, D I

1977-01-01

Melatonin content in the epiphysis, serotonin, noradrenaline, dopamine-in the hypothalamus, gonadotropins--in the hypophysis of rats was studied under normal conditions and following ovariectomy; regularly of the estral cycle phases was studied as well. Two series of experiments were conducted on 120 rats with regular estral cycles. The animals were divided into groups according to the estral cycle phase. Melatonin concentration in the epiphysis, serotonin, noradrenaline, dopamine--in the hypothalamus was subject to variations coinciding with the estral cycle phases. Serotonin, noradrenaline, and dopamine content decreased in the hypophysis of ovariectomized rats in comparison with control; melatonin content rose in the epiphysis. There was no complete extinction of the estral cycle in the course of investigation (20 days). The action of castration on the sexual cycle depended on the phase at which the rats were subjected to ovariectomy. A reverse relationship existed between the melatonin content in the epiphysis and serotonin content in the hypothalamus, this serving as one of the important factors in the regulation of the sexual function.

Sexual Functioning, Beliefs About Sexual Functioning and Quality of Life of Women with Infertility Problems

PubMed Central

Agustus, Prathibha; Munivenkatappa, Manjula; Prasad, Padmini

2017-01-01

Background: The study was conducted in the background of paucity of studies examining the sexual and psychosocial functioning of women with infertility. Aims: The study explored sexual functioning in women with infertility problems, their beliefs about sexuality and their quality of life. Settings and Design: A single group exploratory design with non-probability purposive sampling was used. A total of 30 participants diagnosed with primary infertility were included in the study. Materials and Methods: The data were obtained by individual administration of the following tools: Semi-structured interview schedule, Female Sexual Functioning Inventory, Sexual Dysfunctional Beliefs Questionnaire, World Health Organization Quality of Life Scale − BREF Version and General Health Questionnaire-12. The data obtained were analyzed using descriptive statistics and non-parametric tests. Results: About half of the participants had sexual dysfunction. Pain-related problems were most commonly reported (50%). Factors contributing to dysfunction included inadequate knowledge about sex, sexual stimulation and sexual communication. Along with inadequate self-image, negative childhood experiences, financial difficulties and marital discord in parents influenced the perception of self. Majority of the women had dysfunctional beliefs about sexuality (56%), and greater beliefs were found to be in the domain of sexual conservatism. The overall quality of life was poor, and 56% of women experienced psychological distress. There was significant positive correlation between sexual conservatism and experience of pain and overall sexual functioning. Conclusion: Women with infertility bear dysfunctional beliefs and suffer from problems in sexual functioning, have low quality of life and high psychological distress. PMID:29142451

Sexual and relationship intimacy among women with provoked vestibulodynia and their partners: associations with sexual satisfaction, sexual function, and pain self-efficacy.

PubMed

Bois, Katy; Bergeron, Sophie; Rosen, Natalie O; McDuff, Pierre; Grégoire, Catherine

2013-08-01

Provoked vestibulodynia (PVD) is the most frequent subtype of vulvodynia. Women report negative consequences of PVD on their sexual and romantic relationships. Researchers have recently highlighted the importance of examining interpersonal factors such as intimacy, and of including both women and their partners in study designs. The aim of this study was to investigate sexual and relationship intimacy as defined by the Interpersonal Process Model of Intimacy and their associations with sexual satisfaction, sexual function, pain self-efficacy, and pain intensity among women with PVD and their partners. Ninety-one heterosexual women (M age = 27.38, SD = 6.04) diagnosed with PVD and their partners (M age = 29.37, SD = 7.79) completed measures of sexual and relationship intimacy, sexual satisfaction, sexual function, pain self-efficacy, and pain intensity. Dependent measures were the (i) Global Measure of Sexual Satisfaction Scale; (ii) Female Sexual Function Index; (iii) Painful Intercourse Self-Efficacy Scale; and (iv) visual analog scale of pain intensity during intercourse. After controlling for women's age, women's greater sexual intimacy (β = 0.49, P < 0.001) was associated with women's greater sexual satisfaction and higher pain self-efficacy (β = 0.39, P = 0.001), beyond the effects of partners' sexual intimacy. Also, women's greater sexual intimacy (β = 0.24, P = 0.05) and women's greater relationship intimacy (β = 0.54, P = 0.003) were associated with greater women's sexual function, beyond the effects of partners' sexual and relationship intimacy. Women's self-reported sexual and relationship intimacy in the couple relationship may promote higher sexual satisfaction, sexual function, and pain self-efficacy, as well as possibly foster greater sexual well-being among women with PVD. The authors discuss implications for the inclusion of emotional and interpersonal aspects of the couple's dynamic in clinical interventions and future research in PVD. © 2013 International Society for Sexual Medicine.

Longitudinal trajectory of sexual functioning after hematopoietic cell transplantation: impact of chronic graft-versus-host disease and total body irradiation.

PubMed

Wong, F Lennie; Francisco, Liton; Togawa, Kayo; Kim, Heeyoung; Bosworth, Alysia; Atencio, Liezl; Hanby, Cara; Grant, Marcia; Kandeel, Fouad; Forman, Stephen J; Bhatia, Smita

2013-12-05

This prospective study described the trajectory of sexual well-being from before hematopoietic cell transplantation (HCT) to 3 years after in 131 allogeneic and 146 autologous HCT recipients using Derogatis Interview for Sexual Function and Derogatis Global Sexual Satisfaction Index. Sixty-one percent of men and 37% of women were sexually active pre-HCT; the prevalence declined to 51% (P = .01) in men and increased to 48% (P = .02) in women at 3 years post-HCT. After HCT, sexual satisfaction declined in both sexes (P < .001). All sexual function domains were worse in women compared with men (P ≤ .001). Orgasm (P = .002) and drive/relationship (P < .001) declined in men, but sexual cognition/fantasy (P = .01) and sexual behavior/experience (P = .01) improved in women. Older age negatively impacted sexual function post-HCT in both sexes (P < .01). Chronic graft-versus-host disease was associated with lower sexual cognition/fantasy (P = .003) and orgasm (P = .006) in men and sexual arousal (P = .05) and sexual satisfaction (P = .005) in women. All male sexual function domains declined after total body irradiation (P < .05). This study identifies vulnerable subpopulations that could benefit from interventional strategies to improve sexual well-being.

Longitudinal trajectory of sexual functioning after hematopoietic cell transplantation: impact of chronic graft-versus-host disease and total body irradiation

PubMed Central

Wong, F. Lennie; Francisco, Liton; Togawa, Kayo; Kim, Heeyoung; Bosworth, Alysia; Atencio, Liezl; Hanby, Cara; Grant, Marcia; Kandeel, Fouad; Forman, Stephen J.

2013-01-01

This prospective study described the trajectory of sexual well-being from before hematopoietic cell transplantation (HCT) to 3 years after in 131 allogeneic and 146 autologous HCT recipients using Derogatis Interview for Sexual Function and Derogatis Global Sexual Satisfaction Index. Sixty-one percent of men and 37% of women were sexually active pre-HCT; the prevalence declined to 51% (P = .01) in men and increased to 48% (P = .02) in women at 3 years post-HCT. After HCT, sexual satisfaction declined in both sexes (P < .001). All sexual function domains were worse in women compared with men (P ≤ .001). Orgasm (P = .002) and drive/relationship (P < .001) declined in men, but sexual cognition/fantasy (P = .01) and sexual behavior/experience (P = .01) improved in women. Older age negatively impacted sexual function post-HCT in both sexes (P < .01). Chronic graft-versus-host disease was associated with lower sexual cognition/fantasy (P = .003) and orgasm (P = .006) in men and sexual arousal (P = .05) and sexual satisfaction (P = .005) in women. All male sexual function domains declined after total body irradiation (P < .05). This study identifies vulnerable subpopulations that could benefit from interventional strategies to improve sexual well-being. PMID:24159171

Circulating Endocannabinoid Concentrations and Sexual Arousal in Women

PubMed Central

Klein, Carolin; Hill, Matthew N.; Chang, Sabrina C.H.; Hillard, Cecilia J.; Gorzalka, Boris B.

2013-01-01

Introduction Several lines of evidence point to the potential role of the endocannabinoid system in female sexual functioning. These include results from studies describing the subjective effects of exogenous cannabinoids on sexual functioning in humans and the observable effects of exogenous cannabinoids on sexual functioning in other species, as well as results from studies investigating the location of cannabinoid receptors in the brain and periphery, and the effects of cannabinoid receptor activation on neurotransmitters implicated in sexual functioning. While these lines of research suggest a role for the endocannabinoid system in female sexual functioning, no studies investigating the relationship between concentrations of endogenous cannabinoids (i.e., arachidonoylethanolamide [AEA] and 2-arachidonoylglycerol [2-AG]) and sexual functioning have been conducted in any species. Aim To measure circulating endocannabinoid concentrations in relation to subjective and physiological indices of sexual arousal in women (n = 21). Methods Serum endocannabinoid (AEA and 2-AG) concentrations were measured immediately prior to, and immediately following, viewing of neutral (control) and erotic (experimental) film stimuli in a repeated measures design. Physiological sexual arousal was measured via vaginal photoplethysmography. Subjective sexual arousal was measured both continuously and non-continuously. Pearson’s correlations were used to investigate the relationships between endocannabinoid concentrations and sexual arousal. Main Outcome Measures Changes in AEA and 2-AG concentrations from pre- to post-film and in relation to physiological and subjective indices of sexual arousal. Results Results revealed a significant relationship between endocannabinoid concentrations and female sexual arousal, whereby increases in both physiological and subjective indices of sexual arousal were significantly associated with decreases in AEA, and increases in subjective indices of sexual arousal were significantly associated with decreases in 2-AG. Conclusions These findings support the hypothesis that the endocannabinoid system is involved in female sexual functioning, with implications for furthering understanding of the biological mechanisms underlying female sexual functioning. PMID:22462722

Sexual Outcomes and Satisfaction with Hysterectomy: Influence of Patient Education

PubMed Central

Bradford, Andrea; Meston, Cindy

2010-01-01

Introduction Many women experience improved sexual function after hysterectomy. However, a sizeable minority of women report worsened sexual function after the surgery, and concerns about the effect of surgery on sexual function are common among women planning to undergo hysterectomy. Aim The present study examined the role of education about the potential sexual consequences of hysterectomy in predicting self-reported outcomes and satisfaction with the procedure. Methods We conducted a cross-sectional survey of 204 women who had undergone simple hysterectomy in the preceding 3–12 months. Participants volunteered in response to a Web-based advertisement. Main Outcome Measures Participants indicated their current sexual function using the Female Sexual Function Index (FSFI), and reported positive and negative sexual outcomes experienced after hysterectomy using a checklist. Participants also completed questionnaire items regarding satisfaction with hysterectomy and education from their physicians about sexual risks and benefits prior to surgery. Results Current sexual function scores were related to self-reports of positive and negative sexual outcomes following hysterectomy and overall satisfaction with hysterectomy. Education from a physician about possible adverse sexual outcomes was largely unrelated to self-reports of having experienced those outcomes. However, education about possible negative sexual outcomes predicted overall satisfaction with hysterectomy when controlling for self-reports of positive and negative sexual outcomes. Conclusion Education about potential negative sexual outcomes after surgery may enhance satisfaction with hysterectomy, independent of whether negative sexual outcomes were experienced. Including a discussion of potential sexual changes after surgery may enhance the benefits of presurgical counseling prior to hysterectomy. PMID:17087803

Sexual function and associated factors in Iranian patients with chronic low back pain.

PubMed

Nikoobakht, M; Fraidouni, N; Yaghoubidoust, M; Burri, A; Pakpour, A H

2014-04-01

Case-control study. (i) To describe the prevalence of sexual dysfunction in chronic low back pain (CLBP) patients, (ii) to compare the range of sexual function outcomes between patients with CLBP and healthy controls and (iii) to investigate which factors are associated with sexual function within the cohort of individuals with CLBP. Low back pain (LBP) clinic of Qazvin University of Medical Sciences, Qazvin, Iran. A total of 702 patients with CLBP and 888 healthy controls participated in the study. The Female Sexual Function Index (FSFI), International Index of Erectile Function (IIEF) and Premature Ejaculation Diagnostic Tool (PEDT) were used to evaluate sexual function. In addition, quality of life, anxiety, functional status and pain intensity were assessed in patients. Univariate and multiple linear regression analyses were performed for the identification of factors associated with sexual function. The prevalence of sexual problems in female patients with CLBP was 71.1% (n=177) while the corresponding figure for healthy women was 36.8% (n=161). Erectile dysfunction was present in 59.5% of male patients and in 24.5% of healthy males. Higher sexual function in both male and female patients with CLBP were being younger, lower duration of back pain, lower BMI, higher education level, being unemployed, physically active shorter sick leave, lower level of pain intensity, lower disability, higher family income, lower levels of depressive and anxiety symptoms, and higher psychical functioning and mental functioning. CLBP patients report considerably higher prevalences of sexual problems compared with healthy controls. Sex therapy and sexual management should be added to routine care and treatment of patients with CLBP.

Cognitive aspects of sexual functioning: differences between East Asian-Canadian and Euro-Canadian women.

PubMed

Morton, Heather; Gorzalka, Boris B

2013-11-01

The purpose of this study was to investigate the sexual beliefs of female undergraduates, as well as the thoughts they experience during sexual experiences. The study aimed to determine potential differences in these variables between East Asian-Canadians and Euro-Canadians, as well as the influence of acculturation on these variables. In addition, the relationships between sexual beliefs, automatic thoughts, and specific aspects of sexual functioning were examined. Euro-Canadian (n = 77) and East Asian-Canadian (n = 123) undergraduate women completed the Sexual Dysfunctional Beliefs Questionnaire, the Sexual Modes Questionnaire, the Female Sexual Function Index, and the Vancouver Index of Acculturation. East Asian women endorsed almost all sexual beliefs assessed in this study more than did Euro-Canadian women, and endorsement of these beliefs was associated with acculturation. In addition, East Asian-Canadian and Euro-Canadian women differed in the frequency of experiencing negative automatic thoughts. Results also revealed associations between difficulties in sexual functioning, and both sexual beliefs and automatic thoughts. Together, these results provide preliminary support for the hypothesis that differences in cognitive aspects of sexuality may underlie the differences in sexual functioning previously observed between these two groups.

Benefit of pelvic floor muscle therapy in improving sexual function in women with stress urinary incontinence: a pretest-posttest intervention study.

PubMed

Serati, Maurizio; Braga, Andrea; Di Dedda, Maria Carmela; Sorice, Paola; Peano, Elena; Biroli, Antonella; Torella, Marco; Cromi, Antonella; Uccella, Stefano; Salvatore, Stefano; Ghezzi, Fabio

2015-01-01

Very few data are available on the effect of pelvic floor muscle training on sexual function in incontinent women. The authors used the Female Sexual Function Index to assess the effect of pelvic floor muscle training on female sexual function. Participants included women with stress urinary incontinence, without overactive bladder symptoms, who completed a 3-month pelvic floor muscle training. All patients completed the Female Sexual Function Index and the International Consultation on Incontinence Questionnaire-Short Form at baseline and at the 3-month follow-up. Thirty-four patients completed all of the questionnaires; 64.7% patients were referred with stress urinary incontinence without sexual disorders, while 35.3% complained of stress urinary incontinence and sexual symptoms. The International Consultation on Incontinence Questionnaire-Short Form score significantly decreased after 3 months of pelvic floor muscle training (p =.01). The Female Sexual Function Index score significantly improved after pelvic floor muscle training even in women with sexual disorders (12.5 ± 9.5 vs. 29.7 ± 3.7; p <.001). This study showed that pelvic floor muscle training may improve female sexual function in women with pure stress urinary incontinence.

Demographic and obstetric factors affecting women's sexual functioning during pregnancy.

PubMed

Abouzari-Gazafroodi, Kobra; Najafi, Fatemeh; Kazemnejad, Ehsan; Rahnama, Parvin; Montazeri, Ali

2015-08-19

Sexual desire and frequency of sexual relationships during pregnancy remains challenging. This study aimed to assess factors that affect women's sexual functioning during pregnancy. This was a cross sectional study carried out at prenatal care clinics of public health services in Iran. An author-designed structured questionnaire including items on socio-demographic characteristics, obstetric history, the current pregnancy, and women's sexual functioning during pregnancy was used to collect data. The generalized linear model was performed in order to find out factors that affect women's sexual functioning during pregnancy. In all, 518 pregnant women participated in the study. The mean age of participants was 26.4 years (SD = 4.7). Overall 309 women (59.7%) scored less than mean on sexual functioning. The results obtained from generalized linear model demonstrated that that lower education, unwanted pregnancy, earlier stage of pregnancy, older age, and longer duration of marriage were the most important factors contributing to disturbed sexual functioning among couples. The findings suggest that sexual function during pregnancy might be disturbed due to several factors. Indeed issues on sexual relationship should be included as part of prenatal care and reproductive health programs for every woman.

Multidimensional Sexual Perfectionism and Female Sexual Function: A Longitudinal Investigation.

PubMed

Stoeber, Joachim; Harvey, Laura N

2016-11-01

Research on multidimensional sexual perfectionism differentiates four forms: self-oriented, partner-oriented, partner-prescribed, and socially prescribed. Self-oriented sexual perfectionism reflects perfectionistic standards people apply to themselves as sexual partners; partner-oriented sexual perfectionism reflects perfectionistic standards people apply to their sexual partner; partner-prescribed sexual perfectionism reflects people's beliefs that their sexual partner imposes perfectionistic standards on them; and socially prescribed sexual perfectionism reflects people's beliefs that society imposes such standards on them. Previous studies found partner-prescribed and socially prescribed sexual perfectionism to be maladaptive forms of sexual perfectionism associated with a negative sexual self-concept and problematic sexual behaviors, but only examined cross-sectional relationships. The present article presents the first longitudinal study examining whether multidimensional sexual perfectionism predicts changes in sexual self-concept and sexual function over time. A total of 366 women aged 17-69 years completed measures of multidimensional sexual perfectionism, sexual esteem, sexual anxiety, sexual problem self-blame, and sexual function (cross-sectional data). Three to six months later, 164 of the women completed the same measures again (longitudinal data). Across analyses, partner-prescribed sexual perfectionism emerged as the most maladaptive form of sexual perfectionism. In the cross-sectional data, partner-prescribed sexual perfectionism showed positive relationships with sexual anxiety, sexual problem self-blame, and intercourse pain, and negative relationships with sexual esteem, desire, arousal, lubrication, and orgasmic function. In the longitudinal data, partner-prescribed sexual perfectionism predicted increases in sexual anxiety and decreases in sexual esteem, arousal, and lubrication over time. The findings suggest that partner-prescribed sexual perfectionism contributes to women's negative sexual self-concept and female sexual dysfunction.

Sexual dysfunction in testicular cancer patients subjected to post-chemotherapy retroperitoneal lymph node dissection: a focus beyond ejaculation disorders.

PubMed

Dimitropoulos, K; Karatzas, A; Papandreou, C; Daliani, D; Zachos, I; Pisters, L L; Tzortzis, V

2016-05-01

Post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) represents an integral part of multidisciplinary treatment of advanced germ cell cancer; however, it is associated with a high complications rate. The present study aimed to describe sexual disorders in 53 patients with testicular cancer who underwent full bilateral, non-nerve-sparing PC-RPLND in our institution, focusing beyond ejaculatory dysfunction. The International Index for Erectile Function (IIEF) questionnaire was used as diagnostic tool of male sexual functioning pre-operatively and three months after RPLND, while post-operatively patients were asked to describe and evaluate changes in selected sexual parameters. Study findings demonstrate mixed pattern of changes in sexual functioning, with no difference in erectile functioning before and after operation. However, orgasmic function and intercourse and overall sexual satisfaction were found significantly impaired post-operatively. Sexual desire and frequency of attempted sexual intercourses were found significantly increased post-operatively, in comparison with pre-operative levels. With regard to patients' subjective perception on sexual functioning alterations after PC-RPLND, a significant number of patients reported higher levels of sexual desire, no difference in erectile function and worse orgasmic function and satisfaction post-operatively. Thus, patients subjected to PC-RPLND should be closely and routinely evaluated due to close relationship of sexual dissatisfaction with secondary psychological disorders. © 2015 Blackwell Verlag GmbH.

Testosterone Treatment and Sexual Function in Older Men With Low Testosterone Levels.

PubMed

Cunningham, Glenn R; Stephens-Shields, Alisa J; Rosen, Raymond C; Wang, Christina; Bhasin, Shalender; Matsumoto, Alvin M; Parsons, J Kellogg; Gill, Thomas M; Molitch, Mark E; Farrar, John T; Cella, David; Barrett-Connor, Elizabeth; Cauley, Jane A; Cifelli, Denise; Crandall, Jill P; Ensrud, Kristine E; Gallagher, Laura; Zeldow, Bret; Lewis, Cora E; Pahor, Marco; Swerdloff, Ronald S; Hou, Xiaoling; Anton, Stephen; Basaria, Shehzad; Diem, Susan J; Tabatabaie, Vafa; Ellenberg, Susan S; Snyder, Peter J

2016-08-01

The Testosterone Trials are a coordinated set of seven trials to determine the efficacy of T in symptomatic men ≥65 years old with unequivocally low T levels. Initial results of the Sexual Function Trial showed that T improved sexual activity, sexual desire, and erectile function. To assess the responsiveness of specific sexual activities to T treatment; to relate hormone changes to changes in sexual function; and to determine predictive baseline characteristics and T threshold for sexual outcomes. A placebo-controlled trial. Twelve academic medical centers in the United States. A total of 470 men ≥65 years of age with low libido, average T <275 ng/dL, and a partner willing to have sexual intercourse at least twice a month. Men were assigned to take T gel or placebo for 1 year. Sexual function was assessed by three questionnaires every 3 months: the Psychosexual Daily Questionnaire, the Derogatis Interview for Sexual Function, and the International Index of Erectile Function. Compared with placebo, T administration significantly improved 10 of 12 measures of sexual activity. Incremental increases in total and free T and estradiol levels were associated with improvements in sexual activity and desire, but not erectile function. No threshold T level was observed for any outcome, and none of the 27 baseline characteristics predicted responsiveness to T. In older men with low libido and low T levels, improvements in sexual desire and activity in response to T treatment were related to the magnitude of increases in T and estradiol levels, but there was no clear evidence of a threshold effect.

Impact of fibromyalgia on sexual function in women.

PubMed

Collado-Mateo, D; Olivares, P R; Adsuar, J C; Gusi, N

2018-03-09

The prevalence of sexual problems is very high among women with fibromyalgia. To evaluate the prevalence of sexual problems in women with FM and the potential association among physical activity, quality of life and sexual function. We aimed to contribute in the understanding of the relationships between sexual function and the symptoms of FM. The sample of this cross-sectional study was comprised by 113 women with FM and 116 age-matched women without FM. Sexual function was assessed using the 15D questionnaire. Health-related quality of life (using EQ-5D-5L and 15D questionnaires), impact of fibromyalgia and physical activity were also assessed. The prevalence of sexual problems among women with fibromyalgia was 76%, while it was 15% in healthy controls. This prevalence was even higher among those aged more than 50. Sexual function was significantly associated with quality of life, distance walked, impact of fibromyalgia and four of the symptoms: depression, anxiety, tenderness and memory problems. More than three out of four women with fibromyalgia have any kind of sexual problem. Depression, anxiety and tenderness seems to be the most relevant symptoms associated with sexual function. Physical activity may be protective and reduce the risk of having sexual problems.

Gastrointestinal ostomies and sexual outcomes: a comparison of colorectal cancer patients by ostomy status.

PubMed

Reese, J B; Finan, P H; Haythornthwaite, J A; Kadan, M; Regan, K R; Herman, J M; Efron, J; Diaz, L A; Azad, N S

2014-02-01

Research examining effects of ostomy use on sexual outcomes is limited. Patients with colorectal cancer were compared on sexual outcomes and body image based on ostomy status (never, past, and current ostomy). Differences in depression were also examined. Patients were prospectively recruited during clinic visits and by tumor registry mailings. Patients with colorectal cancer (N = 141; 18 past ostomy; 25 current ostomy; and 98 no ostomy history) completed surveys assessing sexual outcomes (medical impact on sexual function, Female Sexual Function Index, International Index of Erectile Function), body image distress (Body Image Scale), and depressive symptoms (Center for Epidemiologic Studies Depression Scale-Short Form). Clinical information was obtained through patient validated self-report measures and medical records. Most participants reported sexual function in the dysfunctional range using established cut-off scores. In analyses adjusting for demographic and medical covariates and depression, significant group differences were found for ostomy status on impact on sexual function (p < .001), female sexual function (p = .01), and body image (p < .001). The current and past ostomy groups reported worse impact on sexual function than those who never had an ostomy (p < .001); similar differences were found for female sexual function. The current ostomy group reported worse body image distress than those who never had an ostomy (p < .001). No differences were found across the groups for depressive symptoms (p = .33) or male sexual or erectile function (p values ≥ .59). Colorectal cancer treatment puts patients at risk for sexual difficulties and some difficulties may be more pronounced for patients with ostomies as part of their treatment. Clinical information and support should be offered.

Gastrointestinal ostomies and sexual outcomes: a comparison of colorectal cancer patients by ostomy status

PubMed Central

Finan, P. H.; Haythornthwaite, J. A.; Kadan, M.; Regan, K. R.; Herman, J. M.; Efron, J.; Diaz, L. A.; Azad, N. S.

2014-01-01

Purpose Research examining effects of ostomy use on sexual outcomes is limited. Patients with colorectal cancer were compared on sexual outcomes and body image based on ostomy status (never, past, and current ostomy). Differences in depression were also examined. Methods Patients were prospectively recruited during clinic visits and by tumor registry mailings. Patients with colorectal cancer (N = 141; 18 past ostomy; 25 current ostomy; and 98 no ostomy history) completed surveys assessing sexual outcomes (medical impact on sexual function, Female Sexual Function Index, International Index of Erectile Function), body image distress (Body Image Scale), and depressive symptoms (Center for Epidemiologic Studies Depression Scale—Short Form). Clinical information was obtained through patient validated self-report measures and medical records. Results Most participants reported sexual function in the dysfunctional range using established cut-off scores. In analyses adjusting for demographic and medical covariates and depression, significant group differences were found for ostomy status on impact on sexual function (p <.001), female sexual function (p =.01), and body image (p <.001). The current and past ostomy groups reported worse impact on sexual function than those who never had an ostomy (p <.001); similar differences were found for female sexual function. The current ostomy group reported worse body image distress than those who never had an ostomy (p <.001). No differences were found across the groups for depressive symptoms (p =.33) or male sexual or erectile function (p values≥.59). Conclusions Colorectal cancer treatment puts patients at risk for sexual difficulties and some difficulties may be more pronounced for patients with ostomies as part of their treatment. Clinical information and support should be offered. PMID:24091721

Review: The effect of nutrition on timing of pubertal onset and subsequent fertility in the bull.

PubMed

Kenny, D A; Byrne, C J

2018-06-01

The advent of genomic selection has led to increased interest within the cattle breeding industry to market semen from young bulls as early as possible. However, both the quantity and quality of such semen is dictated by the age at which these animals reach puberty. Enhancing early life plane of nutrition of the bull stimulates a complex biochemical interplay involving metabolic and neuroendocrine signalling and culminating in enhanced testicular growth and development and earlier onset of sexual maturation. Recent evidence suggests that an enhanced plane of nutrition leads to an advancement of testicular development in bulls at 18 weeks of age. However, as of yet, much of the neuronal mechanisms regulating these developmental processes remain to be elucidated in the bull. While early life nutrition clearly affects the sexual maturation process in bulls, there is little evidence for latent effects on semen traits post-puberty. Equally the influence of prevailing nutritional status on the fertility of mature bulls is unclear though management practices that result in clinical or even subclinical metabolic disease can undoubtedly impact upon normal sexual function. Dietary supplements enriched with various polyunsaturated fatty acids or fortified with trace elements do not consistently affect reproductive function in the bull, certainly where animals are already adequately nourished. Further insight on how nutrition mediates the biochemical interaction between neuroendocrine and testicular processes will facilitate optimisation of nutritional regimens to optimise sexual maturation and subsequent semen production in bulls.

Using Ecological Momentary Assessment to Investigate Short-Term Variations in Sexual Functioning in a Sample of Peri-Menopausal Women from Iran

PubMed Central

Pakpour, Amir H.; Yekaninejad, Mir Saeed; Pallich, Gianandrea; Burri, Andrea

2015-01-01

The investigation of short-term changes in female sexual functioning has received little attention so far. The aims of the study were to gain empirical knowledge on within-subject and within- and across-variable fluctuations in women’s sexual functioning over time. More specifically, to investigate the stability of women´s self-reported sexual functioning and the moderating effects of contextual and interpersonal factors. A convenience sample of 206 women, recruited across eight Health care Clinics in Rasht, Iran. Ecological momentary assessment was used to examine fluctuations of sexual functioning over a six week period. A shortened version of the Female Sexual Function Index (FSFI) was applied to assess sexual functioning. Self-constructed questions were included to assess relationship satisfaction, partner’s sexual performance and stress levels. Mixed linear two-level model analyses revealed a link between orgasm and relationship satisfaction (Beta = 0.125, P = 0.074) with this link varying significantly between women. Analyses further revealed a significant negative association between stress and all six domains of women’s sexual functioning. Women not only reported differing levels of stress over the course of the assessment period, but further differed from each other in how much stress they experienced and how much this influenced their sexual response. Orgasm and sexual satisfaction were both significantly associated with all other domains of sexual function (P<0.001). And finally, a link between partner performance and all domains of women`s sexual functioning (P<0.001) could be detected. Except for lubrication (P = 0.717), relationship satisfaction had a significant effect on all domains of the sexual response (P<0.001). Overall, our findings support the new group of criteria introduced in the DSM-5, called “associated features” such as partner factors and relationship factors. Consideration of these criteria is important and necessary for clinicians when diagnosing FSD. PMID:25692787

In vitro development of Haemoproteus parasites: the efficiency of reproductive cells increase during simultaneous sexual process of different lineages.

PubMed

Valkiūnas, Gediminas; Palinauskas, Vaidas; Ilgūnas, Mikas; Bernotienė, Rasa; Iezhova, Tatjana A

2014-04-01

Recent in vitro experimental studies reported the complex patterns of haemosporidian (Haemosporida) between-lineage interactions, which prevent mixing of lineages during simultaneous sexual process. Numerous anomalous ookinetes have been observed; these are not involved in sporogony. Massive development of such ookinetes might influence parasite transmission but is insufficiently investigated. The simultaneous sexual process of several lineages is a common phenomenon in vectors due to high prevalence of haemosporidian co-infections in wildlife. It remains unclear if the number of anomalous ookinetes changes during dual-infection sporogony in comparison with the single-infection process. We calculated proportions of the anomalous and normal ookinetes, which developed during single-infection (control) and dual-infection experiments in vitro conditions. Three mitochondrial cytochrome b lineages belonging to three Haemoproteus spp. (Haemosporida, Haemoproteidae) were isolated from naturally infected passerine birds. Sexual process and ookinete development were initiated in vitro by mixing blood containing mature gametocytes of two different parasites; the following experiments were performed: (1) Haemoproteus tartakovskyi (lineage hSISKIN1) × Haemoproteus lanii (lineage hRBS4) and (2) Haemoproteus belopolskyi (hHIICT3) × H. lanii (hRBS4). Genetic difference between lineages was 5.0-5.9%. Normal and anomalous ookinetes developed in all control and dual-infection experiments. The number of anomalous ookinetes markedly decreased, and normal ookinetes increased in all dual-infection experiments in comparison with those in controls, except for H. belopolskyi, in which proportion of the anomalous and normal ookinetes did not change. This study shows that simultaneous sexual process of two genetically distant lineages of haemosporidian parasites might increase the efficiency of reproductive cells, resulting in the development of a greater number of normal ookinetes. The marked increase of the number of normal ookinetes, which is involved in sporogony, indicates the success of sporogony in dual infections. Some haemosporidian lineages might benefit from simultaneous sporogony. Widespread avian Haemoproteus spp. are convenient and laboratory-friendly organisms for in vitro experimental research addressing between-lineage interaction in parasites during the sexual process.

Associations among childhood sexual abuse, language use and adult sexual functioning and satisfaction

PubMed Central

Lorenz, Tierney Ahrold; Meston, Cindy May

2012-01-01

To better understand the link between childhood sexual abuse (CSA) and adult sexual functioning and satisfaction, we examined cognitive differences between women with (N = 128) and without (NSA, N = 99) CSA histories. We used the Linguistic Inquiry Word Count, a computerized text analysis program, to investigate language differences between women with and without CSA histories when writing about their daily life (neutral essay) and their beliefs about sexuality and their sexual experiences (sexual essay). Compared to NSA women, women with CSA histories used fewer first person pronouns in the neutral essay but more in the sexual essay, suggesting women with CSA histories have greater self-focus when thinking about sexuality. Women who reported CSA used more intimacy words and more language consistent with psychological distancing in the sexual essay than did NSA women. Use of positive emotion words in the sexual essay predicted sexual functioning and satisfaction in both groups. These findings support the view that language use differs in significant ways between women with and without sexual abuse histories, and that these differences relate to sexual functioning and satisfaction. PMID:22387124

Hypospadias, all there is to know.

PubMed

van der Horst, H J R; de Wall, L L

2017-04-01

Hypospadias is one of the most common congenital anomalies in men. The condition is typically characterized by proximal displacement of the urethral opening, penile curvature, and a ventrally deficient hooded foreskin. In about 70%, the urethral meatus is located distally on the penile shaft; this is considered a mild form that is not associated with other urogenital deformities. The remaining 30% are proximal and often more complex. In these cases, endocrinological evaluation is advised to exclude disorders of sexual differentiation, especially in case of concomitant unilateral or bilateral undescended testis. Although the etiology of hypospadias is largely unknown, many hypotheses exist about genetic predisposition and hormonal influences. The goal of hypospadias repair is to achieve cosmetic and functional normality, and currently, surgery is recommended between 6 and 18 months of age. Hypospadias can be corrected at any age with comparable complication risk, functional, and cosmetic outcome; however, the optimal age of repair remains conclusive. Although long-term overall outcome concerning cosmetic appearance and sexual function is fairly good, after correction, men may more often be inhibited in seeking sexual contact. Moreover, lower urinary tract symptoms occur twice as often in patients undergoing hypospadias repair and can still occur many years after the initial repair. This study explores the most recent insights into the management of hypospadias. What is Known: • Guidelines advise referral for treatment between 6 and 18 months of age. • Cosmetic outcome is considered satisfactory in over 70% of all patients. What is New: • Long-term complications include urinary tract symptoms and sexual and cosmetic issues. • New developments allow a more individualized approach, hopefully leading to less complications and more patient satisfaction.

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.

Sexual Health and Positive Subjective Well-Being in Partnered Older Men and Women

PubMed Central

Vanhoutte, Bram; Nazroo, James; Pendleton, Neil

2016-01-01

Objectives: We examine the associations between different patterns of sexual behavior and function and three indicators of subjective well-being (SWB) covering eudemonic, evaluative, and affective well-being in a representative sample of partnered older people. Method: Using data from a Sexual Relationships and Activities Questionnaire (SRA-Q) in Wave 6 of the English Longitudinal Study of Ageing, latent class analysis identified groups characterized by distinctive patterns of sexual behavior and function and then examined their link to SWB. Eudemonic SWB was measured using a revised 15-item version of the CASP-19, evaluative SWB using the Satisfaction With Life Scale, and affective SWB using the 8-item version of the Centre for Epidemiologic Studies-Depression scale. Results: Sexual behavior and function was best described by six classes among men and five classes among women. These ranged from high sexual desire, frequent partnered sexual activities, and few sexual problems (Class 1) to low sexual desire, infrequent/no sexual activity, and problems with sexual function (Class 5[women]/6[men]). Men and women who reported either infrequent/no sexual activity, or were sexually active but reported sexual problems, generally had lower SWB than those individuals identified in Class 1. Poorer SWB in men was more strongly associated with sexual function difficulties, whereas in women desire and frequency of partnered activities appeared more important in relation to SWB. Discussion: Within the context of a partnered relationship continuing sexual desire, activity and functioning are associated with higher SWB, with distinctive patterns for women and men. PMID:26993519

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.

Anorexia, masochism, self-mutilation, and autoerotism: the spider mother.

PubMed

Lane, Robert C

2002-02-01

In summary, both self-mutilators and eating-disordered individuals come from dysfunctional homes with a very controlling mother and usually absent father. They often have a history of trauma. They are depressed and obsessive, attached to their mothers, who discourage attempts at emancipation. The symptoms serve the purpose of keeping them as little girls with negative feelings toward menstruation, sexual maturity, development, and femininity in general. These symptoms comprise self-destructive behavior in the service of removing sexual thoughts, temptation, and activities. Favazza (1987) included both eating disorders and self mutilation in his "deliberate self-harm syndrome." The symptoms, whether they be anorexic, bulimic, or a form of self-mutilation are seen as "autoerotic in nature and a substitute for normal masturbation" (Hull & Lane, 1988). Eating disorders and delicate self-mutilation are said to have "a cathartic, self-purifying, function in that they modulate states of anxiety, sexual tension, anger or dissociated emptiness, and they bring about a tremendous quasi-physical sense of relief" (Cross, 1993, p. 50). These patients' use of substitutes prevents maturation and growth as women, causing regression to pregenital phases with the use of pregenital defenses, and the demise of the demands of puberty and mature sexuality.

Isogenic mice exhibit sexually-dimorphic DNA methylation patterns across multiple tissues.

PubMed

McCormick, Helen; Young, Paul E; Hur, Suzy S J; Booher, Keith; Chung, Hunter; Cropley, Jennifer E; Giannoulatou, Eleni; Suter, Catherine M

2017-12-13

Cytosine methylation is a stable epigenetic modification of DNA that plays an important role in both normal physiology and disease. Most diseases exhibit some degree of sexual dimorphism, but the extent to which epigenetic states are influenced by sex is understudied and poorly understood. To address this deficit we studied DNA methylation patterns across multiple reduced representation bisulphite sequencing datasets (from liver, heart, brain, muscle and spleen) derived from isogenic male and female mice. DNA methylation patterns varied significantly from tissue to tissue, as expected, but they also varied between the sexes, with thousands of sexually dimorphic loci identified. The loci affected were largely autonomous to each tissue, even within tissues derived from the same germ layer. At most loci, differences between genders were driven by females exhibiting hypermethylation relative to males; a proportion of these differences were independent of the presence of testosterone in males. Loci harbouring gender differences were clustered in ontologies related to tissue function. Our findings suggest that gender is underwritten in the epigenome in a tissue-specific and potentially sex hormone-independent manner. Gender-specific epigenetic states are likely to have important implications for understanding sexually dimorphic phenotypes in health and disease.

Sexual Function before and after Total Hip Replacement: Narrative Review

PubMed Central

Meiri, Rotem; Rosenbaum, Talli Y; Kalichman, Leonid

2014-01-01

Background More than 1 million total hip replacements (THRs) are performed every year worldwide. Achieving decreased pain, increased mobility, and improved quality of life (QoL) are key factors in the decision to undergo THR. Sexual activity is a valued component of QoL; however, little is known about how THR affects sexual functioning or the extent to which health care providers address sexuality in THR patients. Aim The aim of the study was to assess the literature regarding sexuality and sexual function in patients before and after THR. Methods PubMed, Google Scholar, and PEDro databases were searched without search limitations from inception until December 2013 for terms relating to sexual function and THR. Results Sexual activity before and after a THR is an important QoL issue. In patients with end-stage hip osteoarthritis, THR has been reported to have beneficial effects in restoring sexual satisfaction and performance. While research has recently been conducted to determine the range of motion of the hip joints necessary to execute certain sexual positions, there remains a lack of validated guidelines and the risks related to sexual activity after THR is rarely discussed between patients and medical staff. Conclusions The ability to move comfortably is included among the many physical and psychosocial factors influencing sexual functioning. Practitioners should be encouraged to question their THR patients about sexual concerns and to provide counseling related to physical and functional aspects of sexual activity. Rehabilitation that focuses specifically on activities of daily living of sex should include sexual counseling, therapeutic exercise, and advice regarding sexual positions. Rehabilitation provided by physical therapists may help decrease pain, and facilitate greater self-awareness, self-confidence, and improved body image, all of which encourage and affirm optimal sexual health. Meiri R, Rosenbaum TY, and Kalichman L. Sexual function before and after total hip replacement: Narrative review. PMID:25548647

Sexual Behavior and Contraceptive Use among 18- to 19-Year-Old Adolescent Women by Weight Status: A Longitudinal Analysis.

PubMed

Chang, Tammy; Davis, Matthew M; Kusunoki, Yasamin; Ela, Elizabeth J; Hall, Kelli S; Barber, Jennifer S

2015-09-01

To describe the association between weight status and sexual practices among 18- to 19-year-old women. We analyzed a population-based longitudinal study of 18- to 19-year-old women residing in a Michigan county at cohort inception. Weekly journal surveys measured sexual practices, including contraceptive behaviors. Outcomes included proportion of weeks with a partner, proportion of weeks with sexual intercourse, number of partners, average length of relationships, proportion of weeks with contraception use, and proportion of weeks where contraception was used consistently. We examined 26,545 journal surveys from 900 women over the first study year. Ordinary least squares regression models for each outcome examined differences by weight status, controlling for sociodemographic characteristics. The mean proportion of weeks in which adolescents reported sexual intercourse was 52%; there was no difference by weight status. Among weeks in which adolescents reported sexual activity, obese adolescents had a lower proportion of weeks where any contraception was used compared with normal weight adolescents (84% vs 91%, P = .011). Among weeks in which adolescents reported sexual activity and contraceptive use, obese adolescents had a lower proportion of weeks with consistent contraceptive use (68% vs 78%, P = .016) and oral contraceptive pill use (27% vs 45%, P = .001) compared with normal weight adolescents. All other relationships by weight status were not statistically significant. In this longitudinal study, obese adolescent women were less likely to use contraception, and less likely to use it consistently when compared with normal weight peers. Findings suggest obesity may be an important factor associated with adolescent women's sexual behavior. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Sexual Behavior and Contraceptive Use Among 18 to 19 year old Adolescent Women By Weight Status: A Longitudinal Analysis

PubMed Central

Chang, Tammy; Davis, Matthew M.; Kusunoki, Yasamin; Ela, Elizabeth J.; Hall, Kelli S.; Barber, Jennifer S.

2015-01-01

Objective To describe the association between weight status and sexual practices among 18-19 year-old women. Study design We analyzed a population-based longitudinal study of 18-19 year-old women residing in a Michigan county at cohort inception. Weekly journal surveys measured sexual practices, including contraceptive behaviors. Outcomes included proportion of weeks with a partner, proportion of weeks with sexual intercourse, number of partners, average length of relationships, proportion of weeks with contraception use, and proportion of weeks where contraception was used consistently. We examined 26,545 journal surveys from 900 women over the first study year. Ordinary least squares regression models for each outcome examined differences by weight status, controlling for sociodemographic characteristics. Results The mean proportion of weeks in which adolescents reported sexual intercourse was 52%; there was no difference by weight status. Among weeks in which adolescents reported sexual activity, obese adolescents had a lower proportion of weeks where any contraception was used compared with normal-weight adolescents (84% vs 91%, p=0.011). Among weeks in which adolescents reported sexual activity and contraceptive use, obese adolescents had a lower proportion of weeks with consistent contraceptive use (68% vs 78%, p=0.016) and oral contraceptive pill use (27% vs 45%, p=0.001) compared with normal-weight adolescents. All other relationships by weight status were not statistically significant. Conclusions In this longitudinal study, obese adolescent women were less likely to use contraception, and less likely to use it consistently when compared with normal-weight peers. Findings suggest obesity may be an important factor associated with adolescent women’s sexual behavior. PMID:26143383

Effect of drug use and influence of abstinence on sexual functioning in a Spanish male drug-dependent sample: a multisite study.

PubMed

Vallejo-Medina, Pablo; Sierra, Juan Carlos

2013-02-01

To date, it has been difficult to address the issue of sexual functioning and drug use, and many approaches to it have basic problems and methodological errors. The present cross-sectional study compared the sexual functioning scores of a group of drug users with those of a group of nondrug users. It explored the relationship between drug abstinence and sexual functioning. A sample of 905 males participated in this study (549 met the substance dependence criteria and 356 were controls). All of them were assessed with the Changes in Sexual Functioning Questionnaire-Drugs version. The assessment was conducted from September 2009 to January 2011. The clinical sample was evaluated in nine different substance abuse treatment facilities. Results show that, overall, all dimensions (pleasure, desire, arousal, and orgasm) were moderately impaired. Yet, differences regarding preferred substance were observed. Pleasure and orgasm were the two areas most significantly impaired. In these areas, all drugs seemed to negatively affect sexual functioning. However, desire and arousal were not affected by all the substances. In addition, at least after 2 weeks of drug abstinence, no relationship was found between drug abstinence and improvement in sexual functioning. The sample studied had an average of 1 year of drug abstinence and was found to have poorer sexual functioning than the control group. Therefore, these results seem to contradict those that argue that drug use only impairs sexual functioning temporarily. Moreover, they suggest that sexual functioning does not improve just by stopping drug use. © 2012 International Society for Sexual Medicine.

Male partners of women with provoked vestibulodynia: attributions for pain and their implications for dyadic adjustment, sexual satisfaction, and psychological distress.

PubMed

Jodoin, Mélanie; Bergeron, Sophie; Khalifé, Samir; Dupuis, Marie-José; Desrochers, Geneviève; Leclerc, Bianca

2008-12-01

Provoked vestibulodynia is a female genital pain condition that results in sexual dysfunction and impacts negatively on the couple. Although patients' causal attributions have been linked to worse psychosexual outcomes, no study has documented the male partners' perspective of this distressing problem and its potential influence on their psychosexual adaptation. To identify whether male partners' attributions for vestibulodynia are possible predictors of their dyadic adjustment, sexual functioning, sexual satisfaction, and psychological distress, as well as of women's pain and sexual functioning. Thirty-eight women with vestibulodynia first completed measures of pain intensity and sexual functioning. Male partners responded to mailed questionnaires assessing their own attributions for genital pain as well as their psychological distress, relationship adjustment, sexual functioning, and sexual satisfaction. Women completed the McGill-Melzack Pain Questionnaire (MPQ) and the Female Sexual Function Index (FSFI). Attributions of male partners were measured using an adapted version of the Attributional Style Questionnaire (ASQ)-Partner Version. Men also filled out the Brief Symptom Inventory (BSI), the Dyadic Adjustment Scale (DAS), the Sexual History Form (SHF), and the Global Measure of Sexual Satisfaction (GMSEX). All four negative attribution dimensions and higher levels of women's pain intensity successfully predicted increased psychological distress in male partners. Higher levels of both internal and global attributions were associated with men's poorer dyadic adjustment, whereas global and stable attributions were related to their lower sexual satisfaction. Attributions failed to significantly predict sexual functioning in male partners and women's pain and sexual functioning. Evaluation and treatment of sexual pain problems should involve both partners and should explore the role of negative attributions.

Vitamin D and Male Sexual Function: A Transversal and Longitudinal Study.

PubMed

Tirabassi, Giacomo; Sudano, Maurizio; Salvio, Gianmaria; Cutini, Melissa; Muscogiuri, Giovanna; Corona, Giovanni; Balercia, Giancarlo

2018-01-01

The effects of vitamin D on sexual function are very unclear. Therefore, we aimed at evaluating the possible association between vitamin D and sexual function and at assessing the influence of vitamin D administration on sexual function. We retrospectively studied 114 men by evaluating clinical, biochemical, and sexual parameters. A subsample ( n = 41) was also studied longitudinally before and after vitamin D replacement therapy. In the whole sample, after performing logistic regression models, higher levels of 25(OH) vitamin D were significantly associated with high values of total testosterone and of all the International Index of Erectile Function (IIEF) questionnaire parameters. On the other hand, higher levels of total testosterone were positively and significantly associated with high levels of erectile function and IIEF total score. After vitamin D replacement therapy, total and free testosterone increased and erectile function improved, whereas other sexual parameters did not change significantly. At logistic regression analysis, higher levels of vitamin D increase (Δ-) were significantly associated with high values of Δ-erectile function after adjustment for Δ-testosterone. Vitamin D is important for the wellness of male sexual function, and vitamin D administration improves sexual function.

Reproductive rights of mentally retarded persons.

PubMed

Katalinić, Sanja; Sendula-Jengić, Vesna; Sendula-Pavelić, Martina; Zudenigo, Slaven

2012-03-01

Mental retardation denotes sub-average intellectual functioning, based on IQ, i.e. the inability of normal learning, accompanied by behavioral and developmental disorders. Persons with impairments (cognitive, motor, sensory or psychiatric) have often been, both through human history and today victims of discrimination and deprived of their basic human rights, both in the public and the private life spheres. Since the end of the 20th century, throughout the developed world, many disabled persons can accomplish their dreams and rights. However, the issue of sexuality is still an obstacle in realizing oneself as a whole person, of course in accordance with personal psychophysical abilities. The greatest problem is present in persons with severe disablement, considered not apt enough for information on sexuality and for expressing themselves as persons with their own sexual needs. Thus it is desirable to observe each disabled person individually and flexibly enough in order to establish parameters for the functioning of an intimate affair on the level of understanding and assent. The legal system must protect the most vulnerable and ensure for them the right of choice and consent, as well as the possibility of fulfilling their sexual needs, so that they could love and be loved. Naturally, the system must be built on foundations that satisfy the needs of its users, but also of persons engaged in work with them. Sex education should contain information regarding biological, socio-cultural and spiritual dimensions of sexuality, including cognitive, affective and behavioral domains. Unfortunately, very few educational programs with such aims provide sex education, not only for the disabled young population but also for the healthy. This review article is based on international investigations and Croatian legislative postulates. Its aim is to focus the attention of both professionals and non-professionals on this delicate problem.

Female Partners of Men With Peyronie's Disease Have Impaired Sexual Function, Satisfaction, and Mood, While Degree of Sexual Interference Is Associated With Worse Outcomes.

PubMed

Davis, Seth N P; Ferrar, Saskia; Sadikaj, Gentiana; Gerard, Marina; Binik, Yitzchak M; Carrier, Serge

2016-07-01

Peyronie's disease (PD) causes penile deformity and can result in sexual dysfunction and psychological distress. Currently, nothing is known about the psychosexual impact on the partners of men with PD. Research carried out on the partners of men with other chronic illnesses suggests that the partners of men with PD might have increased rates of sexual dysfunction and decreased sexual satisfaction. To examine (i) sexual functioning, sexual satisfaction, negative affect, and relationship satisfaction of men with PD and their female partners and (ii) the effect of male-perceived sexual interference on partners' outcomes. Forty-four men diagnosed with PD and their female partners completed a questionnaire package. Each partner filled out the Revised Dyadic Adjustment Scale, the Positive and Negative Affect Scale, the Global Measure of Sexual Satisfaction, and the Female Sexual Function Index (women) or the International Index of Erectile Function (men). Overall, partners of men with PD were found to have decreased sexual function, sexual satisfaction, and mood compared with population-based norms. Men and their partners showed non-distressed levels of relationship satisfaction. The degree to which PD interfered with sexual activity was an important correlate of outcomes. Increased sexual interference was associated with lower sexual function and satisfaction for the person experiencing interference. Sexual interference also was associated with negative affect and relationship satisfaction in partners and the person experiencing interference. PD is associated with negative psychosexual and psychosocial effects on those with the disease and their partners. As a result, assessment and intervention should include the two members of the couple. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The Sexual Functioning of Adult Women Molested as Children: A Review of Empirical Studies.

ERIC Educational Resources Information Center

Clarke, Julie Lynn

This paper reviews the research literature from 1978 to 1991 that addresses long-term effects of childhood sexual abuse on adult women's sexual functioning. Frequently reported long-term effects of childhood sexual abuse are noted, including both sexual dissatisfaction and sexual dysfunction. In terms of sexual dysfunction, it is noted that adult…

Long-term side-effects of intermittent androgen suppression therapy in prostate cancer: results of a phase II study.

PubMed

Malone, Shawn; Perry, Gad; Segal, Roanne; Dahrouge, Simone; Crook, Juanita

2005-09-01

To assess the feasibility and tolerability of intermittent androgen suppression therapy (IAS) in prostate cancer. Patients with recurrent or metastic prostate cancer received cyclical periods of treatment with leuprolide acetate and nilutamide for 8 months, and rest periods. Cycles were repeated at progression until the treatment failed to achieve normal prostate-specific antigen (PSA) levels. Patients were followed with PSA level, testosterone level, haemoglobin level, weight and bone mineral density evaluations. The median time to treatment failure, recovery from anaemia, or normalization of testosterone level was estimated by the Kaplan-Meier method. In all, 95 patients received 245 cycles; the median duration of rest periods was 8 months and median time to treatment failure 47 months. Testosterone recovery during rest periods was documented in 117 (61%) of cycles. Anaemia was mild and reported in 33%, 44% and 67% of cycles 1, 2 and 3, respectively. Sexual function recovered during the rest periods in 47% of cycles. There was no significant overall change in body mass index at the end of the treatment period. Osteoporosis was documented in at least one site evaluated in 41 patients (37%). IAS has the potential to reduce side-effects, including recovery of haemoglobin level, return of sexual function and absence of weight gain at the end of the study period.

DHEA-sulfate test

MedlinePlus

... women, DHEA contributes to normal libido and sexual satisfaction. DHEA may also have effects on the immune ... are concerned about low libido or decreased sexual satisfaction. The test is also done in children who ...

Technical refinement and learning curve for attenuating neurapraxia during robotic-assisted radical prostatectomy to improve sexual function.

PubMed

Alemozaffar, Mehrdad; Duclos, Antoine; Hevelone, Nathanael D; Lipsitz, Stuart R; Borza, Tudor; Yu, Hua-Yin; Kowalczyk, Keith J; Hu, Jim C

2012-06-01

While radical prostatectomy surgeon learning curves have characterized less blood loss, shorter operative times, and fewer positive margins, there is a dearth of studies characterizing learning curves for improving sexual function. Additionally, while learning curve studies often define volume thresholds for improvement, few of these studies demonstrate specific technical modifications that allow reproducibility of improved outcomes. Demonstrate and quantify the learning curve for improving sexual function outcomes based on technical refinements that reduce neurovascular bundle displacement during nerve-sparing robot-assisted radical prostatectomy (RARP). We performed a retrospective study of 400 consecutive RARPs, categorized into groups of 50, performed after elimination of continuous surgeon/assistant neurovascular bundle countertraction. Our approach to RARP has been described previously. A single-console robotic system was used for all cases. Expanded Prostate Cancer Index Composite sexual function was measured within 1 yr of RARP. Linear regression was performed to determine factors influencing the recovery of sexual function. Greater surgeon experience was associated with better 5-mo sexual function (p = 0.007) and a trend for better 12-mo sexual function (p = 0.061), with improvement plateauing after 250-300 cases. Additionally, younger patient age (both p<0.02) and better preoperative sexual function (<0.001) were associated with better 5- and 12-mo sexual function. Moreover, trainee robotic console time during nerve sparing was associated with worse 12-mo sexual function (p=0.021), while unilateral nerve sparing/non-nerve sparing was associated with worse 5-mo sexual function (p = 0.009). Limitations include the retrospective single-surgeon design. With greater surgeon experience, attenuating lateral displacement of the neurovascular bundle and resultant neurapraxia improve postoperative sexual function. However, to maximize outcomes, appropriate patient selection must be exercised when allowing trainee nerve-sparing involvement. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Greater Exposure to Sexual Content in Popular Movies Predicts Earlier Sexual Debut and Increased Sexual Risk Taking

PubMed Central

O’Hara, Ross E.; Gibbons, Frederick X.; Gerrard, Meg; Li, Zhigang; Sargent, James D.

2013-01-01

Early sexual debut is associated with risky sexual behavior and an increased risk of unplanned pregnancy and sexually transmitted infections later in life. The relations among early movie sexual exposure (MSE), sexual debut, and risky sexual behavior in adulthood (i.e., multiple sexual partners and inconsistent condom use) were examined in a longitudinal study of U.S. adolescents. MSE was measured using the Beach method, a comprehensive procedure for media content coding. Controlling for characteristics of adolescents and their families, analyses showed that MSE predicted age of sexual debut, both directly and indirectly through changes in sensation seeking. MSE also predicted engagement in risky sexual behaviors both directly and indirectly via early sexual debut. These results suggest that MSE may promote sexual risk taking both by modifying sexual behavior and by accelerating the normal rise in sensation seeking during adolescence. PMID:22810165

Imperfect chemical female mimicry in males of the ant Cardiocondyla obscurior

NASA Astrophysics Data System (ADS)

Cremer, Sylvia; D'Ettorre, Patrizia; Drijfhout, Falko P.; Sledge, Matthew F.; Turillazzi, Stefano; Heinze, Jürgen

2008-11-01

Winged and wingless males coexist in the ant Cardiocondyla obscurior. Wingless (“ergatoid”) males never leave their maternal colony and fight remorselessly among each other for the access to emerging females. The peaceful winged males disperse after about 10 days, but beforehand also mate in the nest. In the first 5 days of their life, winged males perform a chemical female mimicry that protects them against attack and even makes them sexually attractive to ergatoid males. When older, the chemical profile of winged males no longer matches that of virgin females; nevertheless, they are still tolerated, which so far has been puzzling. Contrasting this general pattern, we have identified a single aberrant colony in which all winged males were attacked and killed by the ergatoid males. A comparative analysis of the morphology and chemical profile of these untypical attacked winged males and the tolerated males from several normal colonies revealed that normal old males are still performing some chemical mimicry to the virgin queens, though less perfect than in their young ages. The anomalous attacked winged males, on the other hand, had a very different odour to the females. Our study thus exemplifies that the analysis of rare malfunctioning can add valuable insight on functioning under normal conditions and allows the conclusion that older winged males from normal colonies of the ant C. obscurior are guarded through an imperfect chemical female mimicry, still close enough to protect against attacks by the wingless fighters yet dissimilar enough not to elicit their sexual interest.

Sexual Sensation Seeking, Sexual Compulsivity, and Gender Identity and Its Relationship With Sexual Functioning in a Population Sample of Men and Women.

PubMed

Burri, Andrea

2017-01-01

Despite awareness of the importance of psycho-affective factors in the development of sexual problems, there is a lack of studies exploring the relation of sexual sensation seeking (SSS) and sexual compulsivity (SC) to sexual functioning. Because sex differences in SSS and SC have been reported, gender identity (GI; an individual's own experience of his or her gender that is unrelated to the actual biological sex) might act as a moderator in this relation. To understand the role of SSS and SC for men and women's sexual functioning and to explore whether these potential associations are moderated by GI. A population-based cross-sectional online survey targeted 279 individuals (69.2% women, 30.8% men; mean age = 32 years). Validated questionnaires, including the Sexual Sensation Seeking Scale, the Sexual Compulsivity Scale, the Female Sexual Function Index, the Premature Ejaculation Diagnostic Tool, and the International Index of Erectile Function, were applied. Variations in SSS and SC and their association with sexual functioning were investigated using Spearman rank correlation. Moderation analyses were conducted using regression models in which the interaction terms between SSS and GI and between SCS and GI as predictors of sexual functioning were included. A statistically significant correlation between SSS and SC could be detected in men and women (r = 0.41 and 0.33, respectively; P < .001 for the two comparisons). In women, higher levels of SSS were associated with higher levels of desire, arousal, lubrication, and orgasm and less sexual pain (P < .05 for all comparisons). No moderating effect of GI could be detected. In men, GI was a significant moderator in the relation between SC and erectile function (β = 0.47; P < .001) and between SSS and erectile and ejaculatory function (β = -0.41 and 0.30; P < .001 for the two comparisons). The present study is the first to show a link between SSS and SC and sexual functioning. The results might have important clinical implications and can provide useful information for programs aimed at sexual health enhancement. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Disgust and Sexual Arousal in Young Adult Men and Women.

PubMed

Grauvogl, Andrea; de Jong, Peter; Peters, Madelon; Evers, Silvia; van Overveld, Mark; van Lankveld, Jacques

2015-08-01

Previous research suggested that disgust may interfere with healthy sexual functioning by demonstrating that women with sexual pain disorders are characterized by heightened disgust propensity, relatively strong (physiological and subjective) disgust responses when exposed to sexual stimuli, and relatively strong automatic sex-disgust memory associations. To broaden the understanding of the relationship between sex and disgust, Study 1 tested the relationship between trait disgust and sexual functioning in both men (N = 109) and women (N = 187), and showed that specifically for women both relatively high disgust propensity and high sensitivity were related to lower sexual functioning. Study 2 focused on healthy young adults (N = 19 men and N = 24 women), and tested the relationship between trait disgust and automatic sex-disgust associations as well as the predictive value of trait disgust propensity for participants' level of sexual arousal while watching an erotic video. Participants completed a single-target Implicit Association Task and self-report measures of trait disgust propensity, disgust sensitivity, and sexual functioning. Furthermore, genital and subjective sexual arousal was measured, while participants were watching neutral and erotic video clips. Women showed stronger sex-disgust associations and reported higher disgust propensity than men. Overall, indices of trait disgust and sex-disgust associations were not strongly associated with sexual functioning or sexual arousability. Unexpectedly, specifically in men, high levels of trait disgust sensitivity predicted higher levels of genital and subjective sexual arousal. Overall, no strong evidence was found to support the view that, among young adults without sexual difficulties, high trait disgust or relatively strong automatic sex-disgust associations are associated with low sexual functioning and low sexual arousal.

The perception of sexuality in older adults and its relationship with cognitive functioning.

PubMed

Hartmans, Carien; Comijs, Hannie; Jonker, Cees

2015-03-01

Investigating whether cognitive functioning is associated with the perception of one's sexuality in old age. Cross-sectional analysis, using observation cycle 2005/2006 of the population-based prospective cohort of the Longitudinal Aging Study Amsterdam. Municipal registries in three Dutch regions. 1,908 older adults (mean [standard deviation] age: 71 [8.87] years; 54% women). Sexuality and intimacy were assessed using four questions. Four cognitive domains were assessed: general cognitive functioning (Mini-Mental State Examination), memory performance (Auditory Verbal Learning Test), processing speed (Coding Task), and fluid intelligence (Raven's Coloured Progressive Matrices). Multinomial regression analysis was used, with sexuality as outcome. The interaction effect between gender and sexuality was also tested. Lower fluid intelligence was associated with perceiving sexuality as unimportant; lower general cognitive functioning was associated with perceiving sexuality as unimportant; and lower immediate memory recall was associated with evaluating sexual life as unpleasant. Associations were also found between lower fluid intelligence, processing speed, and general cognitive functioning, and agreeing with sexuality no longer being important. Lower processing speed, general cognitive functioning, and delayed memory recall were associated with disagreeing with a remaining need for intimacy when getting older. Finally, the association between fluid intelligence and perceiving sexuality as important, and the association between immediate memory recall score and evaluating sexual life as pleasant, was only significant in women. The association between lower general cognitive functioning and perceiving sexuality as unimportant seemed stronger in women compared with men. Higher cognitive functioning was associated with the way in which older people perceive their current sexuality. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Emotions during sexual activity: differences between sexually functional and dysfunctional men and women.

PubMed

Nobre, Pedro J; Pinto-Gouveia, José

2006-08-01

The present study investigated the differences in emotional response to automatic thoughts presented during sexual activity between sexually functional and dysfunctional men and women. A total of 376 participants (160 women and 120 men without sexual problems and 47 women and 49 men with a DSM-IV-TR diagnosis of sexual dysfunction) completed the Sexual Modes Questionnaire (SMQ male and female versions; P. J. Nobre & J. Pinto-Gouveia, 2000) and measures of sexual functioning: The International Index of Sexual Function (IIEF; R. C. Rosen et al., 1997), and The Female Sexual Function Index (FSFI; R. C. Rosen et al., 2000). The SMQ is a combined measure constituted by three interdependent subscales: Automatic Thought subscale (AT), Emotional Response subscale (ER), and Sexual Response subscale (SR). Emotions were assessed by the ER subscale, where participants endorsed emotional reactions (worry, sadness, disillusion, fear, guilt, shame, anger, hurt, pleasure, satisfaction) to a list of automatic thoughts (AT subscale) that may occur during sexual activity. Results showed that both men and women with sexual dysfunction had significantly less positive emotional reactions to automatic thoughts during sexual activity. Sexually dysfunctional men had significantly more emotions of sadness, disillusion, and fear, and less pleasure and satisfaction, compared to men without sexual problems. Women with sexual dysfunction had significantly less pleasure and satisfaction, and more sadness, disillusion, guilt, and anger. Findings were congruent with recent studies indicating that emotions related to depressed affect (sadness, disillusion, lack of pleasure) as opposed to negative emotions (mostly related to anxiety) were stronger correlates of sexual dysfunction.

Endometriosis doubles the risk of sexual dysfunction: a cross-sectional study in a large amount of patients.

PubMed

Fairbanks, Flávia; Abdo, Carmita Helena; Baracat, Edmund C; Podgaec, Sergio

2017-07-01

Endometriosis affects several aspects of a woman's life, including sexual function, but which specific aspects of sexual function remains unclear. A cross-sectional study was performed involving 1001 women divided into two groups, according to the presence or absence of endometriosis. We assessed sexual function, anxiety and depression of patients and correlated these findings with symptoms, locations and types of endometriosis and the affected domains of sexual function. Eighteen completed the forms incorrectly, 294 women (29.9%) were excluded due to severe anxiety and depression. One hundred and six patients had symptoms that could have any relation to endometriosis, so they were also excluded. The final cohort was composed of 254 patients with endometriosis and 329 patients without the disease. Sexual function score was assessed using the female sexual quotient (FSQ); Beck inventories were used to assess anxiety and depression. Patients with endometriosis were affected in all phases of sexual response: desire, sexual arousal, genital-pelvic pain/ penetration and orgasm/ sexual satisfaction. In the overall assessment, 43.3% of patients with endometriosis had sexual dysfunction, while the population without endometriosis sexual dysfunction occurred in 17.6% of women. Patients with endometriosis have more than twice sexual dysfunctions as compared to women without the disease.

The Relationship Between Body Image and Domains of Sexual Functioning Among Heterosexual, Emerging Adult Women.

PubMed

Quinn-Nilas, Christopher; Benson, Lindsay; Milhausen, Robin R; Buchholz, Andrea C; Goncalves, Melissa

2016-09-01

Research suggests that body image affects sexual functioning, but the relationship between specific types of body image (evaluative, affective, and behavioral) and domains of sexual functioning (desire, arousal, and orgasm) has not been investigated. To determine whether, and to what degree, body image concerns (evaluative, affective, and behavioral) influence aspects of women's sexual functioning (desire, arousal, and orgasm). Eighty-eight sexually active women in heterosexual romantic relationships completed surveys assessing evaluative, affective, and behavioral body image and sexual functioning. Body composition data also were collected using dual energy x-ray absorptiometry. Sexual functioning was assessed using the desire, arousal, and orgasm subscales of the Female Sexual Functioning Index. Hierarchical multiple regression analysis indicated that poor evaluative, affective, and behavioral body image were detrimental to women's sexual functioning. Specifically, dissatisfaction with one's body predicted decrements in desire (β = -0.31, P < .05) and arousal (β = -0.35, P < .01). Similarly, feeling that others evaluate one's body negatively predicted decrements in desire (β = 0.22, P < .05) and arousal (β = 0.35, P < .01). Feeling negatively about one's appearance predicted decrements in arousal (β = 0.26, P < .05). Negative thoughts and feelings about one's body during a sexual encounter (body image self-consciousness) predicted decrements in arousal (β = -0.37, P < .01) and orgasm (β = -0.25, P < .05). Findings from this study suggest important linkages between body image and sexual functioning constructs and indicates that interventions to improve body image could have concomitant benefits related to sexual experience. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Ureterorenoscopy with Stenting and Its Effect on Female Sexual Function.

PubMed

Akdeniz, Ekrem; Bolat, Mustafa Suat

2017-05-23

Various etiological factors have been studied which negatively affect female sexual function, but theeffects of ureteroscopic stone surgery on women's sexual dysfunction remain unknown. The aim of this study wasto investigate the effect of ureteroscopic stone surgery with postoperative stenting on female sexual function. This study included 30 sexually active female patients who underwent ureteroscopicstone surgery with JJ stenting (study group) and 26 age-matched female patients with ureteral stone surgerywithout JJ stenting (control group). Sexual function was assessed at preoperative and at the first and 3rd monthspostoperative using the Female Sexual Function Index. Overall satisfaction in relation to the age, operation time,presence of stents, body mass index, educational status, previous operations, income status, and psychogenic statuswas evaluated. Sexual function was adversely affected by ureteroscopic stone surgery with JJ stenting; but psychogenic,educational and income status remained stable. Mean individual female sexual function subscores were statistically significant between the study and control groups, but the differences in the mean Beck scores minimally improved between the two groups at preoperative (p = 0.19) visit, whereas first month (p = 0.08) and third month (p = 0.31) of postoperative controls were deteriorated but the differences were not statistically significant, respectively. Ureterorenoscopy with JJ stenting has considerably negative effects on female sexual function. JJ stenting causes temporary sexual deterioration in women and it generally ceases at the end of the 3rd month after ureteroscopic surgery. Therefore, JJ stenting should be avoided or used for as short a time as possible. If JJ stenting is inevitable, patients should be warned about a temporary decline in their sexual function during the first month of the operation that resolves at most in three months.

Sexual function in adolescent and young adult survivors of lower extremity bone tumors.

PubMed

Barrera, Maru; Teall, Tanya; Barr, Ronald; Silva, Mariana; Greenberg, Mark

2010-12-15

Improving survival rates and new surgical options have led to increased interest regarding late effects and quality of life in adolescent and young adult survivors of bone cancers, including their sexual functioning. This study investigated sexual functioning in adolescent and young adult survivors of lower limb bone tumors, in relation to surgical treatments, gender differences, depressive symptoms, global self worth, and physical disability. Twenty-eight participants (age range 18-32 years) completed measures of gender specific sexual function, depressive symptoms, global self worth, and physical disability. For analysis, surgical intervention was grouped into limb sparing surgeries (LS; allograft fusion and endoprosthesis) and amputation or Van Nes rotationplasty (AMP). Male survivors reported significantly higher scores than females on total sexual function scores (P = 0.050), sexual drive (P = 0.002), and frequency of sexual thoughts, fantasies or erotic dreams (P = 0.021). Men also reported significantly better physical functioning scores than women (P = 0.012). LS scored significantly lower on frequency of sexual thoughts, fantasies and erotic dreams (P = 0.048) and frequency of sexual experiences (P = 0.016) compared with AMP. In addition, LS reported significantly more depressive symptoms scores (P = 0.004) and lower self worth scores (P = 0.037), than AMP. These results suggest that male survivors of lower extremity bone tumors experience better sexual functioning than women. Survivors of limb sparing surgeries struggle with sexual function, depressive symptoms, and poor self-perception compared to Van Nes rotationplasty and amputation survivors. Copyright © 2010 Wiley-Liss, Inc.

Sexual behavior and sex-associated environmental cues activate the mesolimbic system in male rats.

PubMed

Balfour, Margaret E; Yu, Lei; Coolen, Lique M

2004-04-01

The mesolimbic system plays an important role in the regulation of both pathological behaviors such as drug addiction and normal motivated behaviors such as sexual behavior. The present study investigated the mechanism by which this system is endogenously activated during sexual behavior. Specifically, the effects of sexual experience and sex-related environmental cues on the activation of several components of the mesolimbic system were studied. The mesolimbic system consists of a dopaminergic projection from the ventral tegmental area (VTA) to the nucleus accumbens (NAc). Previous studies suggest that these neurons are under tonic inhibition by local GABA interneurons, which are in turn modulated by mu opioid receptor (MOR) ligands. To test the hypothesis that opioids are acting in the VTA during sexual behavior, visualization of MOR internalization in VTA was used as a marker for ligand-induced activation of the receptor. Significant increases in MOR internalization were observed following copulation or exposure to sex-related environmental cues. The next goal was to determine if sexual behavior activates dopamine neurons in the VTA, using tyrosine hydroxylase as a marker for dopaminergic neurons and Fos-immunoreactivity as a marker for neuronal activation. Significant increases in the percentage of activated dopaminergic neurons were observed following copulation or exposure to sex-related environmental cues. In addition, mating and sex-related cues activated a large population of nondopaminergic neurons in VTA as well as neurons in both the NAc Core and Shell. Taken together, our results provide functional neuroanatomical evidence that the mesolimbic system is activated by both sexual behavior and exposure to sex-related environmental cues.

(Putative) Sex differences in neuroimmune modulation of memory

PubMed Central

Tronson, Natalie C.; Collette, Katie M.

2016-01-01

The neuroimmune system is significantly sexually dimorphic, with sex differences evident in the number and activation states of microglia, in the activation of astrocytes, and in cytokine release and function. Neuroimmune cells and signaling are now recognized as critical for many neural functions throughout the lifespan, including synaptic plasticity and memory function. Here we address the question of how cytokines, astrocytes, and microglia contribute to memory, and specifically how neuroimmune modulation of memory differentially affects males and females. Understanding sex differences in both normal memory processes and dysregulation of memory in psychiatric and neurological disorders is critical for developing treatment and preventive strategies for memory disorders that are effective for both men and women. PMID:27870428

A review of penile elongation surgery

PubMed Central

Gillis, Joshua

2017-01-01

Penile elongation surgery is less commonly performed in the public sector, but involves a collaborative approach between urology and plastic surgery. Congenital and acquired micropenis are the classic surgical indications for penile elongation surgery. The goal of intervention in these patients is to restore a functional penis size in order to allow normal standing micturition, enable satisfying sexual intercourse and improve patient quality of life. Many men seeking elongation actually have normal length penises, but perceive themselves to be small, a psychologic condition termed ‘penile dysmorphophobia’. This paper will review the anatomy and embryology of congenital micropenis and discuss both conservative and surgical management options for men seeking penile elongation therapy. PMID:28217452

Probable neuro sexual mode of action of Casimiroa edulis seed extract versus [correction of verses] sildenafil citrate (Viagra(tm)) on mating behavior in normal male rats.

PubMed

Ali, Syed Tabrez; Rakkah, Nabeeh I

2008-01-01

The present study deals with the aphrodisiac actions of the aqueous extract of the seeds of the hypotensive plant Casimiroa edulis on the sexual behavior of normal male rats. In this investigation 30 healthy male Wister strain white albino rats showing the brisk sexual activity age 15 weeks, weighing 400-450 grams were included. Female rats were artificially brought into estrous by hormonal treatment. Receptivity was checked by exposing them to the male rats and the most receptive females were selected for the stud The mating responses including Mounting Frequency (MF), Intromission Frequency (IF), Mounting Latency (ML), Intromission Latency (IL), Ejaculatory Latency in first and second series (EL1 and EL2) and Post Ejaculatory Interval (PEI) were recorded after treating the animals with 250 mg/kg casimiroa edulis extract (test reference) and 5 mg/kg sildenafil citrate (standard reference) respectively orally per day for 7 days. Both the groups exhibited a significant increase in Mounting Frequency, Intromission Frequency, and first and second ejaculatory latencies, where as Mounting and Intromission latencies and the Post Ejaculatory Interval showed a significant reduction than the controls. Although a similar pattern of mating behavior was observed among the test and the standard groups, however in all the cases as expected, sildenafil produced greater activity than the casimiroa edulis extract. These results suggest the possibility of a similar mode of action of casimiroa edulis and sildenafil citrate on mating behavior in these animals. Our work reported in this research thus provide preliminary evidence that the aqueous seed extract of casimiroa edulis possesses alphrodisiac activity and may be used as an alternative drug therapy to restore sexual functions probably via a neurogenic mode of action.

Vagal Activity During Physiological Sexual Arousal in Women With and Without Sexual Dysfunction.

PubMed

Stanton, Amelia M; Pulverman, Carey S; Meston, Cindy M

2017-01-02

Recently, heart rate variability (HRV) level has been found to be a risk factor for female sexual dysfunction. Low HRV was a significant predictor of female sexual arousal dysfunction and overall sexual dysfunction. Building upon this finding, the present study examined whether differences in vagal activity between sexually functional and sexually dysfunctional women may be driving the association between low HRV and female sexual dysfunction. Specifically, respiratory sinus arrhythmia (RSA) was assessed before, during, and after physiological sexual arousal in 84 women, aged 18 to 47, to examine potential differences in vagal activity between sexually functional and sexually dysfunctional women. Significant differences in vagal activity between these two groups were observed (p =.02). These findings provide additional specificity to the recently established relationship between HRV and female sexual function while also proposing a mechanism to target during treatments for sexual dysfunction.

Sexual Health and Positive Subjective Well-Being in Partnered Older Men and Women.

PubMed

Lee, David M; Vanhoutte, Bram; Nazroo, James; Pendleton, Neil

2016-07-01

We examine the associations between different patterns of sexual behavior and function and three indicators of subjective well-being (SWB) covering eudemonic, evaluative, and affective well-being in a representative sample of partnered older people. Using data from a Sexual Relationships and Activities Questionnaire (SRA-Q) in Wave 6 of the English Longitudinal Study of Ageing, latent class analysis identified groups characterized by distinctive patterns of sexual behavior and function and then examined their link to SWB. Eudemonic SWB was measured using a revised 15-item version of the CASP-19, evaluative SWB using the Satisfaction With Life Scale, and affective SWB using the 8-item version of the Centre for Epidemiologic Studies-Depression scale. Sexual behavior and function was best described by six classes among men and five classes among women. These ranged from high sexual desire, frequent partnered sexual activities, and few sexual problems (Class 1) to low sexual desire, infrequent/no sexual activity, and problems with sexual function (Class 5([women])/6([men])). Men and women who reported either infrequent/no sexual activity, or were sexually active but reported sexual problems, generally had lower SWB than those individuals identified in Class 1. Poorer SWB in men was more strongly associated with sexual function difficulties, whereas in women desire and frequency of partnered activities appeared more important in relation to SWB. Within the context of a partnered relationship continuing sexual desire, activity and functioning are associated with higher SWB, with distinctive patterns for women and men. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

Gender Relations and the Production of Difference in School-based Sexuality and HIV/AIDS Education in Australia.

ERIC Educational Resources Information Center

Harrison, Lyn

2000-01-01

Uses data from an evaluation of a high school sexuality education program to examine gender relations and production of difference. Participating schools incorporated teaching and learning that normalized sexual diversity and explored HIV-related discrimination and homophobia. Discussion of gender, power, and menstruation and heterosexism and…

Sexuality and gender role in autism spectrum disorder: a case control study.

PubMed

Bejerot, Susanne; Eriksson, Jonna M

2014-01-01

The 'extreme male brain theory of autism' describes an extreme male pattern of cognitive traits defined as strong systemising abilities paired with empathising weaknesses in autism spectrum disorder. However, beyond these cognitive traits, clinical observations have suggested an ambiguous gender-typed pattern regarding several sexually dimorphic traits. The aim of the present study was to investigate if patterns of non-cognitive sexually dimorphic traits differed between the autism spectrum disorder and control groups. Fifty adults with autism spectrum disorder and intelligence within the normal range, and 53 neurotypical controls responded to questions on gender role, self-perceived gender typicality and gender identity, as well as sexuality. Measures used were a Swedish modification of the Bem Sex Role Inventory and questions on sexuality and gender designed for the purpose of this study. Our results showed that one common gender role emerged in the autism spectrum disorder group. Masculinity (e.g. assertiveness, leadership and competitiveness) was weaker in the autism spectrum disorder group than in the controls, across men and women. Self-perceived gender typicality did not differ between the groups but tomboyism and bisexuality were overrepresented amongst women with autism spectrum disorder. Lower libido was reported amongst both male and female participants with autism spectrum disorder compared with controls. We conclude that the extreme male patterns of cognitive functions in the autistic brain do not seem to extend to gender role and sexuality. A gender-atypical pattern for these types of characteristics is suggested in autism spectrum disorder.

Sexuality and Gender Role in Autism Spectrum Disorder: A Case Control Study

PubMed Central

Bejerot, Susanne; Eriksson, Jonna M.

2014-01-01

The ‘extreme male brain theory of autism’ describes an extreme male pattern of cognitive traits defined as strong systemising abilities paired with empathising weaknesses in autism spectrum disorder. However, beyond these cognitive traits, clinical observations have suggested an ambiguous gender-typed pattern regarding several sexually dimorphic traits. The aim of the present study was to investigate if patterns of non-cognitive sexually dimorphic traits differed between the autism spectrum disorder and control groups. Fifty adults with autism spectrum disorder and intelligence within the normal range, and 53 neurotypical controls responded to questions on gender role, self-perceived gender typicality and gender identity, as well as sexuality. Measures used were a Swedish modification of the Bem Sex Role Inventory and questions on sexuality and gender designed for the purpose of this study. Our results showed that one common gender role emerged in the autism spectrum disorder group. Masculinity (e.g. assertiveness, leadership and competitiveness) was weaker in the autism spectrum disorder group than in the controls, across men and women. Self-perceived gender typicality did not differ between the groups but tomboyism and bisexuality were overrepresented amongst women with autism spectrum disorder. Lower libido was reported amongst both male and female participants with autism spectrum disorder compared with controls. We conclude that the extreme male patterns of cognitive functions in the autistic brain do not seem to extend to gender role and sexuality. A gender-atypical pattern for these types of characteristics is suggested in autism spectrum disorder. PMID:24498228

Sexual Dimorphism and Allometric Effects Associated With the Wing Shape of Seven Moth Species of Sphingidae (Lepidoptera: Bombycoidea).

PubMed

de Camargo, Willian Rogers Ferreira; de Camargo, Nícholas Ferreira; Corrêa, Danilo do Carmo Vieira; de Camargo, Amabílio J Aires; Diniz, Ivone Rezende

2015-01-01

Sexual dimorphism is a pronounced pattern of intraspecific variation in Lepidoptera. However, moths of the family Sphingidae (Lepidoptera: Bombycoidea) are considered exceptions to this rule. We used geometric morphometric techniques to detect shape and size sexual dimorphism in the fore and hindwings of seven hawkmoth species. The shape variables produced were then subjected to a discriminant analysis. The allometric effects were measured with a simple regression between the canonical variables and the centroid size. We also used the normalized residuals to assess the nonallometric component of shape variation with a t-test. The deformations in wing shape between sexes per species were assessed with a regression between the nonreduced shape variables and the residuals. We found sexual dimorphism in both wings in all analyzed species, and that the allometric effects were responsible for much of the wing shape variation between the sexes. However, when we removed the size effects, we observed shape sexual dimorphism. It is very common for females to be larger than males in Lepidoptera, so it is expected that the shape of structures such as wings suffers deformations in order to preserve their function. However, sources of variation other than allometry could be a reflection of different reproductive flight behavior (long flights in search for sexual mates in males, and flight in search for host plants in females). © The Author 2015. Published by Oxford University Press on behalf of the Entomological Society of America.

Sexual Function Across Aging.

PubMed

Clayton, Anita H; Harsh, Veronica

2016-03-01

Women experience multiple changes in social and reproductive statuses across the life span which can affect sexual functioning. Various phases of the sexual response cycle may be impacted and can lead to sexual dysfunction. Screening for sexual problems and consideration of contributing factors such as neurobiology, reproductive life events, medical problems, medication use, and depression can help guide appropriate treatment and thereby improve the sexual functioning and quality of life of affected women. Treatment options include psychotropic medications, hormone therapy, and psychotherapy.

Body image in women with primary and secondary provoked vestibulodynia: a controlled study.

PubMed

Maillé, Delphine L; Bergeron, Sophie; Lambert, Bernard

2015-02-01

Provoked vestibulodynia (PVD) is a women's genito-pelvic pain condition associated with psychosexual impairments, including depression. Body image (BI) has been found to be different in women with primary (PVD1) and secondary (PVD2) PVD. No controlled study has compared BI in women with PVD1 and PVD2 and investigated its associations with sexual satisfaction, sexual function, and pain. The aims of this study were to (i) compare BI in women with PVD1, PVD2, and asymptomatic controls and (ii) to examine associations between BI and sexual satisfaction, sexual function, and pain during intercourse in women with PVD. Fifty-seven women (20 with PVD1, 19 with PVD2, and 18 controls) completed measures of BI, sexual satisfaction, sexual function, pain during intercourse, and depression. The main outcome measures were (i) Global Measure of Sexual Satisfaction Scale, (ii) Female Sexual Function Index, and (iii) pain numerical rating scale. Controlling for depression, women with PVD1 reported more body exposure anxiety during sexual activities than women with PVD2 and controls F(2,51)=4.23, P=0.02. For women with PVD, more negative BI during sexual activities was associated with lower sexual satisfaction (β=-0.45, P=0.02) and function (β=-0.39, P=0.04) and higher pain during intercourse (β=0.59, P=0.004). More positive body esteem was associated with higher sexual function (β=0.34, P=0.05). Findings suggest that women with PVD1 present more body exposure anxiety during sexual activities than women with PVD2 and asymptomatic women. Body esteem and general attitudes toward women's genitalia were not significantly different between groups. Higher body exposure anxiety during sexual activities was associated with poorer sexual outcomes in women with PVD. Further studies assessing interventions targeting BI during sexual activities in this population are needed, as improving BI during sexual interactions may enhance sexual outcomes in women with PVD. © 2014 International Society for Sexual Medicine.

An investigation of the relationship between physical fitness, self-concept, and sexual functioning.

PubMed

Jiannine, Lia M

2018-01-01

Obesity and inactivity have led to an increasing number of individuals with sexual dysfunctions (43% of women; 31% of men). Small bouts of exercise can drastically improve sexual functioning. Thus, the present study is designed to examine the effects of physical fitness and self-concept on sexual functioning. Fitness assessments and questionnaires were administered to 133 participants between the ages of 18 and 50 years. Physical fitness was assessed through body composition, cardiovascular endurance, muscular strength, and muscular endurance. Self-concept was presented as a total self-concept score and as six individual concepts of self. Sexual function was presented as both an aggregate score and five separate constructs of sexual functioning - fantasy/cognition, arousal, orgasm, behavior/experience, and drive/desire. The results indicated that sexual behavior/experience was predicted by body fat percentage. In men, fantasy was related to total self-concept; sexual behavior/experience was related to likeability. In women, arousal was predicted by cardiovascular endurance. Total self-concept was related to both orgasm and sex drive/desire. Power and muscular strength were significantly related to number of sexual partners in women but not men. The present study adds to the growing body of evidence indicating a positive relationship between physical fitness and sexual health. Individuals with sexual dysfunctions, particularly women, who are not persuaded by the currently publicized benefits of physical activity, may be inclined to exercise to improve sexual functioning.

Pharmacologically Induced Hypogonadism and Sexual Function in Healthy Young Women and Men

PubMed Central

Schmidt, Peter J; Steinberg, Emma M; Negro, Paula Palladino; Haq, Nazli; Gibson, Carolyn; Rubinow, David R

2008-01-01

Studies fail to find uniform effects of age-related or induced hypogonadism on human sexual function. We examined the effects of induced hypogonadism on sexual function in healthy men and women and attempted to identify predictors of the sexual response to induced hypogonadism or hormone addback. The study design used was a double-blind, controlled, crossover (self-as-own control). The study setting was an ambulatory care clinic in a research hospital, and the participants were 20 men (average ± SD age = 28.5 ± 6.2 years) and 20 women (average ± SD age = 33.5 ± 8.7 years), all healthy and with no history of psychiatric illness. A multidimensional scale assessing several domains of sexual function was the main outcome measure. Participants of the study received depot leuprolide acetate (Lupron) every 4 weeks for 3 months (men) or 5 months (women). After the first month of Lupron alone, men received (in addition to Lupron) testosterone enanthate (200 mg intramuscularly) or placebo every 2 weeks for 1 month each. Women received Lupron alone for 2 months, and then, in addition to Lupron, they received estradiol and progesterone for 5 weeks each. The results of the study: in women, hypogonadism resulted in a significant decrease in global measures of sexual functioning, principally reflecting a significant decrease in the reported quality of orgasm. In men, hypogonadism resulted in significant reductions in all measured domains of sexual function. Testosterone restored sexual functioning scores in men to those seen at baseline, whereas neither estradiol nor progesterone significantly improved the reduced sexual functioning associated with hypogonadism in women. Induced hypogonadism decreased sexual function in a similar number of men and women. No predictors of response were identified except for levels of sexual function at baseline. In conclusion, our data do not support a simple deficiency model for the role of gonadal steroids in human sexual function; moreover, while variable, the role of testosterone in sexual function in men is more apparent than that of estradiol or progesterone in women. PMID:18354393

Metabolic Syndrome and Sexual Function in Postmenopausal Women.

PubMed

Trompeter, Susan E; Bettencourt, Ricki; Barrett-Connor, Elizabeth

2016-12-01

Limited literature suggests that sexual dysfunction in women covaries with the metabolic syndrome. This study examined the association of sexual function with metabolic syndrome and cardiovascular disease in healthy older women. There were 376 postmenopausal, community-dwelling women from the Rancho Bernardo Study (mean baseline age = 73 years) that completed a clinic visit during 1999-2002 and returned the Female Sexual Function Index (FSFI) questionnaire mailed in 2002. Thirty-nine percent reported being sexually active; 41.5% met a diagnosis of metabolic syndrome. The number of metabolic syndrome components was strongly associated with decreased sexual activity, desire, and low sexual satisfaction. Waist girth, diabetes, and hypertension were associated with decreased sexual activity. Elevated triglycerides were associated with low desire. Among the cardiovascular endpoints, heart attack, coronary artery bypass, and angina were associated with decreased sexual activity, but not with sexual desire or satisfaction. Past diagnosis of heart failure, poor circulation, and stroke were not associated with sexual function. Sexually active women with metabolic syndrome met criteria for sexual dysfunction in desire, arousal, orgasm, and satisfaction domains. The FSFI Total Score did not differ significantly between sexually active and inactive women. Metabolic syndrome was associated with decreased sexual activity, desire, and satisfaction in all women and with sexual dysfunction in most domains in sexually active women. Coronary artery disease was more prevalent in women with low sexual activity. Copyright © 2016 Elsevier Inc. All rights reserved.

Kisspeptide in the estrous mare: is it an appropriate ovulation-inducing agent?

PubMed

Magee, C; Bruemmer, J E; Nett, T M; Squires, E L; Clay, C M

2012-12-01

Kisspeptides (KiSS) are a recently discovered family of neuropeptides with a central role in regulating the onset of reproductive function in all animals studied to date. We have established biological and physiological evidence for KiSS signaling in the mare. The objective of the current study was to evaluate the physiological and behavioral responses of mares repeatedly given the equine-specific kisspeptpin decapeptide (eKp-10, YRWNSFGLRY-NH(2)) in an effort to shorten the interovulatory period. Administration of eKp-10 (0.5 mg iv every 4 h) to mares beginning on Day 16 postovulation (Group 2) or in estrus (Group 3) did not shorten the mean ± SEM interovulatory interval compared with untreated (Group 1) controls (21.9 ± 1.2, 22 ± 1.2, and 21.5 ± 1.5 days in Groups 1 to 3, respectively; N = 6 per group), nor was there a significant difference in follicle diameter before ovulation among groups, nor number of days treated with eKp-10 for Groups 2 and 3. Mean daily concentrations of FSH, the preovulatory LH surge (timing, mean, and peak concentrations), and mean progesterone concentrations from the newly formed CL were not significantly different among groups. The initiation of treatment was negatively correlated with sexual receptivity (scored 0 to 5: no interest to strong interest) and serum estradiol concentrations, indicating that eKp-10 can significantly disrupt normal sexual receptivity in the estrous mare. This effect on sexual receptivity was short-lived (< 72 h) and the overall change in sexual receptivity score was not significantly different between Groups 2 and 3 (-1.2 ± 0.5 and -1.4 ± 0.4, respectively). However, the day of the cycle that treatment was initiated significant affected the decline in sexual receptivity score, such that the later in the cycle that treatment was initiated, the greater the estimated decrease in sexual receptivity. In conclusion, the linear hypothalamic-pituitary mechanism for KiSS described in other species was not appropriate for the horse and administration of eKp-10 in the seasonally estrous mare may have been outside of the hormone's normal physiological context. Copyright © 2012. Published by Elsevier Inc.

Empty sella syndrome secondary to intrasellar cyst in adolescence.

PubMed

Raiti, S; Albrink, M J; Maclaren, N K; Chadduck, W M; Gabriele, O F; Chou, S M

1976-09-01

A 15-year-old boy had growth failure and failure of sexual development. The probable onset was at age 10. Endocrine studies showed hypopituitarism with deficiency of growth hormone and follicle-stimulating hormone, an abnormal response to metyrapone, and deficiency of thyroid function. Luteinizing hormone level was in the low-normal range. Posterior pituitary function was normal. Roentgenogram showed a large sella with some destruction of the posterior clinoids. Transsphenoidal exploration was carried out. The sella was empty except for a whitish membrane; no pituitary tissue was seen. The sella was packed with muscle. Recovery was uneventful, and the patient was given replacement therapy. On histologic examination,the cyst wall showed low pseudostratified cuboidal epithelium and occasional squamous metaplasia. Hemosiderin-filled phagocytes and acinar structures were also seen. The diagnosis was probable rupture of an intrasellar epithelial cyst, leading to empty sella syndrome.

Science, medicine and virility surveillance: 'sexy seniors' in the pharmaceutical imagination.

PubMed

Marshall, Barbara L

2010-02-01

Abstract While historically sex has been seen primarily as the prerogative of the young, more recently, the emphasis has been on the maintenance of active sexuality as a marker of successful ageing. A new cultural consensus appears to have emerged which not only emphasises the importance of continued sexual activity across the lifespan, but links sexual function with overall health and encourages increased self-surveillance of, and medical attention to, late-life sexuality. Drawing on historical accounts, clinical research, popular science reporting and health promotion literatures, I explore several key shifts in models of sexual ageing, culminating in the contemporary model of gender, sexuality and ageing that has made ageing populations a key market for biotechnologies aimed at enhancing sexual function. Two central concepts frame my analysis: 'virility surveillance', where age-related changes in sexual function are taken as indicative of decline, and the 'pharmaceutical imagination', where sexual lifecourses are reconstructed as drug effects revise standards of sexual function. After consideration of how narratives emerging from qualitative research with older adults challenge the narrow depiction of sexual functionality promoted by pharmaculture, conclusions call for continued critical inquiry into the biomedical construction of sex and age.

Different Characteristics of the Female Sexual Function Index in a Sample of Sexually Active and Inactive Women.

PubMed

Hevesi, Krisztina; Mészáros, Veronika; Kövi, Zsuzsanna; Márki, Gabriella; Szabó, Marianna

2017-09-01

The Female Sexual Function Index (FSFI) is a widely used measurement tool to assess female sexual function along the six dimensions of desire, arousal, lubrication, orgasm, satisfaction, and pain. However, the structure of the questionnaire is not clear, and several studies have found high correlations among the dimensions, indicating that a common underlying "sexual function" factor might be present. To investigate whether female sexual function is best understood as a multidimensional construct or, alternatively, whether a common underlying factor explains most of the variance in FSFI scores, and to investigate the possible effect of the common practice of including sexually inactive women in studies using the FSFI. The sample consisted of 508 women: 202 university students, 177 patients with endometriosis, and 129 patients with polycystic ovary syndrome. Participants completed the FSFI, and confirmatory factor analyses were used to test the underlying structure of this instrument in the total sample and in samples including sexually active women only. The FSFI is a multidimensional self-report questionnaire composed of 19 items. Strong positive correlations were found among five of the six original factors on the FSFI. Confirmatory factor analyses showed that in the total sample items loaded mainly on the general sexual function factor and very little variance was explained by the specific factors. However, when only sexually active women were included in the analyses, a clear factor structure emerged, with items loading on their six specific factors, and most of the variance in FSFI scores was explained by the specific factors, rather than the general factor. University students reported higher scores, indicating better functioning compared with the patient samples. The reliable and valid assessment of female sexual function can contribute to better understanding, prevention, and treatment of different sexual difficulties and dysfunctions. This study provides a rigorous statistical test of the structure of the FSFI and an explicit decision rule for categorizing sexually inactive women. Limitations include a lack of control over the circumstances of data collection. This study supports the use of the FSFI as a multidimensional measurement of female sexual function but highlights the need to establish clear decision rules for the inclusion or exclusion of sexually active and inactive respondents. Hevesi K, Mészáros V, Kövi Z, et al. Different Characteristics of the Female Sexual Function Index in a Sample of Sexually Active and Inactive Women. J Sex Med 2017;14:1133-1141. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Associations Between Personality Disorder Characteristics, Psychological Symptoms, and Sexual Functioning in Young Women.

PubMed

Grauvogl, Andrea; Pelzer, Britt; Radder, Veerle; van Lankveld, Jacques

2018-02-01

Recently, the etiology of sexual dysfunctions in women has been approached from different angles. In clinical practice and in previous studies, it has been observed that women with sexual problems experience anxiety problems and express more rigid and perfectionistic personality traits than women without these problems. To investigate whether personality disorder characteristics according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) and psychological symptoms are associated with sexual problems in women. 188 women 18 to 25 years old participated in this cross-sectional study. Questionnaires measuring sexual functioning (Female Sexual Function Index), personality disorder characteristics (Assessment of DSM-IV-TR Personality Disorders Questionnaire), and psychological symptoms (Brief Symptom Inventory and Center for Epidemiological Studies Depression Scale) were used. The main outcome measure used was sexual functioning assessed by self-report. Results, using analysis of variance, indicated that women with sexual problems report significantly more cluster A (specifically schizoid) and C (specifically avoidant and obsessive-compulsive) personality disorder characteristics than women without sexual problems. Furthermore, using multiple regression analyses, higher cluster A (specifically schizoid) and lower cluster B (specifically borderline and antisocial) personality disorder characteristics indicated lower levels of sexual functioning. Psychological symptoms partly mediated the effect of cluster A personality disorder characteristics on sexual functioning. The results of this study indicate that clinical practice should extend its scope by focusing more on improving adaptive personality characteristics, such as extraversion and individualism seen in cluster B personality characteristics, and decreasing the perfectionistic, introvert, and self-doubting characteristics seen in cluster C personality characteristics. Because of the correlational design and use of self-report measures, causal relations cannot be established between personality disorder characteristics and sexual functioning. Overall, the results indicate that personality disorder characteristics can play an important associative role in the development and maintenance of sexual functioning problems in women. Grauvogl A, Pelzer B, Radder V, van Lankveld J. Associations Between Personality Disorder Characteristics, Psychological Symptoms, and Sexual Functioning in Young Women. J Sex Med 2018;15:192-200. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Urinary and sexual quality of life 1 year following robotic assisted laparoscopic radical prostatectomy.

PubMed

Shikanov, Sergey A; Eng, Michael K; Bernstein, Andrew J; Katz, Mark; Zagaja, Gregory P; Shalhav, Arieh L; Zorn, Kevin C

2008-08-01

We evaluated urinary and sexual quality of life 1 year following robotic laparoscopic radical prostatectomy and identified preoperative variables predictive of a severe decrease from baseline. Using a prospective robotic laparoscopic radical prostatectomy database we identified patients with greater than 1 year of postoperative followup. The UCLA-PCI SF-36v2 questionnaire was used to evaluate urinary and sexual quality of life before and 1 year after surgery. Severe worsening of the postoperative score was defined as a greater than 1 SD decrease. Demographic and preoperative clinical variables were evaluated along with baseline scores on univariate and multivariate analysis. Between February 2003 and September 2007 a total of 1,225 robotic laparoscopic radical prostatectomies were performed at our center and 361 patients (52%) met inclusion criteria. On multivariate analysis baseline urinary function was the only predictor of significant worsening of urinary function (OR 1.04, p = 0.003). Baseline urinary bother was the only predictor of significant worsening of urinary bother (OR 1.05, p <0.0001). A significant decrease in sexual function was predicted by baseline sexual function (OR 1.03, p = 0.0001), baseline sexual bother (OR 1.03, p = 0.005) and nerve sparing technique (OR 0.31, p = 0.05). Predictors of a significant decrease in sexual bother were also baseline sexual function (OR 1.02, p = 0.0001), baseline sexual bother (OR 1.04, p = 0.0007) and nerve sparing technique (OR 0.38, p = 0.02). ORs indicated that higher baseline scores corresponded to a higher risk of postoperative score worsening. We found that overall better baseline sexual and urinary scores are associated with better postoperative outcomes. However, the risk of a significant decrease in urinary function, urinary bother, sexual function and sexual bother is higher in patients with better baseline scores. Nerve sparing positively affects sexual function and sexual bother.

Sexual life and sexual wellness in individuals with complete androgen insensitivity syndrome (CAIS) and Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS).

PubMed

Fliegner, Maike; Krupp, Kerstin; Brunner, Franziska; Rall, Katharina; Brucker, Sara Y; Briken, Peer; Richter-Appelt, Hertha

2014-03-01

Sexual wellness depends on a person's physical and psychological constitution. Complete Androgen Insensitivity Syndrome (CAIS) and Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS) can compromise sexual well-being. To compare sexual well-being in CAIS and MRKHS using multiple measures: To assess sexual problems and perceived distress. To gain insight into participants' feelings of inadequacy in social and sexual situations, level of self-esteem and depression. To determine how these psychological factors relate to sexual (dys)function. To uncover what participants see as the source of their sexual problems. Data were collected using a paper-and-pencil questionnaire. Eleven individuals with CAIS and 49 with MRKHS with/without neovagina treatment were included. Rates of sexual dysfunctions, overall sexual function, feelings of inadequacy in social and sexual situations, self-esteem and depression scores were calculated. Categorizations were used to identify critical cases. Correlations between psychological variables and sexual function were computed. Sexually active subjects were compared with sexually not active participants. A qualitative content analysis was carried out to explore causes of sexual problems. An extended list of sexual problems based on the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision, by the American Psychiatric Association and related distress. Female Sexual Function Index (FSFI), German Questionnaire on Feelings of Inadequacy in Social and Sexual Situations (FUSS social scale, FUSS sexual scale), Rosenberg Self-Esteem Scale (RSE), Brief Symptom Inventory (BSI) subscale depression. Open question on alleged causes of sexual problems. The results point to a far-reaching lack of sexual confidence and sexual satisfaction in CAIS. In MRKHS apprehension in sexual situations is a source of distress, but sexual problems seem to be more focused on issues of vaginal functioning. MRKHS women report being satisfied with their sex life. Different conditions can affect individuals in diagnosis-specific ways despite some shared clinical features. Professionals should adopt an interdisciplinary approach and provide custom-made care in order to promote sexual well-being in patients. © 2013 International Society for Sexual Medicine.

Establishment of estrogen receptor 1 (ESR1)-knockout medaka: ESR1 is dispensable for sexual development and reproduction in medaka, Oryzias latipes.

PubMed

Tohyama, Saki; Ogino, Yukiko; Lange, Anke; Myosho, Taijun; Kobayashi, Tohru; Hirano, Yu; Yamada, Gen; Sato, Tomomi; Tatarazako, Norihisa; Tyler, Charles R; Iguchi, Taisen; Miyagawa, Shinichi

2017-08-01

Estrogens play fundamental roles in regulating reproductive activities and they act through estrogen receptor (ESR) in all vertebrates. Most vertebrates have two ESR subtypes (ESR1 and ESR2), whereas teleost fish have at least three (Esr1, Esr2a and Esr2b). Intricate functionalization has been suggested among the Esr subtypes, but to date, distinct roles of Esr have been characterized in only a limited number of species. Study of loss-of-function in animal models is a powerful tool for application to understanding vertebrate reproductive biology. In the current study, we established esr1 knockout (KO) medaka using a TALEN approach and examined the effects of Esr1 ablation. Unexpectedly, esr1 KO medaka did not show any significant defects in their gonadal development or in their sexual characteristics. Neither male or female esr1 KO medaka exhibited any significant changes in sexual differentiation or reproductive activity compared with wild type controls. Interestingly, however, estrogen-induced vitellogenin gene expression, an estrogen-responsive biomarker in fish, was limited in the liver of esr1 KO males. Our findings, in contrast to mammals, indicate that Esr1 is dispensable for normal development and reproduction in medaka. We thus provide an evidence for estrogen receptor functionalization between mammals and fish. Our findings will also benefit interpretation of studies into the toxicological effects of estrogenic chemicals in fish. © 2017 Japanese Society of Developmental Biologists.

Comparison of Sexual Functions in Pregnant and Non-Pregnant Women.

PubMed

Aydin, Mustafa; Cayonu, Neval; Kadihasanoglu, Mustafa; Irkilata, Lokman; Atilla, Mustafa Kemal; Kendirci, Muammer

2015-11-14

The physiology and anatomy of pregnant women change during pregnancy. Pregnancy is an anatomically and physiologically amended process experienced by women and as a result of these changes, sexual life of pregnant women alters during pregnancy. We aimed to compare sexual functions of pregnant and non-pregnant women. Sexually active 246 pregnant women were included into this cross-sectional controlled study. A total of 210 non-pregnant women were served as control. Both groups were compared in terms of age, gestational age, presence of urinary incontinence, body mass index, and obstetrical history. Sexual functions of the women were evaluated with Female Sexual Function Index (FSFI). Data were analyzed using chi-square, Mann-Whitney U, Fisher's Exact, Shapiro Wilk, Kruskal Wallis and Dunnett's tests where appropriate. The Pvalues < .05 were considered statistically significant. Mean age in both groups were comparable (P = .053). Median total FSFI scores in the pregnant women were significantly lower than those non-pregnant (18.9 vs. 22.7; P < .05). Additionally, the subgroup analyses of the FSFI scores were found that, total FSFI score is significantly lower in the pregnant group compared to non-pregnant group (P < .05). Furthermore, rate of sexual dysfunction in pregnant women was significantly higher than those non-pregnant women (91.08% vs. 67.61%, P = .0001). However, in pregnant women, no meaningful difference in rate of sexual dysfunction was found according to the trimesters (P = .632). Moreover, gravidity and parity exhibited negative impacts on the sexual functions. But number of abortions did not affect sexual function. These data demonstrate that pregnancy significantly diminishes sexual function in women. We believe that, couples need to be counseled regarding the impact of pregnancy on sexual functions.

Self-Reported Sexual Functioning Concerns among Undergraduate Students

ERIC Educational Resources Information Center

Tambling, Rachel B.; Reckert, Ashley

2014-01-01

Researchers who have studied sexual functioning concerns do not often focus their research on undergraduate populations, perhaps due to perceptions of universal sexual health among this population. The current study examined prevalence and type of sexual functioning concerns in a sample of 347 male and female undergraduate students. Sexual…

The relation between prepregnancy sexuality and sexual function during pregnancy and the postpartum period: a prospective study.

PubMed

Yıldız, Hatice

2015-01-01

This study examined the relation between sexual functions of women in prepregnancy (before conception) and during pregnancy and the postpartum period. This study was conducted on 59 healthy pregnant women. Participants were followed from the eighth week of gestation to 6 months after delivery. Sexual function during pregnancy and the postpartum period was shown to have a significant linear correlation with prepregnancy sexuality. There was no relation between pregnancy and postpartum sexuality. All of the participants who had prepregnancy sexual dysfunction continued to experience it during pregnancy, and the majority of them had a significant level of sexual dysfunction in the postpartum period. Our results showed that prepregnancy sexuality plays an important role in maintaining sexuality during pregnancy and the postpartum period.

Changes in sexual function in middle-aged and older men: longitudinal data from the Massachusetts Male Aging Study.

PubMed

Araujo, Andre B; Mohr, Beth A; McKinlay, John B

2004-09-01

To describe within-individual change in sexual function over a 9-year period and to determine whether the amount of change differs by age group. Cohort study; participants interviewed at baseline (1987-89) and follow-up (1995-97). Population-based; communities surrounding Boston, Massachusetts. One thousand eighty-five men aged 40 to 70 at baseline (born between 1917 and 1947) with complete baseline and follow-up sexual function data. Within-person change (follow-up minus baseline) in the following sexual function variables: sexual intercourse, erection frequency, sexual desire, ejaculation with masturbation, satisfaction with sex, and difficulty with orgasm. Unadjusted analyses showed significant longitudinal changes over the 9-year period in all domains of sexual function except frequency of ejaculation with masturbation, which showed no change between baseline and follow-up. Adjusted for baseline sexual function, within-person change in all outcomes was strongly related to age, with decline in sexual function becoming more pronounced with increasing age. For example, over the 9-year study period, sexual intercourse or activity frequency decreased by less than once per month, two times per month, and three times per month in men in their 40s, 50s, and 60s, respectively. Number of erections per month declined by 3, 9, and 13 in men in their 40s, 50s, and 60s, respectively. This research fills a major gap in the literature by providing age-specific estimates of change in sexual functioning over a 9-year period in a cohort of unselected men. Copyright 2004 American Geriatrics Society

Placebo and Nocebo Effects in Sexual Medicine: An Experimental Approach.

PubMed

Kruger, Tillmann H C; Grob, Carolin; de Boer, Claas; Peschel, Thomas; Hartmann, Uwe; Tenbergen, Gilian; Schedlowski, Manfred

2016-11-16

Few studies have investigated placebo and nocebo effects in a human sexuality context. Studying placebo and nocebo responses in this context may provide insight into their potential to modulate sexual drive and function. To examine such effects in sexual medicine, 48 healthy, male heterosexual participants were divided into four groups. Each group received instruction to expect stimulating effects, no effect, or an inhibitory effect on sexual functions. Only one group received the dopamine agonist cabergoline; all other groups received placebo or nocebo. Modulations in sexual experience were examined through an established experimental paradigm of sexual arousal and masturbation-induced orgasm during erotic film sequences with instruction to induce placebo or nocebo effects. Endocrine data, appetitive, consummatory, and refractory sexual behavior parameters were assessed using the Arizona Sexual Experience Scale (ASEX) and the Acute Sexual Experience Scale (ASES). Results showed increased levels of sexual function after administration of cabergoline with significant effects for several parameters. Placebo effects were induced only to a small degree. No negative effects on sexual parameters in the nocebo condition were noted. This paradigm could induce only small placebo and nocebo effects. This supports the view that healthy male sexual function seems relatively resistant to negative external influences.

Investigating Female Sexual Concordance: Do Sexual Excitation and Sexual Inhibition Moderate the Agreement of Genital and Subjective Sexual Arousal in Women?

PubMed

Velten, Julia; Scholten, Saskia; Graham, Cynthia A; Adolph, Dirk; Margraf, Jürgen

2016-11-01

The agreement of subjective and genital sexual response, also referred to as sexual concordance, shows substantial variability between women. Identifying predictors of sexual arousal and sexual concordance is important to improve our understanding of female sexual response and its relationship to sexual function or dysfunction. The aim of this study was to assess the relevance of sexual excitation and sexual inhibition as predictors of subjective sexual arousal, genital arousal, and sexual concordance. In a laboratory setting, sexual arousal was induced by erotic video stimuli. Subjective sexual arousal was assessed continuously during stimulus presentation and genital arousal was measured with vaginal photoplethysmography. Data of 58 women (M age = 24.95, SD = 4.65) were analyzed using multilevel analyses (HLM). This data analytic technique estimates the within-subject associations of subjective and genital arousal, by controlling for between-subject differences. An interaction term of sexual excitation and sexual inhibition significantly predicted genital sexual arousal. In exploratory analyses, two lower order factors of sexual inhibition (Concerns about Sexual Function and Arousal Contingency) were predictive of sexual concordance. Further examination of these associations might increase our knowledge of female sexual function and deepen our understanding of how sexual excitation and sexual inhibition affect sexual arousal and consequently, impact sexual behaviors, in women.

The longitudinal relationship of sexual function and androgen status in older men: the Concord Health and Ageing in Men Project.

PubMed

Hsu, Benjumin; Cumming, Robert G; Blyth, Fiona M; Naganathan, Vasi; Le Couteur, David G; Seibel, Markus J; Waite, Louise M; Handelsman, David J

2015-04-01

It is unclear whether declining sexual function in older men is a cause or consequence of reduced androgen status. Longitudinal associations were examined between reproductive hormones and sexual function in older men. Men aged 70 years and older from the Concord Health and Ageing in Men Project study were assessed at baseline (n = 1705) and 2-year follow-up (n = 1367), with a total of 1226 men included in the final analyses. At both visits, serum testosterone (T), dihydrotestosterone (DHT), estradiol (E2), and estrone (E1) were measured by liquid chromatography-tandem mass spectrometry, and SHBG, LH, and FSH were measured by immunoassay. Sexual functions (erectile function, sexual activity, and sexual desire) were self-reported via standardized questions. In longitudinal analyses, although baseline hormones (T, DHT, E2, and E1) did not predict decline in sexual function, the decline in serum T (but not DHT, E2, or E1) over 2 years was strongly related to the change in sexual activity and desire (but not erectile function). For each 1-SD decrease in T from baseline to 2-year follow-up, there was a multivariate-adjusted odds ratio of 1.23 (95% confidence interval, 1.12-1.36) for an additional risk of further decline in sexual activity. However, the magnitude of the decrease in serum T was strikingly small (<10%). Similar associations were found for changes over 2 years in serum T and decline in sexual desire, but not for erectile function. We found a consistent association among older men followed over 2 years between the decline in sexual activity and desire, but not in erectile function, with a decrease in serum T. Although these observational findings cannot determine causality, the small magnitude of the decrease in serum T raises the hypothesis that reduced sexual function may reduce serum T rather than the reverse.

Fertility and sexual function in female Hodgkin lymphoma survivors of reproductive age.

PubMed

Eeltink, Corien M; Incrocci, Luca; Witte, Birgit I; Meurs, Saskia; Visser, Otto; Huijgens, Peter; Verdonck-de Leeuw, Irma M

2013-12-01

To assess the perceived fertility status and to determine the association between perceived fertility status and sexual function, as reported by young female Hodgkin lymphoma survivors. Young female Hodgkin lymphoma survivors are at risk of infertility and impaired sexual function. However, little is known about their awareness of infertility and its association with sexual functioning. A descriptive questionnaire survey. In this cross-sectional study, a survey was completed by female Hodgkin lymphoma survivors (< 40 years). Outcome measures included self-reported fertility status and sexual problems and the internationally validated Female Sexual Function Index. In total, 36 survivors were included (mean age 32 years, SD 4). Eighteen women (50%) thought themselves fertile. Eight survivors (22%) who perceived themselves as being infertile were more often treated with alkylator-based chemotherapy, and 63% reported sexual dysfunction. Ten survivors (28%) were not aware as to whether they were fertile or not; seven of these would like to have children. The reported fertility status was related to age and chemotherapy regimen. Regarding sexuality, 14 (39%) of the female Hodgkin lymphoma survivors reported one or more sexual problem and none reported recovery. Female sexual dysfunction according to the Female Sexual Function Index was reported by 11 (31%) survivors. Almost 30% of Hodgkin lymphoma survivors do not know whether they are fertile or not. Overall sexual dysfunction is common in Hodgkin lymphoma survivors and comparable to the general population. However, a lack of desire was significantly more often reported in female Hodgkin lymphoma survivors. To prevent assumed infertility and unintended childlessness by postponing parenthood in young female survivors, awareness of fertility status is needed. There is also a need to routinely assess sexual function and provide adequate interventions to improve arousal and lubrication problems. © 2013 John Wiley & Sons Ltd.

Body image and sexual function in women after treatment for anal and rectal cancer.

PubMed

Benedict, Catherine; Philip, Errol J; Baser, Raymond E; Carter, Jeanne; Schuler, Tammy A; Jandorf, Lina; DuHamel, Katherine; Nelson, Christian

2016-03-01

Treatment for anal and rectal cancer (ARCa) often results in side effects that directly impact sexual functioning; however, ARCa survivors are an understudied group, and factors contributing to the sexual sequelae are not well understood. Body image problems are distressing and may further exacerbate sexual difficulties, particularly for women. This preliminary study sought to (1) describe body image problems, including sociodemographic and disease/treatment correlates, and (2) examine relations between body image and sexual function. For the baseline assessment of a larger study, 70 women completed the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire and Colorectal Cancer-specific Module, including the Body Image subscale, and Female Sexual Function Index. Pearson's correlation and multiple regression evaluated correlates of body image. Among sexually active women (n = 41), hierarchical regression examined relations between body image and sexual function domains. Women were on average 55 years old (standard deviation = 11.6), non-Hispanic White (79%), married (57%), and employed (47%). The majority (86%) reported at least one body image problem. Younger age, lower global health status, and greater severity of symptoms related to poorer body image (p's < 0.05). Poor body image was inversely related to all aspects of sexual function (β range 0.50-0.70, p's < 0.05), except pain. The strongest association was with Female Sexual Function Index Sexual/Relationship Satisfaction. These preliminary findings suggest the importance of assessing body image as a potentially modifiable target to address sexual difficulties in this understudied group. Further longitudinal research is needed to inform the development and implementation of effective interventions to improve the sexual health and well-being of female ARCa survivors. Copyright © 2015 John Wiley & Sons, Ltd.

Change in Sexual Functioning Over the Menopause Transition: Results from the Study of Women’s Health Across the Nation (SWAN)

PubMed Central

Avis, Nancy E.; Colvin, Alicia; Karlamangla, Arun S.; Crawford, Sybil; Hess, Rachel; Waetjen, L. Elaine; Brooks, Maria; Tepper, Ping G.; Greendale, Gail A.

2016-01-01

Objective To identify whether there is a decline in sexual functioning related to the menopause transition or to hysterectomy. Methods In a cohort of 1,390 women aged 42–52, with intact uterus and at least one ovary, not using hormone therapy, and pre- or early perimenopausal at baseline, we fit piecewise linear growth curves to 5,798 repeated measurements (7 visits spanning 14.5 years) of a sexual functioning score (range, 5–25) as a function of time relative to date of final menstrual period (FMP) or hysterectomy. Results Mean sexual functioning at baseline in women with a dateable FMP was 18.0 (standard deviation, 3.4). There was no change in sexual function until 20 months before the FMP. From 20 months before until one year after the FMP, sexual function decreased by 0.35 annually (95% CI:−0.44, −0.26) and continued to decline more than one year after the FMP, but at a slower rate (−0.13 annually, 95% CI:−0.17, −0.10). The decline was smaller in African-Americans and larger in Japanese compared to whites. Vaginal dryness, lubricant use, depressive symptoms, or anxiety did not explain decline in sexual function. Women who had a hysterectomy prior to the FMP did not show decline in sexual function prior to hysterectomy, but scores declined afterwards (0.21 annually, 95% CI:−0.28, −0.14). Conclusions Decline in sexual function became apparent 20 months prior to FMP and slowed one year after FMP through 5 years afterwards. A decline in sexual function was observed immediately after hysterectomy and persisted for the 5 years of observation. PMID:27801705

Sexual Health and Well-being Among Older Men and Women in England: Findings from the English Longitudinal Study of Ageing.

PubMed

Lee, David M; Nazroo, James; O'Connor, Daryl B; Blake, Margaret; Pendleton, Neil

2016-01-01

We describe levels of sexual activity, problems with sexual functioning, and concerns about sexual health among older adults in the English Longitudinal Study of Ageing (ELSA), and associations with age, health, and partnership factors. Specifically, a total of 6,201 core ELSA participants (56 % women) aged 50 to >90 completed a comprehensive Sexual Relationships and Activities questionnaire (SRA-Q) included in ELSA Wave 6 (2012/13). The prevalence of reporting any sexual activity in the last year declined with age, with women less likely than men at all ages to report being sexually active. Poorer health was associated with lower levels of sexual activity and a higher prevalence of problems with sexual functioning, particularly among men. Difficulties most frequently reported by sexually active women related to becoming sexually aroused (32 %) and achieving orgasm (27 %), while for men it was erectile function (39 %). Sexual health concerns most commonly reported by women related to their level of sexual desire (11 %) and frequency of sexual activities (8 %). Among men it was level of sexual desire (15 %) and erectile difficulties (14 %). While the likelihood of reporting sexual health concerns tended to decrease with age in women, the opposite was seen in men. Poor sexual functioning and disagreements with a partner about initiating and/or feeling obligated to have sex were associated with greater concerns about and dissatisfaction with overall sex life. Levels of sexual activity decline with increasing age, although a sizable minority of men and women remain sexually active until the eighth and ninth decades of life. Problems with sexual functioning were relatively common, but overall levels of sexual health concerns were much lower. Sexually active men reported higher levels of concern with their sexual health and sexual dissatisfaction than women at all ages. Older peoples' sexual health should be managed, not just in the context of their age, gender, and general health, but also within their existing sexual relationship.

Changes in sexual functioning from 6 to 12 months following traumatic brain injury: a prospective TBI model system multicenter study.

PubMed

Hanks, Robin A; Sander, Angelle M; Millis, Scott R; Hammond, Flora M; Maestas, Kacey L

2013-01-01

To investigate longitudinal changes in sexual functioning during the first year following moderate to severe traumatic brain injury (TBI). Prospective cohort study. Community. 182 persons (53 women and 129 men) with moderate to severe TBI who were admitted to 1 of 6 participating TBI Model System centers and followed in the community at 6 and 12 months after injury. Derogatis Interview for Sexual Functioning-Self-Report (DISF-SR); Global Sexual Satisfaction Index (GSSI). Mean T-scores on the DISF-SR Arousal subscale demonstrated marginal improvement over time, with a 2.59-point increase (P = .05) from 6 to 12 months after injury. There were no significant differences over this 6-month period on the remaining DISF-SR subscales, including sexual cognition/fantasy, sexual behavior/experience, and orgasm. There was no significant change in satisfaction with sexual functioning on the GSSI from 6 months (72% satisfied) to 12 months (71% satisfied). Sexual function and satisfaction appears to be stable in those with moderate to severe TBI from 6 to 12 months after injury, with the exception of minimal improvement in arousal. These findings, to our knowledge, reflect the first evidence regarding prospective changes in sexual functioning in this population. Future research can go far to assist clinicians in treatment planning and managing patient expectations of recovery of sexual functioning after TBI.

Masturbation Frequency and Sexual Function Domains Are Associated With Serum Reproductive Hormone Levels Across the Menopausal Transition

PubMed Central

Zheng, Huiyong; Avis, Nancy E.; Greendale, Gail A.; Harlow, Siobán D.

2015-01-01

Objective: To determine whether reproductive hormones are related to sexual function during the menopausal transition. Design: The Study of Women's Health Across the Nation (SWAN) is a multiethnic cohort study of the menopausal transition located at seven US sites. At baseline, the 3302 community-based participants, aged 42–52, had an intact uterus and at least one ovary and were not using exogenous hormones. Participants self-identified as White, Black, Hispanic, Chinese, or Japanese. At baseline and at each of the 10 follow-up visits, sexual function was assessed by self-administered questionnaires, and blood was drawn to assay serum levels of T, estradiol, FSH, SHBG, and dehydroepiandrosterone sulfate. Main Outcome Measures: Self-reported frequency of masturbation, sexual desire, sexual arousal, orgasm, and pain during intercourse. Results: Masturbation, sexual desire, and arousal were positively associated with T. Masturbation, arousal, and orgasm were negatively associated with FSH. Associations were modest. Estradiol was not related to any measured sexual function domain. Pain with intercourse was not associated with any hormone. Conclusions: Reproductive hormones were associated with sexual function in midlife women. T was positively associated, supporting the role of androgens in female sexual function. FSH was negatively associated, supporting the role of menopausal status in female sexual function. The modest associations in this large study suggest that the relationships are subtle and may be of limited clinical significance. PMID:25412335

Masturbation frequency and sexual function domains are associated with serum reproductive hormone levels across the menopausal transition.

PubMed

Randolph, John F; Zheng, Huiyong; Avis, Nancy E; Greendale, Gail A; Harlow, Siobán D

2015-01-01

To determine whether reproductive hormones are related to sexual function during the menopausal transition. The Study of Women's Health Across the Nation (SWAN) is a multiethnic cohort study of the menopausal transition located at seven US sites. At baseline, the 3302 community-based participants, aged 42-52, had an intact uterus and at least one ovary and were not using exogenous hormones. Participants self-identified as White, Black, Hispanic, Chinese, or Japanese. At baseline and at each of the 10 follow-up visits, sexual function was assessed by self-administered questionnaires, and blood was drawn to assay serum levels of T, estradiol, FSH, SHBG, and dehydroepiandrosterone sulfate. Self-reported frequency of masturbation, sexual desire, sexual arousal, orgasm, and pain during intercourse. Masturbation, sexual desire, and arousal were positively associated with T. Masturbation, arousal, and orgasm were negatively associated with FSH. Associations were modest. Estradiol was not related to any measured sexual function domain. Pain with intercourse was not associated with any hormone. Reproductive hormones were associated with sexual function in midlife women. T was positively associated, supporting the role of androgens in female sexual function. FSH was negatively associated, supporting the role of menopausal status in female sexual function. The modest associations in this large study suggest that the relationships are subtle and may be of limited clinical significance.

Women's History of Sexual Abuse, Their Sexuality, and Sexual Self-Schemas

ERIC Educational Resources Information Center

Meston, Cindy M.; Rellini, Alessandra H.; Heiman, Julia R.

2006-01-01

In this study, the authors assessed 48 female survivors of child sexual abuse (CSA) and 71 female control participants using measures of adult sexual function, psychological function (i.e., depression and anxiety), and sexual self-schemas. The primary purpose of this study was to examine whether differences existed between women with and without a…

Childhood sexual abuse moderates the relationship between sexual functioning and eating disorder psychopathology in anorexia nervosa and bulimia nervosa: a 1-year follow-up study.

PubMed

Castellini, Giovanni; Lo Sauro, Carolina; Lelli, Lorenzo; Godini, Lucia; Vignozzi, Linda; Rellini, Alessandra H; Faravelli, Carlo; Maggi, Mario; Ricca, Valdo

2013-09-01

Sexual dysfunctions that affect all aspects of sexuality are common in patients with eating disorders. However, only few studies have provided longitudinal information on sexual functioning in patients with eating disorders. To evaluate the longitudinal course of sexual functioning, and how changes in psychopathology and history of childhood abuse interact with sexual functioning in patients with anorexia nervosa (AN) and bulimia nervosa (BN). A total of 27 patients with AN and 31 with BN were assessed at baseline and at 1-year follow-up after a standard individual cognitive behavioral therapy (CBT). Subjects were studied by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV, Female Sexual Function Index (FSFI), Eating Disorder Examination Questionnaire, Beck Depression Inventory, Spielberg's State-Trait Anxiety Inventory, Symptom Checklist-90, and Childhood Experience of Care and Abuse Questionnaire. After treatment, both patients with AN and BN showed a significant improvement in the FSFI total score (P < 0.01 for both AN and BN) and all FSFI subscales, without significant between groups differences. Patients reporting childhood sexual abuse did not show a significant improvement in sexual functioning (β = 0.05; P = 0.58). Reduction in eating disorder severity was directly associated with FSFI improvement, but only in those subjects with no history of sexual abuse (β = 0.28; P = 0.01). Eating disorder-specific psychopathology could be considered as a specific maintaining factor for sexual dysfunction in eating disorders subjects. Subjects reporting a history of childhood sexual abuse represent a subpopulation of patients with a profound uneasiness, involving body perception, as well as sexual functioning, which appeared not to be adequately challenged during standard CBT intervention. The results, though original, should be considered as preliminary, given the relatively small sample size. © 2013 International Society for Sexual Medicine.

Association of arsenobetaine with beta-cell function assessed by homeostasis model assessment (HOMA) in nondiabetic Koreans: data from the fourth Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2009.

PubMed

Baek, Kiook; Lee, Namhoon; Chung, Insung

2017-01-01

Arsenic is known as an endocrine disruptor that people are exposed to through various sources such as drinking water and indigestion of marine products. Although some epidemiological and animal studies have reported a correlation between arsenic exposure and diabetes development, there are limited studies regarding the toxic effects of organic arsenic including arsenobetaine on the human body. Here, we analyzed the association between urine arsenobetaine and the homeostasis model assessment of β-cell function (HOMA-β), which is an index for predicting diabetes development and reflecting the function of pancreatic β-cells. In the fourth Korea National Health and Nutrition Examination Survey (KNHANES), health and nutrition surveys and screening tests were performed. Of the total survey population, people with confirmed values for urine total arsenic and arsenobetaine were included, and known diabetic patients were excluded. A total 369 participants were finally included in the study. We collected surveys on health, height, body weight, body mass index, blood mercury level, fasting glucose level, and serum insulin level and calculated HOMA index. Owing to sexual discrepancy, we performed sexually stratified analysis. Urine total arsenic and total arsenic minus arsenobetaine was not associated with HOMA-IR and HOMA-β in univariate analysis or in sexually stratified analysis. However, urine arsenobetaine showed a statistically significant relationship with HOMA-β in univariate analysis, and only male participants showed a significant correlation in sexually stratified analysis. In the analysis adjusted for age, BMI, smoking, alcohol drinking, physical activity and blood mercury, the HOMA-β value in the group below the 25th percentile of arsenobetaine was significantly higher than the group between 50 and 75th percentile, while no difference was shown for HOMA-IR. In sexually stratified analysis, The value of HOMA-β was significantly higher in male participants with below the 25th percentile urine arsenobetaine than the group between 25 and 50th and between 50 and 75th, while no difference was shown for HOMA-IR. However, female participants did not demonstrate a relationship between HOMA-IR, HOMA-β and urine arsenobetaine. This study revealed the association between urine arsenobetaine and pancreatic β-cell function assessed by HOMA-β in the normal population (without diabetes), especially in males, despite adjusting for factors affecting pancreatic β-cell function and diabetes.

Is infertility a risk factor for female sexual dysfunction? A case-control study.

PubMed

Millheiser, Leah S; Helmer, Amy E; Quintero, Rodolfo B; Westphal, Lynn M; Milki, Amin A; Lathi, Ruth B

2010-11-01

To determine the impact of infertility on female sexual function. A case-control study. Academic infertility and gynecology practices. One hundred nineteen women with infertility and 99 healthy female controls without infertility between the ages of 18 and 45 years were included in this study. Anonymous survey and Female Sexual Function Index. Female Sexual Function Index scores, frequency of sexual intercourse and masturbation, and sex-life satisfaction. Twenty-five percent of our control group had Female Sexual Function Index scores that put them at risk for sexual dysfunction (<26.55), whereas 40% of our patients with infertility met this criterion. Compared with the control group, the patients with infertility had significantly lower scores in the desire and arousal domains and lower frequency of intercourse and masturbation. The patients with infertility retrospectively reported a sex-life satisfaction score that was similar to that of the controls before their diagnosis, whereas their current sex-life satisfaction scores were significantly lower than those of the controls. Women with a diagnosis of infertility were found to be at higher risk for sexual dysfunction on the basis of their Female Sexual Function Index scores compared with women without infertility. The interaction of sexual function and infertility is complex and deserves further study. Copyright © 2010. Published by Elsevier Inc.

Reading the Freudian theory of sexual drives from a functional neuroimaging perspective

PubMed Central

Stoléru, Serge

2014-01-01

One of the essential tasks of neuropsychoanalysis is to investigate the neural correlates of sexual drives. Here, we consider the four defining characteristics of sexual drives as delineated by Freud: their pressure, aim, object, and source. We systematically examine the relations between these characteristics and the four-component neurophenomenological model that we have proposed based on functional neuroimaging studies, which comprises a cognitive, a motivational, an emotional and an autonomic/neuroendocrine component. Functional neuroimaging studies of sexual arousal (SA) have thrown a new light on the four fundamental characteristics of sexual drives by identifying their potential neural correlates. While these studies are essentially consistent with the Freudian model of drives, the main difference emerging between the functional neuroimaging perspective on sexual drives and the Freudian theory relates to the source of drives. From a functional neuroimaging perspective, sources of sexual drives, conceived by psychoanalysis as processes of excitation occurring in a peripheral organ, do not seem, at least in adult subjects, to be an essential part of the determinants of SA. It is rather the central processing of visual or genital stimuli that gives to these stimuli their sexually arousing and sexually pleasurable character. Finally, based on functional neuroimaging results, some possible improvements to the psychoanalytic theory of sexual drives are suggested. PMID:24672467

Predictors of improvement in sexual function of women with urinary incontinence after treatment with pelvic floor exercises: a secondary analysis.

PubMed

Sacomori, Cinara; Cardoso, Fernando Luiz

2015-03-01

Women with urinary incontinence (UI) frequently present with complaints of sexual problems. To evaluate the predictors of sexual function improvement after participating in three physical therapy sessions and performing home-based pelvic floor muscle exercises (PFME) for the treatment of female UI. This is a secondary analysis of a randomized trial with a 3-month follow-up in which the sexual function of 54 women with UI was evaluated. These women joined three supervised physiotherapy sessions that included PFME and health education during 1 month, with a 15-day interval between each session, and kept practicing home-based PFME for a further 2 months. Sexual function was assessed using the Female Sexual Quotient, the pelvic floor muscle strength was measured using the modified Oxford scale, and UI was assessed using the International Consultation on Incontinence Questionnaire. The mean of sexual quotient score improved after treatment (P = 0.001). With respect to specific domains of sexual function, improvement was observed only in the questions about sexual desire, arousal/excitement, and orgasm. Before treatment, 18 women (33.3%) were classified as having sexual dysfunction, and after treatment, eight remained with sexual dysfunction and two other joined this category (total of 18.5%). Those women who had sexual dysfunction at baseline experienced a higher level of improvement of the sexual quotient compared with those without sexual dysfunction (P = 0.001, 95% CI = 9.1-31.9). A multivariate linear regression with backward elimination revealed the following predictors of improvement of the sexual quotient: higher parity, higher adherence to PFME, improvement in the strength of PFM, and a decrease in the frequency of urine leakage (R(2)  = 0.497). PFME was more beneficial with regard to sexual function in those women who presented with sexual dysfunction at baseline. © 2015 International Society for Sexual Medicine.

The assessment of sexual functions in women with male partners complaining of erectile dysfunction: does treatment of male sexual dysfunction improve female partner's sexual functions?

PubMed

Cayan, Selahittin; Bozlu, Murat; Canpolat, Bülent; Akbay, Erdem

2004-01-01

The aims of this prospective study were to compare sexual functioning between women with male partners who have erectile dysfunction (ED) and women without partners with ED and also to investigate the effect of the treatment of male ED on female partner's sexual function. The study included 87 women and their male partners. We divided the women into two groups: 38 women with male partners complaining of ED (ED group) and 49 women with male partners who have no ED (control group). Of the men with ED, 30 were treated with penile prosthesis implantation (n = 17) or oral sildenafil citrate (n = 13). We evaluated all the men with the International Index of Erectile Function (IIEF; Rosen, Cappelleri, Smith, Lipsky, & Pena, 1999), physical examination, and color penile Doppler ultrasound. We evaluated female sexual function with the Female Sexual Function Index (FSFI; Rosen et al., 2000) to assess sexual desire, arousal, lubrication, orgasm, satisfaction, and pain. We compared female sexual function scores between the women of the male partners with and without ED and also compared before both groups and after the treatment of male partners in the ED group. Additionally, we compare the scores according to the type of treatment given to the male partners. Sexual arousal (p = 0.009), lubrication (p = 0.001), orgasm (p = 0.006), satisfaction (p = 0.000), pain (p = 0.039), and total score (p = 0.003) were highly significantly lower in the ED group than in the control group, although sexual desire did not differ between the two groups (p = 0.515). We investigated the effect of male ED on female sexual functions and found no statistically significant differences in the presence of organic type impotence, older age, and lower erection scores on the IIEF (p = 0.53, p = 0.15, and p = 0.1, respectively). After the treatment of male ED, we observed significant improvement in sexual arousal (p = 0.001), lubrication (p = 0.002), orgasm (p = 0.000), satisfaction (p = 0.000), and pain (p = 0.002) in the women. These findings suggest that female sexual function is affected by male erection status and may improve after the treatment of male sexual dysfunction.

Sexual Function Is Correlated With Body Image and Partnership Quality in Female University Students.

PubMed

Wallwiener, Stephanie; Strohmaier, Jana; Wallwiener, Lisa-Maria; Schönfisch, Birgitt; Zipfel, Stephan; Brucker, Sara Y; Rietschel, Marcella; Wallwiener, Christian W

2016-10-01

According to the World Health Organization definition, sexual health is more than mere physical sexual function; it also encompasses emotional, mental, and social well-being in relation to sexuality and is not merely the absence of dysfunction or disease. In line with this definition, various studies have reported that female sexual function is associated with partnership quality, body image, and body self-acceptance. To investigate whether female sexual function is influenced by (i) body self-acceptance and (ii) partnership quality, as important factors in psychosocial well-being, and (iii) whether the effects of body self-acceptance are moderated by partnership quality. In total, 2,685 female medical students no older than 35 years from Germany, Austria, and Switzerland completed an anonymous online questionnaire comprising the Female Sexual Function Index (FSFI) and the Self-Acceptance of the Body Scale. Respondents were asked to state whether they had been in a steady partnership in the preceding 6 months. When present, the quality of the partnership status was rated (enamoredness, love, friendship, or conflicted). To determine correlations, group differences, and moderating effects among body self-acceptance, partnership quality, and sexual function, the data were analyzed using Spearman correlations, Kruskal-Wallis tests, and analyses of variance. Female sexual function (FSFI total score). (i) In sexually active women, higher FSFI scores were significantly associated with greater body self-acceptance and a steady partnership during the preceding 6 months. (ii) Total FSFI scores were highest in women who described their partnership as enamored (29.45) or loving (28.55). Lower scores were observed in single women (26.71) and in women who described their partnerships as friendship (25.76) or as emotionally conflicted (23.41). (iii) Total FSFI score was affected by an interaction between body self-acceptance and partnership quality. Body self- acceptance was positively associated with FSFI total scores, particularly in single women and women in emotionally conflicted partnerships. Our findings suggest that in young women, body self-acceptance and partnership quality are positively associated with better sexual function, and that high body self-acceptance might buffer the negative impact on sexual function of partnership quality. The present data suggest that psychological interventions to improve the body image of younger women can positively affect sexual function and thereby improve sexual health. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Intracellular Membrane and Synaptic Properties in Medial Preoptic Slices Containing the Sexually Dimorphic Nucleus of the Rat

DTIC Science & Technology

1992-01-01

these events appear to be LTS potentials, as originally described in other central regions (Jahnsen and Llings 1984). In some media preoptic neurons, LTS...Kelly, J.S. An intracellular study of grafted and in situ preoptic area neurones in brain slices from normal and hypogonadal mice. J Physiol. 423: 111... central nervous system function. Science 242: 1654-1664, 1988. Llings, R., and Yarom, Y. Electrophysiology of mammalian inferior olivary neurons in vitro

Child Sexual Behaviors in School Context: Age and Gender Differences.

PubMed

Miragoli, Sarah; Camisasca, Elena; Di Blasio, Paola

2017-01-01

The main purpose of the study was to explore the child sexual behaviors that Italian teachers have observed in the school context. A representative sample of 227 children, from 5 to 10 years old, was rated by their teachers through the Child Sexual Behavior Inventory. Frequencies of sexual behaviors among children aged 5 to 6, 7 to 8, and 9 to 10 are presented. Younger children showed a broader range of sexual behaviors that decrease with the growing age, such as males in comparison to females. Moreover, findings showed that child sexual behavior is not only related to age and gender but also to family characteristics. These results suggested that child sexual behaviors reported by teachers through the Child Sexual Behavior Inventory may provide useful information about the development of children's sexuality. The knowledge of age appropriate sexual behaviors can help teachers discern normal sexual behaviors from problematic sexual behaviors.

Erotic Stimulus Processing under Amisulpride and Reboxetine: A Placebo-Controlled fMRI Study in Healthy Subjects

PubMed Central

Wiegers, Maike; Metzger, Coraline D.; Walter, Martin; Grön, Georg; Abler, Birgit

2015-01-01

Background: Impaired sexual function is increasingly recognized as a side effect of psychopharmacological treatment. However, underlying mechanisms of action of the different drugs on sexual processing are still to be explored. Using functional magnetic resonance imaging, we previously investigated effects of serotonergic (paroxetine) and dopaminergic (bupropion) antidepressants on sexual functioning (Abler et al., 2011). Here, we studied the impact of noradrenergic and antidopaminergic medication on neural correlates of visual sexual stimulation in a new sample of subjects. Methods: Nineteen healthy heterosexual males (mean age 24 years, SD 3.1) under subchronic intake (7 days) of the noradrenergic agent reboxetine (4mg/d), the antidopaminergic agent amisulpride (200mg/d), and placebo were included and studied with functional magnetic resonance imaging within a randomized, double-blind, placebo-controlled, within-subjects design during an established erotic video-clip task. Subjective sexual functioning was assessed using the Massachusetts General Hospital-Sexual Functioning Questionnaire. Results: Relative to placebo, subjective sexual functioning was attenuated under reboxetine along with diminished neural activations within the caudate nucleus. Altered neural activations correlated with decreased sexual interest. Under amisulpride, neural activations and subjective sexual functioning remained unchanged. Conclusions: In line with previous interpretations of the role of the caudate nucleus in the context of primary reward processing, attenuated caudate activation may reflect detrimental effects on motivational aspects of erotic stimulus processing under noradrenergic agents. PMID:25612894

Sexual functioning among women with physical disabilities.

PubMed

Nosek, M A; Rintala, D H; Young, M E; Howland, C A; Foley, C C; Rossi, D; Chanpong, G

1996-02-01

Three a priori hypotheses were tested: (1) There are significant differences in sociosexual behaviors of women with physical disabilities compared with women without disabilities; (2) the sexual functioning of women with disabilities is significantly related to age at onset of disability; (3) psychological factors explain more of the variance in the sexual functioning of women with physical disabilities than do disability, social and environmental factors. Case-comparison study using written survey. General community. The questionnaire was mailed to 1,150 women with physical disabilities who were recruited as volunteers or through independent living centers. Each woman gave a second copy of the questionnaire to an able-bodied female friend, which comprised the comparison group. The response rate was 45%, with 475 cases and 425 comparisons eligible to participate. The most common disability type was spinal cord injury (24%), followed by polio (18%), muscular dystrophy (11%), cerebral palsy (11%), multiple sclerosis (10%), joint disorders (7%), and skeletal abnormalities (5%). None. Sexual-functioning, consisting of four factors: (1) sexual desire, (2) sexual activity, (3) sexual response, (4) sexual satisfaction. Highly significant differences were found in level of sexual activity (p = .000001), response (p = .000009), and satisfaction (p=.000001) between women with and without disabilities. No significant differences were found between groups on sexual desire. Severity of disability was not significantly related to level of sexual activity. Psychological and social factors exert a strong impact on the sexual functioning of women with physical disabilities. Further investigations is needed of the effect of social environment on development of self-esteem and sexual self-image, and how these influences affect levels of sexual functioning in women with physical disabilities.

Prevalence and characteristics of vibrator use by men in the United States.

PubMed

Reece, Michael; Herbenick, Debra; Sanders, Stephanie A; Dodge, Brian; Ghassemi, Annahita; Fortenberry, J Dennis

2009-07-01

While vibrating products have been recommended by clinicians for the treatment of male sexual dysfunctions, knowledge is lacking with regard to the prevalence of vibrator use among men in the United States, the characteristics of men who use vibrators, and whether there are relations between vibrator use and sexual function among men. To establish lifetime and recent prevalence rates for vibrator use by men in the United States, to document the characteristics of men who use vibrators and their reasons for using vibrators, and to explore relations between men's vibrator use and sexual function. During April 2008, data were collected from a population-based cross-sectional survey of 1,047 men aged 18-60 years in the United States. Analyses were conducted using post-stratification data weights. Measures included sociodemographics, health status and health-related behaviors, sexual behaviors, vibrator use, and sexual function. For both solo and partnered sexual activities, the prevalence of men who had incorporated a vibrator into sexual activities during their lives was 44.8%, with 10.0% having done so in the past month, 14.2% in the past year, and 20.5% over 1 year ago. Men who had used vibrators, particularly those with more recent use, were more likely to report participation in sexual health promoting behaviors, such as testicular self-exam. Men who had used vibrators recently also scored higher on four of the five domains of the International Index of Erectile Function (erectile function, intercourse satisfaction, orgasmic function, and sexual desire). Among men in the United States, vibrator use during solo and partnered sexual interactions is common and is associated with a wide array of positive sexual health characteristics. Future research should continue to explore ways in which men incorporate vibrators into solo sexual acts, partnered sexual play, and sexual intercourse.

Is sexual function in female partners of men with premature ejaculation compromised?

PubMed

Kaya, Cevdet; Gunes, Mustafa; Gokce, Ali Murat; Kalkan, Senad

2015-01-01

The authors enrolled 32 female partners of sexually active men with premature ejaculation to investigate their sexual functions. An age-matched sample of the same number women whose partners had no sexual dysfunction was also included. Premature ejaculation was defined for all participants as ejaculation that nearly always occurs before or within 2 min of vaginal penetration. An invitation letter was given to men with premature ejaculation to ask whether their female partners could be contacted about completing a questionnaire to measure female sexual status. On the basis of the Female Sexual Function Index, the average sexual function score was significantly lower in partners of men with premature ejaculation (21.8 ± 7.6) compared with that in healthy controls (25.9 ± 6.6). Female sexual dysfunction was diagnosed in 78% of women who has a male partner with premature ejaculation, while 40% of female partner of healthy men. All of the domain scores of Female Sexual Function Index, except the desire and pain levels, were significantly lower in female partners of men with premature ejaculation group than those of healthy subjects.

Challenging Stereotypes: Sexual Functioning of Single Adults with High Functioning Autism Spectrum Disorder

ERIC Educational Resources Information Center

Byers, E. Sandra; Nichols, Shana; Voyer, Susan D.

2013-01-01

This study examined the sexual functioning of single adults (61 men, 68 women) with high functioning autism and Asperger syndrome living in the community with and without prior relationship experience. Participants completed an on-line questionnaire assessing autism symptoms, psychological functioning, and various aspects of sexual functioning. In…

Effects of Intranasal Oxytocin Administration on Sexual Functions in Healthy Women: A Laboratory Paradigm.

PubMed

Kruger, Tillmann H C; Deiter, Frank; Zhang, Yuanyuan; Jung, Stefanie; Schippert, Cordula; Kahl, Kai G; Heinrichs, Markus; Schedlowski, Manfred; Hartmann, Uwe

2018-06-01

The neuropeptide oxytocin (OXT) has a variety of physiological functions in maternal behavior and attachment including sexual behavior. Based on animal research and our previous human studies, we set out to investigate intranasal administration of OXT and hypothesized that OXT should be able to modulate sexual function in women. In a double-blind, placebo-controlled, crossover laboratory setting, the acute effects of intranasal administered OXT (24 international units) on sexual drive, arousal, orgasm, and refractory aspects of sexual behavior were analyzed in 27 healthy females (mean age ± SD, 27.52 ± 8.04) together with physiological parameters using vaginal photoplethysmography. Oxytocin administration showed no effect on subjective sexual parameters (eg, postorgasmic tension; P = 0.051). Physiological parameters (vaginal photoplethysmography amplitude and vaginal blood volume) showed a response pattern towards sexual arousal but were not affected by OXT. Using a well-established laboratory paradigm, we did not find that intranasal OXT influences female sexual parameters. Also, sexual drive and other functions were not affected by OXT. These findings indicate that OXT is not able to significantly increase subjective and objective parameters of sexual function in a setting with high internal validity; however, this might be different in a more naturalistic setting.

Female sexual function and the clitoral complex using pelvic MRI assessment.

PubMed

Vaccaro, Christine M; Fellner, Angela N; Pauls, Rachel N

2014-09-01

To report basic measurements of clitoral anatomy, and explore potential relationships between the clitoral complex and female sexual function using MRI assessment. In this retrospective descriptive study, 20 sexually active women (≥18 years) who had a recent pelvic MRI for various gynecologic concerns were invited to participate. Outcome measures included demographic data, medical and sexual history, quality of life questionnaires: Female Sexual Function Index (FSFI), Body Exposure during Sexual Activities Questionnaire (BESAQ), and Short Form Quality of Life Questionnaire (SF-12). These data were then compared to detailed clitoral MRI measurements and analyzed using the Pearson correlation and Chi square test. FSFI domains of desire, arousal, lubrication, and orgasm were inversely correlated with clitoral size (p=0.01-0.04), as were SF-12 physical composite scores (p=0.003), suggesting improved sexual function and physical health in women with smaller clitoral structures (specifically the clitoral body and crus). Sexual function was improved in women with a smaller-sized clitoris, specifically the clitoral body and crus. Published by Elsevier Ireland Ltd.

Evaluation of sexual function, quality of life, and mental and physical health in pregnant women.

PubMed

Nik-Azin, Amir; Nainian, Mohammad Reza; Zamani, Mahnaz; Bavojdan, Marjan Rabani; Bavojdan, Mozhgan Rabani; Motlagh, Marjan Jamali

2013-12-01

To evaluate sexual function and its relationship with quality of life, and mental and physical health in pregnant women. Obtained results showed that 59 (39/3%) pregnant women were "very dissatisfied", 25 (16/7%) women were "moderately dissatisfied", 64 (42/7%) women were "both satisfied and unsatisfied", only 2 (1/3%) women were relatively satisfied, and no one was "very satisfied". There is a significantly negative weak correlation between female sexual function with anxiety and depression, while there is a significantly positive weak correlation between female sexual function with the general quality of life, psychological health and environment dimensions. Only depression predicts female sexual function significantly. The women more than 10 years passed of their marriage showed more sexual satisfaction compared to those less than 10 years passed of their marriage (p< 0.05). The roles of predictive variables in sexual dissatisfaction, as well as the limitations for the study are discussed in the article. Obtained results showed that 59 (39/3%) pregnant women were "very dissatisfied", 25 (16/7%) women were "moderately dissatisfied", 64 (42/7%) women were "both satisfied and unsatisfied", only 2 (1/3%) women were relatively satisfied, and no one was "very satisfied". There is a significantly negative weak correlation between female sexual function with anxiety and depression, while there is a significantly positive weak correlation between female sexual function with the general quality of life, psychological health and environment dimensions. Only depression predicts female sexual function significantly. The women more than 10 years passed of their marriage showed more sexual satisfaction compared to those less than 10 years passed of their marriage (p< 0.05). The roles of predictive variables in sexual dissatisfaction, as well as the limitations for the study are discussed in the article. Depression as same as environment heath had an important effect on sexual satisfaction in pregnant women and so assessment of depression and environment health in medical program for pregnant women is necessary. Also considering decrease in sexual satisfaction in aging training new methods for sexuality can be useful.

Sexual, marital, and general life functioning in couples coping with colorectal cancer: a dyadic study across time.

PubMed

Traa, Marjan J; Braeken, Johan; De Vries, Jolanda; Roukema, Jan A; Slooter, Gerrit D; Crolla, Rogier M P H; Borremans, Monique P M; Den Oudsten, Brenda L

2015-09-01

This study evaluated the following: (a) levels of sexual, marital, and general life functioning for both patients and partners; (b) interdependence between both members of the couple; and (c) longitudinal change in sexual, marital, and general life functioning and longitudinal stress-spillover effects in these three domains from a dyadic perspective. Couples (n = 102) completed the Maudsley Marital Questionnaire preoperatively and 3 and 6 months postoperatively. Mean scores were compared with norm scores. A multivariate general linear model and a multivariate latent difference score - structural equation modeling (LDS-SEM), which took into account actor and partner effects, were evaluated. Patients and partners reported lower sexual, mostly similar marital, and higher general life functioning compared with norm scores. Moderate to high within-dyad associations were found. The LDS-SEM model mostly showed actor effects. Yet the longitudinal change in the partners' sexual functioning was determined not only by their own preoperative sexual functioning but also by that of the patient. Preoperative sexual functioning did not spill over to the other two domains for patients and partners, whereas the patients' preoperative general life functioning influenced postoperative change in marital and sexual functioning. Health care professionals should examine potential sexual problems but have to be aware that these problems may not spill over to the marital and general life domains. In contrast, low functioning in the general life domain may spill over to the marital and sexual domains. The interdependence between patients and partners implies that a couple-based perspective (e.g., couple-based interventions/therapies) to coping with cancer is needed. Copyright © 2015 John Wiley & Sons, Ltd.

Sexual function of young women with myelomeningocele.

PubMed

Gamé, Xavier; Moscovici, Jacques; Guillotreau, Julien; Roumiguié, Mathieu; Rischmann, Pascal; Malavaud, Bernard

2014-06-01

To assess the sexual function of young women with spina bifida and myelomeningocele and to determine the factors influencing their sexual function. A postal cross-sectional study using a self-administered questionnaire was performed in 44 women, mean age 27.66 ± 5.89 years, with spina bifida and myelomeningocele. The questionnaire included the Brief Index of Sexual Functioning for Women and questions about voiding mode, urinary symptoms, socioeconomic status, education level, lifestyle, and partnership. In parallel, data were also collected from the paediatric surgery records of patients who returned the questionnaire. The response rate was 56.8% (25/44). All domains of female sexual function (thoughts/desires, arousal, frequency of sexual activity, receptivity/initiation, pleasure/orgasm, relationship satisfaction) were altered. Urinary incontinence was likely to be the main factor responsible for altered sexual function and was associated with lower thoughts/desires, arousal, and receptivity/initiation scores. Wearing pads also constituted a limitation to achieving intimacy. Young myelomeningocele women report poor sexual functioning. The presence of urinary incontinence is associated with lower thoughts/desire, arousal, and receptivity/initiation. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

[Assessment of sexual function in men with idiopathic Parkinson's disease using the International Index of Erectile Dysfunction (IIEF-15)].

PubMed

Roumiguié, M; Guillotreau, J; Castel-Lacanal, E; Malavaud, B; De Boissezon, X; Marque, P; Rischmann, P; Gamé, X

2011-01-01

to assess the sexual function in men with idiopathic Parkinson's disease. a cross-sectional study was performed in 35 men, mean age 68 ± 9 years, with idiopathic Parkinson's disease followed in a single urological department. The 15 questions International Index of the Erectile Function was sent by postal mail. the answer's rate was 42.9% (15 patients). The mean age of the responders was 68.7 ± 10.0 years. Mean duration of the disease was 10.4 ± 6.8 years. Sexual dysfunction was the second cause for consultation in urology. Despite a sustained sexual desire, patients had an altered sexual function with low erectile function, orgasmic function, intercourse satisfaction and total satisfaction scores. According to the Cappelleri's classification, the erectile dysfunction was severe in 54% of the cases and moderate in 26.6%. Age, institutionalization and overactive bladder symptoms were associated with erectile, orgasmic function and intercourse satisfaction alteration, sexual desire alteration, intercourse and global satisfaction alteration, respectively. men with idiopathic Parkinson's disease had a severe sexual dysfunction. The sexual desire was usually maintained but all the other domains were severely altered. 2010 Elsevier Masson SAS. All rights reserved.

Emotional Dysregulation: Concurrent Relation to Sexual Problems among Trauma-Exposed Adult Cigarette Smokers

PubMed Central

Rellini, Alessandra H.; Vujanovic, Anka A.; Zvolensky, Michael J.

2010-01-01

Despite the documented association between trauma exposure and sexual problems (sexual dissatisfaction and sexual functioning), only a paucity of studies have investigated possible mechanisms underlying this association. The present study tested the role of emotion dysregulation in regard to levels of sexual dissatisfaction and functioning among a sample of 43 trauma-exposed cigarette smokers (17 women; Mage = 20.20, SD = 10.87). When controlling for negative affectivity, type of trauma (sexual vs. non-sexual), daily smoking rate, posttraumatic stress symptoms, and anxiety sensitivity, emotion dysregulation provided an independent and unique contribution to sexual dissatisfaction, but not sexual function. These preliminary findings suggest that emotion dysregulation may be more important to understanding certain sexual problems (dissatisfaction) among cigarette smoking trauma survivors than previously recognized, and is therefore, a topic worthy of further investigation. PMID:20169494

Childhood Sexual Abuse: Long-Term Effects on Psychological and Sexual Functioning in a Nonclinical and Nonstudent Sample of Adult Women.

ERIC Educational Resources Information Center

Greenwald, Evan; And Others

1990-01-01

Comparison of psychological and sexual functioning of 54 women sexually abused as children and 54 nonabused women found no differences in self-esteem, but abused women reported more symptoms of distress and psychological symptoms previously associated with sexual abuse. No differences in self-reported sexual satisfaction or dysfunction were found.…

How has early testicular cancer affected your life? A study of sexual function in men attending active surveillance for stage one testicular cancer.

PubMed

Brand, Sue; Williams, Hilary; Braybrooke, Jeremy

2015-06-01

Testicular cancer is the most common cancer in young men, it is frequently diagnosed at key times in relationship formation. In early stage disease the vast majority of tumours will be cured by surgery alone with patients being offered active surveillance rather than adjuvant therapies. To date, research has not evaluated how surveillance alone impacts on sexual function. The aim of this quantitative longitudinal study was to ascertain the sexual function of men with stage one disease at 3 and 12 months post diagnosis and to compare with normative data. Additional data was collected on the information men sought regarding sexual function and media they used to access this. This study shows that men's sexual function is altered at diagnosis and improves by 3 months. At 12 months, whilst not statistically significant, sexual function improves but not to the same level as normative data comparison. Men appear to find verbal information useful at 3 months, however men appear to be seeking written and online information at 12 months. The intricacies of sexual function together with the low number of participants may have been best met with a qualitative approach. However, the information data indicates the importance of further research into the effects of early stage testicular cancer on sexual function. Therefore, further qualitative research is recommended to explore the effects of early stage testicular cancer in relation to sexual function. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sexual Functioning in Men Living with a Spinal Cord Injury-A Narrative Literature Review.

PubMed

Sunilkumar, M M; Boston, Patricia; Rajagopal, M R

2015-01-01

Sexual dysfunction is a major concern for Indian men living with a spinal cord injury. To examine the literature related to sexuality traumatic cord injury and its impact on sexual functioning. Databases using Cumulative Index to Nursing and Allied Health Literature (CINAHL) 2000-2012, Medline 1989-2012, Applied Social Sciences Index and Abstracts (ASSIA) 1989-2012 and Google Scholar were the search engines used used for literature review. The search yielded a total of 457 articles and only 75 of them were found relevant. The minimum number of articles required to meet the inclusion criteria for this review was 25-30 articles. Out of the 75 articles, 33 were considered relevant or related to the topic of sexual functioning, spinal cord injury, and paraplegia. Six areas were identified: Sexual stigmatization, physiological barriers to sexual satisfaction, clinical aspects of sexual functioning, biomedical approaches to sexual dysfunction, partner satisfaction, and lack of accessibility to sexual education. Spinal cord injury and sexual functioning affects a large segment of the male Indian population, yet most current research focuses on quantitative measurement with the emphasis on ejaculatory dysfunction, orgasm impairment, incontinence, and other physiological dysfunction. Further research is needed to address the subjective accounts of patients themselves with respect to the emotional and social impact of sexual disability. This would help to identify the best possible outcomes for both treatment and rehabilitation.

Longitudinal Changes in Sexual Functioning as Women Transition Through Menopause: Results from the Study of Women’s Health Across the Nation (SWAN)

PubMed Central

Avis, Nancy E.; Brockwell, Sarah; Randolph, John F.; Shen, Shunhua; Cain, Virginia S.; Ory, Marcia; Greendale, Gail A.

2009-01-01

Objective Sexual functioning is an important component of women’s lives. The extent to which the menopause transition is associated with decreased sexual functioning remains inconclusive. This study seeks to determine if advancing through the menopause transition is associated with changes in sexual functioning. Design A prospective, longitudinal cohort study of women aged 42–52 at baseline recruited at 7 US sites (N=3302) in the Study of Women’s Health Across the Nation (SWAN). Cohort eligible women had an intact uterus, at least one ovary, were not currently using exogenous hormones, were either pre- or early perimenopausal, and self-identified as one of the study’s designated racial/ethnic groups. Data from the baseline interview and six annual follow-up visits are reported. Outcomes are self-reported ratings of importance of sex; frequency of sexual desire, arousal, masturbation, sexual intercourse, and pain during intercourse; degree of emotional satisfaction and physical pleasure. Results Adjusting for baseline age, chronological aging, and relevant social, health, and psychological parameters, the odds of reporting vaginal or pelvic pain increased and desire decreased by late perimenopause. Masturbation increased at early perimenopause, but declined during postmenopause. Menopausal transition was unrelated to other outcomes. Health, psychological functioning, and importance of sex were related to all sexual function outcomes. Age, race/ethnicity, marital status, change in relationship, and vaginal dryness were also associated with sexual functioning. Conclusions Pain during sexual intercourse increases and sexual desire decreases over the menopausal transition. Masturbation increases during the early transition, but then declines in postmenopause. Adjusting for other factors, the menopausal transition was not independently associated with reports of the importance of sex, sexual arousal, frequency of sexual intercourse, emotional satisfaction with partner, or physical pleasure. PMID:19212271

Longitudinal changes in sexual functioning as women transition through menopause: results from the Study of Women's Health Across the Nation.

PubMed

Avis, Nancy E; Brockwell, Sarah; Randolph, John F; Shen, Shunhua; Cain, Virginia S; Ory, Marcia; Greendale, Gail A

2009-01-01

Sexual functioning is an important component of women's lives. The extent to which the menopausal transition is associated with decreased sexual functioning remains inconclusive. This study seeks to determine if advancing through the menopausal transition is associated with changes in sexual functioning. This was a prospective, longitudinal cohort study of women aged 42 to 52 years at baseline recruited at seven US sites (N = 3,302) in the Study of Women's Health Across the Nation (SWAN). Cohort-eligible women had an intact uterus, had at least one ovary, were not currently using exogenous hormones, were either premenopausal or early perimenopausal, and self-identified as one of the study's designated racial/ethnic groups. Data from the baseline interview and six annual follow-up visits are reported. Outcomes are self-reported ratings of importance of sex; frequency of sexual desire, arousal, masturbation, sexual intercourse, and pain during intercourse; and degree of emotional satisfaction and physical pleasure. With adjustment for baseline age, chronological aging, and relevant social, health, and psychological parameters, the odds of reporting vaginal or pelvic pain increased and desire decreased by late perimenopause. Masturbation increased at early perimenopause but declined during postmenopause. The menopausal transition was unrelated to other outcomes. Health, psychological functioning, and importance of sex were related to all sexual function outcomes. Age, race/ethnicity, marital status, change in relationship, and vaginal dryness were also associated with sexual functioning. Pain during sexual intercourse increases and sexual desire decreases over the menopausal transition. Masturbation increases during the early transition, but then declines in postmenopause. With adjustment for other factors, the menopausal transition was not independently associated with reports of the importance of sex, sexual arousal, frequency of sexual intercourse, emotional satisfaction with partner, or physical pleasure.

Cognitive and sexual functions in patients with traumatic brain injury

PubMed Central

War, Firdous A.; Jamuna, R.; Arivazhagan, A.

2014-01-01

Background: Traumatic brain injury (TBI) has an immense psychosocial impact on an individual as well as on the close relatives. Sexuality is one among the functions which are usually found compromised post injury. The aim of present study was to examine cognitive and sexual functions post TBI. The objective of the study was to explore these domains and their relationship with each other. Tools: The tools used were sociodemographics record sheet, Edinburg handedness inventory, brief sexual function inventory, depression anxiety stress scales-21 and NIMHANS head injury battery. The sample consisted of 30 patients with mild-to-moderate TBI. All the subjects were tested individually in their regional language. Results: On cognitive domain, patients performed inadequately on all the tests; however, the percentage was higher in mental speed (43.3%), sustained attention (26.7%), verbal working memory (30%), response inhibition (36.7%), verbal memory (immediate and delayed) (43%) and visual (immediate, 23.3% and delayed, 26.7%). On the domain of sexual functions, all the four domains (sexual drive, erection, ejaculation and problem assessment) were affected however overall satisfaction (93.3%) was adequate. Among the four domains higher percentage of involvement was noted on problem assessment (70%), ejaculation (56.7%), and erection (46.7%). Significant correlation was found between mental speed, verbal working memory, planning, and visual memory with sexual drive, erection, ejaculation and overall satisfaction domains of sexual functioning. Negative correlation was found between motor speed and sustained attention with sexual drive, erection and ejaculation. Conclusion: Both cognitive and sexual functioning were found effected post TBI. However less emphasis is given to sexual functioning by the professionals. Educational intervention is needed to sensitize professional about this area and to include this area for better management. PMID:24891887

Dopamine activates masculine sexual behavior independent of the estrogen receptor alpha.

PubMed

Wersinger, S R; Rissman, E F

2000-06-01

Estrogen receptor alpha (ERalpha) is believed to be a critical part of the regulatory processes involved in normal reproduction and sexual behavior. However, in this study we show the ERalpha is not required for display of masculine sexual behavior. Male and female, ERalpha knock-out (ERalphaKO) and wild-type mice were gonadectomized and implanted with testosterone. Sexual behavior and social preferences were tested after injection of the dopamine agonist, apomorphine (APO), or vehicle. All wild-type mice showed normal masculine behavior, including mounts and pelvic thrusts in females, and ejaculation in males. In agreement with past reports, ERalphaKO mice, given vehicle, failed to show mating behavior. Yet, ERalphaKO males given APO showed masculine copulatory behavior and chemoinvestigatory behavior directed at females. ERalphaKO females, treated with APO, mounted and thrusted when tested with receptive females. HPLC revealed that wild-type and ERalphaKO mice had equivalent catecholamine content in brain regions associated with masculine sexual behavior. These data show that the ERalpha is not essential during development or adulthood for the expression of masculine sexual behavior in mice. Moreover, dopamine can activate sexual behavior via a mechanism that either acts on an ER other than ERalpha or via an estrogen-independent pathway.

Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction.

PubMed

Vannier, Sarah A; Rosen, Natalie O

2017-03-01

Sexual problems are common during pregnancy, but the proportion of pregnant women who experience sexual distress is unknown. In non-pregnant samples, sexual distress is associated with lower sexual and relationship satisfaction. To identify the proportion of women experiencing sexual distress during pregnancy and to compare the sexual and relationship satisfaction of women who report sexual distress during pregnancy with that of women without distress. Two-hundred sixty-one pregnant women completed a cross-sectional online survey. Women completed validated measurements of sexual functioning (Female Sexual Function Index; score < 26.55 indicates a sexual problem), sexual distress (Female Sexual Distress Scale; score ≥ 15 indicates clinically significant distress), sexual satisfaction (Global Measure of Sexual Satisfaction), and relationship satisfaction (Couples Satisfaction Index). Overall, 42% of women met the clinical cutoff for sexual distress. Of sexually active women (n = 230), 26% reported concurrent sexual problems and distress and 14% reported sexual distress in the absence of sexual problems. Sexual distress and/or problems in sexual functioning were linked to lower sexual and relationship satisfaction compared with pregnant women with lower sexual distress and fewer sexual problems. Sexual distress is common during pregnancy and associated with lower sexual and relationship satisfaction. Health care providers should ask pregnant women about feelings of sexual distress. Identifying pregnant women who experience sexual distress and referring them to appropriate resources could help minimize sexual and relationship problems during pregnancy. Vannier SA, Rosen NO. Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction. J Sex Med 2017;14:387-395. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

A Single Session of Autogenic Training Increases Acute Subjective and Physiological Sexual Arousal in Sexually Functional Women.

PubMed

Stanton, Amelia; Meston, Cindy

2017-10-03

Heart rate variability (HRV) has recently been associated with female sexual function (Stanton, Lorenz, Pulverman, & Meston, 2015). Below-average HRV was identified as a possible risk factor for sexual arousal dysfunction and overall sexual dysfunction in women. Based on this newly established relationship between HRV and female sexual function, the present study examined the effect of autogenic training to increase HRV on acute physiological and subjective sexual arousal in women. Specifically, vaginal pulse amplitude (VPA), an index of genital sexual arousal, and subjective sexual arousal were assessed in 33 sexually functional women, aged 18 to 27, before and after a short session of autogenic training. Autogenic training, a relaxation technique that restores the balance between the activity of the sympathetic and the parasympathetic branches of the autonomic nervous system, has been shown to significantly increase HRV (Miu, Heilman, & Miclea, 2009). After autogenic training, significant increases in both VPA (p <.05) and subjective sexual arousal (p <.005) were observed. Moreover, change in HRV from pre- to postmanipulation significantly moderated changes in subjective sexual arousal (p <.05) when it was measured continuously during the presentation of the erotic stimulus. This cost-effective, easy-to-administer behavioral intervention may have important implications for increasing sexual arousal in women.

Anastomotic Repair versus Free Graft Urethroplasty for Bulbar Strictures: A Focus on the Impact on Sexual Function

PubMed Central

Palminteri, Enzo; Spinoit, Anne-Françoise; Hoebeke, Piet; François, Philippe; Decaestecker, Karel

2015-01-01

Objectives. To evaluate alterations in sexual function and genital sensitivity after anastomotic repair (AR) and free graft urethroplasty (FGU) for bulbar urethral strictures. Methods. Patients treated with AR (n = 31) or FGU (n = 16) were prospectively evaluated before, 6 weeks and 6 months after urethroplasty. Evaluation included International Prostate Symptom Score (IPSS), 5-Item International Index of Erectile Function (IIEF-5), Ejaculation/Orgasm Score (EOS), and 3 questions on genital sensitivity. Results. At 6 weeks, there was a significant decline of IIEF-5 for AR (−4.8; p = 0.005), whereas there was no significant change for FGU (+0.9; p = 0.115). After 6 months, differences with baseline were not significant overall and among subgroups. At 6 weeks, there was a significant decline in EOS for AR (−1.4; p = 0.022). In the FGU group there was no significant change (+0.6; p = 0.12). Overall and among subgroups, EOS normalized at 6 months. After 6 weeks and 6 months, respectively, 62.2 and 52% of patients reported alterations in penile sensitivity with no significant differences among subgroups. Conclusions. AR is associated with a transient decline in erectile and ejaculatory function. This was not observed with FGU. Bulbar AR and FGU are likely to alter genital sensitivity. PMID:26494997

The Impact of Illicit Use of Amphetamine on Male Sexual Functions.

PubMed

Chou, Nan-Hua; Huang, Yung-Jui; Jiann, Bang-Ping

2015-08-01

Data concerning the impact of amphetamine on male sexual functions are limited, although amphetamine has been used as an aphrodisiac. This cross-sectional study was to assess the impact of illicit use of amphetamine on male sexual functions. Male illicit drug users in a Drug Abstention and Treatment Center were recruited to complete a self-administered questionnaire, and data were compared with age-matched controls. The International Index of Erectile Function (IIEF) and global assessment questions were used to assess sexual functions. Of 1,159 amphetamine mono-illicit drug users, the mean age was 31.9 ± 7.5 (18-57) years, and mean duration of drug use was 30.7 ± 52.2 (median 9, range 0.1-252) months. Half of them reported that drug use had no impact on their sexual functions. The other half reported drug impacts as reduced erectile rigidity and sexual life satisfaction, enhanced orgasmic intensity, and prolonged ejaculation latency time more often than the opposite effects, while they reported enhanced or reduced effect equally on sexual desire. Dosing frequency of amphetamine was associated with its impact on sexual functions, but duration of its use had little association with that. Compared with 211 age-matched controls, the amphetamine mono-illicit drug users had lower IIEF scores in the domains of erectile function, orgasmic function, and overall satisfaction, but there are no significant differences in intercourse satisfaction and sexual desire scores. The prevalence of erectile dysfunction (ED) was significantly higher in the drug users than in the controls (29.3% vs. 11.9%). The odds ratio of ED for amphetamine use was 2.1 (95% confidence interval 1.2-3.6) after adjustment for other risk factors. The impact of illicit use of amphetamine on male sexual functions varied among users, and their ED prevalence was higher than the controls. © 2015 International Society for Sexual Medicine.

Use of an Ecological Model to Study Sexual Satisfaction in a Heterosexual Spanish Sample.

PubMed

Del Mar Sánchez-Fuentes, María; Salinas, José María; Sierra, Juan Carlos

2016-11-01

Sexual satisfaction is a key factor in sexual health and has been associated with quality of life. However, few studies have focused on the factors related to sexual satisfaction in the population in Spain. The main goal of this research was to analyze the predictive capacity of an ecological model for the study of sexual satisfaction in a Spanish sample of 723 men and 851 women, with mean age equal to 36.28 (SD = 12.59) and who were in a heterosexual relationship. We analyzed, using structural equation modeling, the degree to which sexual satisfaction was related to different variables. These variables were the following: personal variables (depression and sexual attitudes); interpersonal variables (relationship satisfaction, sexual function, and sexual assertiveness); social variables (social support, parenthood, and annual income); and cultural variables (political ideology, religion, and religious practice). In men, sexual satisfaction was directly predicted by relationship satisfaction and sexual function. Furthermore, political ideology, religious practice, social support, annual income, initiation sexual assertiveness, and sexual attitudes were indirectly associated with sexual satisfaction. In women, sexual satisfaction was directly predicted by relationship satisfaction, sexual function, sexual assertiveness, and sexual attitudes. In addition, political ideology, religious practice, and social support were indirectly associated with sexual satisfaction. Implications for research and therapy are also discussed.

Major depressive disorder: gender differences in symptoms, life quality, and sexual function.

PubMed

Lai, Chien-Han

2011-02-01

To investigate the gender differences of symptoms, life quality, functional impairment, and sexual function of patients with moderately severe major depressive disorder (MDD). One hundred forty-six outpatients with MDD were enrolled into this study with specific selection criteria (male, 57; female, 89; mean ± SD age, 38.30 ± 11.69 years). All the patients self-rated the Quick Inventory of Depressive Symptomatology--Self-Report (QIDS-SR16) and the Integral Inventory for Depression (IID) for the assessment of symptoms assessment as well as the EuroQol life quality scale (EQ5D) was for the subjective life quality, the Sheehan disability scale was for the functional impairments, and the Arizona Sexual Experience Scale was for sexual function evaluation. All data were analyzed to estimate correlation and gender difference. Female patients had higher scores of the QIDS-SR16, IID, and Arizona Sexual Experience scales. Significant gender differences of sadness, sleep, appetite, calmness, painful symptoms, and sexual functioning were observed. The female-specific sexual dysfunctions included lower sexual drive, lower sexual arousal, lower horny feelings, lower orgasms, and lower satisfaction of orgasm. The MDD episodes were related to the EuroQol life quality scale and the SDS. Interepisode years were associated with the IID. The Sheehan disability scale was correlated with QIDS-SR16 with statistical significance. Patients with MDD showed a correlation between symptoms and functional impairment. Female patients might be more sexually impaired, more vegetative, more depressed, and experiencing more sadness and physical pain.

Association of carotene rich diet with hypogonadism in a male athlete.

PubMed

Adamopoulos, Dimitrios; Venaki, Evangelia; Koukkou, Eftychia; Billa, Evangelia; Kapolla, Niki; Nicopoulou, Stamatina

2006-07-01

To report on a unique case of hypogonadism associated with excessive carotene intake in a young male athlete. A 20-year-old patient presented with a gradual decline in muscular and physical activity, sexual interest and erectile ability associated with a high in carotene and low in animal fat diet of his own design a year prior to the clinical manifestations. Clinically, he presented with very overt signs of carotene excess: his palms and soles were yellow. Moreover, 2 weeks after normalization of his diet, carotene B levels were at the upper end of the normal range. Repeated stimulation tests of hypothalamic, pituitary and testicular function were performed before and at 3, 6 and 12 months after the introduction of a balanced diet. Very low basal and stimulated values for gonadotropins and gonadal steroids were found at the initial evaluation with a progressive recovery shown after months of a balanced diet and carotene B restoration. Complete androgen secretion and sexual response recovery were observed only after 9-12 months from diagnosis. This is the first report associating excessive carotene intake with a hypothalamic form of hypogonadism in a young man.

Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: a prospective controlled study.

PubMed

Aerts, L; Christiaens, M R; Enzlin, P; Neven, P; Amant, F

2014-10-01

Breast cancer (BC) and/or its treatments may affect sexual functioning based on physiological and psychosocial mechanisms. The aim of this study was to prospectively investigate sexual adjustment of BC patients during a follow-up period of one year after mastectomy (ME) or breast conserving therapy (BCT). In this prospective controlled study, women with BC and an age-matched control group of healthy women completed the Beck Depression Inventory Scale, World Health Organization 5 Well-being scale, Body Image Scale, EORTC QLQ questionnaire, Dyadic Adjustment Scale, Short Sexual Functioning Scale and Specific Sexual Problems Questionnaire to assess various aspects of sexual and psychosocial functioning before surgery, six months and one year after surgical treatment. In total, 149 women with BC and 149 age-matched healthy controls completed the survey. Compared to the situation before surgery, significantly more BCT women reported problems with sexual arousal six months after surgery and significantly more women of the ME group reported problems with sexual desire, arousal and the ability to achieve an orgasm six months and one year after surgery. While in comparison with healthy controls, no significant differences in sexual functioning were found after BCT surgery, significantly more women who underwent ME reported problems with sexual desire, arousal, the ability to achieve an orgasm and intensity of the orgasm. Although little differences were seen in sexual functioning in the BCT group during prospective analyses and in comparison with healthy controls, analyses revealed that women who underwent a ME were at risk for post-operative sexual dysfunctions. Copyright © 2014. Published by Elsevier Ltd.

Non-erotic thoughts and sexual functioning.

PubMed

Purdon, Christine; Watson, Chris

2011-10-01

This study sought to replicate and extend investigations of current models of sexual dysfunction (Barlow, 2002; Janssen, Everaerd, Spiering, & Janssen, 2000) which implicate factors such as spectatoring, failure to use ameliorative strategies, and information processing biases in the development and persistence of sexual difficulties. A sample of 165 (n = 71 men) undergraduates completed measures of sexual dysfunction and relationship satisfaction, and reported on the content and frequency of non-erotic thoughts during sex with a partner (i.e., spectatoring), the emotional impact of non-erotic thoughts, and the strategies used to manage them. They also reported on their main sexual functioning difficulties and the strategies they used to manage those difficulties. Finally, participants were presented with a series of hypothetical sexual scenarios and were asked to report their immediate interpretation of events in the scenario. The content of non-erotic thoughts was similar to previous work (Purdon & Holdaway, 2006), although gender differences in thought content were less pronounced. As in previous research, greater frequency of, and anxiety evoked by, non-erotic thoughts was associated with poorer sexual functioning, but we found that this was over and above relationship satisfaction. Participants both high and low in sexual functioning reported using a variety of strategies to manage their non-erotic thoughts, thought suppression being the least effective, and also used a variety of strategies to manage sexual difficulties. Poorer sexual functioning was associated with more negative interpretations of ambiguous sexual scenarios, but this was mediated by relationship satisfaction. However, positive interpretations were predicted by sexual functioning. Results were discussed in terms of their theoretical and clinical implications.

The Sexual Thoughts Questionnaire: Psychometric Evaluation of a Measure to Assess Self-Reported Thoughts During Exposure to Erotica Using Sexually Functional Individuals.

PubMed

Sigre-Leirós, Vera; Carvalho, Joana; Nobre, Pedro J

2016-05-01

Validated instruments for assessing specific thought content during exposure to sexually explicit material are lacking. To investigate the psychometric properties of a measure that assesses self-reported thoughts during exposure to sexual stimuli in laboratory settings, namely the Sexual Thoughts Questionnaire. The factorial structure of the questionnaire and its reliability and validity were examined. One hundred sixty-seven sexually functional individuals (97 women and 70 men) were exposed to sexually explicit material while their genital arousal was being assessed. Subjective sexual arousal and thoughts during exposure to sexually explicit material also were assessed. Women's genital arousal was measured with a vaginal photoplethysmograph and men's genital arousal was measured with an indium-gallium strain gauge. Subjective sexual arousal and thoughts during exposure to erotica were assessed with self-report scales. Principal component analysis with varimax rotation identified five factors: sexual arousal thoughts, distractive and disengaging thoughts, body image and performance thoughts, actress's physical attractiveness thoughts, and sinful and lack of affection thoughts. Moreover, the scale showed satisfactory levels of internal consistency. Studies on convergent validity showed an association between self-reported thoughts and subjective sexual arousal levels in the women and men. The Sexual Thoughts Questionnaire showed adequate psychometric properties in a sexually functional sample. It could be useful in further experimental research on the role of cognitions in sexual response and allow further comparison between sexually functional and dysfunctional individuals, with possible significant implications for the assessment and treatment of sexual problems. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Childhood Sexual Abuse Moderates the Association between Sexual Functioning and Sexual Distress in Women

ERIC Educational Resources Information Center

Stephenson, Kyle R.; Hughan, Corey P.; Meston, Cindy M.

2012-01-01

Objective: To assess the degree to which a history of childhood sexual abuse (CSA) moderates the association between sexual functioning and sexual distress in women. Method: Women with (n = 105, M age = 33.71, 66.1% Caucasian) and without (n = 71, M age = 32.63, 74.7% Caucasian) a history of CSA taking part in a larger clinical trial completed…

Sexual satisfaction and distress in sexual functioning in a sample of the BDSM community: a comparison study between BDSM and non-BDSM contexts.

PubMed

Pascoal, Patrícia Monteiro; Cardoso, Daniel; Henriques, Rui

2015-04-01

Little attention has been paid to distress in sexual functioning or the sexual satisfaction of people who practice BDSM (Bondage and Discipline, Domination and Submission, Sadism and Masochism). The purpose of this study was to describe sociodemographic characteristics and BDSM practices and compare BDSM practitioners' sexual outcomes (in BDSM and non-BDSM contexts). A convenience sample of 68 respondents completed an online survey that used a participatory research framework. Cronbach's alpha and average inter-item correlations assessed scale reliability, and the Wilcoxon paired samples test compared the total scores between BDSM and non-BDSM contexts separately for men and women. Open-ended questions about BDSM sexual practices were coded using a preexisting thematic tree. We used self-reported demographic factors, including age at the onset of BDSM interest, age at first BDSM experience, and favorite and most frequent BDSM practices. The Global Measure of Sexual Satisfaction measured the amount of sexual distress, including low desire, arousal, maintaining arousal, premature orgasm, and anorgasmia. The participants had an average age of 33.15 years old and were highly educated and waited 6 years after becoming interested in BDSM to act on their interests. The practices in which the participants most frequently engaged did not coincide with the practices in which they were most interested and were overwhelmingly conducted at home. Comparisons between genders in terms of distress in sexual functioning in BDSM and non-BDSM contexts demonstrate that, with the exception of maintaining arousal, we found distress in sexual functioning to be statistically the same in BDSM and non-BDSM contexts for women. For men, we found that distress in sexual functioning, with the exception of premature orgasm and anorgasmia, was statistically significantly lower in the BDSM context. There were no differences in sexual satisfaction between BDSM and non-BDSM contexts for men or women. Our findings suggest that BDSM sexual activity should be addressed in clinical settings that account for BDSM identities, practices, relationships, preferences, sexual satisfaction, and distress in sexual function for men and women. Additional research needs are identified, such as the need to define distressful sexual functioning experiences and expand our understanding of the development of BDSM sexual identities. © 2015 International Society for Sexual Medicine.

[The role of physical therapy in the treatment of female sexual dysfunction].

PubMed

Rosenbaum, Talli Y; Ben-Dror, Inbal

2009-09-01

Healthy sexual function requires physical, mental, and emotional well-being. Physical presentations that may limit sexual activity include decreased mobility, alterations in sensation, decreased genital circulation and pain. Physical therapists play an important role in facilitating optimal sexual function by providing treatment to restore function, improve mobility and relieve pain. This article illustrates, through four case reports, the importance of physiotherapy in the multidisciplinary approach to the treatment of female sexual dysfunction.

Female sexual function mediates the effects of medication adherence on quality of life in people with epilepsy.

PubMed

Lin, Chung-Ying; Burri, Andrea; Fridlund, Bengt; Pakpour, Amir H

2017-02-01

The purpose of this study was to understand the mediating effects of female sexual functioning in the association between medication adherence and quality of life (QoL) in Iranian women with epilepsy (WWE). Women's sexual functioning was measured using Female Sexual Function Index; QoL using Quality of Life in Epilepsy; epilepsy severity using Liverpool Seizure Severity Scale; subjective medication adherence using Medication Adherence Report Scale; and objective medication adherence using serum level for antiepileptic drugs in 567 WWE. Medication adherence was measured at baseline, while women's sexual functioning, QoL, and epilepsy severity were measured at the 6-month follow-up. Structural equation modeling and regression models were conducted to examine the mediating role of women's sexual functioning. The mediating effects of sexual functioning in the relationship between medication adherence (including subjective and objective measures) and QoL were supported in the total score of Female Sexual Function Index (coefficient=0.415, SE=0.117, p<0.001 for subjective medication adherence; coefficient=1.980, SE=0.446, p<0.001 for objective medication adherence). Seizure severity was significantly associated with QoL but only when objective medication adherence was measured (coefficient=-0.094, SE=0.036, p=0.009). Our results extended the importance of medication adherence from symptom reduction to the beneficial effects of women's sexual functioning and QoL. Health care providers should be aware of these additional benefits of medication adherence and use these arguments to encourage female patients to take their medication, which can eventually increase their sexual satisfaction and overall QoL. Copyright © 2016 Elsevier Inc. All rights reserved.

Risk factors for negative impacts on sexual activity and function in younger breast cancer survivors.

PubMed

Lee, Maria; Kim, Yun Hwan; Jeon, Myung Jae

2015-09-01

We aim to examine changes in sexual activity and function among younger breast cancer survivors who were sexually active before diagnosis and to investigate risk factors for negative impacts on them. An observational cohort study enrolled 304 premenopausal and sexually active women diagnosed with early stage breast cancer. Questionnaires were completed, and sexual activity was measured at two time points: after surgery, to assess sexual activity and function before diagnosis, and then at least 12 months after the completion of chemotherapy or endocrine therapy. For each domain of the Female Sexual Function Index, a score below 3 was classified as indicative of a sexual problem. Each sexual problem was considered to be dysfunctional if it was associated with distress. The median age at the last survey was 46.0 years (range: 23-57). Of the participants, 35 (11.5%) became sexually inactive after treatment. Among the 269 women who remained sexually active, 31.6% were currently experiencing sexual dysfunction, which was significantly higher compared with the frequency before diagnosis. In the multivariate logistic regression model, chemo-related menopause, thyroid dysfunction, and depression were independent risk factors for sexual inactivity. Chemo-related menopause was a significant risk factor for sexual dysfunction. Chemo-related menopause was significantly associated with both sexual inactivity and dysfunction after treatment. Thyroid dysfunction and depression were risk factors for sexual inactivity in younger breast cancer survivors. Copyright © 2015 John Wiley & Sons, Ltd.

'The Trouble with Normal': (Re)Imagining Sexuality Education with Young People

ERIC Educational Resources Information Center

Coll, Leanne; O'Sullivan, Mary; Enright, Eimear

2018-01-01

What do young people believe sexuality education ought to be about? It is within the absence of a sustained and critical consideration of the possibilities and politics of engaging in research with rather than for young people in the reimagining of sexuality education that this paper is positioned. Data were generated as part of an 18-month Youth…

Sexual Assault and Rape Perpetration by College Men: The Role of the Big Five Personality Traits

ERIC Educational Resources Information Center

Voller, Emily K.; Long, Patricia J.

2010-01-01

A sample of 521 college men completed the Revised NEO Personality Inventory and an expanded version of the Sexual Experiences Survey to examine whether variation in the Big Five personality traits in a normal, college population provides any insight into the nature of sexual assault and rape perpetrators. Rape perpetrators reported lower levels of…

Urogynaecological and obstetric issues in women with the exstrophy-epispadias complex.

PubMed

Mathews, R I; Gan, M; Gearhart, J P

2003-06-01

To review of the sexual and urogynaecological issues faced by a large cohort of women with the exstrophy-epispadias complex (EEC). The study comprised 83 women and girls with EEC; a confidential survey was mailed to identify their social and sexual concerns. Fifty-six women had classical bladder exstrophy (CBE), 13 had female epispadias (FE) and 14 had cloacal exstrophy (CE). Data on the initial method of reconstruction and urogynaecological problems were obtained from a review of the hospital records. Information on continence, infection and sexual function was obtained from 34 completed surveys. The bladder was closed in 51 patients with CBE and 13 with CE. Urinary calculi developed in 10 patients with CBE, two with FE and three with CE. Vaginal and uterine prolapse occurred an earlier age in patients with EEC. Eight women had 13 pregnancies, eight of which resulted in normal healthy children. Overall continence was achieved in 85% of the women surveyed. Urinary tract infections remained a frequent problem for women with EEC; only 27% of respondents indicated that they were infection-free. Women aged > 18 years (24) who responded indicated that they had appropriate sexual desire; 16 were sexually active and the mean age for commencing sexual activity was 19.9 years. Six patients had dyspareunia and 10 indicated that they had orgasms. However, five additional patients indicated that they had restricted intercourse, as they were dissatisfied with the cosmesis of their external genitalia. Sexual and gynaecological issues become increasingly important in patients with EEC as they become adults. Understanding these issues faced by patients with EEC as they mature will permit better counselling of future patients.

Structure-Activity Studies of Semiochemicals from the Spider Orchid Caladenia plicata for Sexual Deception.

PubMed

Bohman, Bjorn; Karton, Amir; Flematti, Gavin R; Scaffidi, Adrian; Peakall, Rod

2018-05-01

Sexually deceptive orchids attract specific pollinators by mimicking insect sex pheromones. Normally this mimicry is very specific and identical compounds have been identified from orchids and matching females of the pollinators. In this study, we conduct a detailed structure-activity investigation on isomers of the semiochemicals involved in the sexual attraction of the male pollinator of the spider orchid Caladenia plicata. This orchid employs an unusual blend of two biosynthetically unrelated compounds, (S)-β-citronellol and 2-hydroxy-6-methylacetophenone, to lure its Zeleboria sp. thynnine wasp pollinator. We show that the blend is barely attractive when (S)-β-citronellol is substituted with its enantiomer, (R)-β-citronellol. Furthermore, none of the nine-possible alternative hydroxy-methylacetophenone regioisomers of the natural semiochemical are active when substituted for the natural 2-hydroxy-6-methylacetophenone. Our results were surprising given the structural similarity between the active compound and some of the analogues tested, and results from previous studies in other sexually deceptive orchid/wasp systems where substitution with analogues was possible. Interestingly, high-level ab initio and density functional theory calculations of the hydroxy-methylacetophenones revealed that the active natural isomer, 2-hydroxy-6-methylacetophenone, has the strongest intramolecular hydrogen bond of all regioisomers, which at least in part may explain the specific activity.

Sexual behavior and intention to engage in sexual behavior in junior secondary school students in Hong Kong.

PubMed

Shek, D T L

2013-06-01

The present study examined the prevalence, changes, and demographic as well as psychosocial correlates of sexual behavior and intention to engage in sexual behavior in early adolescents in Hong Kong, with sexual behavior indexed by sexual intercourse. Three waves of longitudinal data on sexual intercourse, intention to engage in sexual intercourse, family functioning, and positive youth development were collected from 28 secondary schools in Hong Kong. There were significant influences of grade and gender on adolescent sexual behavior or intention to engage in sexual behavior. Significant main effects of immigration status on sexual behavior were also found. While no effect of family economic background was found, effect of family intactness existed for sexual behavior. Family functioning and positive youth development at Grade 7 were negatively associated with students' sexual behavior and intention to engage in sexual behavior at Grade 9. Grade, gender, immigration status, and family intactness were related to sexual behavior and/or intention to engage in sexual behavior in junior secondary school students. Promoting positive youth development and family functioning could serve as protective factors to reduce sexual behavior and intention to engage in sexual behavior in Chinese early adolescents in Hong Kong. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Sexual Function in 16- to 21-Year-Olds in Britain.

PubMed

Mitchell, Kirstin R; Geary, Rebecca; Graham, Cynthia; Clifton, Soazig; Mercer, Catherine H; Lewis, Ruth; Macdowall, Wendy; Datta, Jessica; Johnson, Anne M; Wellings, Kaye

2016-10-01

Concern about young people's sexuality is focused on the need to prevent harmful outcomes such as sexually transmitted infections and unplanned pregnancy. Although the benefit of a broader perspective is recognized, data on other aspects of sexuality, particularly sexual function, are scant. We sought to address this gap by measuring the population prevalence of sexual function problems, help seeking, and avoidance of sex in young people. A cross-sectional stratified probability sample survey (Natsal-3) of 15,162 women and men in Britain (response rate: 57.7%), using computer-assisted self-interviews. Data come from 1875 (71.9%) sexually active, and 517 sexually inactive (18.7%), participants aged 16-21 years. Measures were single items from a validated measure of sexual function (the Natsal-SF). Among sexually active 16- to 21-year-old participants, 9.1% of men and 13.4% of women reported a distressing sexual problem lasting 3 months or more in the last year. Most common among men was reaching a climax too quickly (4.5%), and among women was difficulty in reaching climax (6.3%). Just over a third (35.5%) of men and 42.3% of women reporting a problem had sought help, but rarely from professional sources. Among those who had not had sex in the last year, just >10% of young men and women said they had avoided sex because of sexual difficulties. Distressing sexual function problems are reported by a sizeable minority of sexually active young people. Education is required, and counseling should be available, to prevent lack of knowledge, anxiety, and shame progressing into lifelong sexual difficulties. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A dual physiological character for sexual function: libido and sexual pheromones.

PubMed

Motofei, Ion G

2009-12-01

Human sexual response is a complex function involving many cerebral, spinal and peripheral aspects; the last are relatively known and benefit from good pharmacological control, as in the case of erectile dysfunction. Spinal cord sexual reflexes also have a good theoretical and experimental description. There is minimal understanding of the cerebral sexual processes (libido, sexual arousal, orgasm). The initial perspective was that the cerebral areas implied in sexuality exert descending stimulatory and inhibitory influences on spinal cord sexual centres/reflexes. This was a wrong supposition, which inhibited progress in this subject, with a considerable impact on a subject's individual and social life. A new approach to sexual function arises from the idea that simple neurological structures can support only simple functions, while a more complex function requires correspondingly complex anatomical structures. For this reason the spinal cord would not be able to realise the integration of multiple (spinal and psychosensorial) stimuli into a unique and coherent ejaculation response. Consequently, all mechanisms implied in human sexuality would be cerebral processes, ejaculation reflexes ascending in evolution to the cerebral level. This new evolutionary concept was developed after 2001 in five distinct articles on the cerebral duality of sexual arousal, sexual hormones, ejaculation and serotonergic receptors. During this period other published results suggested a possible cerebral duality for sexual pheromones and libido in humans. All these dual physiological aspects are integrated in this review into one neurophysiological model, thus trying to further develop the new concepts of sexual function and perhaps relational behaviour. In conclusion, ejaculation is a dual cerebral process with arousal sensation (hormonally modulated) and libido perception (pheromonally modulated) as the afferent part. Two neurophysiological axes could exist in both men and women. In this assumption the mechanisms for libido and sexual arousal are not the only ones invoked, their correlations and implications are also suggested, perhaps critical aspects for further developments in the field.

Erotic stimulus processing under amisulpride and reboxetine: a placebo-controlled fMRI study in healthy subjects.

PubMed

Graf, Heiko; Wiegers, Maike; Metzger, Coraline D; Walter, Martin; Grön, Georg; Abler, Birgit

2014-10-31

Impaired sexual function is increasingly recognized as a side effect of psychopharmacological treatment. However, underlying mechanisms of action of the different drugs on sexual processing are still to be explored. Using functional magnetic resonance imaging, we previously investigated effects of serotonergic (paroxetine) and dopaminergic (bupropion) antidepressants on sexual functioning (Abler et al., 2011). Here, we studied the impact of noradrenergic and antidopaminergic medication on neural correlates of visual sexual stimulation in a new sample of subjects. Nineteen healthy heterosexual males (mean age 24 years, SD 3.1) under subchronic intake (7 days) of the noradrenergic agent reboxetine (4 mg/d), the antidopaminergic agent amisulpride (200mg/d), and placebo were included and studied with functional magnetic resonance imaging within a randomized, double-blind, placebo-controlled, within-subjects design during an established erotic video-clip task. Subjective sexual functioning was assessed using the Massachusetts General Hospital-Sexual Functioning Questionnaire. Relative to placebo, subjective sexual functioning was attenuated under reboxetine along with diminished neural activations within the caudate nucleus. Altered neural activations correlated with decreased sexual interest. Under amisulpride, neural activations and subjective sexual functioning remained unchanged. In line with previous interpretations of the role of the caudate nucleus in the context of primary reward processing, attenuated caudate activation may reflect detrimental effects on motivational aspects of erotic stimulus processing under noradrenergic agents. © The Author 2015. Published by Oxford University Press on behalf of CINP.

Emerging roles for neurosteroids in sexual behavior and function.

PubMed

King, Steven R

2008-01-01

Although gonadal and adrenal steroids heavily impact sexual function at the level of the brain, the nervous system also produces its own steroids de novo that may regulate sexual behavior and reproduction. Current evidence points to important roles for neurosteroids in sexual and gender-typical behaviors, control of ovulation, and behaviors that strongly influence sexual interest and motivation like aggression, anxiety and depression. At the cellular level, neurosteroids act through stimulating rapid changes in excitability and direct activation of membrane receptors in neurons. Thus, unlike peripheral steroids, neurosteroids can have immediate and specific effects on select neuronal pathways to regulate sexual function.

Attachment and sexual functioning in women and men seeking fertility treatment.

PubMed

Purcell-Lévesque, Coralie; Brassard, Audrey; Carranza-Mamane, Belina; Péloquin, Katherine

2018-05-11

The purpose of the study was to examine the frequency of sexual difficulties and the associations among attachment insecurities (anxiety, avoidance) and sexual functioning (problems with sexual function, sexual dissatisfaction) in women and couples seeking fertility treatment. In a cross-sectional study, 88 Canadian women and 45 couples receiving fertility treatments completed self-reported measures of adult attachment and sexual functioning. The frequency of problems in sexual function varied from 14.8% (pain) to 58.0% (desire) in women and from 6.7% (satisfaction with orgasm) to 28.9% (desire) in men. Among women, attachment-related avoidance predicted their low levels of sexual satisfaction (β = -0.30, p = .007) and sexual pain (β = 0.22, p = .044). Dyadic analyses revealed associations between men's attachment-related anxiety and their difficulties in reaching erection (β = 0.30, p = .042) and orgasm (β = 0.33, p = .009). Anxiety in women was related to their lubrication difficulties (β = 0.44, p = .006). One partner effect was found: men's avoidance was related to their partners' difficulty in achieving orgasms (β = 0.39, p = .045). Results support the pertinence of attachment theory and the relevance of using dyadic designs to understand sexuality in couples seeking fertility treatment.

The relationship between function and sexual satisfaction with sexual violence among women in Ahvaz, Iran.

PubMed

Tadayon, Mitra; Hatami-Manesh, Zahra; Sharifi, Nasibeh; Najar, Shahnaz; Saki, Azadeh; Pajohideh, Zahra

2018-04-01

One of the forms of violence that receives less attention due to cultural and social issues is sexual violence against women, which is a hidden and a constant epidemic and impact on their health. This study aimed to determine the relationship between function and sexual satisfaction in women who have experienced sexual violence in Ahvaz-Iran. This study was a case-control study which was conducted on 105 women (cases=35 and control=70) referred to one forensic center and seventeen Shahrivar health centers during 2013-2014 in Ahwaz-Iran. The data collection tools included questionnaires for evaluating demographic characteristics and sexual satisfaction, sexual female function index and sexual violence. The data were analyzed using descriptive and inferential statistics (Chi-square, Fisher's exact, and independent-samples t-test) in SPSS, version 19. P-value < 0.05 was considered significant. Two groups of women were matched according to age and education. Mean ± SD sexual satisfaction was (71.4±15.84) in the case group and (99.44±15.68) in the control group (p<0.001). The mean ± SD of sexual function was (17.1±4.94) in the case group and (26.37±5.27) in the control group. The groups had a statistically significant difference in terms of sexual arousal, sexual orgasm, sexual lubrication, pain and sexual satisfaction (p<0.001). Sexual dysfunction and dissatisfaction have a relation with sexual violence, and a major concern is that the sexual violence in most cases is hidden and can seriously affect the general health condition of women.

Provoked Vestibulodynia: Does Pain Intensity Correlate With Sexual Dysfunction and Dissatisfaction?

PubMed

Aerts, Leen; Bergeron, Sophie; Pukall, Caroline F; Khalifé, Samir

2016-06-01

Provoked vestibulodynia (PVD) is suspected to be the most frequent cause of vulvodynia in premenopausal women. Previous research has been inconclusive as to whether higher vulvovaginal pain ratings are associated with lower sexual function and satisfaction in women with PVD. Whether pain intensity correlates with sexual impairment is an important question given its implications for treatment recommendations. To examine the associations among self-reported and objective pain measurements, sexual function, and sexual satisfaction in a large combined clinical and community sample of premenopausal women diagnosed with PVD. Ninety-eight women with PVD underwent a cotton-swab test, a vestibular friction pain measurement, and a vestibular pressure-pain threshold measurement. In addition to sociodemographics, participants completed measurements of pain, sexual function, and sexual satisfaction. Self-report measurements were the pain numerical rating scale (0-10), the McGill-Melzack Pain Questionnaire, the Female Sexual Function Index, and the Global Measure of Sexual Satisfaction. Objective measurements were pain during a cotton-swab test, pain during a vestibular friction procedure, and the vestibular pressure-pain threshold measurement. Age and relationship duration were significantly correlated with the Female Sexual Function Index total score (r = -0.31, P < .01; and r = -0.22, P < .05, respectively). When controlling for age, intercourse-related pain intensity, pain during the cotton-swab test, pain during vestibular friction, the vestibular pressure-pain threshold, and the McGill-Melzack Pain Questionnaire sensory and affective subscale scores were not significantly associated with sexual function and satisfaction in women with PVD. The findings show that in women with PVD, self-report and objective pain ratings are not associated with sexual function and satisfaction. The results support the biopsychosocial nature of PVD and underscore the importance of a patient-focused multidisciplinary treatment approach for PVD. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

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. These models are important for understanding the etiology of female sexual function and for future development of pharmacological treatments for sexual dysfunctions with or without pain. PMID:27784584

Etiological correlates of vaginismus: sexual and physical abuse, sexual knowledge, sexual self-schema, and relationship adjustment.

PubMed

Reissing, Elke D; Binik, Yitzchak M; Khalifé, Samir; Cohen, Deborah; Amsel, Rhonda

2003-01-01

This study investigated the role of sexual and physical abuse, sexual self-schema, sexual functioning, sexual knowledge, relationship adjustment, and psychological distress in 87 women matched on age, relationship status, and parity and assigned to 3 groups--vaginismus, dyspareunia/vulvar vestibulitis syndrome (VVS), and no pain. More women with vaginismus reported a history of childhood sexual interference, and women in both the vaginismus and VVS groups reported lower levels of sexual functioning and a less positive sexual self-schema. Lack of support for traditionally held hypotheses concerning etiological correlates of vaginismus and the relationship between vaginismus and dyspareunia are discussed.

Improvement in quality of life and sexual functioning in a comorbid sample after the unified protocol transdiagnostic group treatment.

PubMed

de Ornelas Maia, Ana Claudia Corrêa; Sanford, Jenny; Boettcher, Hannah; Nardi, Antonio E; Barlow, David

2017-10-01

Patients with multiple mental disorders often experience sexual dysfunction and reduced quality of life. The unified protocol (UP) is a transdiagnostic treatment for emotional disorders that has the potential to improve quality of life and sexual functioning via improved emotion management. The present study evaluates changes in quality of life and sexual functioning in a highly comorbid sample treated with the UP in a group format. Forty-eight patients were randomly assigned to either a UP active-treatment group or a medication-only control group. Treatment was delivered in 14 sessions over the course of 4 months. Symptoms of anxiety and depression were assessed using the Beck Anxiety Inventory and Beck Depression Inventory. Sexual functioning was assessed by the Arizona Sexual Experience Scale (ASEX), and quality of life was assessed by the World Health Organization Quality of Life-BREF scale (WHOQOL-BREF). Quality of life, anxiety and depression all significantly improved among participants treated with the UP. Some improvement in sexual functioning was also noted. The results support the efficacy of the UP in improving quality of life and sexual functioning in comorbid patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

The reliability and validity of a sexual functioning questionnaire.

PubMed

Corty, E W; Althof, S E; Kurit, D M

1996-01-01

The present study assessed the reliability and validity of a measure of sexual functioning, the CMSH-SFQ, for male patients and their partners. The CMSH-SFQ measures erectile and orgasmic functioning, sexual drive, frequency of sexual behavior, and sexual satisfaction. Test-retest reliability was assessed with 19 males and 19 females for the baseline CMSH-SFQ. Criterion validity was measured by comparing the answers of 25 male patients to those of their partners at baseline and follow-up. The majority of items had acceptable levels of reliability and validity. The CMSH-SFQ provides a reliable and valid device that can be used to measure global sexual functioning in men and their partners and may be used to evaluate the efficacy of treatments for sexual dysfunctions. Limitations and suggestions for use of the CMSH-SFQ are addressed.

Influence of androgen receptor CAG polymorphism on sexual function recovery after testosterone therapy in late-onset hypogonadism.

PubMed

Tirabassi, Giacomo; Corona, Giovanni; Biagioli, Andrea; Buldreghini, Eddi; delli Muti, Nicola; Maggi, Mario; Balercia, Giancarlo

2015-02-01

Androgen receptor (AR) CAG polymorphism has been found to influence sexual function. However, no study has evaluated its potential to condition sexual function recovery after testosterone replacement therapy (TRT) in a large cohort of hypogonadic subjects. To evaluate the role of this polymorphism in sexual function improvement after TRT in late-onset hypogonadism (LOH). Seventy-three men affected by LOH were retrospectively considered. Evaluations were performed before TRT started (time 0) and before the sixth undecanoate testosterone injection. International Index of Erectile Function (IIEF) questionnaire (erectile function [EF], orgasmic function [OF], sexual desire [SD], intercourse satisfaction [IS], overall satisfaction [OS], and total IIEF-15 score); total and free testosterone and estradiol; AR gene CAG repeat number. TRT induced a significant increase in total and free testosterone and estradiol. All IIEF domains significantly improved after TRT. AR CAG repeats negatively and significantly correlated with all the variations (Δ-) of sexual function domains, except for Δ-OS. Conversely, Δ-total testosterone was found to be positively and significantly correlated with sexual function domain variations, except for Δ-IS and Δ-OS. Δ-estradiol did not correlate significantly with any of the variations of sexual function domains. After inclusion in generalized linear models, the number of AR gene CAG triplets was found to be independently and negatively associated with Δ-EF, Δ-SD, Δ-IS, and Δ-Total IIEF-15 score, whereas Δ-total testosterone was independently and positively associated with Δ-EF, Δ-OF, Δ-SD, and Δ-Total IIEF-15 score. However, after including time 0 total testosterone in the model, AR gene CAG triplets remained independently and negatively associated only with Δ-EF and Δ-Total IIEF-15 score, whereas Δ-total testosterone was independently and positively associated only with Δ-EF. Longer length of AR gene CAG repeat tract seems to lower TRT-induced improvement of sexual function in LOH. © 2014 International Society for Sexual Medicine.

The Sexual Function Questionnaire's Medical Impact Scale (SFQ-MIS): validation among a sample of first-time mothers.

PubMed

Jawed-Wessel, Sofia; Schick, Vanessa; Herbenick, Debby

2013-11-01

Changes in sexual function can be difficult to capture, especially when an attempt is made to assess the effects of pregnancy or childbirth on the sexual function of first-time mothers. Commonly used sexual function measures are limited and fail to account for pregnancy or birth in assessment of function. The purpose of this study was to explore the utility of the Sexual Function Questionnaire Medical Impact Scale (SFQ-MIS) in assessing impact of childbirth on sexual function among first-time mothers with infants aged one year or younger. A total of 255 women completed a cross-sectional, web-based survey. Exploratory factor analysis was utilized to assess the factor structure of the SFQ-MIS scores in this sample. Variations in SFQ-MIS scores based upon participant characteristics were conducted to further evaluate the SFQ-MIS scores. SFQ-MIS score was the primary measure of interest. Factors related to pregnancy and childbirth, such as mode of delivery, infant date of birth, last menstrual period, need for an episiotomy or perineal stitches, breastfeeding status, and score on the Perceived Stress Scale, were also assessed in order to further evaluate the validity and predictive capacity of the SFQ-MIS. Results indicated one factor that accounted for 58.27% of the variance in impact on sexual function due to childbirth. Cronbach's α coefficient for all five items was acceptable (0.82). Women who were breastfeeding (P<0.05), those who had received perineal stitches after a vaginal delivery (P<0.05), and those who reported no sexual activity in the past month (P < 0.001) experienced significantly greater impact than those who were not breastfeeding, those who had not required stitches, and those who had been sexually active in the past month. The SFQ-MIS appears to be a useful and valid indicator of changes in sexual function following childbirth, such as those related to arousal, desire, and orgasm. © 2013 International Society for Sexual Medicine.

Feeling well and talking about sex: psycho-social predictors of sexual functioning after cancer

PubMed Central

2014-01-01

Background Changes to sexual wellbeing are acknowledged to be a long-term negative consequence of cancer and cancer treatment. These changes can have a negative effect on psychological well-being, quality of life and couple relationships. Whilst previous conclusions are based on univariate analysis, multivariate research can facilitate examination of the complex interaction between sexual function and psycho-social variables such as psychological wellbeing, quality of life, and relationship satisfaction and communication in the context of cancer, the aim of the present study. Method Six hundred and fifty seven people with cancer (535 women, 122 men) and 148 partners (87 women, 61 men), across a range of sexual and non-sexual cancers, completed a survey consisting of standardized measures of sexual functioning, depression and anxiety, quality of life, relationship satisfaction, dyadic sexual communication, and self-silencing, as well as ratings of the importance of sex to life and relationships. Results Men and women participants, reported reductions in sexual functioning after cancer across cancer type, for both people with cancer and partners. Multiple regression analysis examined psycho-social predictors of sexual functioning. Physical quality of life was a predictor for men and women with cancer, and for male partners. Dyadic sexual communication was a predictor for women with cancer, and for men and women partners. Mental quality of life and depression were also predictors for women with cancer, and the lower self-sacrifice subscale of self-silencing a predictor for men with cancer. Conclusion These results suggest that information and supportive interventions developed to alleviate sexual difficulties and facilitate sexual renegotiation should be offered to men and women with both sexual and non-sexual cancers, rather than primarily focused on individuals with sexual and reproductive cancers, as is the case currently. It is also important to include partners in supportive interventions. Interventions aimed at improving sexual functioning should include elements aimed at improving physical quality of life and sexual communication, with a focus on psychological wellbeing also being important for women with cancer. PMID:24673768

Sexual Functioning in Men Living with a Spinal Cord Injury–A Narrative Literature Review

PubMed Central

Sunilkumar, MM; Boston, Patricia; Rajagopal, MR

2015-01-01

Background: Sexual dysfunction is a major concern for Indian men living with a spinal cord injury Objectives: To examine the literature related to sexuality traumatic cord injury and its impact on sexual functioning. Materials and Methods: Databases using Cumulative Index to Nursing and Allied Health Literature (CINAHL) 2000–2012, Medline 1989–2012, Applied Social Sciences Index and Abstracts (ASSIA) 1989–2012 and Google Scholar were the search engines used used for literature review. Results: The search yielded a total of 457 articles and only 75 of them were found relevant. The minimum number of articles required to meet the inclusion criteria for this review was 25–30 articles. Out of the 75 articles, 33 were considered relevant or related to the topic of sexual functioning, spinal cord injury, and paraplegia. Six areas were identified: Sexual stigmatization, physiological barriers to sexual satisfaction, clinical aspects of sexual functioning, biomedical approaches to sexual dysfunction, partner satisfaction, and lack of accessibility to sexual education. Conclusion: Spinal cord injury and sexual functioning affects a large segment of the male Indian population, yet most current research focuses on quantitative measurement with the emphasis on ejaculatory dysfunction, orgasm impairment, incontinence, and other physiological dysfunction. Further research is needed to address the subjective accounts of patients themselves with respect to the emotional and social impact of sexual disability. This would help to identify the best possible outcomes for both treatment and rehabilitation. PMID:26600694

The effects of self-focused attention, performance demand, and dispositional sexual self-consciousness on sexual arousal of sexually functional and dysfunctional men.

PubMed

van Lankveld, Jacques J D M; van den Hout, Marcel A; Schouten, Erik G W

2004-08-01

Sexually functional (N=26) and sexually dysfunctional heterosexual men with psychogenic erectile disorder (N=23) viewed two sexually explicit videos. Performance demand was manipulated through verbal instruction that a substantial genital response was to be expected from the videos. Self-focused attention was manipulated by introducing a camera pointed at the participant. Dispositional self-consciousness was assessed by questionnaire. Performance demand was found to independently inhibit the genital response. No main effect of self-focus was found. Self-focus inhibited genital response in men scoring high on general and sexual self-consciousness traits, whereas it enhanced penile tumescence in low self-conscious men. Inhibition effects were found in both volunteers and patients. No interaction effects of performance demand and self-focus were found. Subjective sexual arousal in sexually functional men was highest in the self-focus condition. In sexually dysfunctional men, subjective sexual response proved dependent on locus of attention as well as presentation order.

Sexual Behavior in High-Functioning Male Adolescents and Young Adults with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Hellemans, Hans; Colson, Kathy; Verbraeken, Christine; Vermeiren, Robert; Deboutte, Dirk

2007-01-01

Group home caregivers of 24 institutionalized, male, high-functioning adolescents and young adults with Autism Spectrum Disorder, were interviewed with the Interview Sexuality Autism. Most subjects were reported to express sexual interest and to display some kind of sexual behavior. Knowledge of socio-sexual skills existed, but practical use was…

Functional behavior and reproduction in androgenic sex reversed zebrafish (Danio rerio).

PubMed

Larsen, Mia G; Baatrup, Erik

2010-08-01

Endocrine-disrupting chemicals released into natural watercourses may cause biased sex ratios by sex reversal in fish populations. The present study investigated the androgenic sex reversal of zebrafish (Danio rerio) exposed to the androgenic compound 17beta-trenbolone (TB) and whether sex-changed females would revert to the female phenotype after cessation of TB exposure. 17beta-Trenbolone is a metabolite of trenbolone acetate, an anabolic steroid used as a growth promoter in beef cattle. 17beta-Trenbolone in runoff from cattle feedlots may reach concentrations that affect fish sexual development. Zebrafish were exposed to a concentration of 20 ng/L TB in a flow-through system for five months from egg until sexual maturity. This resulted in an all-male population. It was further found that all these phenotypic males displayed normal male courtship behavior and were able to reproduce successfully, implying that the sex reversal was complete and functional. None of the phenotypic males developed into females after six months in clean water, demonstrating that androgenic sex reversal of zebrafish is irreversible. Copyright 2010 SETAC

Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse? A randomized controlled trial.

PubMed

Braekken, Ingeborg H; Majida, Memona; Ellström Engh, Marie; Bø, Kari

2015-02-01

Pelvic floor muscle training (PFMT) has level 1 evidence of reducing the size and symptoms associated with pelvic organ prolapse (POP). There is scant knowledge, however, regarding whether PFMT has an effect on sexual function. The aim of the trial was to evaluate the effect of PFMT on sexual function in women with POP. In this randomized controlled trial, 50 women were randomized to an intervention group (6 months of PFMT and lifestyle advice) and 59 women were randomized to a control group (lifestyle advice only). Participants completed a validated POP-specific questionnaire to describe frequency and bother of prolapse, bladder, bowel, and sexual symptoms and answered a semi-structured interview. No significant change in number of women being sexually active was reported. There were no significant differences between groups regarding change in satisfaction with frequency of intercourse. Interview data revealed that 19 (39%) of women in the PFMT group experienced improved sexual function vs. two (5%) in the control group (P<0.01). Specific improvements reported by some of the women were increased control, strength and awareness of the pelvic floor, improved self-confidence, sensation of a "tighter" vagina, improved libido and orgasms, resolution of pain with intercourse, and heightened sexual gratification for partners. Women who described improved sexual function demonstrated the greatest increases in pelvic floor muscle (PFM) strength (mean 16 ± 10 cmH2 0) and endurance (mean 150 ± 140 cmH2 0s) (P<0.01). PFMT can improve sexual function in some women. Women reporting improvement in sexual function demonstrated the greatest increase in PFM strength and endurance. © 2014 International Society for Sexual Medicine.

Sexual function in infertile women with polycystic ovary syndrome and unexplained infertility.

PubMed

Diamond, Michael P; Legro, Richard S; Coutifaris, Christos; Alvero, Ruben; Robinson, Randal D; Casson, Peter A; Christman, Gregory M; Huang, Hao; Hansen, Karl R; Baker, Valerie; Usadi, Rebecca; Seungdamrong, Aimee; Bates, G Wright; Rosen, R Mitchell; Schlaff, William; Haisenleder, Daniel; Krawetz, Stephen A; Barnhart, Kurt; Trussell, J C; Santoro, Nanette; Eisenberg, Esther; Zhang, Heping

2017-08-01

While female sexual dysfunction is a frequent occurrence, characteristics in infertile women are not well delineated. Furthermore, the impact of infertility etiology on the characteristics in women with differing androgen levels observed in women with polycystic ovary syndrome and unexplained infertility has not been assessed. The objective of the study was to determine the characteristics of sexual dysfunction in women with polycystic ovary syndrome and unexplained infertility. A secondary data analysis was performed on 2 of Eunice Kennedy Shriver National Institute of Child Health and Human Development Cooperative Reproductive Medicine Networks clinical trials: Pregnancy in Polycystic Ovary Syndrome Study II and Assessment of Multiple Intrauterine Gestations From Ovarian Stimulation. Both protocols assessed female sexual function using the Female Sexual Function Inventory and the Female Sexual Distress Scale. Women with polycystic ovary syndrome had higher weight and body mass index than women with unexplained infertility (each P < .001), greater phenotypic (Ferriman-Gallwey hirsutism score, sebum score, and acne score; each P < .001), and hormonal (testosterone, free testosterone, and dehydroepiandrosterone; each P < .001) evidence of androgen excess. Sexual function scores, as assessed by the Female Sexual Function Inventory, were nearly identical. The Female Sexual Distress Scale total score was higher in women with polycystic ovary syndrome. The mean Female Sexual Function Inventory total score increased slightly as the free androgen index increased, mainly as a result of the desire subscore. This association was more pronounced in the women with unexplained infertility. Reproductive-age women with infertility associated with polycystic ovary syndrome and unexplained infertility, despite phenotypic and biochemical differences in androgenic manifestations, do not manifest clinically significant differences in sexual function. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of sexuality in a Paraguayan mid-aged female urban population using the six-item Female Sexual Function Index.

PubMed

Sánchez, S C; Chedraui, P; Pérez-López, F R; Ortiz-Benegas, M E; Palacios-De Franco, Y

2016-06-01

Background There are scant data related to sexuality assessed among mid-aged women from Paraguay. Objective To assess sexual function in a sample of mid-aged Paraguayan women. Methods This was a cross-sectional study in which 265 urban-living women from Asunción (Paraguay) aged 40-65 years were surveyed with the six-item version of the Female Sexual Function Index (FSFI-6) and a questionnaire containing personal and partner data. Results The median age of the sample was 48 years, 48.2% were postmenopausal (median/interquartile range age at menopause 46/13 years), 11.3% used hormone therapy, 37.0% used psychotropic drugs, 44.5% had hypertension, 7.2% diabetes, 46.1% abdominal obesity and 89.4% had a partner (n = 237). Overall, 84.1% (223/265) of surveyed women were sexually active, presenting a median total FSFI-6 score of 23.0, and 25.6% obtained a total score of 19 or less, suggestive of sexual dysfunction (lower sexual function). Upon bivariate analysis, several factors were associated with lower total FSFI-6 scores; however, multiple linear regression analysis found that lower total FSFI-6 scores (worse sexual function) were significantly correlated to the postmenopausal status and having an older partner, whereas coital frequency was positively correlated to higher scores (better sexual function). Conclusion In this pilot sample of urban-living, mid-aged Paraguayan women, as determined with the FSFI-6, lower sexual function was related to menopausal status, coital frequency and partner age. There is a need for more research in this regard in this population.

Effects of female genital mutilation/cutting on the sexual function of Sudanese women: a cross-sectional study.

PubMed

Rouzi, Abdulrahim A; Berg, Rigmor C; Sahly, Nora; Alkafy, Susan; Alzaban, Faten; Abduljabbar, Hassan

2017-07-01

Female genital mutilation/cutting (FGM/C) is a cultural practice that involves several types of removal or other injury to the external female genitalia for nonmedical reasons. Although much international research has focused on the health consequences of the practice, little is known about sexual functioning among women with various types of FGM/C. To assess the impact of FGM/C on the sexual functioning of Sudanese women. This is a cross-sectional study conducted at Doctor Erfan and Bagedo Hospital, Jeddah, Saudi Arabia. Eligible women completed a survey and a clinical examination, which documented and verified women's type of FGM/C. The main outcome measure was female sexual function, as assessed by the Arabic Female Sexual Function Index. A total of 107 eligible women completed the survey and the gynecological examination, which revealed that 39% of the women had FGM/C Type I, 25% had Type II, and 36% had Type III. Reliability of self-report of the type of FGM/C was low, with underreporting of the extent of the procedure. The results showed that 92.5% of the women scored lower than the Arabic Female Sexual Function Index cut-off point for sexual dysfunction. The multivariable regression analyses showed that sexual dysfunction was significantly greater with more extensive type of FGM/C, across all sexual function domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) and overall. The study documents that a substantial proportion of women subjected to FGM/C experience sexual dysfunction. It shows that the anatomical extent of FGM/C is related to the severity of sexual dysfunction. Copyright © 2017 Elsevier Inc. All rights reserved.

Sexual learning, sexual experience, and healthy adolescent sex.

PubMed

Fortenberry, J Dennis

2014-01-01

This chapter is organized around the question "How do adolescents learn to have healthy sex?" The chapter assumes that sexual learning derives from a broad range of both informal and formal sources that contribute to learning within the context of neurocognitive brain systems that modulate sexual motivations and self-regulation. The overall objective is to consider how adolescents become sexually functional and healthy and to provide a conceptual basis for expansion of sexual learning to better support healthy sexual functioning. © 2014 Wiley Periodicals, Inc.

Changes in Sexual Activity in Male Patients Surgically Treated for Kyphosis due to Ankylosing Spondylitis.

PubMed

Yao, Ziming; Du, Jianwei; Wang, Zheng; Zheng, Guoquan; Zhang, Xuesong; Cui, Geng; Wang, Yan

2016-09-01

A retrospective study. The aim of this study was to assess the changes in sexual activities in male patients surgically treated for ankylosing spondylitis (AS)-induced kyphosis and the correlation between these changes and spinal sagittal realignment. Sexual function may be affected by AS. However, little is known about the effect of spinal surgery on the sexual activity of patients with AS-induced kyphosis. Data of 45 male patients who had been surgically treated for AS-induced kyphosis were retrospectively reviewed. Changes in sexual activity were evaluated by the international index of erectile function (IIEF), frequency of sexual activity, and time point at which sexual activity began postoperatively. We compared the above-mentioned parameters before and 24 months postoperatively and analyzed the correlation of the changes in the IIEF with the changes in radiological characteristics. Each domain of the IIEF and the total IIEF were increased postoperatively. Improved sexual function was correlated with changes in spinal sagittal characteristics, among which lumbar lordosis (LL) and the chin-brow vertical angle (CBVA) were the most significant causes (P < 0.05). Most patients (71.1%) resumed their sexual activity 5 to 12 weeks after surgery. At the 24-month follow-up, the frequency of patients' sexual activity was higher than that before surgery (P < 0.05). Surgical correction of spinal deformity may improve sexual function and increase the frequency of sexual activity in men with AS. Spinal sagittal realignment and pelvic rotation may be correlated with improvement of sexual function. 4.

Obesity and Sexuality Among Older Couples.

PubMed

Kwon, Soyoung; Schafer, Markus H

2016-04-01

We investigate whether obesity is associated with sexual activity, sexual frequency, and the range of sexual behaviors in heterosexual older couples. We assess to what extent associations between obesity and sexuality are explained by physical, psychological, and sexual health, and by relationship quality. We use data from 1,698 older adults in 849 partnered dyads in the 2010-2011 wave of the National Social Life, Health, and Aging Project and conduct couple-level analysis featuring women's and men's characteristics. Women's obesity-particularly at severe levels-is negatively associated with coupled sexual activity, and that the association is not mediated by hypothesized mediators. Men's obesity did not have any association with sexual activity. There was no significant difference between overweight and normal weight adults across all three sexuality measures. The growing number of older adults with high levels of body mass index, particularly women, may face certain difficulties in maintaining active sexual lives.

Helping the Middle Aged Couple With Sexual Problems

PubMed Central

Still, H. C.

1977-01-01

A behavioral approach developed by Jack Annon for brief sexual counselling and described here, is recommended for use by family physicians. The effects of aging on male and female sexuality sometimes result in sexual problems if patients are unaware that these effects are normal. Permission to use pleasuring (masturbation) as a therapeutic tool often must be given to those who feel guilty about it. Counselling is often necessary to avoid sexual problems resulting from surgery and illness in middle age. Given average good health and the right partner, sex in middle and old age can still be fun. PMID:21304849

Construct validity of the PROMIS® sexual function and satisfaction measures in patients with cancer

PubMed Central

2013-01-01

Background With data from a diverse sample of patients either in treatment for cancer or post-treatment for cancer, we examine inter-domain and cross-domain correlations among the core domains of the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction measures (PROMIS® SexFS) and the corresponding domains from conceptually-similar measures of sexual function, the International Index of Erectile Function and the Female Sexual Function Index. Findings Men (N=389) and women (N=430) were recruited from a tumor registry, oncology clinics, and an internet panel. The PROMIS SexFS, International Index of Erectile Function, and Female Sexual Function Index were used to collect participants’ self-reported sexual function. The domains shared among the measures include desire/interest in sexual activity, lubrication and vaginal discomfort/pain (women), erectile function (men), orgasm, and satisfaction. We examined correlations among different domains within the same instrument (discriminant validity) and correlations among similar domains measured by different instruments (convergent validity). Correlations demonstrating discriminant validity ranged from 0.38 to 0.73 for men and 0.48 to 0.74 for women, while correlations demonstrating convergent validity ranged from 0.62 to 0.83 for men and 0.71 to 0.92 for women. As expected, correlations demonstrating convergent validity were higher than correlations demonstrating discriminant validity, with one exception (orgasm for men). Conclusions Construct validity was supported by convergent and discriminant validity in a diverse sample of patients with cancer. For patients with cancer who may or may not have sexual dysfunction, the PROMIS SexFS measures provide a comprehensive assessment of key domains of sexual function and satisfaction. PMID:23497200

Confirmatory factor analysis of the female sexual function index.

PubMed

Opperman, Emily A; Benson, Lindsay E; Milhausen, Robin R

2013-01-01

The Female Sexual Functioning Index (Rosen et al., 2000 ) was designed to assess the key dimensions of female sexual functioning using six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. A full-scale score was proposed to represent women's overall sexual function. The fifth revision to the Diagnostic and Statistical Manual (DSM) is currently underway and includes a proposal to combine desire and arousal problems. The objective of this article was to evaluate and compare four models of the Female Sexual Functioning Index: (a) single-factor model, (b) six-factor model, (c) second-order factor model, and (4) five-factor model combining the desire and arousal subscales. Cross-sectional and observational data from 85 women were used to conduct a confirmatory factor analysis on the Female Sexual Functioning Index. Local and global goodness-of-fit measures, the chi-square test of differences, squared multiple correlations, and regression weights were used. The single-factor model fit was not acceptable. The original six-factor model was confirmed, and good model fit was found for the second-order and five-factor models. Delta chi-square tests of differences supported best fit for the six-factor model validating usage of the six domains. However, when revisions are made to the DSM-5, the Female Sexual Functioning Index can adapt to reflect these changes and remain a valid assessment tool for women's sexual functioning, as the five-factor structure was also supported.

Gonadal status and reproductive function following treatment for Hodgkin's disease in childhood: The Stanford experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ortin, T.T.; Shostak, C.A.; Donaldson, S.S.

To ascertain the impact of therapy on gonadal function and reproductive outcome among children treated for Hodgkin's disease, we reviewed the experience at Stanford University Medical Center during the years 1965-1986. There were 240 children 15 years of age or younger, 92 girls and 148 boys; with median follow-up of 9 years, maximum follow-up was 26 years. Of this cohort, data on gonadal function were available on 20 boys, 5 of whom were considered prepubescent; they had no clinical evidence of sexual maturation and were less than 13 years of age. Evaluation of the boys included testicular biopsy, semen analysesmore » and the ability to procreate. Serum gonadotropin hormone levels (FSH, LH) were studied in 11 boys who also had semen analyses. Sexual maturation was attained in all boys without the need for androgen replacement. Among the eight boys treated with radiation alone, four were able to father a child (3 following 40-45 Gy pelvic radiation dose, 1 without pelvic radiation) from 3-19 years following treatment. Three others who received 30-44 Gy pelvic radiation were oligospermic when tested at 10 to 15 years post-treatment. Semen analyses in 10 of 12 (83%) boys who had been treated with six cycles of MOPP with or without pelvic radiation revealed absolute azoospermia with no evidence of recovery as along as 11 years of follow-up. Following prolonged azoospermia, 2 of the 12 boys (17%) had recovery of fertility, with normalization of sperm count and/or ability to procreate at 12 and 15 years following treatment. There was no correlation with serum gonadotropin levels and sterility. Data on menstrual history, pregnancy and offspring were available in 86 (92%) of the girls. Seventy-five of the 86 girls (87%) have normal menstrual function. However, none of the females who underwent pelvic radiation without prior oophoropexy has maintained ovarian function.« less

Correlation Between Transperineal 3-Dimensional Ultrasound Measurements of Levator Hiatus and Female Sexual Function.

PubMed

Aydin, Serdar; Bakar, Rabia Zehra; Arioğlu Aydin, Çağri; Ateş, Seda

The aim of this study is to investigate the association of sexual functions with levator hiatus biometry measurements and levator ani muscle defect. In 62 heterosexual, sexually active premenopausal women without pelvic floor disorders or urinary incontinence, 3-dimensional transperineal ultrasound imaging was used. Two 3-dimensional volumes were recorded, one at rest and one on Valsalva maneuver. Levator biometry measurements and levator defect were evaluated in an axial plane. Sexual function was assessed by a validated questionnaire, Female Sexual Function Index (FSFI). The primary outcome measure was correlation of sexual functions with the levator hiatus area, transverse and anteroposterior diameters, levator ani muscle thickness, vaginal length, and changes in measurements with Valsalva and levator defect. Forty-two women (67.7%) had low total FSFI scores (<26.55). Levator defect rates were similar in female sexual dysfunction (7/42, 16.7%) and women without female sexual dysfunction (5/20, 25%). The FSFI was negatively and weakly correlated with Δhiatal anteroposterior diameter (r = -0.33, P < 0.009) in the study population. There was a weak and inverse correlation between Δhiatal anteroposterior diameter and arousal (r = -0.35, P < 0.002), desire (r = -0.38, P < 0.001), and orgasm (r = -0.33, P < 0.007). Pain and lubrication did not correlate with any measurement. Hiatal area and diameters at rest are not related to sexual functions. Changes in anteroposterior diameter of the levator hiatus during Valsalva, which may be a sign of pelvic floor laxity or levator muscle weakness, are weakly associated with sexual functions, particularly desire, arousal, and orgasm domains.

Conceptualization of the Sexual Response Models in Men: Are there Differences Between Sexually Functional and Dysfunctional Men?

PubMed

Connaughton, Catherine; McCabe, Marita; Karantzas, Gery

2016-03-01

Research to validate models of sexual response empirically in men with and without sexual dysfunction (MSD), as currently defined, is limited. To explore the extent to which the traditional linear or the Basson circular model best represents male sexual response for men with MSD and sexually functional men. In total, 573 men completed an online questionnaire to assess sexual function and aspects of the models of sexual response. In total, 42.2% of men (242) were sexually functional, and 57.8% (331) had at least one MSD. Models were built and tested using bootstrapping and structural equation modeling. Fit of models for men with and without MSD. The linear model and the initial circular model were a poor fit for men with and without MSD. A modified version of the circular model demonstrated adequate fit for the two groups and showed important interactions between psychological factors and sexual response for men with and without MSD. Male sexual response was not represented by the linear model for men with or without MSD, excluding possible healthy responsive desire. The circular model provided a better fit for the two groups of men but demonstrated that the relations between psychological factors and phases of sexual response were different for men with and without MSD as currently defined. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Sexual Anxiety and Eroticism Predict the Development of Sexual Problems in Youth With a History of Sexual Abuse

PubMed Central

Simon, Valerie A.; Feiring, Candice

2017-01-01

Youth with confirmed histories of sexual abuse (N = 118) were followed longitudinally to examine associations between their initial sexual reactions to abuse and subsequent sexual functioning. Participants were interviewed at abuse discovery (ages 8 through 15) and again 1 and 6 years later. Eroticism and sexual anxiety emerged as distinct indices of abuse-specific sexual reactions and predicted subsequent sexual functioning. Eroticism was associated with indicators of heightened sexuality, including more sexual risk behavior and views of sexual intimacy focused on partners’ needs. Sexual anxiety was associated with indicators of diminished sexuality, including few sexual partners and avoidant views of sexual intimacy. Age at abuse discovery moderated some associations, suggesting that the timing of abuse-specific reactions affects trajectories of sexual development. Findings point to the need for a developmental approach to understanding how abuse-specific sexual reactions disrupt sexual development and the need for early interventions promoting healthy sexual development. PMID:18408212

Body Image and Sexual Function in Women after Treatment for Anal and Rectal Cancer

PubMed Central

Benedict, Catherine; Philip, Errol J.; Baser, Raymond E.; Carter, Jeanne; Schuler, Tammy A.; Jandorf, Lina; DuHamel, Katherine; Nelson, Christian

2016-01-01

Objective Treatment for anal and rectal cancer (ARCa) often results in side effects that directly impact sexual functioning; however, ARCa survivors are an understudied group and factors contributing to the sexual sequelae are not well understood. Body image problems are distressing and may further exacerbate sexual difficulties, particularly for women. This preliminary study sought to (1) describe body image problems, including sociodemographic and disease/treatment correlates; and (2) examine relations between body image and sexual function. Methods For the baseline assessment of a larger study, 70 women completed the EORTC QLQ-C30 and CR38, including the Body Image subscale, and Female Sexual Function Index (FSFI). Pearson’s correlation and multiple regression evaluated correlates of body image. Among sexually active women (n=41), hierarchical regression examined relations between body image and sexual function domains. Results Women were an average 55 years old (SD=11.6), Non-Hispanic White (79%), married (57%), and employed (47%). The majority (86%) reported at least one body image problem. Younger age, lower global health status, and greater severity of symptoms related to poorer body image (p’s<.05). Poor body image was inversely related to all aspects of sexual function (β range .50 to .70, p’s<.05), except pain. The strongest association was with FSFI Sexual/Relationship Satisfaction. Conclusion These preliminary findings suggest the importance of assessing body image as a potentially modifiable target to address sexual difficulties in this understudied group. Further longitudinal research is needed to inform the development and implementation of effective interventions to improve the sexual health and well-being of female ARCa survivors. PMID:25974874

Mating Strategies and Sexual Functioning in Personality Disorders: A Comprehensive Review of Literature.

PubMed

Collazzoni, Alberto; Ciocca, Giacomo; Limoncin, Erika; Marucci, Carmela; Mollaioli, Daniele; Di Sante, Stefania; Di Lorenzo, Giorgio; Niolu, Cinzia; Siracusano, Alberto; Maggi, Mario; Castellini, Giovanni; Rossi, Alessandro; Jannini, Emmanuele A

2017-10-01

Personality disorders impair several aspects of intrapsychic and interpersonal life. In particular, mating strategies and sexual functioning could manifest in different and/or dysfunctional ways in people with personality disorders. To describe, through a comprehensive review of the literature, the mating strategies and sexual functioning in patients with personality disorders. We listed and discussed the principal studies on the relation between mating strategies and sexual functioning in personality disorders. The search strategy used search terms in PubMed for the main studies published from January 2000 to December 2016. We considered two main sections for our selection according to the aim of the present review: mating and sexuality. Interesting evidence on mating strategies in personality disorders was found. In particular, the major items were found in the dramatic-unpredictable cluster, with borderline personality disorder being the most studied. In contrast, the bizarre-eccentric cluster had fewer items, with the schizoid personality disorder being the least studied. For sexual behavior, borderline personality seems to be the unique disorder sufficiently studied, with evidence of major histories of child sexual abuse, the presence of sexual dysfunctions, and paraphilic interests. A large spectrum of mating strategies characterizes different personality disorders, although an inconsistent knowledge about the relation between sexual function and personality disorders emerged from our analysis of the literature. Hence, we invite clinicians and researchers to integrate psychodiagnostic and sexual assessments in psychiatric disciplines for people with personality disorders. Collazzoni A, Ciocca G, Limoncin E, et al. Mating Strategies and Sexual Functioning in Personality Disorders: A Comprehensive Review of Literature. Sex Med Rev 2017;5:414-428. Copyright © 2017 International Society for Sexual Medicine. All rights reserved.

Can you ask? We just did! Assessing sexual function and concerns in patients presenting for initial gynecologic oncology consultation

PubMed Central

Kennedy, Vanessa; Abramsohn, Emily; Makelarski, Jennifer; Barber, Rachel; Wroblewski, Kristen; Tenney, Meaghan; Lee, Nita Karnik; Yamada, S. Diane; Lindau, Stacy Tessler

2015-01-01

Objectives To describe patterns of response to, and assess sexual function and activity elicited by, a self-administered assessment incorporated into a new patient intake form for gynecologic oncology consultation. Methods A cross-sectional study of patients presenting to a single urban academic medical center between January 2010 and September 2012. New patients completed a self-administered intake form, including six brief sexual activity and function items. These items, along with abstracted medical record data, were descriptively analyzed. Logistic regression was used to assess the association between sexual activity and function and disease status, adjusting for age. Results Median age was 50 years (range 18–91, N = 499); more than half had a final diagnosis of cancer. Most patients completed all sex-related items on the intake form; 98% answered at least one. Among patients who were sexually active in the prior 12 months (57% with cancer, 64% with benign disease), 52% indicated on the intake form having, during that period, a sexual problem lasting several months or more. Of these, 15% had physician documentation of the sexual problem. Eighteen women were referred for care. Providers reported no patient complaints about the inclusion of sexual items on the intake form. Conclusions Nearly all new patients presenting for gynecologic oncology consultation answered self-administered items to assess sexual activity and function. Further study is needed to determine the role of pretreatment identification of sexual function concerns in improving sexual outcomes associated with cancer diagnosis and treatment. PMID:25582823

Can you ask? We just did! Assessing sexual function and concerns in patients presenting for initial gynecologic oncology consultation.

PubMed

Kennedy, Vanessa; Abramsohn, Emily; Makelarski, Jennifer; Barber, Rachel; Wroblewski, Kristen; Tenney, Meaghan; Lee, Nita Karnik; Yamada, S Diane; Lindau, Stacy Tessler

2015-04-01

To describe patterns of response to, and assess sexual function and activity elicited by, a self-administered assessment incorporated into a new patient intake form for gynecologic oncology consultation. A cross-sectional study of patients presenting to a single urban academic medical center between January 2010 and September 2012. New patients completed a self-administered intake form, including six brief sexual activity and function items. These items, along with abstracted medical record data, were descriptively analyzed. Logistic regression was used to assess the association between sexual activity and function and disease status, adjusting for age. Median age was 50 years (range 18-91, N=499); more than half had a final diagnosis of cancer. Most patients completed all sex-related items on the intake form; 98% answered at least one. Among patients who were sexually active in the prior 12 months (57% with cancer, 64% with benign disease), 52% indicated on the intake form having, during that period, a sexual problem lasting several months or more. Of these, 15% had physician documentation of the sexual problem. Eighteen women were referred for care. Providers reported no patient complaints about the inclusion of sexual items on the intake form. Nearly all new patients presenting for gynecologic oncology consultation answered self-administered items to assess sexual activity and function. Further study is needed to determine the role of pre-treatment identification of sexual function concerns in improving sexual outcomes associated with cancer diagnosis and treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

Changes in Sympathetic Nervous System Activity are Associated with Changes in Sexual Wellbeing in Women with a History of Childhood Sexual Abuse

PubMed Central

Lorenz, Tierney K.; Harte, Christopher B.; Meston, Cindy M.

2015-01-01

Introduction Women with histories of childhood sexual abuse (CSA) have higher rates of sexual difficulties, as well as high sympathetic nervous system (SNS) response to sexual stimuli. Aim To examine whether treatment-related changes in autonomic balance, as indexed by heart rate variability (HRV), were associated with changes in sexual arousal and orgasm function. Methods In Study 1, we measured HRV while writing a sexual essay in 42 healthy, sexually functional women without any history of sexual trauma. These data, along with demographics, were used to develop HRV norms equations. In Study 2, 136 women with a history of CSA were randomized to one of three active expressive writing treatments that focused on their trauma, sexuality, or daily life (control condition). We recorded HRV while writing a sexual essay at pre-treatment, post-treatment, and 2 week, 1 month, and 6 month follow-ups; we also calculated the expected HRV for each participant based on the norms equations from Study 1. Main Outcome Measures Heart rate variability, Female Sexual Function Index (FSFI), Sexual Satisfaction Scale – Women (SSS-W) Results The difference between expected and observed HRV decreased over time, indicating that, post-treatment, CSA survivors displayed HRV closer to the expected HRV of a demographics-matched woman with no history of sexual trauma. Also, over time, participants whose HRV became less dysregulated showed the biggest gains in sexual arousal and orgasm function. These effects were consistent across condition. Conclusions Treatments that reduce autonomic imbalance may improve sexual wellbeing among CSA populations. PMID:25963394

Impaired sexual maturation associated with sleep apnea syndrome during puberty: a case study.

PubMed

Mosko, S S; Lewis, E; Sassin, J F

1980-01-01

A 20-year-old hypogonadal man was discovered to have had obstructive sleep apnea syndrome--secondary to hypertrophied tonsils, adenoids, and uvula--spanning the years of puberty. All-night polysomnographic recordings and 24 hr measurements of plasma luteinizing hormone (LH) concentrations (sampling at 20 min intervals) were performed before and after combined tonsillectomy, adenoidectomy, and uvulectomy. Two weeks preoperatively, nocturnal sleep was markedly disturbed by 407 apneic episodes, and the patient was found to be hypogonadotropic. Daytime LH concentrations were in the low-normal range for an adult male, and concentrations fell dramatically during nocturnal sleep. This contrasts with both the sleep-related elevation of LH normally seen in puberty and the adult pattern, where no difference is observed in mean concentrations during waking and sleep. Two week and 6 month postoperative evaluations revealed complete alleviation of the sleep apnea syndrome and normalization of the 24 hr pattern of plasma LH, although LH values remained in the low-normal range. Plasma testosterone concentrations were in the low to low-normal range both pre- and postoperatively. No evidence of continued sexual development, beyond that achieved preoperatively, was observed 20 months after surgery, despite continued relief from apnea. These data suggest that sleep apnea during puberty may impair sexual development by preventing the sleep-related elevation in LH secretion normally observed during a critical period spanning puberty.

Sexual Health Care, Sexual Behaviors and Functioning, and Female Genital Cutting: Perspectives From Somali Women Living in the United States.

PubMed

Connor, Jennifer Jo; Hunt, Shanda; Finsaas, Megan; Ciesinski, Amanda; Ahmed, Amira; Robinson, Beatrice Bean E

2016-01-01

We investigated the sexual values, attitudes, and behaviors of 30 Somali female refugees living in a large metropolitan area of Minnesota by collecting exploratory sexual health information based on the components of the sexual health model-components posited to be essential aspects of healthy human sexuality. A Somali-born bilingual interviewer conducted the semistructured interviews in English or Somali; 22 participants chose to be interviewed in Somali. Interviews were translated, transcribed, and analyzed using descriptive statistics and thematic analyses. Our study findings highlighted a sexually conservative culture that values sexual intimacy, female and male sexual pleasure, and privacy in marriage; vaginal sexual intercourse as the only sanctioned sexual behavior; and the importance of Islamic religion in guiding sexual practices. Findings related to human immunodeficiency virus (HIV) revealed HIV testing at immigration, mixed attitudes toward condom use, and moderate knowledge about HIV transmission modes. Female genital cutting (FGC) was a pervasive factor affecting sexual functioning in Somali women, with attitudes about the controversial practice in transition. We recommend that health professionals take the initiative to discuss sexual health care and safer sex, sexual behaviors/functioning, and likely challenges to sexual health with Somali women--as they may be unlikely to broach these subjects without permission and considerable encouragement.

Sexual Harassment of Girls in Elementary School: A Concealed Phenomenon within a Heterosexual Romantic Discourse

ERIC Educational Resources Information Center

Gadin, Katja Gillander

2012-01-01

The aim of this study was to enhance the understanding of young girls' experiences of peer sexual harassment in elementary school and of normalizing processes of school-related sexualized violence. Six focus group interviews with girls in Grade 1 through 6 were carried out in an elementary school in the northern part of Sweden. A content analyses…

How to Talk with Your Child about Sexuality--A Parent's Guide. Family Communication Series

ERIC Educational Resources Information Center

Planned Parenthood Federation of America, Inc., 2007

2007-01-01

It is best to start talking with children about sexuality in early childhood, but it is never too late. Parents should always be open and available when a child wants to talk. The most important lesson they can share with their kids is, "Being different is normal." Answers to the following questions are discussed: (1) What Is Sexuality?; (2) Why…

Basic Course Deskbook, Volume 2: General Administrative Law

DTIC Science & Technology

2002-03-01

jurisdictions can result in a void marriage. 5. Impotence: usually must render the party physically incapable of normal sexual relations and must...ground for annulment in itself, but may constitute fraud if the party never intended to have sexual relations. IX. UNIFORMED SERVICES FORMER SPOUSES...must submit a sworn statement articulating reasonable facts supporting the existence or nonexistence of requisite sexual contact before genetic

International spinal cord injury male sexual function and female sexual and reproductive function basic data sets-version 2.0.

PubMed

Alexander, Marcalee S; New, Peter W; Biering-Sørensen, Fin; Courtois, Frederique; Popolo, Giulio Del; Elliott, Stacy; Kiekens, Carlotte; Vogel, Lawrence; Previnaire, Jean G

2017-01-01

Data set review and modification. To describe modifications in the International Spinal Cord Injury (SCI) Male Sexual Function Basic Data Set Version 2.0 and the International SCI Female Sexual and Reproductive Function Basic Data Set Version 2.0. International expert work group using on line communication. An international team of experts was compiled to review and revise the International SCI Male Sexual Function and Female Sexual and Reproductive Function Basic Data Sets Version 1.0. The group adapted Version 1.0 based upon review of published research, suggestions from concerned individuals and on line work group consensus. The revised data sets were then posted on the International Spinal Cord Society (ISCoS) and American Spinal Injury Association (ASIA) websites for 2 months for review. Subsequently, the data sets were approved by the ISCoS Scientific and Executive Committees and ASIA board of directors. The data sets were modified to a self-report format. They were reviewed for appropriateness for the pediatric age group and adapted to include a new variable to address the issue of sexual orientation. A clarification of the difference between the data sets and the autonomic standards was also developed. Sexuality is a continuously evolving topic. Modifications were needed to address this topic in a comprehensive fashion. It is recommended that Version 2.0 of these data sets are used for ongoing documentation of sexual status in the medical record and for documentation of sexual concerns during on-going research.

Combined Oral Contraceptives and Sexual Function in Women-a Double-Blind, Randomized, Placebo-Controlled Trial.

PubMed

Zethraeus, Niklas; Dreber, Anna; Ranehill, Eva; Blomberg, Liselott; Labrie, Fernand; von Schoultz, Bo; Johannesson, Magnus; Hirschberg, Angelica Lindén

2016-11-01

There is a lack of knowledge about how oral contraceptives may affect sexual function. To determine whether there is a causal effect of oral contraceptives on sexuality. We hypothesized that a widely used pill impairs sexuality. A double-blind, randomized, placebo-controlled trial. Enrollment began in February 2012 and was completed in August 2015. Karolinska University Hospital, Stockholm, Sweden. A total of 340 healthy women, aged 18-35 years, were randomized to treatment, and 332 completed the study. A combined oral contraceptive (150 μg levonorgestrel and 30 μg ethinylestradiol) or placebo for 3 months of treatment. The primary outcome was the aggregate score on the Profile of Female Sexual Function (PFSF). Secondary outcomes were the seven domains of the PFSF, the Sexual Activity Log, and the Personal Distress Scale. Overall sexual function was similar in women in the oral contraceptive and placebo groups. The PFSF domains desire (-4.4; 95% confidence interval [CI], -8.49 to -0.38; P = .032), arousal (-5.1; 95% CI, -9.63 to -0.48; P = .030), and pleasure (-5.1; 95% CI, -9.97 to -0.32; P = .036) were significantly reduced in comparison to placebo, whereas orgasm, concern, responsiveness, and self-image were similar between groups. The mean frequency of satisfying sexual episodes and personal distress were also similar between groups. This study shows no negative impact of a levonorgestrel-containing oral contraceptive on overall sexual function, although three of seven sexual function domains were adversely affected.

Women's Sexual Health and Reproductive Function After SCI.

PubMed

Courtois, Frédérique; Alexander, Marcalee; McLain, Amie B Jackson

2017-01-01

Sexual function and to a lesser extent reproduction are often disrupted in women with spinal cord injuries (SCI), who must be educated to better understand their sexual and reproductive health. Women with SCI are sexually active; they can use psychogenic or reflexogenic stimulation to obtain sexual pleasure and orgasm. Treatment should consider a holistic approach using autonomic standards to describe remaining sexual function and to assess both genital function and psychosocial factors. Assessment of genital function should include thoracolumbar dermatomes, vulvar sensitivity (touch, pressure, vibration), and sacral reflexes. Self-exploration should include not only clitoral stimulation, but also stimulation of the vagina (G spot), cervix, and nipples conveyed by different innervation sources. Treatments may consider PDE5 inhibitors and flibanserin on an individual basis, and secondary consequences of SCI should address concerns with spasticity, pain, incontinence, and side effects of medications. Psychosocial issues must be addressed as possible contributors to sexual dysfunctions (eg, lower self-esteem, past sexual history, depression, dating habits). Pregnancy is possible for women with SCI; younger age at the time of injury and at the time of pregnancy being significant predictors of successful pregnancy, along with marital status, motor score, mobility, and occupational scores. Pregnancy may decrease the level of functioning (eg, self-care, ambulation, upper-extremity tasks), may involve complications (eg, decubitus ulcers, weight gain, urological complications), and must be monitored for postural hypotension and autonomic dysreflexia. Taking into consideration the physical and psychosocial determinants of sexuality and childbearing allows women with SCI to achieve positive sexual and reproductive health.

Sexuality in Perimenopausal and Postmenopausal Women.

ERIC Educational Resources Information Center

Morokoff, Patricia J.

1988-01-01

Reviews psychological and biological aspects of effects of menopause on sexuality. Discusses population studies revealing that postmenopausal status is associated with decline in some components of sexual functioning. Notes that little research has examined psychological response to menopause and its effect on sexual functioning. Research on…

Correlates of Sexual Functioning and Relationship Satisfaction Among Men and Women Experiencing Chronic Pain.

PubMed

Finn, Erica; Morrison, Todd G; McGuire, Brian E

2018-05-01

The aims of the study were to 1) examine the prevalence of sexual functioning difficulties in a chronic pain sample; 2) identify correlates of sexual functioning and relationship satisfaction utilizing pain variables (pain severity and pain interference) and psychological variables (mood, pain-related cognitions, self-efficacy, self-esteem, body-image); and 3) investigate possible sex differences in the correlates of sexual functioning and relationship satisfaction. Two hundred sixty-nine participants were recruited online from chronic pain organizations, websites, social media sites, and discussion forums. Those who met criteria for inclusion were presented with a variety of measures related to pain, sexual functioning, and relationship satisfaction (for those in a relationship), as well as cognitive and affective variables. Participant mean age was 37 years, and the majority were female, heterosexual, and currently in a relationship. High levels of pain severity and interference from pain, fatigue, depression, anxiety, stress, and body image concerns were reported, along with low levels of self-esteem and pain self-efficacy. In addition, substantial proportions of male (43%) and female (48%) respondents had scores indicative of sexual problems. Exploratory hierarchical regression analyses revealed that, for women, age and relationship satisfaction (which were both treated as covariates) as well as depression emerged as statistically significant correlates of sexual functioning (i.e., women who were older and reported greater levels of depression and less satisfaction with their current relationship indicated poorer sexual functioning). When relationship satisfaction was the criterion measure, age and sexual functioning (again, treated as covariates) and perceived stress emerged as significant (i.e., women who were older, reported poorer sexual functioning, and reported greater perceived stress also indicated being less satisfied with their current relationship). For male participants, age emerged as the only statistically significant correlate of sexual functioning (i.e., older men reported poorer functioning). In terms of relationship satisfaction, self-esteem was the lone significant correlate variable (men who reported lower self-esteem also were less satisfied with their current relationship). Some sex differences were evident in the variables that predict sexual difficulties and relationship satisfaction among those suffering from chronic pain. Of note is that when psychological variables were considered, pain-specific physical variables (e.g., pain severity and activity limitations) accounted for very little additional variance.

A Multidisciplinary Approach to Sexual and Fertility Rehabilitation: The Sexual Rehabilitation Framework

PubMed Central

Hocaloski, Shea; Carlson, Marie

2017-01-01

Many studies have identified improvement in sexual function as a priority for persons with spinal cord injury (SCI). Due to the various secondary sensory, motor, and autonomic consequences following SCI and due to the complexity of sexuality per se, this area can be overwhelming to many health care professionals. The literature indicate that sexual and fertility rehabilitation must be addressed in a biopsychosocial manner and include various disciplines. The multidisciplinary utilization of a Sexual Rehabilitation Framework (SRF) allows the medical and/or psychosocial factors that impede or improve sexual and reproductive function to be examined. The SRF is a user-friendly and simplified way to proactively address the major biopsychosocial areas of sexuality and to create a plan of action for the person with SCI. It is an adjunct tool to the full sexual history, and it encourages all disciplines involved in SCI rehabilitation to address the issue of sexual function in the same manner as they would other activities of daily living. Eight areas are included in the SRF: sexual drive/interest, sexual functioning, fertility and contraception, factors associated with the condition, motor and sensory influences, bladder and bowel influences, sexual self-view and self-esteem, and partnership issues. The use of the SRF is encouraged in both inpatient and outpatient settings. Multidisciplinary or interdisciplinary team work is encouraged in sexual and fertility rehabilitation to move clinicians toward providing proactive and comprehensive care for individuals with SCI or other chronic disabilities. PMID:29339877

Sexual Function and Testosterone Level in Men With Conservatively Treated Chronic Kidney Disease.

PubMed

Fugl-Meyer, Kerstin S; Nilsson, Marie; Hylander, Britta; Lehtihet, Mikael

2017-07-01

Sexual dysfunctions are common, but underrecognized, in patients with chronic kidney disease (CKD) and are inversely associated with the glomerular filtration rate (GFR). Sexual dysfunctions may affect quality of life in males with CKD. The aim of this study was to analyze the relationship among sex hormones, sexual function, and sexual satisfaction in a group of men between 18 and 50 years of age with CKD Stages 1 to 5 not treated with hemodialysis or peritoneal dialysis. Fasting blood samples for hemoglobin, testosterone, prolactin, and luteinizing hormone and questionnaire surveys (Sexual Complaints Screener for Men, International Index of Erectile Function, and Aging Male Symptom scale) were evaluated in 100consecutive men. Higher CKD stage (i.e., lower renal function) had a statistically significant ( p < .01) correlation with lower total testosterone, free testosterone, and hemoglobin levels, and higher luteinizing hormone and prolactin levels. Sexual function/dysfunctions were not significantly associated with CKD stage, even after adjustment for age and serum testosterone. The results indicate that CKD stage is a factor affecting testosterone levels in combination with age in men between 18 and 50 years of age at different stages of CKD but not treated with hemodialysis or peritoneal dialysis. Sexual dysfunctions are common but not strongly correlated to testosterone levels, prolactin levels, and survey (Sexual Complaints Screener for Men, International Index of Erectile Function, and Aging Male Symptom scale) responses in patients with CKD.

Associations Between Penetration Cognitions, Genital Pain, and Sexual Well-being in Women with Provoked Vestibulodynia.

PubMed

Anderson, Alexandra B; Rosen, Natalie O; Price, Lisa; Bergeron, Sophie

2016-03-01

Provoked vestibulodynia (PVD) is a common vulvovaginal pain condition that negatively impacts women's psychological and sexual well-being. Controlled studies have found that women with PVD report greater negative and less positive cognitions about penetration; however, associations between these types of cognitions and women's pain and sexual well-being remain unknown. Further, researchers have yet to examine how interpersonal variables such as sexual communication may impact the association between women's penetration cognitions and PVD outcomes. We examined associations between vaginal penetration cognitions and sexual satisfaction, sexual function, and pain in women with PVD, as well as the moderating role of sexual communication. Seventy-seven women (M age = 28.32, SD = 6.19) diagnosed with PVD completed the catastrophic and pain cognitions and positive cognitions subscales of the Vaginal Penetration Cognition Questionnaire, as well as the Dyadic Sexual Communication Scale. Participants also completed measures of sexual satisfaction, sexual function, and pain. Dependent measures were the (i) Global Measure of Sexual Satisfaction Scale; (ii) Female Sexual Function Index; and (iii) Present Pain Intensity scale of the McGill Pain Questionnaire, with reference to pain during vaginal intercourse. Women's lower catastrophic and pain cognitions, higher positive cognitions, and higher sexual communication were each uniquely associated with higher sexual satisfaction and sexual function. Lower catastrophic and pain cognitions also were associated with women's lower pain. For women who reported higher sexual communication, as positive cognitions increased, there was a significantly greater decrease in pain intensity during intercourse compared to women who reported lower levels of sexual communication. Findings may inform cognitive-behavioral interventions aimed at improving the pain and sexual well-being of women with PVD. Targeting the couple's sexual communication and women's penetration cognitions may improve women's sexual adjustment and reduce pain. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Sacral neuromodulation for lower urinary tract dysfunction and impact on erectile function.

PubMed

Lombardi, Giuseppe; Mondaini, Nicola; Giubilei, Gianluca; Macchiarella, Angelo; Lecconi, Filippo; Del Popolo, Giulio

2008-09-01

The first sacral nerve stimulators were for urinary urgency incontinence, urgency-frequency, and nonobstructive urinary retention. Since then, observations have been made for benefits beyond voiding disorders. To evaluate if sacral neuromodulation (SNM) using the InterStim system (Medtronic Inc., Minneapolis, MN, USA) improves erectile function. From January 1999 to January 2007, 54 males, mean age 42.8, underwent a permanent SNM for lower urinary tract symptoms (LUTS). Pre-SNM only subjects with concomitant erectile impairment according to the five-item version of the International Index of Erectile Function (IIEF-5), with normal blood sexual hormonal status, and responding to an intracavernous injection test 10 microg were enrolled in our study. Three months after permanent implantation, the IIEF-5 was completed again. Those who benefited significantly in erectile function completed the IIEF-5 semiannually. A final checkup was performed in July 2007. A score of IIEF-5 equal to or higher than 25% compared to baseline indicated remarkable clinical enhancement. Presurgery, two patients were excluded. Overall, 22 subjects (42.3%) showed erectile impairment (14 were neurogenic). In the first visit post-SNM, five retentionists of neurogenic origin and two with overactive bladder syndrome of idiopathic origin achieved noticeable erectile improvement. Their median IIEF-5 score shifted from 14.6 to 22.2, and 15.5 to 22.5, respectively. During follow-up, two neurogenics lost the benefits concerning voiding and erection and recovered them after a new implant in the contralateral sacral S3 root. In the final visit, the seven responders reached an IIEF-5 score of at least 22. Our study showed a clinically important benefit of sexual function mainly for neurogenic retentionists. Future research should test SNM in a larger sample of subjects, exclusively with sexual dysfunctions, in order to better understand the mechanism of action of SNM on erectile function.

Substance Use and Cognitive Function as Drivers of Condomless Anal Sex Among HIV-Positive Gay, Bisexual, and Other Men Who Have Sex with Men Aged 50 and Older: The Gold Studies.

PubMed

Kupprat, Sandra A; Krause, Kristen D; Ompad, Danielle C; Halkitis, Perry N

2017-12-01

Substance use has been linked to the sexual transmission of HIV among gay, bisexual, and other men who have sex with men (MSM) across the lifespan. Among older, HIV-positive, MSM populations, cognitive dysfunction associated with age and HIV disease progression also may play a role in sexual risk-taking. People aged 50 years and older represent a growing proportion of the overall HIV-positive population. This study aimed to explore relationships between substance use and cognitive function, and their impact on condomless anal sex (CAS) among HIV-positive gay, bisexual, and other MSM aged 50 years and older. Data from a cross-sectional study of HIV-positive MSM, aged 50 and older (N = 169) were gathered using a computer-assisted survey, researcher-administered behavioral and neurocognitive measures. More than 50% of the men used substances and had one or more cognitive impairments. However, only 25% were at higher risk for dementia (i.e., two or more cognitive impairments). Multivariable modeling indicated that use of alcohol to intoxication and date of HIV diagnosis were the strongest predictors of CAS in both a model that included dementia risk and a model that included impaired executive function risk. Current illicit substance use was a significant predictor of CAS only in the model that included dementia risk. Those with better cognitive and executive function had higher odds of CAS. However, only executive function was a significant cognitive predictor of CAS. Further research is needed to clarify the impact of cognitive function and substance use on sexual risk behaviors as these HIV-positive men achieve normal life expectancies, while continuing to use substances and engage in CAS. Furthermore, addiction treatment remains a critical need for this group even as they transition into later adulthood.

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.

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.

Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study.

PubMed

Dongre, Swati; Langade, Deepak; Bhattacharyya, Sauvik

2015-01-01

Many women experience sexual dysfunction where there are orgasm disorders and sexual difficulties. Ashwagandha (Withania somnifera) is a herb known to improve the body's physical and psychological condition. The purpose of the study was to determine the efficacy and safety of a high-concentration ashwagandha root extract (HCARE) supplementation for improving sexual function in healthy females. In this pilot study, 50 study subjects were randomized to either (i) HCARE-treated group or (ii) placebo- (starch-) treated group. The subjects consumed either HCARE or placebo capsules of 300mg twice daily for 8 weeks. Sexual function was assessed using two psychometric scales, the Female Sexual Function Index (FSFI) Questionnaire and the Female Sexual Distress Scale (FSDS), and by the number of total and successful sexual encounters. The analysis indicates that treatment with HCARE leads to significantly higher improvement, relative to placebo, in the FSFI Total score (p < 0.001), FSFI domain score for "arousal" (p < 0.001), "lubrication" (p < 0.001), "orgasm" (p = 0.004), and "satisfaction" (p < 0.001), and also FSDS score (p < 0.001) and the number of successful sexual encounters (p < 0.001) at the end of the treatment. This study demonstrated that oral administration of HCARE may improve sexual function in healthy women. The present study is registered in the Clinical Trial Registry, Government of India, with a number CTRI/2015/07/006045.

Preference for aggressive and sexual stimuli in children with disruptive behavior disorder and normal controls.

PubMed

van Goozen, Stephanie H M; Cohen-Kettenis, Peggy T; Matthys, Walter; van Engeland, Herman

2002-06-01

Children with disruptive behavior disorders (DBD) have poor social skills and show aggressive interaction patterns. There is evidence from prospective studies of an association between early physical abuse, later social information-processing patterns, and aggressive behavior. A pattern of hypervigilance to hostile cues has been found in DBD children, but very few studies have investigated encoding or perceptual preference for specific classes of stimuli. Some DBD children have a suspected history of sexual abuse and a few have themselves been sexually offensive. Our belief that the sexuality of DBD children should be investigated raised the issue of how to go about doing this. A procedure was developed in which we measured the relative preference for sexual and aggressive stimuli in comparison to other stimulus categories, and the data of DBD children were compared with those of normal controls. It was found that DBD children preferred viewing sexual slides and had a lower preference for nonaggressive slides. Furthermore, boys in general preferred viewing aggressive slides, did so for longer, and chose them earlier, whereas the more aggressive DBD children distinguished themselves in selecting aggressive stimuli earlier. The implications of these findings were discussed and it was concluded that sexuality is clearly an important topic to address in aggressive children in general and not only in the abused ones.

The historical response to female sexuality.

PubMed

Studd, John; Schwenkhagen, Anneliese

2009-06-20

In the past, medical attitudes to female sexuality were grotesque, reflecting the anxiety and hypocrisy of the times. In the medieval world, the population feared hunger, the devil, and women, being particularly outraged and threatened by normal female sexuality. The 19th century attitude was no better as academics confirmed the lower intellectual status of women, particularly if they ventured into education. The medical contribution to this prejudice was shocking, with gynaecologists and psychiatrists leading the way designing operations for the cure of the apparently serious contemporary disorders of masturbation and nymphomania. The gynaecologist, Isaac Baker Brown (1811-1873), and the distinguished endocrinologist, Charles Brown-Séquard (1817-1894) advocated clitoridectomy to prevent the progression to masturbatory melancholia, paralysis, blindness and even death. Even after the public disgrace of Baker Brown in 1866-1867, the operation remained respectable and widely used in other parts of Europe. This medical contempt for normal female sexual development was reflected in public and literary attitudes. There is virtually no novel or opera in the last half of the 19th century where the heroine with "a past" survives to the end. The wheel has turned full circle and in the last 50 years new research into the sociology, psychology and physiology of sexuality has provided a greater understanding of decreased libido and inadequate sexual response in the form of hypoactive sexual desire disorder (HSDD). This is now regarded as a disorder worthy of treatment.

A review of affecting factors on sexual satisfaction in women.

PubMed

Shahhosseini, Zohreh; Gardeshi, Zeinab Hamzeh; Pourasghar, Mehdi; Salehi, Fariba

2014-12-01

Sex is a complex, important and sensitive issue in human being and interwoven with the whole of human existence. Given the serious changes in attitude, function and behavior in sex, the need to address sexual function, especially sexual satisfaction, is felt completely. Sexual satisfaction has a very important role in creating marital satisfaction and any defect in sexual satisfaction is significantly associated with risky sexual behaviors, serious mental illness, social crimes and ultimately divorce. The aim of this study was to explore affecting factors on sexual satisfaction in women based on an overview in scientific database. In this narrative review the researchers searched MEDLINE database, Google Scholar and Science Direct as well as Persian database like Scientific Information Database with search terms of sexual satisfaction and sexual function, restricted to English/ Persian language, during the 20 years ago. Then those articles written by renowned experts were selected. In this regard, 57 articles have been reviewed, which 30 articles related to this research have been extracted. The findings were divided in to four categories including: Demographic factors, Pathophysiological factors, Psychological factors and Sociocultural factors. Sexuality, especially sexual intimacy is sophisticated and yet elegant affair that the other persons has different definitions and different functions. Discrepancies in the results of the studies show that analysis of factors affecting sexual satisfaction regardless of the women's' sociocultural context, religious beliefs, and personal attitudes is undoubtedly inefficient, unscientific and irrational.

Association between higher levels of sexual function, activity, and satisfaction and self-rated successful aging in older postmenopausal women.

PubMed

Thompson, Wesley K; Charo, Lindsey; Vahia, Ipsit V; Depp, Colin; Allison, Matthew; Jeste, Dilip V

2011-08-01

To determine whether measures of successful aging are associated with sexual activity, satisfaction, and function in older postmenopausal women. Cross-sectional study using self-report surveys; analyses included chi-square and t-tests and multiple linear regression analyses. Community-dwelling older postmenopausal women in the greater San Diego region. One thousand two hundred thirty-five community-dwelling women aged 60 to 89 participating at the San Diego site of the Women's Health Initiative. Demographic information and self-reported measures of sexual activity, function, and satisfaction and successful aging. Sexual activity and functioning (desire, arousal, vaginal tightness, use of lubricants, and ability to climax) were negatively associated with age, as were physical and mental health. In contrast, sexual satisfaction and self-rated successful aging and quality of life remained unchanged across age groups. Successful aging measures were positively associated with sexual measures, especially self-rated quality of life and sexual satisfaction. Self-rated successful aging, quality of life, and sexual satisfaction appear to be stable in the face of declines in physical health, some cognitive abilities, and sexual activity and function and positively associated with each other from age 60 to 89. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

Association between higher levels of sexual function, activity, and satisfaction and self-rated successful aging in older postmenopausal women

PubMed Central

Thompson, Wesley K.; Charo, Lindsey; Vahia, Ipsit V.; Depp, Colin; Allison, Matthew; Jeste, Dilip V.

2014-01-01

Objectives To determine if measures of successful-aging are associated with sexual activity, satisfaction, and function in older post-menopausal women. Design Cross-sectional study using self-report surveys; analyses include chi-square and t-tests and multiple linear regression analyses. Setting Community-dwelling older post-menopausal women in the greater San Diego Region. Participants 1,235 community-dwelling women aged 60-89 years participating at the San Diego site of the Women's Health Initiative. Measurements Demographics and self-report measures of sexual activity, function, and satisfaction and successful aging. Results Sexual activity and functioning (desire, arousal, vaginal tightness, use of lubricants, and ability to climax) were negatively associated with age, as were physical and mental health. In contrast, sexual satisfaction and self-rated successful aging and quality of life remained unchanged across age groups. Successful aging measures were positively associated with sexual measures, especially self-rated quality of life and sexual satisfaction. Conclusions Self-rated successful aging, quality of life, and sexual satisfaction appear to be stable in the face of declines in physical health, some cognitive abilities, and sexual activity and function and are positively associated with each other across ages 60-89 years. PMID:21797827

Sexual functioning 1 year after traumatic brain injury: findings from a prospective traumatic brain injury model systems collaborative study.

PubMed

Sander, Angelle M; Maestas, Kacey Little; Pappadis, Monique R; Sherer, Mark; Hammond, Flora M; Hanks, Robin

2012-08-01

To investigate the incidence and types of sexual difficulties in men and women with traumatic brain injury (TBI) 1 year after injury, as well as their comfort level in discussing problems with health care professionals. Prospective cohort study. Community. Persons with TBI (N=223; 165 men and 58 women) who had been treated at 1 of 6 participating TBI Model Systems inpatient rehabilitation units and were living in the community. None. Derogatis Interview for Sexual Functioning-self-report (DISF-SR); Global Sexual Satisfaction Index (GSSI); structured interview regarding changes in sexual functioning; and comfort level discussing sexuality with health care professionals. Women with TBI scored significantly below the normative sample for all subscales of the DISF-SR, including sexual cognition/fantasy, arousal, sexual behavior/experience, and orgasm. Men scored significantly below the normative sample on all scales except arousal. Women reported greater dysfunction than men for sexual cognition/fantasy and arousal. Twenty-nine percent of participants reported dissatisfaction with sexual functioning on the GSSI, with a greater percentage of men reporting dissatisfaction. Sixty-eight percent of participants indicated that they would spontaneously raise issues of sexual difficulties with health care professionals, while the remainder would either bring it up only if directly asked or would not discuss it at all. Sexual difficulties were present in a substantial portion of community-dwelling people with TBI at 1 year after injury. Educational interventions to increase awareness among people with TBI and rehabilitation professionals are warranted, as well as interventions to improve sexual functioning. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A Preliminary Examination of Negative Life Events and Sexual Assault Victimization as Predictors of Psychological Functioning in Female College Students: Does One Matter More Than the Other?

PubMed

Chang, Edward C; Lee, Jerin; Morris, Lily E; Lucas, Abigael G; Chang, Olivia D; Hirsch, Jameson K

2017-07-01

The present study examined negative life events (NLEs) and sexual assault victimization as predictors of positive and negative psychological functioning in a sample of 151 female college students. Results obtained from conducting regression analyses indicated several notable patterns. NLEs, compared with sexual assault victimization, were a stronger negative predictor of positive functioning based on indices related to subjective well-being (e.g., life satisfaction, positive affect). Alternatively, sexual assault victimization, compared with NLEs, was a stronger positive predictor of negative functioning based on indices related to posttraumatic stress disorder symptoms (e.g., anxiety) and related conditions (e.g., alcohol use). Furthermore, both NLEs and sexual assault victimization were found to be positive predictors of negative functioning based on indices related to suicide risk (e.g., depressive symptoms, suicidal behaviors). Overall, our findings indicate that both NLEs and sexual assault victimization represent important and distinct predictors of psychological functioning in female college students.

How does health-promoting lifestyle relate to sexual function among women of reproductive age in Iran?

PubMed

Abedi, Parvin; Jorfi, Maryam; Afshari, Poorandokht; Fakhri, Ahmad

2017-08-01

This study aimed to evaluate the relation between health-promoting lifestyle and sexual function among women of reproductive age. In this cross-sectional study, 1200 women were recruited randomly from 10 public health centers in Ahvaz, Iran. A demographic questionnaire, Health Promoting Lifestyle Profile 2 (HPLP2), and Female Sexual Function Index (FSFI) were used for data collection. The inclusion criteria were as follows: women aged 15-45 years, married, monogamous, and having basic literacy. Data were analyzed using Kruskal-Wallis test, chi-square test, Spearman correlation coefficient, and logistic regression. All aspects of sexual function showed a significant relationship with different dimensions of HPLP2, except for pain and physical activity ( p < 0.001). Women who had better self-actualization were more likely to have better sexual function than other women (OR = 1.10, 95% CI: 1.06-1.14, p < 0.001). Other variables like responsibility, interpersonal relations and stress management also showed a significant correlation with sexual function. Results of this study showed that health-promoting lifestyle dimensions are significantly related to all aspects of sexual function in women of reproductive age. Health policy makers should take lifestyle-related factors of reproductive-aged women into account when seeking to improve the sexual wellbeing of this population. Further attention should also be given to assessing the direction of causality.

Sexual Response Models: Toward a More Flexible Pattern of Women's Sexuality.

PubMed

Ferenidou, Fotini; Kirana, Paraskevi-Sofia; Fokas, Konstantinos; Hatzichristou, Dimitrios; Athanasiadis, Loukas

2016-09-01

Recent research suggests that none of the current theoretical models can sufficiently describe women's sexual response, because several factors and situations can influence this. To explore individual variations of a sexual model that describes women's sexual responses and to assess the association of endorsement of that model with sexual dysfunctions and reasons to engage in sexual activity. A sample of 157 randomly selected hospital employees completed self-administered questionnaires. Two models were developed: one merged the Master and Johnson model with the Kaplan model (linear) and the other was the Basson model (circular). Sexual function was evaluated by the Female Sexual Function Index and the Brief Sexual Symptom Checklist for Women. The Reasons for Having Sex Questionnaire was administered to investigate the reasons for which women have sex. Women reported that their current sexual experiences were at times consistent with the linear and circular models (66.9%), only the linear model (27%), only the circular model (5.4%), and neither model (0.7%). When the groups were reconfigured to the group that endorsed more than 5 of 10 sexual experiences, 64.3% of women endorsed the linear model, 20.4% chose the linear and circular models, 14.6% chose the circular model, and 0.7% selected neither. The Female Sexual Function Index, demographic factors, having sex for insecurity reasons, and sexual satisfaction correlated with the endorsement of a sexual response model. When these factors were entered in a stepwise logistic regression analysis, only the Female Sexual Function Index and having sex for insecurity reasons maintained a significant association with the sexual response model. The present study emphasizes the heterogeneity of female sexuality, with most of the sample reporting alternating between the linear and circular models. Sexual dysfunctions and having sex for insecurity reasons were associated with the Basson model. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Talking About Sex When Sex Is Painful: Dyadic Sexual Communication Is Associated With Women's Pain, and Couples' Sexual and Psychological Outcomes in Provoked Vestibulodynia.

PubMed

Rancourt, Kate M; Rosen, Natalie O; Bergeron, Sophie; Nealis, Logan J

2016-11-01

Provoked vestibulodynia (PVD) is a recurrent vulvovaginal pain condition associated with psychological and sexual consequences for affected women and their partners, including lower quality of dyadic sexual communication compared to pain-free couples. Although greater sexual communication is associated with positive sexual and relational outcomes for both pain-free couples and couples experiencing painful sex, little is known about its role in women's pain and psychological outcomes, especially in a relational context. The present study examined associations between dyadic sexual communication and pain, sexual satisfaction, sexual functioning, and depressive symptoms in a sample of 107 couples in which the woman was diagnosed with PVD via a standardized gynecological assessment. Women completed a measure of pain intensity, and both members of the couple completed measures of their dyadic sexual communication, sexual satisfaction, sexual functioning, and depressive symptoms. Analyses were guided by the actor-partner interdependence model. Women and partners' own perceptions of greater dyadic sexual communication were associated with their own greater sexual satisfaction and sexual functioning, and lower depressive symptoms. Partners' perceptions of greater dyadic sexual communication were also associated with women's lower pain and greater sexual satisfaction. Results point to the importance of dyadic coping conceptualizations for both individual and interpersonal outcomes in PVD. Dyadic sexual communication may be a key treatment target for interventions aimed at improving the pain and psychological and sexual impairments of women with PVD and their partners.

Women with deep infiltrating endometriosis: sexual satisfaction, desire, orgasm, and pelvic problem interference with sex.

PubMed

Montanari, Giulia; Di Donato, Nadine; Benfenati, Arianna; Giovanardi, Giulia; Zannoni, Letizia; Vicenzi, Claudia; Solfrini, Serena; Mignemi, Giuseppe; Villa, Gioia; Mabrouk, Mohamed; Schioppa, Claudio; Venturoli, Stefano; Seracchioli, Renato

2013-06-01

Endometriosis is a chronic and progressive condition of women of reproductive age. It is strongly associated with a significant reduction of quality of life (QOL) and sexual function. This study aims to objectively evaluate sexual function in women with deep infiltrating endometriosis (DIE) and to study the impact of endometriosis symptoms and type of lesion on patient's sexual function. This is a cross-sectional study in a tertiary care university hospital. It included 182 patients with preoperative clinical and ultrasound diagnosis of DIE who were referred to our center from 2008 to 2011. A sexual activity questionnaire, the Sexual Health Outcomes in Women Questionnaire (SHOW-Q) was used to collect data pertaining to satisfaction, orgasm, desire, and pelvic problem interference with sex. Short Form 36 (SF-36) was used to evaluate QOL. Demographic and clinical characteristics were assessed: age, body mass index, parity, ethnicity, postsecondary education, employment, smoking, history of surgical treatment, and hormonal contraception. Patients were asked about pain symptoms (dysmenorrhea, dyspareunia, dyschezia, chronic pelvic pain, and dysuria) using a visual analog scale. The mean values obtained on the different scales of the SHOW-Q showed poor sexual function (mean SHOW-Q total score 56.38 ± 22.74). Satisfaction was the dimension most affected (mean satisfaction score 55.66 ± 34.55), followed by orgasm (mean orgasm score 56.90 ± 33.77). We found a significant correlation between the SF-36 scores and the SHOW-Q scores (P < 0.0001). Sexual dysfunction and deterioration of QOL seem to be correlated. Analyzing the impact of symptoms and lesions on sexual function, we found that dyspareunia and vaginal DIE nodules significantly affect sexual activity (P < 0.05). The results of this study demonstrated that women with DIE have a sexual function impairment, correlated with the overall well-being decrease. Moreover, the presence of dyspareunia and vaginal endometriotic lesions seems to be involved in sexual dysfunction. © 2013 International Society for Sexual Medicine.

The impact of primary Sjögren's syndrome on female sexual function.

PubMed

van Nimwegen, Jolien F; Arends, Suzanne; van Zuiden, Greetje S; Vissink, Arjan; Kroese, Frans G M; Bootsma, Hendrika

2015-07-01

Prevalence of vaginal dryness and dyspareunia is high in women with primary SS (pSS). Our aim was to compare sexual function and sexual distress in women with pSS with healthy controls, as well as to assess parameters that are associated with sexual dysfunction and distress in pSS. Forty-six women fulfilling the American-European Consensus Group criteria for pSS [mean age 46.3 years (s.d. 10.5)] and 43 age-matched healthy controls were included. Participants completed self-administered questionnaires, namely the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), Multidimensional Fatigue Inventory (MFI), Hospital Anxiety and Depression Scale (HADS), Maudsley Marital Questionnaire (MMQ) and RAND 36-item Health Survey (RAND-36). In addition, the European League Against Rheumatism Sjögren's Syndrome Disease Activity Index (ESSDAI) and Patient Reported Index (ESSPRI) were recorded in patients. Women with pSS had impaired sexual function compared with healthy controls (median FSFI 20.6 vs 30.3, P < 0.001), as reflected by significantly lower scores in the domains of desire, arousal, orgasm, lubrication and pain. Furthermore, pSS patients experienced more sexual distress (median FSDS 7 vs 4, P < 0.05) and were sexually active less frequently than controls (76% vs 93%, P < 0.05). Sexual dysfunction correlated significantly with patient-reported symptoms of pSS (ESSPRI), symptoms of fatigue (MFI), depressive symptoms (HADS), relationship dissatisfaction (MMQ) and lower mental quality of life (RAND-36), but not with systemic disease activity (ESSDAI). Women with pSS have impaired sexual function and more sexual distress compared with healthy controls. Sexual function and distress are influenced by vaginal dryness and patient-reported symptoms of pSS as well as psychosocial factors. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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 associated with specific measures of psychological well-being, most notably Sexual/Relationship Satisfaction. These results suggest that sexual functioning may require focused assessment by providers, beyond broad QOL assessments, and that attention to Sexual/Relationship Satisfaction may be critical in the development and implementation of interventions for this cohort of patients. © 2013 International Society for Sexual Medicine.

Development and validation of the Female Sexual Function Index adaptation for breast cancer patients (FSFI-BC).

PubMed

Bartula, Iris; Sherman, Kerry A

2015-08-01

Sexual dysfunction following breast cancer treatment is common and screening for this is recommended. This study determined the reliability, validity, and acceptability of a breast cancer-specific adaptation of the Female Sexual Function Index, the FSFI-BC. This new measure addresses limitations in the FSFI when assessing sexual dysfunction of women with breast cancer regarding applicability to non-sexually active women, measuring distress and changes after cancer. Female breast cancer survivors (n = 596; 429 sexually active, 166 non-sexually active) completed an online survey including demographic/medical information, the FSFI-BC, and scales measuring sexual functioning, fatigue, body image, physical and mental health, and relationship adjustment (Time 1). Three weeks later, 326 women (245 sexually active; 81 non-sexually active) completed the Time 2 survey including the FSFI-BC, and questions regarding its acceptability and perceived change in sexual functioning. Reliability, construct validity, and acceptability were examined using standard scale validation techniques. Exploratory factor analysis delineated seven factors: Changes after cancer, desire/arousal, lubrication, orgasm, pain, satisfaction, and distress, accounting for 79.98 % (sexually active) and 77.19 % (non-active) variance in responses. Acceptable internal consistencies (non-active: α = 0.71-0.96; sexually active: α = 0.89-0.96) and test-retest reliabilities (non-active: r = 0.63-0.86; sexually active: r = 0.71-0.88) were evident. Inter-scale correlations provided evidence for convergent and divergent validities of the FSFI-BC. Both sexually active and non-active women provided positive feedback about the FSFI-BC. The optional partner questions demonstrated clinical utility. With desirable psychometric properties and acceptability to participants, the FSFI-BC is suitable for screening for sexual dysfunction in women with breast cancer.

Latent structures of female sexual functioning.

PubMed

Carvalho, Joana; Vieira, Armando Luís; Nobre, Pedro

2012-08-01

For the last three decades, male and female sexual responses have been conceptualized as similar, based on separated and sequential phases as proposed by the models of Masters and Johnson (1966) and Kaplan (1979) model. However, there is a growing debate around the need to conceptualize female sexual response and the classification of sexual dysfunction in women, in view of the upcoming editions of the DSM and ICD. The aim of this study was to test, using structural equation modeling, five conceptual, alternative models of female sexual function, using a sample of women with sexual difficulties and a sample of women without sexual problems. A total of 1993 Portuguese women participated in the study and completed a modified version of the Female Sexual Function Index. Findings suggested a four-factor solution as the model that best fit the data regarding women presenting sexual difficulties: (1) desire/arousal; (2) lubrication; (3) orgasm; (4) pain/vaginismus. In relation to sexually healthy women, the best model was a five-factor solution comprising of (1) desire; (2) arousal; (3) lubrication; (4) orgasm; and (5) pain/vaginismus. Discriminant validity between factors was supported, suggesting that these dimensions measure distinct phenomena. Model fit to the data significantly decreased in both samples, as models began to successively consider greater levels of overlap among phases of sexual function, towards a single-factor solution. By suggesting the overlap between pain and vaginismus, results partially support the new classification that is currently being discussed regarding DSM-5. Additionally, results on the relationship between sexual desire and arousal were inconclusive as sexually healthy women were better characterized by a five-factor model that considered the structural independence among these factors, whereas women with sexual difficulties better fit with a four-factor model merging sexual desire and subjective sexual arousal.

Trade-offs between sexual advertisement and immune function in the pied flycatcher (Ficedula hypoleuca).

PubMed

Kilpimaa, Janne; Alatalo, Rauno V; Siitari, Heli

2004-02-07

Good genes models of sexual selection assume that sexual advertisement is costly and thus the level of advertisement honestly reveals heritable viability. Recently it has been suggested that an important cost of sexual advertisement might be impairment of the functioning of the immune system. In this field experiment we investigated the possible trade-offs between immune function and sexual advertisement by manipulating both mating effort and activity of immune defence in male pied flycatchers. Mating effort was increased in a non-arbitrary manner by removing females from mated males during nest building. Widowed males sustained higher haematocrit levels than control males and showed higher expression of forehead patch height, suggesting that manipulation succeeded in increasing mating effort. Males that were experimentally forced to increase mating effort had reduced humoral immune responsiveness compared with control males. In addition, experimental activation of immune defence by vaccination with novel antigens reduced the expression of male ornament dimensions. To conclude, our results indicate that causality behind the trade-off between immune function and sexual advertisement may work in both directions: sexual activity suppresses immune function but immune challenge also reduces sexual advertisement.

Trade-offs between sexual advertisement and immune function in the pied flycatcher (Ficedula hypoleuca).

PubMed Central

Kilpimaa, Janne; Alatalo, Rauno V.; Siitari, Heli

2004-01-01

Good genes models of sexual selection assume that sexual advertisement is costly and thus the level of advertisement honestly reveals heritable viability. Recently it has been suggested that an important cost of sexual advertisement might be impairment of the functioning of the immune system. In this field experiment we investigated the possible trade-offs between immune function and sexual advertisement by manipulating both mating effort and activity of immune defence in male pied flycatchers. Mating effort was increased in a non-arbitrary manner by removing females from mated males during nest building. Widowed males sustained higher haematocrit levels than control males and showed higher expression of forehead patch height, suggesting that manipulation succeeded in increasing mating effort. Males that were experimentally forced to increase mating effort had reduced humoral immune responsiveness compared with control males. In addition, experimental activation of immune defence by vaccination with novel antigens reduced the expression of male ornament dimensions. To conclude, our results indicate that causality behind the trade-off between immune function and sexual advertisement may work in both directions: sexual activity suppresses immune function but immune challenge also reduces sexual advertisement. PMID:15058434

Factors associated with sexual functioning in women following spinal cord injury.

PubMed

Harrison, J; Glass, C A; Owens, R G; Soni, B M

1995-12-01

Research into sexuality following spinal cord injury (SCI) has tended to concentrate on male experiences and the physical capabilities for sexual intercourse. The sexuality of women following SCI has only recently been addressed and studies are limited to small numbers and the use of non-standardised measures. The present investigation utilised standard measures of affective state and body satisfaction together with pre and post-injury questionnaire information of sexual dysfunction, feelings about sex and importance of sexual activity in a group of 85 women with SCI. Sexual dysfunction increased significantly post-injury, whilst feelings about sex and it's importance were unaffected. Sexual dysfunction and the importance of sex were inversely correlated. General and Head satisfaction estimates were not significantly different to control samples, whilst Body Satisfaction was increased for women with disabilities. None of the body satisfaction measures were related to the sexual functioning measure. General dissatisfaction was associated depression. Both anxiety and depression were experienced by the same individuals, and anxiety related to current sexual dysfunction. Qualitative data supported previous findings concerning the effects of social and attitudinal barriers on sexual functioning.

Affective disorders and sexual function: from neuroscience to clinic.

PubMed

Barata, Bernardo C

2017-11-01

Sexual dysfunction is a frequent issue in patients with affective disorders, affecting its quality of life and posing challenges to the approach of these patients. In recent years, human sexuality has attracted interest from the scientific community, and today we have a much deeper knowledge of the mechanisms involved in the sexual response. Paraphilias or sexual dysfunctions like low sexual desire, premature ejaculation, and erectile dysfunction, are frequent in affective disorders, and the frequency of each sexual problem varies according to the affective disorder. Comparing what is currently known about the sexual response with the main neurobiological findings of depressive, anxiety, obsessive-compulsive and posttraumatic stress disorders, it is possible to better understand specific sexual complaints of patients with these disorders. A better understanding of sexual function in affective disorders may help clinicians to choose treatments more suited to specific needs of these patients. Although the current state of science already allows us to have some understanding about sexual function in affective disorders, this critical area of research is still in its infancy, waiting for more investment.

Objective and Perceived Weight: Associations with Risky Adolescent Sexual Behavior

PubMed Central

Akers, Aletha Y.; Cohen, Elan D.; Marshal, Michael P.; Roebuck, Geoff; Yu, Lan; Hipwell, Alison E.

2016-01-01

CONTEXT Studies have shown that obesity is associated with increased sexual risk-taking, particularly among adolescent females, but the relationships between obesity, perceived weight and sexual risk behaviors are poorly understood. METHODS Integrative data analysis was performed that combined baseline data from the 1994–1995 National Longitudinal Study of Adolescent Health (from 17,606 respondents in grades 7–12) and the 1997 National Longitudinal Survey of Youth (from 7,752 respondents aged 12–16). Using six sexual behaviors measured in both data sets (age at first intercourse, various measures of contraceptive use and number of partners), cluster analysis was conducted that identified five distinct behavior clusters. Multivariate ordinal logistic regression analysis examined associations between adolescents’ weight status (categorized as underweight, normal-weight, overweight or obese) and weight perception and their cluster membership. RESULTS Among males, being underweight, rather than normal-weight, was negatively associated with membership in increasingly risky clusters (odds ratio, 0.5), as was the perception of being overweight, as opposed to about the right weight (0.8). However, being overweight was positively associated with males’ membership in increasingly risky clusters (1.3). Among females, being obese, rather than normal-weight, was negatively correlated with membership in increasingly risky clusters (0.8), while the perception of being overweight was positively correlated with such membership (1.1). CONCLUSIONS Both objective and subjective assessments of weight are associated with the clustering of risky sexual behaviors among adolescents, and these behavioral patterns differ by gender. PMID:27608419

Objective and Perceived Weight: Associations with Risky Adolescent Sexual Behavior.

PubMed

Akers, Aletha Y; Cohen, Elan D; Marshal, Michael P; Roebuck, Geoff; Yu, Lan; Hipwell, Alison E

2016-09-01

Studies have shown that obesity is associated with increased sexual risk-taking, particularly among adolescent females, but the relationships between obesity, perceived weight and sexual risk behaviors are poorly understood. Integrative data analysis was performed that combined baseline data from the 1994-1995 National Longitudinal Study of Adolescent Health (from 17,606 respondents in grades 7-12) and the 1997 National Longitudinal Survey of Youth (from 7,752 respondents aged 12-16). Using six sexual behaviors measured in both data sets (age at first intercourse, various measures of contraceptive use and number of partners), cluster analysis was conducted that identified five distinct behavior clusters. Multivariate ordinal logistic regression analysis examined associations between adolescents' weight status (categorized as underweight, normal-weight, overweight or obese) and weight perception and their cluster membership. Among males, being underweight, rather than normal-weight, was negatively associated with membership in increasingly risky clusters (odds ratio, 0.5), as was the perception of being overweight, as opposed to about the right weight (0.8). However, being overweight was positively associated with males' membership in increasingly risky clusters (1.3). Among females, being obese, rather than normal-weight, was negatively correlated with membership in increasingly risky clusters (0.8), while the perception of being overweight was positively correlated with such membership (1.1). Both objective and subjective assessments of weight are associated with the clustering of risky sexual behaviors among adolescents, and these behavioral patterns differ by gender. Copyright © 2016 by the Guttmacher Institute.

Differences in the association between childhood trauma and BMI in black and white South African women.

PubMed

Goedecke, J H; Forbes, J; Stein, D J

2013-05-01

Childhood trauma has previously been associated with adult obesity. The aim of this study was to determine if ethnicity altered the relationship between childhood trauma and obesity in South African women. Forty-four normal-weight (BMI < 25kg/m(2)) and obese (BMI > 30kg/m(2)), black and white premenopausal women completed the Childhood Trauma Questionnaire (CTQ), which retrospectively assessed emotional and physical neglect, and emotional, physical and sexual abuse in childhood. Body composition did not differ by ethnicity in the normal-weight and obese groups. However,independent of BMI group, there were significant differences in socioeconomic status (SES) between black and white women (P < 0.01). Total CTQ score, as well as the sub-scales, physical and emotional neglect, and physical and sexual abuse were higher in black than white women (all P < 0.05), but these scores did not differ between BMI groups. Apart from the sexual abuse score, the differences in physical and emotional neglect and physical abuse scores were no longer significant after adjusting for ethnic differences in age and SES. For sexual abuse, there was a significant interaction between ethnicity and BMI group(P = 0.04), with scores in normal weight women being higher in black than white women, but scores in obese women not differing by ethnicity. Ethnicity alters the association between childhood sexual abuse and BMI status. Larger studies are required to verify this finding, including measures of body image and body size satisfaction that may explain these findings.

Sexual health and function in later life: a population-based study of 606 older adults with a partner.

PubMed

Wang, Vicki; Depp, Colin A; Ceglowski, Jennifer; Thompson, Wesley K; Rock, David; Jeste, Dilip V

2015-03-01

Sexual health and function is an important yet understudied aspect of overall health and well-being in older adults. There are limited data on the relative strength of associations between various aspects of sexual health with the physical, emotional, and cognitive function in older adults. Additionally, there is little information on how these associations differ by age and sex. In this Successful Aging Evaluation (SAGE) study, 606 community-dwelling adults in San Diego County, aged 50-99 years and who had a partner, were included in the analysis. Evaluations included a phone-based cognitive screening followed by a comprehensive mail-in survey including rating scales of sexual health, depression, anxiety, and physical function. The mean age of the sample was 75.2 years. Over 80% of respondents had engaged in sexual activity in the past year, over 70% engaged in sexual activity weekly or more than once a week, and over 60% were somewhat or very satisfied with their sex lives. No sex differences were evident on dimensions of sexual health except for a higher rate of rejection of sexual overtures by women. Depressive symptoms were negatively associated with all assessed aspects of sexual health, even after adjusting for age, physical functioning, anxiety, cognitive ability, or perceived stress in both men and women. In this population-based study older men and women who had a partner reported frequent engagement in and satisfaction with sexual activity. Depressive symptoms were broadly associated with worse sexual health, more so than physical function, anxiety or stress, or age itself. Copyright © 2015. Published by Elsevier Inc.

Dyadic Aspects of Sexual Well-Being in Men with Laser-Treated Penile Carcinoma.

PubMed

Skeppner, Elisabet; Fugl-Meyer, Kerstin

2015-06-01

Coping with cancer, its treatment and recovery are dyadic processes within a relationship. Sexual dysfunctions and problems of penile cancer may add to the demands of coping. The prospective study aimed to describe the dyadic aspects of sexual well-being and life satisfaction before and 1 year after organ-sparing laser treatment of penile carcinoma. A consecutive series of 29 patients with penile carcinoma suitable for laser treatment were included together with their partners, median age 60 (37-73) years and 57 (30-72) years, respectively. Median length of relationship was 29 years (1-54 years). The participants completed structured interviews before treatment, at 6 months' and 12 months' follow-up. The interview addressed sexual activities, sexual functions, verbal (sexual) communication, and life satisfaction. Three well-validated instruments were included: Hospital Anxiety and Depression Scale, International Index of Erectile Function-5, and Life Satisfaction checklist, LiSat-11. The interviews contained the same questions for patients and partners at all three measuring points. There was a high level of within-couple agreement on sexual activities, sexual function, and life satisfaction before and after organ-sparring treatment. No significant differences between interview data at 6 and 12 months' follow-up occurred. Before treatment, sexual dysfunctions were common among men, especially decreased sexual interest and dyspareunia. At follow-up, increased sexual function was found, with the exception of erectile function and women's orgasm. A rather high proportion was being unsatisfactory sexually inactive. Few had an ongoing verbal (sexual) mutual communication. Couples with an active sexual life at follow-up showed coherence in high satisfaction with life as a whole. A high level of within-couple agreement concerning sexuality and life satisfaction points to the necessity of including an adequate sexological case history, counseling, and treatment for this group of patients and their partners.

Mediators of sexual functioning and marital quality in chronically depressed adults with and without a history of childhood sexual abuse.

PubMed

Dunlop, Boadie W; Hill, Eric; Johnson, Benjamin N; Klein, Daniel N; Gelenberg, Alan J; Rothbaum, Barbara O; Thase, Michael E; Kocsis, James H

2015-03-01

Sexual dysfunction is common among depressed adults. Childhood sexual abuse (CSA) and depressive symptomology are among the risk factors for sexual dysfunction, and these factors may interact to predict adult relationship functioning. Several models have been developed postulating interactions between these variables. We tested models of the effects of CSA and elucidate the associations between CSA, sexual dysfunction, depression severity, anxiety, and relationship quality in chronically depressed adults. Baseline data from 808 chronically depressed outpatients enrolled in the Research Evaluating the Value of Augmenting Medication with Psychotherapy study were evaluated using structural equation modeling. The Inventory of Depressive Symptomology, self-report version (IDS-SR) assessed depression severity, and the Mood and Anxiety Symptom Questionnaire Anxious Arousal subscale assessed anxiety. Sexual function was assessed with the Arizona Sexual Experiences Scale (ASEX), and the Quality of Marriage Index (QMI) assessed relationship quality for patients in stable relationships. CSA scores predicted depression severity on the IDS-SR, as well as lower relationship quality and sexual satisfaction. ASEX scores were significantly associated with depression severity but were not correlated with the QMI. Two models were evaluated to elucidate these associations, revealing that (i) depression severity and anxious arousal mediated the relationship between CSA and adult sexual function, (ii) anxious arousal and sexual functioning mediated the association between CSA and depression symptoms, and (iii) when these models were combined, anxious arousal emerged as the most important mediator of CSA on depression which, in turn, mediated associations with adult sexual satisfaction and relationship quality. Although CSA predicts lower relationship and sexual satisfaction among depressed adults, the long-term effects of CSA appear to be mediated by depressive and anxious symptoms. It is important to address depression and anxiety symptoms when treating patients with CSA who present with sexual dysfunction or marital concerns. © 2014 International Society for Sexual Medicine.

New findings and concepts about the G-spot in normal and absent vagina: precautions possibly needed for preservation of the G-spot and sexuality during surgery.

PubMed

Thabet, Saeed Mohamad Ahmad

2013-08-01

The aim of this study was to extend the clinicohistological study to involve the whole normal and absent vagina for confirming the presence of the G-spot and its relation to the surrounding organs and sexuality and to identify certain precautions for its preservation during surgery. This study was a descriptive randomized prospective study conducted at Kasr El Aini School of Medicine, Cairo University, Egypt. The G-spot was examined in 1500 women, 500 of them having vaginal and vulval surgery done for gynecological reasons. The G-spot was examined for its clinical and histological features and for determining the effect of surgery on its state and function. The G-spot was found to be present in all women. It was a localized spot in 58% and diffuse in 42% of cases. Associated ejaculation was reported in all cases of the localized type and in 24.5% of the diffuse types. Clinical examination was found to be associated with certain local response in 52.7% of the local types. The G-spot was also found to be connected to the hymen in 100%, the urethra in 52.7%, the vulva in 82.2% and the cervix in 10.8% of cases. The mean of the sex scores and sexuality were significantly decreased in surgery involving the G-spot area. Recorded figures were 93.6 ± 3.4 and 88.2 ± 3.3 before and after surgery, respectively. The corresponding figures in the cases having a general spot were 86.4 ± 4.4 and 84.5 ± 2.4, respectively. The G-spot was found in cases of absent vagina to be localized in 59%, generalized in 28.2% and absent in 12.8% of cases. The G-spot is actually present in all women. It is originally related to the lower urinary tract and it is connected to different parts of the genital tract. It may be localized or generalized. Its integrity is essential for obtaining normal physiological sexuality. Surgery may affect the integrity of the G-spot, so surgical precautions must be carried out to maintain the integrity of this spot and the patient's sexuality. © 2013 The Author. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

Prevalence and differences between type 1 and type 2 diabetes mellitus regarding female sexual dysfunction: a cross-sectional Egyptian study.

PubMed

Ahmed, Magdy R; Shaaban, Mohamed M; Sedik, Wael F; Mohamed, Tamer Y

2017-04-24

To evaluate the female sexual dysfunction in both type 1 and type 2 diabetes mellitus (DM). This cross-sectional study was carried out at Suez Canal University Hospitals from the start of February 2015 to the end of May 2016 among 189 married premenopausal women attending endocrinology and diabetology outpatient clinic for regular follow-up; 25 of whom refused to participate and 18 more were excluded due to incomplete data sets resulting in a final sample of 146 diabetic females. Ninety healthy women were recruited from the administrative staff at the hospital as a control group. Sexual dysfunction was assessed using female sexual function index (FSFI), a validated 19-item, self-administered, screening questionnaire comprising the six major sexual domains: desire, arousal, lubrication, orgasm, satisfaction and pain. Responses to each question were reported and scored on 0-5 scale with 0 representing no sexual activity and 5 suggestive of normal sexual activity. Prevalence of sexual dysfunction was significantly higher in both type 1 and 2 DM groups (44 and 25%, respectively) than in the control group (9%). FSFI mean total score was significantly lower in type 1 DM (21.1 ± 3.9) than type 2 DM (26.4 ± 4.2) and both were significantly lower than the control group (31.5 ± 5.8). With regard to FSFI domains, mean values for desire, arousal, lubrication, orgasm, satisfaction and pain were significantly lower in both type 1 and type 2 DM groups when compared with the controls. FSD is a significant health problem among premenopausal diabetic Egyptian women. Type 1 DM women were more affected than type 2 DM that in turn was more affected than healthy control females.

[Interactions between human sexual arousal and sexual desire: a challenge for social neuroscience].

PubMed

Ortigue, Stephanie; Bianchi-Demicheli, Francesco

2007-03-28

The frequent interaction and synergy between sexual arousal and sexual desire occuring during a sexual experience explains the difficulty in disentagling these two phenomena in the human sexual response. Sexual desire is defined as a goal-directed motivational state integrating the other in one's personal sphere on the basis of intentionality, rather than by instinct only. Sexual arousal includes physical manifestations and subjective perception of excitement. Interest in sexual arousal has engendered a growing body of research concerning its nature and function as well as the biological basis of the mechanisms sustaining it. Recent functional imaging has played a key role in seeking to isolate brain regions specific to sexual arousal. This field may represent a new challenge for social neuroscience.

Mindfulness-Based Sex Therapy Improves Genital-Subjective Arousal Concordance in Women With Sexual Desire/Arousal Difficulties.

PubMed

Brotto, Lori A; Chivers, Meredith L; Millman, Roanne D; Albert, Arianne

2016-11-01

There is emerging evidence for the efficacy of mindfulness-based interventions for improving women's sexual functioning. To date, this literature has been limited to self-reports of sexual response and distress. Sexual arousal concordance-the degree of agreement between self-reported sexual arousal and psychophysiological sexual response-has been of interest due to the speculation that it may be a key component to healthy sexual functioning in women. We examined the effects of mindfulness-based sex therapy on sexual arousal concordance in a sample of women with sexual desire/arousal difficulties (n = 79, M age 40.8 years) who participated in an in-laboratory assessment of sexual arousal using a vaginal photoplethysmograph before and after four sessions of group mindfulness-based sex therapy. Genital-subjective sexual arousal concordance significantly increased from pre-treatment levels, with changes in subjective sexual arousal predicting contemporaneous genital sexual arousal (but not the reverse). These findings have implications for our understanding of the mechanisms by which mindfulness-based sex therapy improves sexual functioning in women, and suggest that such treatment may lead to an integration of physical and subjective arousal processes. Moreover, our findings suggest that future research might consider the adoption of sexual arousal concordance as a relevant endpoint in treatment outcome research of women with sexual desire/arousal concerns.

Women's Sexual Health and Reproductive Function After SCI

PubMed Central

Alexander, Marcalee; McLain, Amie B. (Jackson)

2017-01-01

Sexual function and to a lesser extent reproduction are often disrupted in women with spinal cord injuries (SCI), who must be educated to better understand their sexual and reproductive health. Women with SCI are sexually active; they can use psychogenic or reflexogenic stimulation to obtain sexual pleasure and orgasm. Treatment should consider a holistic approach using autonomic standards to describe remaining sexual function and to assess both genital function and psychosocial factors. Assessment of genital function should include thoracolumbar dermatomes, vulvar sensitivity (touch, pressure, vibration), and sacral reflexes. Self-exploration should include not only clitoral stimulation, but also stimulation of the vagina (G spot), cervix, and nipples conveyed by different innervation sources. Treatments may consider PDE5 inhibitors and flibanserin on an individual basis, and secondary consequences of SCI should address concerns with spasticity, pain, incontinence, and side effects of medications. Psychosocial issues must be addressed as possible contributors to sexual dysfunctions (eg, lower self-esteem, past sexual history, depression, dating habits). Pregnancy is possible for women with SCI; younger age at the time of injury and at the time of pregnancy being significant predictors of successful pregnancy, along with marital status, motor score, mobility, and occupational scores. Pregnancy may decrease the level of functioning (eg, self-care, ambulation, upper-extremity tasks), may involve complications (eg, decubitus ulcers, weight gain, urological complications), and must be monitored for postural hypotension and autonomic dysreflexia. Taking into consideration the physical and psychosocial determinants of sexuality and childbearing allows women with SCI to achieve positive sexual and reproductive health. PMID:29339874

It Takes Two: Sexual Communication Patterns and the Sexual and Relational Adjustment of Couples Coping With Provoked Vestibulodynia.

PubMed

Rancourt, Kate M; Flynn, Michelle; Bergeron, Sophie; Rosen, Natalie O

2017-03-01

Provoked vestibulodynia (PVD) is a prevalent vulvovaginal pain condition that is associated with sexual and relational consequences for women and their partners. Greater perceived quality of sexual communication has been associated with women's lower pain during intercourse and with couples' better sexual and relational well-being. Whether couples' collaborative (eg, expressing feelings or problem solving) and negative (eg, withdrawing or criticizing) sexual communication patterns (SCPs) are differentially associated with couples' adjustment to PVD is unknown. To examine associations between collaborative and negative SCPs and women's pain and the sexual and relationship adjustment of women with PVD and their partners. Women diagnosed with PVD (N = 87) and their partners completed the Sexual Communication Patterns Questionnaire and measurements of pain (women only), sexual functioning, sexual satisfaction, sexual distress, and relationship satisfaction. (i) Numerical rating scale of pain during intercourse, (ii) Female Sexual Function Index and International Index of Erectile Function, (iii) Global Measure of Sexual Satisfaction, (iv) Female Sexual Distress Scale-Revised, and (v) Couple Satisfaction Index. When women reported greater collaborative SCP, they also reported higher sexual and relationship satisfaction. When women reported greater negative SCP, they reported less relationship satisfaction and had partners who reported greater sexual distress. When partners reported greater collaborative SCP, they also reported higher relationship satisfaction and had female partners who were less sexually distressed. When partners reported higher negative SCP, they also reported less relationship satisfaction. There were no associations between SCP and women's or partners' sexual functioning or women's pain. Collaborative SCP may benefit couples' sexual and relational well-being, whereas negative SCP may impede sexual and relational adjustment to PVD. Findings provide preliminary support for the need to assess and target collaborative and negative SCPs in psychological interventions for couples affected by PVD. Rancourt KM, Flynn M, Bergeron S, Rosen NO. It Takes Two: Sexual Communication Patterns and the Sexual and Relational Adjustment of Couples Coping With Provoked Vestibulodynia. J Sex Med 2017;14:434-443. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Incontinence and sexuality in later life.

PubMed

Garrett, Dawne; Tomlin, Karen

2015-07-01

This article explores the interrelated aspects of incontinence and sexuality in older age. It describes the physiological changes that may have an effect on sexual function and the genitourinary system as people age. The enduring importance of sexual intimacy is discussed. Treatments for incontinence and to improve sexual function are explored. The authors conclude that nurses, particularly those involved in continence management, have a role in ensuring sensitive assessment and access to treatment, which can support many older people to maintain fulfilling sexual activity.

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.

Hypnotic Relaxation Therapy and Sexual Function in PostmenopausalWomen: Results of a Randomized Clinical Trial.

PubMed

Johnson, Aimee K; Johnson, Alisa J; Barton, Debra; Elkins, Gary

2016-01-01

Sexual dysfunction is a common problem for postmenopausal women. This study, as part of a larger randomized controlled trial, examined the effect of hypnotic relaxation therapy on sexual dysfunction, a secondary study outcome, in postmenopausal women. Sexual function was assessed using the Sexual Activity Questionnaire (SAQ). Significant improvement in sexual pleasure and discomfort were reported following 5 weekly sessions of hypnotic relaxation therapy, compared with those receiving an attention control. Total SAQ scores showed significant improvement in the hypnotic relaxation therapy treatment group while holding baseline SAQ scores constant. Improvements showed a slight increase at the Week 12 follow-up. The results of this analysis provide initial support for the use of hypnotic relaxation therapy to improve sexual function in postmenopausal women.

Sexuality and the older woman.

PubMed

Tremayne, Penny; Norton, Wendy

2017-07-27

Sexual health is a key public health issue. The older woman faces a number of changes to her sexual health, wellbeing and sexuality. These changes result in many older women having to adapt to a series of complex transitions that can be challenging. This article aims to identify and explore some of these changes and how they can have a significant impact on women's quality of life. Nurses play an important role in assessing and helping women to manage normal and pathological age-related changes in order to improve the sexual health of older women and ensure they receive the advice and support needed at this stage of their life.

Comparing the effects of the second-and third-generation oral contraceptives on sexual functioning.

PubMed

Shahnazi, Mahnaz; Bayatipayan, Somaye; Khalili, Azizeh Farshbaf; Kochaksaraei, Fatemeh Ranjbar; Jafarabadi, Mohammad Asghari; Banoi, Kamala Gaza; Nahaee, Jila

2015-01-01

The aim of this study was to compare the effects of the second- and third-generation oral contraceptives on women's reproductive sexual function. This randomized, double-blind, placebo-controlled clinical trial was conducted on 82 married women of reproductive age in Tehran. Samples were randomized into the groups receiving second- and third-generation oral contraceptive pills. Female Sexual Function Index (FSFI) tool was used before the intervention and 2 and 4 months after the intervention. Data analysis was carried out using analysis of variance (ANOVA) within repeated measures and P < 0.05 were considered significant. There was a statistically significant difference in the positive and negative moods between the experimental and control groups before the intervention in the second and fourth months. The second-generation pills caused a decrease in sexual function in the second month and an increase in sexual function in the fourth month, but the third-generation pills led to an increase in sexual function in the second and fourth months. The increase in sexual function that resulted from using the third-generation pills was significantly higher than that resulted on using the second-generation pills. According to the results of this study, sexual functioning decreased in the second month of using the second-generation pills and sexual performance was significantly more on using the third-generation pills compared to second-generation pills. The most common type of oral contraceptive used in Iran is the second-generation oral contraceptive LD™ (low-dose estrogen), which is freely distributed in health centers. Therefore, it is necessary for women who wish to use these contraceptive methods to be educated and consulted before they start using them. The third-generation contraceptive pills can be recommended to women who wish to use oral contraceptives.

Satisfaction guaranteed? How individual, partner, and relationship factors impact sexual satisfaction within partnerships

PubMed Central

Margraf, Jürgen

2017-01-01

Within committed relationships, a wide range of factors may challenge or facilitate sexual satisfaction. The aim of this study was to clarify which individual, partner-, and partnership-related aspects of a sexual relationship are crucial for the prediction of sexual satisfaction. The study included data of a representative sample of 964 couples from the general population. The actor-partner interdependence model was used to estimate actor and partner effects. Overall, predictors explained 57% of outcome variance. Actor effects were found for sexual function, sexual distress, frequency of sexual activity, desire discrepancy, sexual initiative, sexual communication, sociosexual orientation, masturbation, and life satisfaction. Gender-specific partner effects were found for sexual function and sexual distress. Neither age, nor relationship duration were significant predictors. To deepen our understanding of sexual satisfaction, it is necessary to take quantitative and qualitative aspects of sexual relationships into account and to consider actor-, partner-, and relationship-related predictors. PMID:28231314

TAC3 and TACR3 mutations in familial hypogonadotropic hypogonadism reveal a key role for Neurokinin B in the central control of reproduction.

PubMed

Topaloglu, A Kemal; Reimann, Frank; Guclu, Metin; Yalin, Ayse Serap; Kotan, L Damla; Porter, Keith M; Serin, Ayse; Mungan, Neslihan O; Cook, Joshua R; Imamoglu, Sazi; Akalin, N Sema; Yuksel, Bilgin; O'Rahilly, Stephen; Semple, Robert K

2009-03-01

The timely secretion of gonadal sex steroids is essential for the initiation of puberty, the postpubertal maintenance of secondary sexual characteristics and the normal perinatal development of male external genitalia. Normal gonadal steroid production requires the actions of the pituitary-derived gonadotropins, luteinizing hormone and follicle-stimulating hormone. We report four human pedigrees with severe congenital gonadotropin deficiency and pubertal failure in which all affected individuals are homozygous for loss-of-function mutations in TAC3 (encoding Neurokinin B) or its receptor TACR3 (encoding NK3R). Neurokinin B, a member of the substance P-related tachykinin family, is known to be highly expressed in hypothalamic neurons that also express kisspeptin, a recently identified regulator of gonadotropin-releasing hormone secretion. These findings implicate Neurokinin B as a critical central regulator of human gonadal function and suggest new approaches to the pharmacological control of human reproduction and sex hormone-related diseases.

Sexuality in High-Functioning Autism: A Systematic Review and Meta-Analysis

ERIC Educational Resources Information Center

Pecora, Laura A.; Mesibov, Gary B.; Stokes, Mark A.

2016-01-01

Preliminary research examining sexuality within High-Functioning Autism (HFA) has been yet to consider the impact sex may have on the sexual/romantic functioning of this population. A systematic database search was carried out to identify 27 observational and cross-sectional publications meeting predetermined inclusion criteria. Using standardised…

Variations in Sexual Behavior.

ERIC Educational Resources Information Center

Juhasz, Anne McCreary

1983-01-01

Questions are raised about the difficulty of defining normal and atypical sexual behavior. Variations from normalcy that students, parents, and educators are most likely to encounter are discussed. The importance of dealing with variations in ways that are best for the individual and the group is emphasized. (PP)

Comparing group dehumanization and intra-sexual competition among normally ovulating women and hormonal contraceptive users.

PubMed

Piccoli, Valentina; Foroni, Francesco; Carnaghi, Andrea

2013-12-01

Two studies address the role of hormonal shift across menstrual cycle in female dehumanization of other women. In Study 1, normally ovulating women (NOW) and women who use hormonal contraceptives (HCW) are compared in terms of how much they dehumanize other women and two other control targets (men and elderly people). In NOW, the level of dehumanization of other women, but not of men and elderly people, increases as the conception risk is enhanced. HCW do not show this pattern of results. In Study 2, we investigate the level of dehumanization of other women and of intra-sexual competition. Findings concerning dehumanization replicate those of Study 1. Intra-sexual competition increases with the rise of conception risk only in NOW. In addition, dehumanization is significantly associated with intra-sexual competition in NOW but not in HCW. Together, these studies demonstrate that dehumanization of women is elicited by menstrual cycle-related processes and associated with women's mate-attraction goals.

Sexual Functioning in Clinical Couples: Discriminant Validity of the Sexual Interaction System Scale.

ERIC Educational Resources Information Center

Woody, Jane D.; And Others

1994-01-01

Examines whether a new instrument for measuring couple functioning would differentiate couples in therapy for sexual dysfunction from couples in therapy for other problems. While the other-problems group had greater sexual satisfaction than the sex dysfunction group, the groups were similar in experiencing moderate marital distress. (JPS)

Associations among Childhood Sexual Abuse, Language Use, and Adult Sexual Functioning and Satisfaction

ERIC Educational Resources Information Center

Lorenz, Tierney Ahrold; Meston, Cindy May

2012-01-01

Objectives: To better understand the link between childhood sexual abuse (CSA) and adult sexual functioning and satisfaction, we examined cognitive differences between women with (N = 128) and without (NSA, N = 99) CSA histories. Methods: We used the Linguistic Inquiry Word Count, a computerized text analysis program, to investigate language…

Randomised Trial of CPAP and Vardenafil on Erectile and Arterial Function in Men with Obstructive Sleep Apnea and Erectile Dysfunction.

PubMed

Melehan, Kerri L; Hoyos, Camilla M; Hamilton, Garun S; Wong, Keith K; Yee, Brendon J; McLachlan, Rob I; O'Meagher, Shamus; Celermajer, David; Ng, Martin K; Grunstein, Ronald R; Liu, Peter Y

2018-02-01

Erectile function is important for life satisfaction and is often impaired in men with obstructive sleep apnea (OSA). Uncontrolled studies show that treating OSA with continuous positive airway pressure (CPAP) improves erectile function. Phosphodiesterase type 5 inhibitors (e.g. vardenafil) are the first-line therapy for erectile dysfunction (ED), but may worsen OSA. To assess the effects of CPAP and vardenafil on ED. Sixty one men with moderate-to-severe OSA and ED were randomised to 12 weeks of CPAP or sham CPAP, and 10mg daily vardenafil or placebo, in a 2x2 factorial design. International Index of Erectile Function (primary endpoint), treatment and relationship satisfaction, sleep related erections, sexual function, endothelial function, arterial stiffness, quality of life, and sleep-disordered breathing. CPAP increased the frequency of sleep-related-erections, overall sexual satisfaction, and arterial stiffness but did not change erectile function or treatment satisfaction or relationship satisfaction. Vardenafil did not alter erectile function, endothelial function, arterial stiffness or sleep disordered breathing, but did improve overall self-esteem and relationship satisfaction, other aspects of sexual function and treatment satisfaction. Adherent CPAP improved erectile function, sexual desire, overall sexual, self-esteem and relationship, and treatment satisfaction, as well as sleepiness, and quality of life. Adherent vardenafil use did not consistently change nocturnal erection quality. CPAP improves overall sexual satisfaction, sleep related erections, and arterial stiffness. Low dose daily vardenafil improves certain aspects of sexual function, and did not worsen OSA. Adherent CPAP or vardenafil use further improves ED and quality of life. Copyright © 2018 Endocrine Society

Sexual function and quality of life in women with cervical cancer before radiotherapy: a pilot study.

PubMed

Grion, Regina Celia; Baccaro, Luiz Francisco; Vaz, Ana Francisca; Costa-Paiva, Lúcia; Conde, Délio Marques; Pinto-Neto, Aarão Mendes

2016-04-01

To achieve a better understanding of issues related to sexual function and quality of life (QOL) of women with cervical cancer before radiotherapy treatment. A pilot study with 80 women with cervical cancer from Jan/2013 to Mar/2014. The outcome variables were sexual function assessed using the Female Sexual Function Index (FSFI) and QOL, assessed using the World Health Organization questionnaire. Independent variables were clinical and sociodemographic data. Statistical analysis was carried out using Student's t test, Mann-Whitney test, ANOVA and multiple linear regression. The mean age was 48.1 years, 57.5 % were premenopausal and 55 % had clinical stage IIIB. Thirty percent had been sexually active in the 3 months prior to their interviews. The main adverse events during sexual intercourse were bleeding (41.7 %), lack of pleasure (33.3 %), dyspareunia (25 %), and vaginal dryness (16.7 %). The 18 women who had been sexually active in the previous month showed significant sexual dysfunction (total mean FSFI score = 25.6). Advanced clinical stage, using any chronic medication and not having undergone surgery for cancer were negatively correlated with QOL. Higher family income, a longer duration of schooling and no smoking were positive correlated with QOL. One-third of women with cervical cancer were sexually active 3 months prior to their interviews, but have concomitant significant sexual dysfunction. Factors related to the disease are primarily responsible for the deterioration of sexual function. QOL is influenced not only by factors related to the cancer itself, but also by lifestyle habits, comorbidities, and sociodemographic characteristics.

Sexual dysfunction in married women with Systemic Sclerosis

PubMed Central

Frikha, Faten; Masmoudi, Jawaher; Saidi, Noura; Bahloul, Zouhir

2014-01-01

Introduction Sexuality is an often neglected area in patients with rheumatic disease. The aim of this study is to assess sexual functioning and quality of life in a group of married women with Systemic Sclerosis (SSc). Methods This is a horizontal study for descriptive and analytical purposes. Married women with SSc were interviewed about their sexual functioning and their quality of life. Results A total of ten patients who met the criteria have accepted to participate to the study. Their mean age was 52, 4± 8,2 years. Eight women thought that the disease had affected their sexual activity. All patients reported a decrease in the frequency of intercourse since the onset of their disease. Eight of the sample reported a diminished desire for a sexual relationship. The reasons were fatigue, altered body image and pain. The assessment of sexual functioning using the Female sexual function index (FSFI) showed a mean FSFI score at 14,2±7,8 with nine women scoring in the range associated with sexual dysfunction (SD) (<26). All the subscales were affected. Our patients reported a mean total score on WHOQOL-brief (World Health Quality of Life-Brief Version) of 60 out of 120 indicating a moderate altered quality of life. Depression has been identified as determinants of impaired sexual function. Conclusion The prevalence of SD in women with SSc is high when a specific questionnaire is used to assess it. These results indicate that in daily practice, inquiring about sexuality and screening for depressive symptoms is indicated for every patient with SSc. PMID:25452828

The influence of testosterone combined with a PDE5-inhibitor on cognitive, affective, and physiological sexual functioning in women suffering from sexual dysfunction.

PubMed

van der Made, Flip; Bloemers, Jos; Yassem, Wadi E; Kleiverda, Gunilla; Everaerd, Walter; van Ham, Diana; Olivier, Berend; Koppeschaar, Hans; Tuiten, Adriaan

2009-03-01

Women with female sexual dysfunction have a reduced sensitivity to sexual stimuli. Activation of central mechanisms may open a window for phosphodiesterase type 5 inhibitors (PDE5) to be effective; as a consequence, the combination of testosterone and a PDE5 inhibitor will restore sexual function. To demonstrate that the combination of testosterone and vardenafil will increase the sensitivity for sexual stimuli and will improve the desire and arousal components of the sexual response. Methods. In a double-blind randomly assigned placebo-controlled crossover design, 28 women with desire and/or arousal disorder underwent four different drug treatments on four separate experimental days. A masked version of the emotional Stroop task with sexual and nonsexual words was used to measure sensitivity for sexual content. Neutral and erotic film fragments were used to determine genital-physiological and subjective reactions. A masked version of the emotional Stroop task, vaginal pulse amplitude. For subjective measurement, responses were collected continuously with a lever and two self-report measures were used. In two subgroups, which were differentiated on the basis of their initial preconscious attentional bias for sexual cues, a different sexual response profile was found. In an initially low-attention group, preconscious attentional bias for sexual cues increased under the testosterone condition. In these women, the combination of testosterone and vardenafil caused an improvement in genital response and subjective indices of sexual functioning. In the group that had initially a high attention for sexual cues, preconscious attentional bias for sexual cues decreased under the condition of testosterone. In these women, the combination of testosterone and vardenafil had no effect on any of the indices of their sexual functioning. In women suffering from low sexual desire-associated with low attention for sexual cues-the combination of testosterone and vardenafil may be a promising new treatment.

Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study

PubMed Central

Dongre, Swati

2015-01-01

Background. Many women experience sexual dysfunction where there are orgasm disorders and sexual difficulties. Ashwagandha (Withania somnifera) is a herb known to improve the body's physical and psychological condition. Objective. The purpose of the study was to determine the efficacy and safety of a high-concentration ashwagandha root extract (HCARE) supplementation for improving sexual function in healthy females. Methods. In this pilot study, 50 study subjects were randomized to either (i) HCARE-treated group or (ii) placebo- (starch-) treated group. The subjects consumed either HCARE or placebo capsules of 300mg twice daily for 8 weeks. Sexual function was assessed using two psychometric scales, the Female Sexual Function Index (FSFI) Questionnaire and the Female Sexual Distress Scale (FSDS), and by the number of total and successful sexual encounters. Results. The analysis indicates that treatment with HCARE leads to significantly higher improvement, relative to placebo, in the FSFI Total score (p < 0.001), FSFI domain score for “arousal” (p < 0.001), “lubrication” (p < 0.001), “orgasm” (p = 0.004), and “satisfaction” (p < 0.001), and also FSDS score (p < 0.001) and the number of successful sexual encounters (p < 0.001) at the end of the treatment. Conclusions. This study demonstrated that oral administration of HCARE may improve sexual function in healthy women. The present study is registered in the Clinical Trial Registry, Government of India, with a number CTRI/2015/07/006045. PMID:26504795

Sexual Perfectionism in Women: Not as Simple as Adaptive or Maladaptive.

PubMed

Kluck, Annette S; Zhuzha, Kseniya; Hughes, Kelly

2016-11-01

According to research and theory, the construct of perfectionism may apply to specific life domains, including being a perfect sexual partner. We extended the research on sexual perfectionism (SP) by examining the relationships between its various dimensions (i.e., self-directed, partner-directed, socially prescribed, partner-prescribed) and communication about sex, sexual functioning, and appearance self-consciousness during sex. Women (N = 208) of ages 19-50 were recruited online to respond to the Multidimensional Sexual Perfectionism Questionnaire and measures of communication about sex, sexual functioning, and physical appearance self-consciousness during sex. Dimensions of SP demonstrated a mixed pattern of relationships with measures of adaptive functioning. Partner-prescribed SP was related to greater appearance self-consciousness during sex, indicating an unfavorable role of this dimension of SP. An indirect effect of socially prescribed and partner-prescribed SP on sexual functioning through poor dyadic communication about sex and greater appearance self-consciousness was also found. Self-directed SP was less clearly problematic and uniquely related to better dyadic communication, whereas partner-directed SP was uniquely related to fewer concerns about the body appearance during sex. In conclusion, with respect to personal functioning, higher standards directed towards sexual partners may be less problematic but perceptions that romantic partners expect one to be a perfect sexual partner may have deleterious effects. Overall, SP may relate to sexual experiences of women beyond the college-age group with some aspects of SP being more problematic than others.

Sexual well being in parkinsonian patients after deep brain stimulation of the subthalamic nucleus

PubMed Central

Castelli, L; Perozzo, P; Genesia, M; Torre, E; Pesare, M; Cinquepalmi, A; Lanotte, M; Bergamasco, B; Lopiano, L

2004-01-01

Objectives: To evaluate changes in sexual well being in a group of patients with Parkinson's disease following deep brain stimulation (DBS) of the subthalamic nucleus (STN). Methods: 31 consecutive patients with Parkinson's disease (21 men and 10 women), bilaterally implanted for DBS of STN, were evaluated one month before and 9–12 months after surgery. Sexual functioning was assessed using a reduced form of the Gollombok Rust inventory of sexual satisfaction (GRISS). Depression (Beck depression inventory) and anxiety (STAI-X1/X2) were also evaluated. Relations between sexual functioning and modifications in the severity of disease (Hoehn and Yahr stage), reduction in levodopa equivalent daily dosage (LEDD), age, and duration of disease were analysed. Results: While no modifications were found in female patients, male patients reported slightly but significantly more satisfaction with their sexual life after DBS of STN. When only male patients under 60 years old were considered, a greater improvement in sexual functioning was found, though still small. Modifications in depressive symptoms and anxiety, as well as duration of the disease, reduction in LEDD, and improvement in the severity of disease, showed no relation with changes in sexual functioning after DBS of STN. Conclusions: DBS of STN appears to affect sexual functioning in a small but positive way. Male patients with Parkinson's disease, especially when under 60, appeared more satisfied with their sexual well being over a short term follow up period. PMID:15314111

When love hurts. A systematic review on the effects of surgical and pharmacological treatments for endometriosis on female sexual functioning.

PubMed

Barbara, Giussy; Facchin, Federica; Meschia, Michele; Berlanda, Nicola; Frattaruolo, Maria P; VercellinI, Paolo

2017-06-01

Endometriosis is associated with an increased risk of dyspareunia, therefore this chronic gynecologic disease should be considered as a major cause of sexual dysfunctions. The aims of this study were to review the literature on the effects of surgical and pharmacological treatments for endometriosis on female sexual functioning, and to provide suggestions for future treatment strategies. We followed the PRISMA guidelines to conduct this systematic review, which involved an electronic database search of studies on the association between endometriosis and sexuality published between 2000 and 2016. As a result of the screening process, 22 studies were included in this systematic review. The 22 studies included were divided into two categories: (a) surgical intervention studies (n = 17), examining postoperative sexual outcomes of surgery for endometriosis; (b) pharmacological intervention studies (n = 5), evaluating the effects of pharmacological endometriosis treatments on sexual functioning. The studies considered showed that overall surgical and pharmacological interventions for endometriosis can lead to medium-/long-term improvement, but not necessarily to a definitive resolution of female sexual dysfunctions due to endometriosis. Sexual functioning is a multidimensional phenomenon and the ideal treatment for endometriosis-related sexual dysfunctions should be conducted by a multidisciplinary team that involves not only gynecologists, but also sexologists and psychologists/psychotherapists. Improving global sexual functioning, and not just reducing pain at intercourse, should be considered as a major clinical goal of endometriosis treatment. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

A new non-pharmacological vacuum therapy for female sexual dysfunction.

PubMed

Billups, K L; Berman, L; Berman, J; Metz, M E; Glennon, M E; Goldstein, I

2001-01-01

Although Female Sexual Dysfunction (FSD) affects 40% of American women, there is no FDA-approved pharmaceutical therapy. The EROS-CTD (Clitoral Therapy Device, UroMetrics, Inc., St. Paul, MN) treatment is the first FDA cleared-to-market therapy for FSD. Clitoral engorgement is believed to play an important role in female sexual arousal and overall sexual satisfaction. The EROS-CTD is a small, battery-powered device designed to enhance clitoral engorgement, increase blood flow to the clitoris, and ultimately improve arousal in women with FSD. The objective of this study was to assess the effectiveness of the EROS-CTD on sexual arousal (genital sensation, vaginal lubrication, ability to reach orgasm, and sexual satisfaction) in normal volunteers and women with FSD.

Experiment of nurture: ablatio penis at 2 months, sex reassignment at 7 months, and a psychosexual follow-up in young adulthood.

PubMed

Bradley, S J; Oliver, G D; Chernick, A B; Zucker, K J

1998-07-01

Guidelines of psychosexual management for infants born with physical intersex conditions are intended to assist physicians and parents in making decisions about sex of assignment and rearing including the following: 1) sex assignment should be to the gender that carries the best prognosis for good reproductive function, good sexual function, normal-looking external genitalia and physical appearance, and a stable gender identity; 2) the decision regarding sex assignment should be made as early as possible, preferably during the newborn period, with an upper age limit for reversal of an initial sex assignment no later than 18 to 24 months; and 3) there should be minimal uncertainty and ambiguity on the part of parents and professionals regarding the final decision about sex assignment and rearing. J. Money used these guidelines in a case of a biologically normal male infant (one of a pair of monozygotic twins) whose penis was accidentally ablated during a circumcision at the age of 7 months. The decision to reassign the infant boy to the female sex and to rear him as a girl was made at 17 months, with surgical castration and initial genital reconstruction occurring at 21 months. Money reported follow-up data on this child through the age of 9 years. Although the girl was described as having many "tomboyish" behavioral traits, a female gender identity had apparently differentiated. Thus, it was concluded that gender identity is sufficiently incompletely differentiated at birth as to permit successful assignment of a genetic male as a girl, in keeping with the experiences of rearing. Subsequent follow-up by other investigators reported that by early adolescence the patient had rejected the female identity and began to live as a male at the age of 14 years. In adulthood, the patient recalled that he had never felt comfortable as a girl, and his mother reported similar recollections. At age 25, the patient married a woman and adopted her children. The patient reported exclusive sexual attraction to females. The present case report is a long-term psychosexual follow-up on a second case of ablatio penis in a 46 XY male. During an electrocautery circumcision at the age of 2 months, the patient sustained a burn of the skin of the entire penile shaft, and the penis eventually sloughed off. At age 7 months, the remainder of the penis and the testes were removed. By age 7 months, if not earlier, the decision was made to reassign the patient as a female and to raise the infant as a girl. The patient was interviewed on two occasions: at 16 years and twice while in the hospital for additional surgery at 26 years of age. At ages 16 and 26, the patient was living socially as a woman and denied any uncertainty about being a female. During childhood, the patient recalled that she self-identified as a "tomboy" and enjoyed stereotypically masculine toys and games; however, the patient also recalled that her favorite playmates were usually girls and that her best friend was always a girl. When seen at age 16, the patient had been admitted to the hospital for vaginoplasty. At that time, she wished to proceed with the further repair of her genitalia to make them suitable for sexual intercourse with males. At age 26, the patient returned to the hospital for further vaginoplasty. Regarding the patient's sexual orientation, she was attracted predominantly to women in fantasy, but had had sexual experiences with both women and men. At the time of the second surgery, she was in a relationship with a man and wished to be able to have intercourse. The patient's self-described sexual identity was "bisexual." After surgery at age 26 years, the patient developed a rectovaginal fistula. Within a few months of the surgery, the patient and her male partner separated for reasons other than the patient's physical problems. The patient subsequently began living with a new partner, a woman, in a lesbian relationship. The psychosexual development of our patient was bot the other patient was married to a woman. Our patient had a "bisexual" sexual identity; the other patient had a "heterosexual" sexual identity. The patients were similar in that they had a childhood history of "tomboyism." Our patient was predominantly sexually attracted to women; the other patient was exclusively sexually attracted to women. Our patient had sexual experiences with both women and men; the other patient had sexual experiences only with women. The most plausible explanation of our patient's differentiation of a female gender identity is that sex of rearing as a female, beginning at around age 7 months, overrode any putative influences of a normal prenatal masculine sexual biology. Because cases of ablatio penis in infancy are so rare and long-term follow-up data are scant, it is obviously impossible to know whether our patient or the previous case would be more typical of the psychosexual outcome in a larger sample of such individuals. However, our case suggests that it is possible for a female gender identity to differentiate in a biologically "normal" genetic male. At present, however, the clinical literature is deeply divided on the best way to manage cases of traumatic loss of the penis during infancy. Further study is clearly required to decide on the optimal model of psychosocial and psychosexual management for affected individuals.

Influence of sexual stimulation on sperm parameters in semen samples collected via masturbation from normozoospermic men or cryptozoospermic men participating in an assisted reproduction programme.

PubMed

Yamamoto, Y; Sofikitis, N; Mio, Y; Miyagawa, I

2000-05-01

To evaluate the influence of sexual stimulation via sexually stimulating videotaped visual images (VIM) on sperm function, two semen samples were collected from each of 19 normozoospermic men via masturbation with VIM. Two additional samples were collected from each man via masturbation without VIM. The volume of seminal plasma, total sperm count, sperm motility, percentage of morphologically normal spermatozoa, outcome of hypo-osmotic swelling test and zona-free hamster oocyte sperm penetration assay, and markers of the secretory function of prostate were significantly larger in semen samples collected via masturbation with VIM than masturbation without VIM. The improved sperm parameters in the samples collected via masturbation with VIM may reflect an enhanced prostatic secretory function and increased loading of the vas deferens at that time. In a similar protocol, two semen samples were collected via masturbation with VIM from each of 22 non-obstructed azoospermic men. Semen samples from these men had been occasionally positive in the past for a very small number of spermatozoa (cryptozoospermic men). Two additional samples were collected from each cryptozoospermic man via masturbation without VIM. The volume of seminal plasma, total sperm count, sperm motility, and a marker of the secretory function of prostate were significantly larger in semen samples collected via masturbation with VIM. Fourteen out of the 22 men were negative for spermatozoa in both samples collected via masturbation without VIM. These men demonstrated spermatozoa in both samples collected via masturbation with VIM. Six men with immotile spermatozoa in both samples collected via masturbation without VIM exposed motile spermatozoa in both samples collected via masturbation with VIM. High sexual stimulation during masturbation with VIM results in recovery of spermatozoa of greater fertilizing potential both in normozoospermic and cryptozoospermic men. The appearance of spermatozoa after masturbation with VIM in the vast majority of cryptozoospermic men is of clinical significance in programmes applying intracytoplasmic sperm injections for the management of severe male infertility and obviates the need for testicular biopsy.

Woman and partner-perceived partner responses predict pain and sexual satisfaction in provoked vestibulodynia (PVD) couples.

PubMed

Rosen, Natalie O; Bergeron, Sophie; Leclerc, Bianca; Lambert, Bernard; Steben, Marc

2010-11-01

Provoked vestibulodynia (PVD) is a highly prevalent vulvovaginal pain condition that results in significant sexual dysfunction, psychological distress, and reduced quality of life. Although some intra-individual psychological factors have been associated with PVD, studies to date have neglected the interpersonal context of this condition. We examined whether partner responses to women's pain experience-from the perspective of both the woman and her partner-are associated with pain intensity, sexual function, and sexual satisfaction. One hundred ninety-one couples (M age for women=33.28, standard deviation [SD]=12.07, M age for men=35.79, SD=12.44) in which the woman suffered from PVD completed the spouse response scale of the Multidimensional Pain Inventory, assessing perceptions of partners' responses to the pain. Women with PVD also completed measures of pain, sexual function, sexual satisfaction, depression, and dyadic adjustment. Dependent measures were women's responses to: (i) a horizontal analog scale assessing the intensity of their pain during intercourse; (ii) the Female Sexual Function Index; and (iii) the Global Measure of Sexual Satisfaction Scale. Controlling for depression, higher solicitous partner responses were associated with higher levels of women's vulvovaginal pain intensity. This association was significant for partner-perceived responses (β=0.29, P<0.001) and for woman-perceived partner responses (β=0.16, P=0.04). After controlling for sexual function and dyadic adjustment, woman-perceived greater solicitous partner responses (β=0.16, P=0.02) predicted greater sexual satisfaction. Partner-perceived responses did not predict women's sexual satisfaction. Partner responses were not associated with women's sexual function. Findings support the integration of dyadic processes in the conceptualization and treatment of PVD by suggesting that partner responses to pain affect pain intensity and sexual satisfaction in affected women. © 2010 International Society for Sexual Medicine.

Who reports sexual function problems? Empirical evidence from Britain's 2000 National Survey of Sexual Attitudes and Lifestyles

PubMed Central

Mercer, C; Fenton, K; Johnson, A; Copas, A; Macdowall, W; Erens, B; Wellings, K

2005-01-01

Objective: To identify sociodemographic, sexual, and health behavioural and attitudinal factors associated with reporting sexual function problems. Methods: A probability sample survey of 11 161 men and women aged 16–44 years resident in Britain in 2000. Data collected by a combination of computer assisted face to face and self interviewing. Outcomes were self report of a range of sexual function problems, considered as "any problems" (1+ lasting 1+ months in the past year) and "persistent problems" (1+ lasting 6+ months in the past year), and associations with sociodemographic, behavioural, and attitudinal variables. Results: Both "any" and "persistent" sexual function problems were more commonly reported by women than men. A variety of sociodemographic factors were associated with both measures but differed by gender. For example, the adjusted odds ratio (AOR) for reporting any problems for married v single respondents was 0.70 (95% confidence interval (CI) 0.57 to 0.87) v 1.31 (95% CI 1.10 to 1.56) for men and women, respectively. Sexual behaviours significantly associated with reporting sexual function problems included competence at first sex, paying for sex in the past 5 years, number of occasions of sex and masturbation, both in the past 4 weeks. For men (only), reporting STI diagnosis(es) was significantly associated with reporting "any" problems (AOR 2.1, 95% CI 1.4 to 3.2) and "persistent" problems (AOR 2.1, 95% CI 1.1 to 3.9). Both measures were significantly more likely among men and women who reported communication difficulties with their partners, with AORs in excess of 1.9. Conclusions: Sexual fulfilment is an important part of sexual health. Understanding factors associated with reporting sexual problems, and recognising that such factors maybe partnership specific, is an important step towards improving our understanding of sexual function and thus improving the provision of care and support available. PMID:16199738

Androgen receptor gene CAG repeat polymorphism independently influences recovery of male sexual function after testosterone replacement therapy in postsurgical hypogonadotropic hypogonadism.

PubMed

Tirabassi, Giacomo; Delli Muti, Nicola; Corona, Giovanni; Maggi, Mario; Balercia, Giancarlo

2014-05-01

Few and contradictory studies have evaluated the possible influence of androgen receptor (AR) gene CAG repeat polymorphism on male sexual function. In this study we evaluated the role of AR gene CAG repeat polymorphism in the recovery of sexual function after testosterone replacement therapy (TRT) in men affected by postsurgical hypogonadotropic hypogonadism, a condition which is often associated with hypopituitarism and in which the sexual benefits of TRT must be distinguished from those of pituitary-function replacement therapies. Fifteen men affected by postsurgical hypogonadotropic hypogonadism were retrospectively assessed before and after TRT. Main outcome measures included sexual parameters as assessed by the International Index of Erectile Function questionnaire, levels of pituitary dependent hormones (total testosterone, free T3, free T4, cortisol, insulin-like growth factor-1 [IGF-1], prolactin), and results of genetic analysis (AR gene CAG repeat number). Plasma concentrations of free T3, free T4, cortisol, and prolactin did not vary significantly between the two phases, while testosterone and IGF-1 increased significantly after TRT. A significant improvement in all sexual parameters studied was found. The number of CAG triplets was negatively and significantly correlated with changes in all the sexual parameters, while opposite correlations were found between changes in sexual parameters and changes in testosterone levels; no correlation of change in IGF1 with change in sexual parameters was reported. On multiple linear regression analysis, after correction for changes in testosterone, nearly all the associations between the number of CAG triplets and changes in sexual parameters were confirmed. Shorter length AR gene CAG repeat number is associated with the recovery of sexual function after TRT in postsurgical male hypogonadotropic hypogonadism, independently of the effects of concomitant pituitary-replacement therapies. © 2014 International Society for Sexual Medicine.

Iatrogenic sexual dysfunction and the protective withholding of information: in whose best interest?

PubMed

Higgins, A; Barker, P; Begley, C M

2006-08-01

In recent years a growing body of evidence has highlighted the impact of neuroleptics and antidepressants on sexual function. Research from a service user's perspective suggested that service users are dissatisfied with the information that they received on drugs, and would like more education, in particular, on the side effects of medication that impact on sexual function. This paper reports some of the findings of a grounded theory study that explored how psychiatric nurses responded to issues of sexuality in practice. Emphasis within the paper is given to how nursing staff addressed the side effects of drugs that impact on sexual function. Findings suggested that nurse addressed the issue of prescribed medication and sexual function in practice, using a 'Veiling Sexualities Cycle', which had three subcategories: 'Hanging the Veil', 'Lifting the Veil' and 'Re-veiling'. In the light of contemporary mental health policy, findings from the study are discussed and recommendations for practice and education made.

Medical Male Circumcision Is Associated With Improvements in Pain During Intercourse and Sexual Satisfaction in Kenya.

PubMed

Nordstrom, Monica P C; Westercamp, Nelli; Jaoko, Walter; Okeyo, Timothy; Bailey, Robert C

2017-04-01

Two cohort studies using data from randomized controlled trials in Africa offer the best evidence to date on the effects of voluntary medical male circumcision (VMMC) on male sexual function and satisfaction, suggesting no significant impairments in sexual function or satisfaction and some improvements in sexual function after male circumcision. To assess the effects of VMMC on sexual function and satisfaction in a large population-based cohort of men circumcised as adults and uncircumcised controls in Kenya. Sexual function and satisfaction of young (median age = 20 years) sexually active men (1,509 newly circumcised men and 1,524 age-matched uncircumcised controls after 5% loss to follow-up) were assessed at baseline and 6, 12, 18, and 24 months, with data collected in 2008 to 2012. Self-reported data on lack of sexual interest or pleasure, difficulty getting or maintaining erections, orgasm difficulties, premature ejaculation, pain during intercourse, and satisfaction with sexual intercourse were analyzed with mixed-effect models to detect differences between circumcised and uncircumcised men and changes over time. Changes over time in sexual interest, desire and pleasure, erectile and ejaculatory function, and pain during intercourse (dyspareunia) in circumcised and uncircumcised men; group differences in time trends; satisfaction with sexual performance; and enjoyment of sex before and after circumcision. Sexual dysfunctions decreased in the two study groups from 17% to 54% at baseline to 11% to 44% at 24 months (P < .001), except dyspareunia, which decreased only in circumcised men (P < .001). Sexual satisfaction outcomes increased in the two study groups from 34% to 82% at baseline to 66% to 93% at 24 months (P < .001), with greater improvements in circumcised men (P < .001). On average, 97% of circumcised men were satisfied with sexual intercourse and 92% rated sex as more enjoyable or no different after circumcision compared with before circumcision. Results are applicable to VMMC programs seeking to increase the acceptability of male circumcision as part of comprehensive HIV prevention. Large-scale population-based longitudinal data restricted to sexually active individuals and adjusted for differences in baseline levels of outcomes and potential confounders are used. The questionnaire used, although not a standardized survey instrument, includes all major domains of male sexual function and satisfaction used in the most common standardized tools. Results are consistent with large cohort studies of VMMC using data from randomized controlled trials and indicate that VMMC has no significant detrimental effect or might have beneficial effects on male sexual function and satisfaction for the great majority of men circumcised as adults. Nordstrom MPC, Westercamp N, Jaoko W, et al. Medical Male Circumcision Is Associated With Improvements in Pain During Intercourse and Sexual Satisfaction in Kenya. J Sex Med 2017;14:601-612. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Reexamining issues of conceptualization and willing consent: the hidden role of coercion in experiences of sexual acquiescence.

PubMed

Conroy, Nicole E; Krishnakumar, Ambika; Leone, Janel M

2015-07-01

This study problematizes the literature's conceptualization of sexual compliance, predominantly defined as willing participation in, and consent to, unwanted sexual activity in the absence of immediate partner pressure. Using a feminist theoretical framework, we argue that covert forms of social coercion, including normalized expectations for heterosexual women to participate in sexual activity and maintain relationship satisfaction, ultimately pressure women into participating in unwanted sexual activity. In other words, immediate partner pressure is not necessary for a sexually coercive experience to occur. Results of the current study indicate that relationship control and media influence significantly predict sexual acquiescence, and women acquiesce to unwanted sexual activity in an effort to maintain relationships and partner satisfaction as well as to avoid negative outcomes. Women cite various forms of social coercion, such as fulfilling sexual scripts and relationship obligations, as primary reasons for participating in unwanted sexual activity without resisting their partners. © The Author(s) 2014.

Turner's syndrome and other forms of congenital hypogonadism impair quality of life and sexual function.

PubMed

Ros, Cristina; Alobid, Isam; Balasch, Juan; Mullol, Joaquim; Castelo-Branco, Camil

2013-06-01

We sought to assess the burden of Turner's syndrome (TS) and other congenital hypogonadisms (OCH) on quality of life (QOL) and sexual function. An observational study was undertaken in a gynecological endocrinology unit of a teaching hospital. Three cohorts of women aged 20-50 years were compared: 26 TS patients, 21 women with OCH and wild-type karyotype, and 41 healthy age-matched women who were included as controls. All subjects filled out the Medical Outcome Study Short Form (SF-36) and the Female Sexual Function Index. TS subjects had significantly worse QOL scores in physical functioning (P = .026) and role physical functioning (P = .032) whereas OCH showed significantly worse scores in physical functioning (P = .027) and bodily pain (P = .025) compared to controls. In all, 80% of OCH and 50% of TS patients declared sexual activity. Sexually active TS patients had poorer arousal outcomes (P = .009) and OCH women showed significantly worse scores in arousal (P = .002), orgasm (P = .007), pain (P = .001), and Female Sexual Function Index total score (P = .004) compared with healthy controls. No differences between sexually active and inactive TS women were found in SF-36 scores, clinical characteristics, or anthropomorphic characteristics. TS and OCH subjects presented impaired physical domains in QOL. Women with TS are less likely to be involved in sexual activity, arousal dysfunctions being their main symptom. Conversely, arousal, orgasm, pain, and total score were significantly affected in OCH subjects. Copyright © 2013 Mosby, Inc. All rights reserved.

Sexuality: Desire, activity and intimacy in the elderly

PubMed Central

Kalra, Gurvinder; Subramanyam, Alka; Pinto, Charles

2011-01-01

Background: Sexual function and activity in old age have been inadequately studied world over. It is important to know that aging processes are not confined to persons beyond the age of 60 years; many changes in elderly have their antecedents in the middle age. Aims: This study sought to determine the patterns of sexual activity and function in individuals over 50 years of age. It also sought to discuss barriers such as chronic illness that may interfere with sexual function. Materials and Methods: We conducted a study of subjects above the age of 50 years in various outpatient departments (OPDs) of a teaching municipal hospital in Mumbai, by interviewing 60 individuals who attended the OPDs, after taking their informed consent. Socio-demographic and other information on their sexual function and activities were obtained. Data was analyzed using statistical package for social sciences v15. Results: 72% individuals below 60 were sexually active, while only 57% above 60 were active. Others had become completely abstinent at some time in their lives. Statistical analysis revealed significant gender, health and educational status based differences in the sample. Conclusion: Our study showed significant presence of sexual desire, activity and function even after the age of 50 years; a decline by the age of 60 and above was a finding that reflected more in women. Chronic illness did affect sexual function and desire. PMID:22303037

Psychological evaluation of treated females with virilizing congenital adrenal hyperplasia.

PubMed

Hurtig, A L; Radhakrishnan, J; Reyes, H M; Rosenthal, I M

1983-12-01

The psychological development of females with congenital adrenal hyperplasia (CAH) has been previously studied by Money, et al, who found that psychological development of sex identity was consistent with sex assignment despite virilizing adrenal hormones and abnormal external genitalia requiring surgical correction. In this study, using a variety of psychological tests, we assessed the sex-dimorphic behavior, body image, cognitive functioning, and sex-role identity of nine patients ranging in age from 13 to 21, all treated with glucocorticoids and surgical correction. Four of the nine showed moderate virilization despite treatment. Psychological measures included the Wechsler Intelligence Scale for Children-Revised (WISC-R), the Bem Sex-Role Inventory, the Draw-A-Person (DAP) and an interview with patient and family. Results indicate that patients fall within the normal expectable range for this developmental period in visual-spatial and verbal cognitive functioning, in sex-role identity, and in social interpersonal early behaviors. In two areas of functioning these patients demonstrated some variance from the norms, specifically in sexual identity and early activity levels. This suggests that sexual identity and physical activity are most prone to hormonal and psychological impact but that cognition and sex-role identity are not affected. Future studies of this sample will look at personality dimensions such as ego functioning, defense and affect to consider the impact of body image concerns and conflicts.

Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

PubMed Central

Mitchell, Kirstin R; Mercer, Catherine H; Ploubidis, George B; Jones, Kyle G; Datta, Jessica; Field, Nigel; Copas, Andrew J; Tanton, Clare; Erens, Bob; Sonnenberg, Pam; Clifton, Soazig; Macdowall, Wendy; Phelps, Andrew; Johnson, Anne M; Wellings, Kaye

2013-01-01

Summary Background Despite its importance to sexual health and wellbeing, sexual function is given little attention in sexual health policy. Population-based studies are needed to understand sexual function across the life course. Methods We undertook a probability sample survey (the third National Survey of Sexual Attitudes and Lifestyles [Natsal-3]) of 15 162 individuals aged 16–74 years who lived in Britain (England, Scotland, and Wales). Interviews were done between Sept 6, 2010, and Aug 31, 2012. We assessed the distribution of sexual function by use of a novel validated measure (the Natsal-SF), which assessed problems with individual sexual response, sexual function in a relationship context, and self-appraisal of sex life (17 items; 16 items per gender). We assess factors associated with low sexual function (defined as the lowest quintile of distribution of Natsal-SF scores) and the distribution of components of the measure. Participants reporting one or more sexual partner in the past year were given a score on the Natsal-SF (11 690 participants). 4122 of these participants were not in a relationship for all of the past year and we employed the full information maximum likelihood method to handle missing data on four relationship items. Findings We obtained data for 4913 men and 6777 women for the Natsal-SF. For men and women, low sexual function was associated with increased age, and, after age-adjustment, with depression (adjusted odds ratio 3·70 [95% CI 2·90–4·72] for men and 4·11 [3·36–5·04] for women) and self-reported poor health status (2·63 [1·73–3·98] and 2·41 [1·72–3·39]). Low sexual function was also associated with experiencing the end of a relationship (1·52 [1·18–1·95] and 1·77 [1·44–2·17]), inability to talk easily about sex with a partner (2·36 [1·94–2·88] and 2·82 [2·28–3·48]), and not being happy in the relationship (2·89 [2·32–3·61] and 4·10 [3·39–4·97]). Associations were also noted with engaging in fewer than four sex acts in the past 4 weeks (3·13 [2·58–3·79] and 3·38 [2·80–4·09]), having had same sex partners (2·28 [1·56–3·35] and 1·60 [1·16–2·20]), paying for sex (in men only; 2·62 [1·46–4·71]), and higher numbers of lifetime sexual partners (in women only; 2·12 [1·68–2·67] for ten or more partners). Low sexual function was also associated with negative sexual health outcomes such as experience of non-volitional sex (1·98 [1·14–3·43] and 2·18 [1·79–2·66]) and STI diagnosis (1·50 [1·06–2·11] and 1·83 [1·35–2·47]). Among individuals reporting sex in the past year, problems with sexual response were common (41·6% of men and 51·2% of women reported one or more problem) but self-reported distress about sex lives was much less common (9·9% and 10·9%). For individuals in a sexual relationship for the past year, 23·4% of men and 27·4% of women reported an imbalance in level of interest in sex between partners, and 18·0% of men and 17·1% of women said that their partner had had sexual difficulties. Most participants who did not have sex in the past year were not dissatisfied, distressed, or avoiding sex because of sexual difficulties. Interpretation Wide variability exists in the distribution of sexual function scores. Low sexual function is associated with negative sexual health outcomes, supporting calls for a greater emphasis on sexual function in sexual health policy and interventions. Funding Grants from the UK Medical Research Council and the Wellcome Trust, with support from the Economic and Social Research Council and the Department of Health. PMID:24286787