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.

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.

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.

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.

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.

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

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.

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.

Psychological Correlates of Sexual Dysfunction in Female Rectal and Anal Cancer Survivors: Analysis of Baseline Intervention Data

PubMed Central

Philip, Errol J.; Nelson, Christian; Temple, Larissa; Carter, Jeanne; Schover, Leslie; Jennings, Sabrina; Jandorf, Lina; Starr, Tatiana; Baser, Ray; DuHamel, Katherine

2013-01-01

Introduction 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. Aim 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. Main Outcomes Measures Quality of life (EORTC-QLQ-C30 & QLQ-CR38), sexual functioning (FSFI) and psychological well-being (BSI Depression/Anxiety, IES-R, CR-38 Body Image). Methods There were 70 female post-treatment 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. Results Women enrolled in the study intervention were on average 55 years old, predominantly Caucasian (79%), married (57%) and a median of 4 years post-primary 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=−.45 to −.70, all p<.01). Body image, anxiety and cancer-specific post-traumatic distress were notable in their association with subscales of sexual functioning, while a global quality of life measure was largely unrelated. Conclusions 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 quality of life assessments, and that attention to Sexual/Relationship Satisfaction may be critical in the development and implementation of interventions for this cohort of patients. PMID:23551928

Assessment of sexual difficulties associated with multi-modal treatment for cervical or endometrial cancer: A systematic review of measurement instruments.

PubMed

White, Isabella D; Sangha, Amrit; Lucas, Grace; Wiseman, Theresa

2016-12-01

Practitioners and researchers require an outcome measure that accurately identifies the range of common treatment-induced changes in sexual function and well-being experienced by women after cervical or endometrial cancer. This systematic review critically appraised the measurement properties and clinical utility of instruments validated for the measurement of female sexual dysfunction (FSD) in this clinical population. A bibliographic database search for questionnaire development or validation papers was completed and methodological quality and measurement properties of selected studies rated using the Consensus-based Standards for the selection of health Measurement Instrument (COSMIN) checklist. 738 articles were screened, 13 articles retrieved for full text assessment and 7 studies excluded, resulting in evaluation of 6 papers; 2 QoL and 4 female sexual morbidity measures. Five of the six instruments omitted one or more dimension of female sexual function and only one instrument explicitly measured distress associated with sexual changes as per DSM V (APA 2013) diagnostic criteria. None of the papers reported measurement error, responsiveness data was available for only two instruments, three papers failed to report on criterion validity, and test-retest reliability reporting was inconsistent. Heterosexual penile-vaginal intercourse remains the dominant sexual activity focus for sexual morbidity PROMS terminology and instruments lack explicit reference to solo or non-coital sexual expression or validation in a non-heterosexual sample. Four out of six instruments included mediating treatment or illness items such as vaginal changes, menopause or altered body image. Findings suggest that the Female Sexual Function Index (FSFI) remains the most robust sexual morbidity outcome measure, for research or clinical use, in sexually active women treated for cervical or endometrial cancer. Development of an instrument that measures sexual dysfunction in women who are infrequently/not sexually active due to treatment consequences is still required to identify women in need of sexual rehabilitation. Copyright © 2016 Elsevier Inc. All rights reserved.

Measuring sexual function in community surveys: development of a conceptual framework.

PubMed

Mitchell, Kirstin R; Wellings, Kaye

2013-01-01

Among the many psychometric measures of sexual (dys)function, none is entirely suited to use in community surveys. Faced with the need to include a brief and non-intrusive measure of sexual function in a general population survey, a new measure was developed. Findings from qualitative research with men and women in the community designed to inform the conceptual framework for this measure are presented. Thirty-two semi-structured interviews with individuals recruited from a general practice, an HIV/AIDS charity, and a sexual problems clinic were conducted. From their accounts, 31 potential criteria of a functional sex life were identified. Using evidence from qualitative data and the existing literature, and applying a set of decision rules, the list was reduced to 13 (eight for those not in a relationship), and a further eight criteria were added to enable individuals to self-rate their level of function and indicate the severity of difficulties. These criteria constitute a conceptual framework that is grounded in participant perceptions; is relevant to all, regardless of sexual experience or orientation; provides opportunity to state the degree of associated distress; and incorporates relational, psychological, and physiological aspects. It provides the conceptual basis for a concise and acceptable measure of sexual function.

Association of Sex Hormones With Sexual Function, Vitality, and Physical Function of Symptomatic Older Men With Low Testosterone Levels at Baseline in the Testosterone Trials

PubMed Central

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

2015-01-01

Context: The prevalence of sexual dysfunction, low vitality, and poor physical function increases with aging, as does the prevalence of low total and free testosterone (TT and FT) levels. However, the relationship between sex hormones and age-related alterations in older men is not clear. Objective: To test the hypotheses that baseline serum TT, FT, estradiol (E2), and sex hormone-binding globulin (SHBG) levels are independently associated with sexual function, vitality, and physical function in older symptomatic men with low testosterone levels participating in the Testosterone Trials (TTrials). Design: Cross-sectional study of baseline measures in the TTrials. Setting: The study was conducted at 12 sites in the United States. Participants: The 788 TTrials participants were ≥ 65 years and had evidence of sexual dysfunction, diminished vitality, and/or mobility disability, and an average of two TT < 275 ng/dL. Interventions: None. Main Outcome Measures: Question 4 of Psychosocial Daily Questionnaire (PDQ-Q4), the FACIT-Fatigue Scale, and the 6-minute walk test. Results: Baseline serum TT and FT, but not E2 or SHBG levels had small, but statistically significant associations with validated measures of sexual desire, erectile function, and sexual activity. None of these hormones was significantly associated within or across trials with FACIT-Fatigue, PHQ-9 Depression or Physical Function-10 scores, or gait speed. Conclusions: FT and TT levels were consistently, independently, and positively associated, albeit to a small degree, with measures of sexual desire, erectile function, and sexual activity, but not with measures of vitality or physical function in symptomatic older men with low T who qualified for the TTrials. PMID:25548978

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.

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.

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.

Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function.

PubMed

Alexander, Angel M; Flynn, Kathryn E; Hahn, Elizabeth A; Jeffery, Diana D; Keefe, Francis J; Reeve, Bryce B; Schultz, Wesley; Reese, Jennifer Barsky; Shelby, Rebecca A; Weinfurt, Kevin P

2014-08-01

There is a significant gap in research regarding the readability and comprehension of existing sexual function measures. Patient-reported outcome measures may use terms not well understood by respondents with low literacy. This study aims to test comprehension of words and phrases typically used in sexual function measures to improve validity for all individuals, including those with low literacy. We recruited 20 men and 28 women for cognitive interviews on version 2.0 of the Patient-Reported Outcome Measurement Information System(®) (PROMIS(®) ) Sexual Function and Satisfaction measures. We assessed participants' reading level using the word reading subtest of the Wide Range Achievement Test. Sixteen participants were classified as having low literacy. In the first round of cognitive interviews, each survey item was reviewed by five or more people, at least two of whom had lower than a ninth-grade reading level (low literacy). Patient feedback was incorporated into a revised version of the items. In the second round of interviews, an additional three or more people (at least one with low literacy) reviewed each revised item. Participants with low literacy had difficulty comprehending terms such as aroused, orgasm, erection, ejaculation, incontinence, and vaginal penetration. Women across a range of literacy levels had difficulty with clinical terms like labia and clitoris. We modified unclear terms to include parenthetical descriptors or slang equivalents, which generally improved comprehension. Common words and phrases used across measures of self-reported sexual function are not universally understood. Researchers should appreciate these misunderstandings as a potential source of error in studies using self-reported measures of sexual function. This study also provides evidence for the importance of including individuals with low literacy in cognitive pretesting during the measure development. © 2014 International Society for Sexual Medicine.

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

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…

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

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.

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.

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.

Association of sex hormones with sexual function, vitality, and physical function of symptomatic older men with low testosterone levels at baseline in the testosterone trials.

PubMed

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

2015-03-01

The prevalence of sexual dysfunction, low vitality, and poor physical function increases with aging, as does the prevalence of low total and free testosterone (TT and FT) levels. However, the relationship between sex hormones and age-related alterations in older men is not clear. To test the hypotheses that baseline serum TT, FT, estradiol (E2), and sex hormone-binding globulin (SHBG) levels are independently associated with sexual function, vitality, and physical function in older symptomatic men with low testosterone levels participating in the Testosterone Trials (TTrials). Cross-sectional study of baseline measures in the TTrials. The study was conducted at 12 sites in the United States. The 788 TTrials participants were ≥ 65 years and had evidence of sexual dysfunction, diminished vitality, and/or mobility disability, and an average of two TT < 275 ng/dL. None. Question 4 of Psychosocial Daily Questionnaire (PDQ-Q4), the FACIT-Fatigue Scale, and the 6-minute walk test. Baseline serum TT and FT, but not E2 or SHBG levels had small, but statistically significant associations with validated measures of sexual desire, erectile function, and sexual activity. None of these hormones was significantly associated within or across trials with FACIT-Fatigue, PHQ-9 Depression or Physical Function-10 scores, or gait speed. FT and TT levels were consistently, independently, and positively associated, albeit to a small degree, with measures of sexual desire, erectile function, and sexual activity, but not with measures of vitality or physical function in symptomatic older men with low T who qualified for the TTrials.

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.

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.

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

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.

Improving Patients’ Understanding of Terms and Phrases Commonly Used in Self-Reported Measures of Sexual Function

PubMed Central

Alexander, Angel M.; Flynn, Kathryn E.; Hahn, Elizabeth A.; Jeffery, Diana D.; Keefe, Francis J.; Reeve, Bryce B.; Schultz, Wesley; Reese, Jennifer Barsky; Shelby, Rebecca A.; Weinfurt, Kevin P.

2014-01-01

Introduction There is a significant gap in research regarding the readability and comprehension of existing sexual function measures. Patient-reported outcome measures may use terms not well understood by respondents with low literacy. Aim To test comprehension of words and phrases typically used in sexual function measures to improve validity for all individuals, including those with low literacy. Methods We recruited 20 men and 28 women for cognitive interviews on version 2.0 of the PROMIS Sexual Function and Satisfaction measures. We assessed participants’ reading level using the word reading subtest of the Wide Range Achievement Test (WRAT). Sixteen participants were classified as having low literacy. Main Outcome Measures In the first round of cognitive interviews, each survey item was reviewed by 5 or more people, at least 2 of whom had lower than a ninth-grade reading level (low literacy). Patient feedback was incorporated into a revised version of the items. In the second round of interviews, an additional 3 or more people (at least 1 with low literacy) reviewed each revised item. Results Participants with low literacy had difficulty comprehending terms such as aroused, orgasm, erection, ejaculation, incontinence, and vaginal penetration. Women across a range of literacy levels had difficulty with clinical terms like labia and clitoris. We modified unclear terms to include parenthetical descriptors or slang equivalents, which generally improved comprehension. Conclusions Common words and phrases used across measures of self-reported sexual function are not universally understood. Researchers should appreciate these misunderstandings as a potential source of error in studies using self-reported measures of sexual function. PMID:24902984

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.

Factor Analysis of the Modified Sexual Adjustment Questionnaire-Male

PubMed Central

Wilmoth, Margaret C.; Hanlon, Alexandra L.; Ng, Lit Soo; Bruner, Debra W.

2015-01-01

Background and Purpose The Sexual Adjustment Questionnaire (SAQ) is used in National Cancer Institute–sponsored clinical trials as an outcome measure for sexual functioning. The tool was revised to meet the needs for a clinically useful, theory-based outcome measure for use in both research and clinical settings. This report describes the modifications and validity testing of the modified Sexual Adjustment Questionnaire-Male (mSAQ-Male). Methods This secondary analysis of data from a large Radiation Therapy Oncology Group trial employed principal axis factor analytic techniques in estimating validity of the revised tool. The sample size was 686; most subjects were White, older than the age 60 years, and with a high school education and a Karnofsky performance scale (KPS) score of greater than 90. Results A 16-item, 3-factor solution resulted from the factor analysis. The mSAQ-Male was also found to be sensitive to changes in physical sexual functioning as measured by the KPS. Conclusion The mSAQ-Male is a valid self-report measure of sexuality that can be used clinically to detect changes in male sexual functioning. PMID:25255676

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.

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

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.

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.

Differences in Perceived and Physiologic Genital Arousal Between Women With and Without Sexual Dysfunction.

PubMed

Handy, Ariel B; Stanton, Amelia M; Pulverman, Carey S; Meston, Cindy M

2018-01-01

Many sexual psychophysiologic studies have failed to find differences in physiologic genital arousal between women with and those without sexual dysfunction. However, differences in self-reported (ie, perceived) measures of genital responses between these 2 groups of women have been noted. To determine whether women with and without sexual dysfunction differ on measures of physiologic and perceived genital arousal based on type of analytic technique used, to explore differences in perceived genital arousal, and to assess the relation between physiologic and perceived genital arousal. Data from 5 studies (N = 214) were used in this analysis. Women were categorized into 3 groups: women with arousal-specific sexual dysfunction (n = 40), women with decreased sexual function (n = 72), and women who were sexually functional (n = 102). Women viewed an erotic film while their physiologic genital arousal was measured using a vaginal photoplethysmograph. After watching the film, women completed a self-report measure of perceived genital arousal. There were differences in vaginal pulse amplitude (VPA) levels and association of VPA with perceived genital sensations based on level of sexual function. Commonly used methods of analysis failed to identify significant differences in VPA among these groups of women. When VPA data were analyzed with hierarchical linear modeling, significant differences emerged. Notably, women with arousal-specific dysfunction exhibited lower VPA than sexually functional women at the beginning of the assessment. As the erotic film progressed, women with arousal-specific dysfunction became aroused at a faster rate than sexually functional women, and these 2 groups ultimately reached a similar level of VPA. Sexually functional women reported the highest levels of perceived genital responses among the 3 groups of women. No significant relation between VPA and perceived genital arousal emerged. Women's perception of their genital responses could play a role in women's experience of sexual dysfunction and might be more clinically relevant for women with sexual dysfunction than genital blood flow. This study's large sample is unique in sexual psychophysiology, and it strengthens the credibility of the findings. However, this study is limited in that arousal-specific dysfunction was determined with self-report measures, not by a clinician-administered assessment. These findings suggest distinct response trajectories in women with and without sexual dysfunction, and although perceived genital responses are important for women who are experiencing problems with arousal, they do not seem to be related to objective measures of physiologic arousal. Handy AB, Stanton AM, Pulverman CS, Meston CM. Differences in Perceived and Physiologic Genital Arousal Between Women With and Without Sexual Dysfunction. J Sex Med 2018;15:52-63. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

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.

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)

Testofen, a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease, increases testosterone levels and improves sexual function in healthy aging males in a double-blind randomised clinical study.

PubMed

Rao, Amanda; Steels, Elizabeth; Inder, Warrick J; Abraham, Suzanne; Vitetta, Luis

2016-06-01

This study examined the effect of Testofen, a specialised Trigonella foenum-graecum seed extract on the symptoms of possible androgen deficiency, sexual function and serum androgen concentrations in healthy aging males. This was a double-blind, randomised, placebo-controlled trial involving 120 healthy men aged between 43 and 70 years of age. The active treatment was standardised Trigonella foenum-graecum seed extract at a dose of 600 mg/day for 12 weeks. The primary outcome measure was the change in the Aging Male Symptom questionnaire (AMS), a measure of possible androgen deficiency symptoms; secondary outcome measures were sexual function and serum testosterone. There was a significant decrease in AMS score over time and between the active and placebo groups. Sexual function improved, including number of morning erections and frequency of sexual activity. Both total serum testosterone and free testosterone increased compared to placebo after 12 weeks of active treatment. Trigonella foenum-graecum seed extract is a safe and effective treatment for reducing symptoms of possible androgen deficiency, improves sexual function and increases serum testosterone in healthy middle-aged and older men.

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.

Assessment of the psychometric properties of the Short-Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) following surgical placement of Prolift+M: a transvaginal partially absorbable mesh system for the treatment of pelvic organ prolapse.

PubMed

Roy, Sanjoy; Mohandas, Anita; Coyne, Karin; Gelhorn, Heather; Gauld, Judi; Sikirica, Vanja; Milani, Alfredo L

2012-04-01

Impairment of sexual function is a significant problem among women suffering from pelvic organ prolapse (POP). Because anatomical measures of POP do not always correspond with patients' subjective reports of their condition, patient-reported outcome measures may provide additional valuable information regarding the experiences of women who have undergone surgery. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) is a validated, widely used condition-specific questionnaire focused on sexual function among patients with POP or urinary incontinence. This study aims to report sexual function outcomes as measured by PISQ-12 and to evaluate the psychometric characteristics of the questionnaire following surgical mesh implant for the treatment of POP. The PISQ-12 was used to measure sexual function, while a set of other measures, namely, Pelvic Organ Prolapse Quantification, Patient Global Impression of Change, Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire, and Surgical Satisfaction Questionnaire, was used for validation. Data for the study were collected from a prospective multicenter, single-arm study of surgical POP repair via the transvaginal placement of a partially absorbable mesh system. For baseline, month 3, and month 12 following POP surgery, several psychometric properties of the PISQ-12 were evaluated, including internal consistency (Cronbach's alpha), concurrent validity, discriminant validity, and responsiveness. As measured by the PISQ-12 questionnaire, statistically significant improvements were observed in the composite summary score as well as all three subscale scores at 1 year. The PISQ-12 generally demonstrated good psychometric properties including internal consistency reliability, validity, and responsiveness. The PISQ-12 items had good distributional properties at baseline, with substantial ceiling effects at follow-up visits reflecting improvements experienced by the patients. The PISQ-12 is a valid measure of sexual function in studies involving patients with POP. © 2012 International Society for Sexual Medicine.

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.

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.

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.

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.

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.

Correlates of sexuality in men and women aged 52-90 years attending a university medical health service in Colombia.

PubMed

Arias-Castillo, Liliana; Ceballos-Osorio, Janeth; Ochoa, Jhon Jair; Reyes-Ortiz, Carlos A

2009-11-01

Limited information is available regarding sexuality among Colombian adults aged 50 years and older. To assess demographic or health characteristics associated with sexuality measures among middle- and older-aged men and women. Cross-sectional face-to-face interviews were conducted with retired persons from a university ambulatory medical care setting. Data on sexuality were obtained along with data on their demographic, emotional intimacy, practice of religion, medical conditions, and functional health measures. There were 136 participants. Appropriateness of sex, sexual desire, importance of sex, masturbation, and sexual intercourse. Fifty-seven percent of the participants were over 65 years of age, 52% were female, and 66% reported being married; 67% indicated sex is appropriate, 58% reported having sexual desire, 45% considered sex very important in their lives, 54% reported one or more instances of sexual intercourse, and 16% reported masturbating within the last year. In multivariate analyses, importance of sex and sexual intercourse decreased by age. Women had decreased odds ratios (0.20 to 0.33) for sexuality measures compared with men with the exception of appropriateness of sex. Married persons had increased odds ratios (3.06 to 9.45) for importance of sex, appropriateness of sex, and sexual intercourse compared with those of the same age who reported being unmarried. Other factors associated with some particular sexuality measures were emotional intimacy, religious practice, medical conditions, and functional health measures. There were significant mediation effects for appropriateness of sex on the relationship between sexual desire and sexual intercourse, and for importance of sex on the relationship between appropriateness of sex and sexual intercourse. Men and married persons had higher rates of most sexuality measures compared with women or their unmarried counterparts. These differences were greater at older ages (> or =65) for all sexuality measures except sexual intercourse.

A quantitative approach to measure women's sexual function using electromyography: a preliminary study of the Kegel exercise.

PubMed

Mohktar, Mas Sahidayana; Ibrahim, Fatimah; Mohd Rozi, Nur Farahana; Mohd Yusof, Juhaida; Ahmad, Siti Anom; Su Yen, Khong; Omar, Siti Zawiah

2013-12-13

Currently, the reference standard used to clinically assess sexual function among women is a qualitative questionnaire. Hence, a generalised and quantitative measurement tool needs to be available as an alternative. This study investigated whether an electromyography (EMG) measurement technique could be used to help quantify women's sexual function. A preliminary intervention study was conducted on 12 female subjects, who were randomised into a control (n=6) and an intervention (n=6) group. Intervention involved a set regimen of pelvic floor muscle exercises (Kegel) and the control group did not have any treatment. All subjects were asked to answer a validated, self-rated Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ). EMG measurements of the pelvic floor muscles (PFM) and the abdominal muscles were taken from all women at recruitment and 8 weeks after study commencement. After 8 weeks, most of the subjects in the control group did not display any noted positive difference in either PISQ score (4/6) or in their muscle strength (4/6). However, a noted progressive difference were observed in subjects who were placed in the Kegel group; PISQ score (5/6) and muscles strength (4/6). The noted difference in the Kegel group subjects was that if progress is observed in the sexual function, improvement is also observed in the strength of at least 2 types of muscles (either abdominal or PFM muscles). Thus, EMG measurement is a potential technique to quantify the changes in female sexual function. Further work will be conducted to validate this assumption.

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

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.

Acceptance of vulvovaginal pain in women with provoked vestibulodynia and their partners: associations with pain, psychological, and sexual adjustment.

PubMed

Boerner, Katelynn E; Rosen, Natalie O

2015-06-01

Provoked vestibulodynia (PVD) is a common vulvovaginal pain condition associated with negative psychological and sexual consequences for affected women and their sexual partners. Greater pain acceptance has been found to be associated with better functional and psychological outcomes in individuals with chronic pain, and acceptance-based strategies are being increasingly incorporated into treatment protocols. The present study is a novel investigation of pain acceptance in PVD couples. The aim was to examine the associations between acceptance of vulvovaginal pain and women's pain during intercourse, as well as the psychological and sexual adjustment of both women with PVD and their partners. Sixty-one couples (M(age) for women = 27.95 years, SD = 5.87; M(age) for men = 30.48 years, SD = 6.70) in which the woman was diagnosed with PVD completed the Chronic Pain Acceptance Questionnaire, in reference to women's vulvovaginal pain. Women also rated their pain during intercourse, and couples completed measures of anxiety, depression, sexual function, and sexual satisfaction. Dependent measures were (i) women's self-reported pain during intercourse on a numerical rating scale; (ii) State-Trait Anxiety Inventory trait subscale; (iii) Beck Depression Inventory-II; (iv) Derogatis Interview for Sexual Functioning; and (v) Global Measure of Sexual Satisfaction Scale. Women's greater pain acceptance was associated with their lower self-reported pain during intercourse, controlling for partner's pain acceptance. Greater pain acceptance among women was associated with their own lower anxiety and depression, greater sexual functioning, as well as their own and their partner's greater sexual satisfaction, controlling for the partner's pain acceptance. Additionally, greater pain acceptance among male partners was associated with their own lower depression. Findings suggest that psychological interventions for PVD should target increasing couples' vulvovaginal pain acceptance in order to improve women's pain and the sexual and psychological functioning of both members of the couple. © 2015 International Society for Sexual Medicine.

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.

Brain activation patterns in women with acquired hypoactive sexual desire disorder and women with normal sexual function: a cross-sectional pilot study

PubMed Central

Woodard, Terri L.; Nowak, Nicole T.; Balon, Richard; Tancer, Manuel; Diamond, Michael P.

2013-01-01

Objective To examine and compare brain activation patterns of premenopausal women with normal sexual function and those with hypoactive sexual desire disorder (HSDD) during viewing of validated sexually explicit film clips. Design Cross-sectional pilot study. Setting University-based clinical research center. Patient(s) Premenopausal women. Intervention(s) None. Main Outcome Measure(s) Areas of brain activation during viewing of sexually explicit film clips. Result(s) Women with normal sexual function showed significantly greater activation of the right thalamus, left insula, left precentral gyrus, and left parahippocampal gyrus in comparison with women with HSDD, who exhibited greater activation of the right medial frontal gyrus and left precuneus regions. Conclusion(s) Women with HSDD may have alterations in activation of limbic and cortical structures responsible for acquiring, encoding, and retrieving memory, the processing and memory of emotional reactions, and areas responsible for heightened attention to one’s own physical state. PMID:23830149

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

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.

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.

Treatment of antidepressant-associated sexual dysfunction with sildenafil: a randomized controlled trial.

PubMed

Nurnberg, H George; Hensley, Paula L; Gelenberg, Alan J; Fava, Maurizio; Lauriello, John; Paine, Susan

2003-01-01

Sexual dysfunction is a common adverse effect of antidepressants that frequently results in treatment noncompliance. To assess the efficacy of sildenafil citrate in men with sexual dysfunction associated with the use of selective and nonselective serotonin reuptake inhibitor (SRI) antidepressants. Prospective, parallel-group, randomized, double-blind, placebo-controlled trial conducted between November 1, 2000, and January 1, 2001, at 3 US university medical centers among 90 male outpatients (mean [SD] age, 45 [8] years) with major depression in remission and sexual dysfunction associated with SRI antidepressant treatment. Patients were randomly assigned to take sildenafil (n = 45) or placebo (n = 45) at a flexible dose starting at 50 mg and adjustable to 100 mg before sexual activity for 6 weeks. The primary outcome measure was score on the Clinical Global Impression-Sexual Function (CGI-SF); secondary measures were scores on the International Index of Erectile Function, Arizona Sexual Experience Scale, Massachusetts General Hospital-Sexual Functioning Questionnaire, and Hamilton Rating Scale for Depression (HAM-D). Among the 90 randomized patients, 93% (83/89) of patients treated per protocol took at least 1 dose of study drug and 85% (76/89) completed week 6 end-point assessments with last observation carried forward analyses. At a CGI-SF score of 2 or lower, 54.5% (24/44) of sildenafil compared with 4.4% (2/45) of placebo patients were much or very much improved (P<.001). Erectile function, arousal, ejaculation, orgasm, and overall satisfaction domain measures improved significantly in sildenafil compared with placebo patients. Mean depression scores remained consistent with remission (HAM-D score < or =10) in both groups for the study duration. In our study, sildenafil effectively improved erectile function and other aspects of sexual function in men with sexual dysfunction associated with the use of SRI antidepressants. These improvements may allow patients to maintain adherence with effective antidepressant treatment.

Sensory Dysfunction and Sexuality in the U.S. Population of Older Adults.

PubMed

Zhong, Selena; Pinto, Jayant M; Wroblewski, Kristen E; McClintock, Martha K

2018-04-01

The sexual experience is shaped by sensory function; with aging, sensory dysfunction may interfere with sexuality and sexual behavior between partners. Specifically, older adults with age-related sensory dysfunction may have less sexual activity than those with better sensory function. In addition, since sexual desire and attraction rests in part upon sensory function, sensory dysfunction may also be associated with less sexual motivation. To test the association between sexual activity and motivation in older adults and their sensory dysfunction. Sensory dysfunction was measured both by global sensory impairment (a validated measure of dysfunction shared among the 5 classic senses: olfaction, vision, taste, touch, hearing) and by total sensory burden (cumulative sensory loss). Sexual activity was quantified by frequency and type of sexual behavior. Sexual motivation was measured by the frequency of sexual ideation and the importance of sex to the respondent. We used cross-sectional data from a nationally representative sample of community-dwelling older adults (aged 57-85 years) in the United States (National Social Life, Health, and Aging Project, N = 3,005) in logistic regression analyses. Sexual activity, sexual motivation, and satisfaction with the sexual relationship were self-reported. Older adults with sensory dysfunction were less likely to be sexually active-an association that persisted when accounting for other factors that also affected sexual activity (age, gender, partnered status, mental and physical health, and relationship satisfaction). Nonetheless, sensory dysfunction did not impair sexual motivation, nor affect the physical and emotional satisfaction with the sexual relationship. Among currently sexually active older adults, sensory dysfunction did not affect the frequency of sex or the type of sexual activity (foreplay, vaginal intercourse, or oral sex). These results were the same for 2 different measures of sensory dysfunction. This is the first nationally representative study of sexuality and multisensory dysfunction in community-dwelling older adults. 4 of the 5 classic senses were measured with objective tests, and hearing was rated by interviewers in the context of their conversation. Medical and health care interventions that can reduce the burden of sensory dysfunction may improve older adults' sexual experience. Sensory dysfunction is associated with sexual inactivity, but not with sexual motivation. Among those who are sexually active, sensory dysfunction did not interfere with sexual expression. Improving the sexual experience of older adults requires a focus on sensory dysfunction as an impediment to sexual activity given that older adults remain sexually motivated. Zhong S, Pinto JM, Wroblewski KE, et al. Sensory Dysfunction and Sexuality in the U.S. Population of Older Adults. J Sex Med 2018;15:502-509. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

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.

Effect of sildenafil on subjective and physiologic parameters of the female sexual response in women with sexual arousal disorder.

PubMed

Berman, J R; Berman, L A; Lin, H; Flaherty, E; Lahey, N; Goldstein, I; Cantey-Kiser, J

2001-01-01

Sexual dysfunction is a complaint of 30-50% of American women. Aside from hormone replacement therapy, there are no current FDA-approved medical treatments for female sexual complaints. The goal of this pilot study was to determine safety and efficacy of sildenafil for use in women with sexual arousal disorder (SAD). Evaluations were completed on 48 women with complaints of SAD. Physiologic measurements, including genital blood flow, vaginal lubrication, intravaginal pressure-volume changes, and genital sensation were recorded pre- and postsexual stimulation at baseline and following 100 mg sildenafil. Subjective sexual function was assessed using a validated sexual function inventory at baseline and following 6 weeks of home use of sildenafil. At termination of the study patients also completed an intervention efficacy index (FIEI). Following sildenafil, poststimulation physiologic measurements improved significantly compared to baseline. Baseline subjective sexual function complaints, including low arousal, low desire, low sexual satisfaction, difficulty achieving orgasm, decreased vaginal lubrication, and dyspareunia also improved significantly following 6 weeks home use of sildenafil. Sildenafil appears to significantly improve both subjective and physiologic parameters of the female sexual response. Double-blind, placebo-controlled studies are currently in progress to further determine efficacy of this medication for treatment of female sexual dysfunction complaints in different populations of women.

Development and Initial Validation of the PROMIS(®) Sexual Function and Satisfaction Measures Version 2.0.

PubMed

Weinfurt, Kevin P; Lin, Li; Bruner, Deborah Watkins; Cyranowski, Jill M; Dombeck, Carrie B; Hahn, Elizabeth A; Jeffery, Diana D; Luecht, Richard M; Magasi, Susan; Porter, Laura S; Reese, Jennifer Barsky; Reeve, Bryce B; Shelby, Rebecca A; Smith, Ashley Wilder; Willse, John T; Flynn, Kathryn E

2015-09-01

The Patient-Reported Outcomes Measurement Information System (PROMIS)(®) Sexual Function and Satisfaction measure (SexFS) version 1.0 was developed with cancer populations. There is a need to expand the SexFS and provide evidence of its validity in diverse populations. The aim of this study was to describe the development of the SexFS v2.0 and present preliminary evidence for its validity. Development built on version 1.0, plus additional review of extant items, discussions with 15 clinical experts, 11 patient focus groups (including individuals with diabetes, heart disease, anxiety, depression, and/or are lesbian, gay, bisexual, or aged 65 or older), 48 cognitive interviews, and psychometric evaluation in a random sample of U.S. adults plus an oversample for specific sexual problems (2281 men, 1686 women). We examined differential item functioning (DIF) by gender and sexual activity. We examined convergent and known-groups validity. The final set of domains includes 11 scored scales (interest in sexual activity, lubrication, vaginal discomfort, clitoral discomfort, labial discomfort, erectile function, orgasm ability, orgasm pleasure, oral dryness, oral discomfort, satisfaction), and six nonscored item pools (screeners, sexual activities, anal discomfort, therapeutic aids, factors interfering with sexual satisfaction, bother). Domains from version 1.0 were reevaluated and improved. Domains considered applicable across gender and sexual activity status, namely interest, orgasm, and satisfaction, were found to have significant DIF. We identified subsets of items in each domain that provided consistent measurement across these important respondent groups. Convergent and known-groups validity was supported. The SexFS version 2.0 has several improvements and enhancements over version 1.0 and other extant measures, including expanded evidence for validity, scores centered around norms for sexually active U.S. adults, new domains, and a final set of items applicable for both men and women and those sexually active with a partner and without. The SexFS is customizable, allowing users to select relevant domains and items for their study. © 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.

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.

Gonadotrophin-releasing hormone agonist treatment for sexual offenders: A systematic review.

PubMed

Lewis, Alexandra; Grubin, Don; Ross, Callum C; Das, Mrigendra

2017-10-01

Sexual offending is a significant international issue causing long-term consequences for victims, perpetrators and society. The purpose of this study was to review the existing research data assessing the efficacy of gonadotrophin-releasing hormone agonists for treating adult, male, sexual offenders. The method of this review involved the examination of studies involving participants prescribed at least one month of a gonadotrophin-releasing hormone agonist for the purposes of reducing sexual drive related to offending. The primary outcome measures were recidivism rates and sexual functioning. Secondary outcome measures included assessment of side effects and effects on interpersonal/psychiatric functioning. Studies in the English language that were dated 1969-2015 were included. Twelve eligible studies (323 participants) were identified. A reduction in a variety of measures of sexual functioning and/or risk was found in all studies. Robust recidivism data was limited. Medication was rarely described as ineffectual. All studies reported side effects. Reduction in bone density and potential long-term reduction in fertility in some subjects were issues of concern. Whilst identified studies showed promising results with respect to sexual functioning, challenges in performing randomised control trials in this subject group meant that included studies were methodologically limited. This review recommends that future research must be performed before the effectiveness and tolerability of gonadotrophin-releasing hormone agonists in this population can be confirmed.

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.

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

Cognitive representations of sexual self differ as a function of gender and sexual debut.

PubMed

Lindgren, Kristen P; Schacht, Rebecca L; Mullins, Peter M; Blayney, Jessica A

2011-02-01

This research evaluated the association between gender and sexual debut (initial sexual intercourse) and indirect measures of sexuality. A sample of 440 U.S. college students (pre-sexual debut: 144 women, 153 men; post-sexual debut: 49 women, 94 men) completed the Sexual Self-Schema Scale (SSSS), which assessed cognitive representations about sexual aspects of oneself, and three Implicit Association Tests (IAT), which measured the strength of the associations between the concepts of self + sex, women + sex, and men + sex. Results replicated previous findings that (1) men more strongly associated self + sex and women + sex than did women, and (2) men and women had similarly strong associations of men + sex. Post-sexual debut women's self + sexual and women + sexual associations were stronger than pre-sexual debut women's. Men's associations did not differ significantly as a function of sexual debut. Post-sexual debut women's SSSS scores were more direct, more romantic, and less conservative than pre-sexual debut women's. Post-sexual debut men's SSSS scores were more aggressive and more open-minded than pre-sexual debut men's. Sexual debut appeared to be associated with sexualized and sexually liberal cognitive representations in women and, to a lesser extent, sexually liberal and aggressive cognitive representations in men. Findings were consistent with theories of cognitive consistency and provide preliminary evidence that sexual debut status was associated with differing cognitive representations.

Approach and Avoidance Sexual Goals in Couples with Provoked Vestibulodynia: Associations with Sexual, Relational, and Psychological Well-Being.

PubMed

Rosen, Natalie O; Muise, Amy; Bergeron, Sophie; Impett, Emily A; Boudreau, Gillian K

2015-08-01

Provoked vestibulodynia (PVD) is a prevalent vulvovaginal pain condition that is triggered primarily during sexual intercourse. PVD adversely impacts women's and their partners' sexual relationship and psychological well-being. Over 80% of women with PVD continue to have intercourse, possibly because of sexual goals that include wanting to pursue desirable outcomes (i.e., approach goals; such as a desire to maintain intimacy) and avoid negative outcomes (i.e., avoidance goals; such as avoiding a partner's disappointment). The aim of this study was to investigate associations between approach and avoidance sexual goals and women's pain, as well as the sexual, relational, and psychological well-being of affected couples. Women with PVD (N = 107) and their partners completed measures of sexual goals, sexual satisfaction, relationship satisfaction, and depression. Women also completed measures of pain during intercourse and sexual functioning. (1) Global Measure of Sexual Satisfaction Scale, (2) Dyadic Adjustment Scale-Revised or the Couple Satisfaction Index, (3) Beck Depression Inventory-II, (4) numerical rating scale of pain during intercourse, and (5) Female Sexual Function Index. When women reported higher avoidance sexual goals, they reported lower sexual and relationship satisfaction, and higher levels of depressive symptoms. In addition, when partners of women reported higher avoidance sexual goals, they reported lower relationship satisfaction. When women reported higher approach sexual goals, they also reported higher sexual and relationship satisfaction. Targeting approach and avoidance sexual goals could enhance the quality and efficacy of psychological couple interventions for women with PVD and their partners. © 2015 International Society for Sexual Medicine.

Do romantic partners' responses to entry dyspareunia affect women's experience of pain? The roles of catastrophizing and self-efficacy.

PubMed

Lemieux, Ashley J; Bergeron, Sophie; Steben, Marc; Lambert, Bernard

2013-09-01

Entry dyspareunia is a sexual health concern which affects about 21% of women in the general population. Characterized by pain provoked during vaginal penetration, introital dyspareunia has been shown by controlled studies to have a negative impact on the psychological well-being, sexual function, sexual satisfaction, and quality of life of afflicted women. Many cognitive and affective variables may influence the experience of pain and associated psychosexual problems. However, the role of the partner's cognitive responses has been studied very little. The aim of the present study was to examine the associations between partners' catastrophizing and their perceptions of women's self-efficacy at managing pain on one side and women's pain intensity, sexual function, and sexual satisfaction on the other. One hundred seventy-nine heterosexual couples (mean age for women = 31, SD = 10.0; mean age for men = 33, SD = 10.6) in which the woman suffered from entry dyspareunia participated in the study. Both partners completed quantitative measures. Women completed the Pain Catastrophizing Scale and the Painful Intercourse Self-Efficacy Scale. Men completed the significant-other versions of these measures. Dependent measures were women's responses to (i) the Pain Numeric Visual Analog Scale; (ii) the Female Sexual Function Index; and (iii) the Global Measure of Sexual Satisfaction scale. Controlled for women's pain catastrophizing and self-efficacy, results indicate that higher levels of partner-perceived self-efficacy and lower levels of partner catastrophizing are associated with decreased pain intensity in women with entry dyspareunia, although only partner catastrophizing contributed unique variance. Partner-perceived self-efficacy and catastrophizing were not significantly associated with sexual function or satisfaction in women. The findings suggest that partners' cognitive responses may influence the experience of entry dyspareunia for women, pointing toward the importance of considering the partner when treating this sexual health problem. © 2013 International Society for Sexual Medicine.

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.

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

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 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.

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.

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.

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.

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.

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.

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

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.

Validation of the Female Sexual Function Index (FSFI) in Women with Female Orgasmic Disorder and in Women with Hypoactive Sexual Desire Disorder

PubMed Central

Meston, Cindy M.

2010-01-01

The Female Sexual Functioning Index (FSFI; Rosen et al., 2000) is a self-report measure of sexual functioning that has been validated on a clinically diagnosed sample of women with female sexual arousal disorder. The present investigation extended the validation of the FSFI to include women with a primary clinical diagnosis of female orgasmic disorder (FOD; n = 71) or hypoactive sexual desire disorder (HSDD; n = 44). Internal consistency and divergent validity of the FSFI were within the acceptable range for these populations of women. Significant differences between women with FOD and controls and between women with HSDD and controls were noted for each of the FSFI domain and total scores. PMID:12519665

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

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

A brief mindfulness-based cognitive behavioral intervention improves sexual functioning versus wait-list control in women treated for gynecologic cancer

PubMed Central

Brotto, Lori A.; Erskine, Yvonne; Carey, Mark; Ehlen, Tom; Finlayson, Sarah; Heywood, Mark; Kwon, Janice; McAlpine, Jessica; Stuart, Gavin; Thomson, Sydney; Miller, Dianne

2012-01-01

Goal The goal of this study was to evaluate a mindfulness-based cognitive behavioral intervention for sexual dysfunction in gynecologic cancer survivors compared to a wait-list control group. Methods Thirty-one survivors of endometrial or cervical cancer (mean age 54.0, range 31–64) who self-reported significant and distressing sexual desire and/or sexual arousal concerns were assigned either to three, 90-minute mindfulness-based cognitive behavior therapy sessions or two months of wait-list control prior to entering the treatment arm. Validated measures of sexual response, sexual distress, and mood, as well as laboratory-evoked physiological and subjective sexual arousal were assessed at pre-, one month post-, and 6-months following treatment. Results There were no significant effects of the wait-list condition on any measure. Treatment led to significant improvements in all domains of sexual response, and a trend towards significance for reducing sexual distress. Perception of genital arousal during an erotic film was also significantly increased following the intervention despite no change in physiologically-measured sexual arousal. Conclusions A brief mindfulness-based intervention was effective for improving sexual functioning. Geographic restrictions permitted only a select sample of survivors to participate, thus, the generalizability of the findings is limited. Future studies should aim to develop online modalities for treatment administration to overcome this limitation. PMID:22293042

A brief mindfulness-based cognitive behavioral intervention improves sexual functioning versus wait-list control in women treated for gynecologic cancer.

PubMed

Brotto, Lori A; Erskine, Yvonne; Carey, Mark; Ehlen, Tom; Finlayson, Sarah; Heywood, Mark; Kwon, Janice; McAlpine, Jessica; Stuart, Gavin; Thomson, Sydney; Miller, Dianne

2012-05-01

The goal of this study was to evaluate a mindfulness-based cognitive behavioral intervention for sexual dysfunction in gynecologic cancer survivors compared to a wait-list control group. Thirty-one survivors of endometrial or cervical cancer (mean age 54.0, range 31-64) who self-reported significant and distressing sexual desire and/or sexual arousal concerns were assigned either to three, 90-minute mindfulness-based cognitive behavior therapy sessions or two months of wait-list control prior to entering the treatment arm. Validated measures of sexual response, sexual distress, and mood, as well as laboratory-evoked physiological and subjective sexual arousal were assessed at pre-, one month post-, and 6-months following treatment. There were no significant effects of the wait-list condition on any measure. Treatment led to significant improvements in all domains of sexual response, and a trend towards significance for reducing sexual distress. Perception of genital arousal during an erotic film was also significantly increased following the intervention despite no change in physiologically-measured sexual arousal. A brief mindfulness-based intervention was effective for improving sexual functioning. Geographic restrictions permitted only a select sample of survivors to participate, thus, the generalizability of the findings is limited. Future studies should aim to develop online modalities for treatment administration to overcome this limitation. Copyright © 2012 Elsevier B.V. All rights reserved.

Sexual Interaction in Nonclinical Couples.

ERIC Educational Resources Information Center

Woody, Jane D.; D'Souza, Henry J.

1997-01-01

Reports on the sexual functioning and interaction of 58 nonclinical heterosexual couples as measured by the Sexual Interaction System Scale (SISS). On all five SISS factors, the nonclinical sample scored significantly better than persons in therapy for sexual dysfunction; they also reported satisfactory relationship adjustment and high levels of…

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.

Interactions of Sexual Activity, Gender, and Depression with Immunity

PubMed Central

Lorenz, Tierney; van Anders, Sari

2015-01-01

Introduction Depression can suppress immune function, leading to lower resistance against infection and longer healing times in depressed individuals. Sexuality may also influence immune function, with evidence that sexual activity is associated with lowered immune function in women and mixed results in men. Immune mediators like immunoglobulin A (IgA) are immediately relevant to sexual health, since they are the first line of defense against pathogens at mucous membranes like the vagina. Aim This study aims to determine if and how depression, sexual activity, and their interaction impact salivary IgA (SIgA) in men and women. Methods In Study 1, a community-based sample of 84 women and 88 men provided saliva samples and completed questionnaires on their demographic background, level of depression, and frequency of partnered and solitary sexual activity. Study 2, conducted separately in an undergraduate student sample of 54 women and 52 men, had similar methods. Main Outcome Measures The main outcome measures were scores on the General Well-Being Schedule depression subscale, reported frequency of sexual activity, and SIgA levels as measured by enzyme immunoassay. Results Across studies, higher levels of partnered sexual activity were associated with lower SIgA for women with high depression scores, but not for women with low depression scores. In contrast, higher levels of partnered sexual activity were associated with higher SIgA for men with high depression scores, but not for men with low depression scores. Conclusion Our results show that partnered sexual activity is a risk factor for lowered immunity in women with depressive symptoms but a possible resilience factor for men with depressive symptoms. This suggests a role for sexual activity in determining the impact of depression on physical health parameters. PMID:23448297

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.

Assessing the Relationship Between Sexual Concordance, Sexual Attractions, and Sexual Identity in Women.

PubMed

Suschinsky, Kelly D; Dawson, Samantha J; Chivers, Meredith L

2017-01-01

On average, there is a gender difference in sexual concordance, with men exhibiting greater agreement between genital and self-reported sexual arousal, relative to women. Much less is known about the substantial variation in women's sexual concordance; women's genital and self-reported sexual responses may correlate strongly and positively, not at all, or even strongly negatively. The within-gender variation in sexual concordance suggests that individual differences may be related to sexual concordance. We examined whether sexual concordance varies as a function of sexual orientation (based on self-reported sexual attractions and sexual identity labels) in a sample (N = 76) that included exclusively androphilic, predominantly androphilic, ambiphilic, and predominantly/exclusively gynephilic women. Participants viewed sexual and nonsexual stimuli that varied by actor gender while their vaginal vasocongestion and subjective sexual responses were measured. Women's sexual concordance varied as a function of their sexual attractions; women with any degree of gynephilia exhibited higher sexual concordance than exclusively androphilic women across a variety of sexual concordance measures, and these effects were demonstrated using correlation and multi-level modeling analyses. Only sexual concordance based on overall feelings of arousal varied by sexual identity, with heterosexual women exhibiting the lowest sexual concordance. Stimulus gender significantly influenced sexual concordance for most groups of women: Ambiphilic and predominantly/exclusively gynephilic women exhibited greater sexual concordance to female stimuli and exclusively androphilic women exhibited greater sexual concordance to male stimuli. These findings suggest that sexual orientation (particularly one's degree of gynephilia) may explain some of the within-gender variation seen in women's sexual concordance.

Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: Results from a randomized clinical trial

PubMed Central

Meston, Cindy M.; Lorenz, Tierney A.; Stephenson, Kyle R.

2013-01-01

Introduction Women with a history of childhood sexual abuse (CSA) have high rates of depression, post-traumatic stress disorder, and sexual problems in adulthood. Aim We tested an expressive writing based intervention for its effects on psychopathology, sexual function, satisfaction and distress in women who have a history of CSA. Main Outcome measures Validated self-report measures of psychopathology and sexual function were conducted at post-treatment, 2 weeks, one month, and six months. Methods Seventy women with CSA histories completed five 30-minute sessions of expressive writing, either with a trauma focus or a sexual schema focus. Results Women in both writing interventions exhibited improved symptoms of depression and posttraumatic stress disorder (PTSD). Women who were instructed to write about the impact of the abuse on their sexual schema were significantly more likely to recover from sexual dysfunction. Conclusions Expressive writing may improve depressive and PTSD symptoms in women with CSA histories. Sexual schema-focused expressive writing in particular appears to improve sexual problems, especially for depressed women with CSA histories. Both treatments are accessible, cost-effective, and acceptable to patients. PMID:23875721

Female Sexual Function Index Short Version: A MsFLASH Item Response Analysis.

PubMed

Carpenter, Janet S; Jones, Salene M W; Studts, Christina R; Heiman, Julia R; Reed, Susan D; Newton, Katherine M; Guthrie, Katherine A; Larson, Joseph C; Cohen, Lee S; Freeman, Ellen W; Jane Lau, R; Learman, Lee A; Shifren, Jan L

2016-11-01

The Female Sexual Function Index (FSFI) is a psychometrically sound and popular 19-item self-report measure, but its length may preclude its use in studies with multiple outcome measures, especially when sexual function is not a primary endpoint. Only one attempt has been made to create a shorter scale, resulting in the Italian FSFI-6, later translated into Spanish and Korean without further psychometric analysis. Our study evaluated whether a subset of items on the 19-item English-language FSFI would perform as well as the full-length FSFI in peri- and postmenopausal women. We used baseline data from 898 peri- and postmenopausal women recruited from multiple communities, ages 42-62 years, and enrolled in randomized controlled trials for vasomotor symptom management. Goals were to (1) create a psychometrically sound, shorter version of the FSFI for use in peri- and postmenopausal women as a continuous measure and (2) compare it to the Italian FSFI-6. Results indicated that a 9-item scale provided more information than the FSFI-6 across a spectrum of sexual functioning, was able to capture sample variability, and showed sufficient range without floor or ceiling effects. All but one of the items from the Italian 6-item version were included in the 9-item version. Most omitted FSFI items focused on frequency of events or experiences. When assessment of sexual function is a secondary endpoint and subject burden related to questionnaire length is a priority, the 9-item FSFI may provide important information about sexual function in English-speaking peri- and postmenopausal women.

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.

Prevalence and characteristics of vibrator use by women in the United States: results from a nationally representative study.

PubMed

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

2009-07-01

Although vibrators are commonly recommended by clinicians as adjunct to treatment for female sexual dysfunction, and for sexual enhancement, little is known about their prevalence or correlates of use. The aim of this study was to determine the lifetime and recent prevalence of women's vibrator use during masturbation and partnered sex, and the correlates of use related to sociodemographic variables, health behaviors, and sexual function. A nationally representative sample of 3,800 women aged 18-60 years were invited to participate in a cross-sectional Internet-based survey; 2,056 (54.1%) participated. The prevalence of vibrator use, the relationship between vibrator use and physical and psychological well-being (as assessed by the Centers for Disease Control and Prevention [CDC] Healthy Days measure) and health-promoting behaviors, the relationship between vibrator use and women's scores on the Female Sexual Function Index, and an assessment of the frequency and severity of side effects potentially associated with vibrator use. The prevalence of women's vibrator use was found to be 52.5% (95% CI 50.3-54.7%). Vibrator users were significantly more likely to have had a gynecologic exam during the past year (P < 0.001) and to have performed genital self-examination during the previous month (P < 0.001). Vibrator use was significantly related to several aspects of sexual function (i.e., desire, arousal, lubrication, orgasm, pain, overall function) with recent vibrator users scoring higher on most sexual function domains, indicating more positive sexual function. Most women (71.5%) reported having never experienced genital symptoms associated with vibrator use. There were no significant associations between vibrator use and participants' scores on the CDC Healthy Days Measures. Vibrator use among women is common, associated with health-promoting behaviors and positive sexual function, and rarely associated with side effects. Clinicians may find these data useful in responding to patients' sexual issues and recommending vibrator use to improve sexual function. Further research on the relationships between vibrator use and sexual health is warranted.

Sexual satisfaction, sexual compatibility, and relationship adjustment in couples: the role of sexual behaviors, orgasm, and men's discernment of women's intercourse orgasm.

PubMed

Klapilová, Kateřina; Brody, Stuart; Krejčová, Lucie; Husárová, Barbara; Binter, Jakub

2015-03-01

Research indicated that (i) vaginal orgasm consistency is associated with indices of psychological, intimate relationship, and physiological functioning, and (ii) masturbation is adversely associated with some such measures. The aim of this study was to examine the association of various dyadic and masturbation behavior frequencies and percentage of female orgasms during these activities with: (i) measures of dyadic adjustment; (ii) sexual satisfaction; and (iii) compatibility perceived by both partners. In a sample of 85 Czech long-term couples (aged 20-40; mean relationship length 5.4 years), both partners provided details of recent sexual behaviors and completed sexual satisfaction, Spanier dyadic adjustment, and Hurlbert sexual compatibility measures. Multiple regression analyses were used. The association of sexual behaviors with dyadic adjustment, sexual compatibility, and satisfaction was analyzed. In multivariate analyses, women's dyadic adjustment is independently predicted by greater vaginal orgasm consistency and lower frequency of women's masturbation. For both sexes, sexual compatibility was independently predicted by higher frequency of penile-vaginal intercourse and greater vaginal orgasm consistency. Women's sexual satisfaction score was significantly predicted by greater vaginal orgasm consistency, frequency of partner genital stimulation, and negatively with masturbation. Men's sexual satisfaction score was significantly predicted by greater intercourse frequency and any vaginal orgasm of their female partners. Concordance of partner vaginal orgasm consistency estimates was associated with greater dyadic adjustment. The findings suggest that specifically penile-vaginal intercourse frequency and vaginal orgasm consistency are associated with indices of greater intimate relationship adjustment, satisfaction, and compatibility of both partners, and that women's masturbation is independently inversely associated with measures of dyadic and personal function. Results are discussed in light of previous research and an evolutionary theory of vaginal orgasm. © 2014 International Society for Sexual Medicine.

Risk-reducing bilateral salpingo-oophorectomy and sexual health: a qualitative study.

PubMed

Brotto, Lori A; Branco, Nadia; Dunkley, Cara; McCullum, Mary; McAlpine, Jessica N

2012-02-01

To examine the impact of risk-reducing bilateral salpingo-oophorectomy (RRBSO) on sexual function in BRCA gene mutation carriers, compared with the effect on women undergoing BSO (bilateral salpingo-oophorectomy) for benign indications from a qualitative perspective. Our study included 25 women who had undergone either a RRBSO because of BRCA carrier status or a BSO for a benign gynaecologic indication. Women were invited to participate if they were at least six months post-BSO. They took part in an individual, private interview during which they were asked open-ended questions about their sexual health in the context of undergoing BSO. They also completed self-report measures of sexual response, sexual distress, sexual self-image, and mood. Using content analysis of interviews, saturation in themes was reached after 15 interviews and four main themes were identified: (1) preoperative knowledge of sexual side effects, (2) preoperative drive to educate oneself on BSO side effects, (3) partner support, and (4) treatment for sexual side effects. Preoperative awareness of post-BSO sexual side effects was highly correlated with patient satisfaction and inversely correlated with postoperative sexual distress. A majority of participants reported that they did not discuss post-BSO sexual functioning with their physicians, and had to seek out information independently. Satisfaction with RRBSO remained high regardless of whether or not participants reported post-BSO sexual distress. Self-report questionnaires did not reveal any differences between the two groups on measures of sexual function. This study provided a nuanced view of sexual health in women following RRBSO that was not captured by self-report questionnaires. Women with preoperative knowledge of post-BSO sexual side effects report being more prepared for surgery, and experience less sexual distress following their BSO.

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.

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.

Sexual Signaling and Immune Function in the Black Field Cricket Teleogryllus commodus

PubMed Central

Drayton, Jean M.; Hall, Matthew D.; Hunt, John; Jennions, Michael D.

2012-01-01

The immunocompetence handicap hypothesis predicts that male sexual trait expression should be positively correlated with immunocompetence. Here we investigate if immune function in the cricket, Teleogryllus commodus, is related to specific individual components of male sexual signals, as well as to certain multivariate combinations of these components that females most strongly prefer. Male T. commodus produce both advertisement and courtship calls prior to mating. We measured fine-scale structural parameters of both call types and also recorded nightly advertisement calling effort. We then measured two standard indices of immune function: lysozyme-like activity of the haemolymph and haemocyte counts. We found a weak, positive relationship between advertisement calling effort and lysozyme-like activity. There was, however, little evidence that individual structural call components or the net multivariate attractiveness of either call type signalled immune function. The relationships between immunity and sexual signaling did not differ between inbred and outbred males. Our data suggest that it is unlikely that females assess overall male immune function using male calls. PMID:22808047

The International Index of Erectile Function: a methodological critique and suggestions for improvement.

PubMed

Yule, Morag; Davison, Joyce; Brotto, Lori

2011-01-01

The International Index of Erectile Function is a well-worded and psychometrically valid self-report questionnaire widely used as the standard for the evaluation of male sexual function. However, some conceptual and statistical problems arise when using the measure with men who are not sexually active. These problems are illustrated using 2 empirical examples, and the authors provide recommended solutions to further strengthen the efficacy and validity of this measure.

Are primary and secondary provoked vestibulodynia two different entities? A comparison of pain, psychosocial, and sexual characteristics.

PubMed

Aerts, Leen; Bergeron, Sophie; Corsini-Munt, Serena; Steben, Marc; Pâquet, Myriam

2015-06-01

Provoked vestibulodynia (PVD) is suspected to be the most frequent cause of vulvodynia in premenopausal women. Based on the onset of PVD relative to the start of sexual experience, PVD can be divided into primary (PVD1) and secondary PVD (PVD2). Studies comparing these PVD subgroups are inconclusive as to whether differences exist in sexual and psychosocial functioning. The aim of this study was to compare the pain, sexual and psychosocial functioning of a large clinical and community-based sample of premenopausal women with PVD1 and PVD2. A total of 269 women (n = 94 PVD1; n = 175 PVD2) completed measures on sociodemographics, pain, sexual, and psychosocial functioning. Dependent variables were the 0-10 pain numerical rating scale, McGill-Melzack Pain Questionnaire, Female Sexual Function Index, Global Measure of Sexual Satisfaction, Beck Depression Inventory-II, Painful Intercourse Self-Efficacy Scale, Pain Catastrophizing Scale, State-Trait Anxiety Inventory Trait Subscale, Ambivalence over Emotional Expression Questionnaire, Hurlbert Index of Sexual Assertiveness, Experiences in Close Relationships Scale--Revised, and Dyadic Adjustment Scale-Revised. At first sexual relationship, women with PVD2 were significantly younger than women with PVD1 (P < 0.01). The average relationship duration was significantly longer in women with PVD2 compared with women with PVD1 (P < 0.01). Although women with PVD1 described a significantly longer duration of pain compared with women with PVD2 (P < 0.01), no significant subtype differences were found in pain intensity during intercourse. When controlling for the sociodemographics mentioned earlier, no significant differences were found in sexual, psychological, and relational functioning between the PVD subgroups. Nevertheless, on average, both groups were in the clinical range of sexual dysfunction and reported impaired psychological functioning. The findings show that there are no significant differences in the sexual and psychosocial profiles of women with PVD1 and PVD2. Results suggest that similar psychosocial and sex therapy interventions should be offered to both subgroups of PVD. © 2015 International Society for Sexual Medicine.

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.

The interaction of state and trait aspects of self-focused attention affects genital, but not subjective, sexual arousal in sexually functional women.

PubMed

van Lankveld, Jacques; Bergh, Simone

2008-04-01

In this study we investigated the effects of state and trait aspects of self-focused attention on genital and subjective sexual arousal of sexually functional, healthy women during presentation of audiovisual erotic stimuli. Psychophysiological sexual response was measured as vaginal pulse amplitude using a vaginal photoplethysmograph. Experiential aspects of sexual arousal were measured both during stimulus presentation and retrospectively after stimulus offset. Trait level of sexual self-focus was measured with the Sexual Self-Consciousness Scale. State self-focus was induced by switching on a TV camera that pointed at the participant's face and upper torso. A manipulation check revealed that both groups experienced equally elevated levels of self-focused attention of their physical appearance. Induction of state self-focus per se did not affect genital responses, but an interaction effect of self-focus and participants' level of trait sexual self-focus was revealed. Compared with women with low scores on this trait, women with high scores exhibited smaller genital responses when state self-focus was induced. Both groups did not differ when no self-focus was induced. Increase of state self-focus did not affect subjective sexual arousal, but participants with a high level of trait sexual self-focus reported stronger subjective arousal, compared with those with low trait level. The results were discussed with reference to previous work in this field. Some implications for treatment of sexual arousal disorder were discussed.

Testosterone Dose-Response Relationships in Hysterectomized Women with and without Oophorectomy: Effects on Sexual Function, Body Composition, Muscle Performance and Physical Function in a Randomized Trial

PubMed Central

Huang, Grace; Basaria, Shehzad; Travison, Thomas G.; Ho, Matthew H.; Davda, Maithili; Mazer, Norman A.; Miciek, Renee; Knapp, Philip E.; Zhang, Anqi; Collins, Lauren; Ursino, Monica; Appleman, Erica; Dzekov, Connie; Stroh, Helene; Ouellette, Miranda; Rundell, Tyler; Baby, Merilyn; Bhatia, Narender N.; Khorram, Omid; Friedman, Theodore; Storer, Thomas W.; Bhasin, Shalender

2015-01-01

Objective To determine dose-dependent effects of testosterone on sexual function, body composition, muscle performance, and physical function in hysterectomized women with and without oophorectomy. Methods 71 menopausal women who previously underwent hysterectomy with or without oophorectomy with total testosterone<31ng/dl or free testosterone<3.5 pg/ml received a standardized transdermal estradiol regimen during the 12-week run-in period, and were then randomized to receive weekly IM injections of placebo, or 3, 6.25, 12.5 or 25 mg testosterone enanthate for 24 weeks. Total and free testosterone levels were measured by LC-MS/MS and equilibrium dialysis, respectively. The primary outcome was change in sexual function measured using Brief Index of Sexual Function (BISF-W); Secondary outcomes included changes in sexual activity, sexual distress, DeRogatis Inventory of Sexual Function, lean (LBM) and fat mass, muscle strength and power, and physical function. Results 71 women were randomized; five groups were similar at baseline. 62 women with analyzable data for the primary outcome were included in the final analysis. Mean on-treatment total testosterone concentrations were 19, 78, 102, 128 and 210ng/dl in the placebo, 3, 6.25, 12.5 and 25-mg groups, respectively. Changes in composite BISF-W scores, thoughts-desire, arousal, frequency of sexual activity, LBM, chest-press power and loaded stair-climb power were significantly related to increases in free testosterone concentrations; changes were significantly greater in women assigned to the 25-mg group when compared to placebo but not at the lower dose groups. Sexual activity increased by 2.7 encounters per week in 25-mg group. Frequency of androgenic adverse events was low. Conclusion Testosterone administration in hysterectomized women with and without oophorectomy for 24-weeks was associated with dose and concentration-dependent gains in several domains of sexual function, LBM, chest-press power and loaded stair-climb power. Long-term trials are needed to weigh improvements in these outcomes against potential long-term adverse effects. PMID:24281237

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.

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

An evaluation of the effect of infertility on marital, sexual satisfaction indices and health-related quality of life in women.

PubMed

Valsangkar, Sameer; Bodhare, Trupti; Bele, Samir; Sai, Surendranath

2011-05-01

The effect of infertility on marital and sexual functioning, health-related quality of life (QoL) and the acceptability of the treatment modalities is a poorly researched area in India. To measure and compare the impact of infertility on marital adjustment, sexual functioning, QoL and the acceptability of various treatment modalities in infertility. Hospital-based cross-sectional controlled study. Data regarding infertility, socio-demographic characteristics and treatment acceptability was obtained via a semi-structured questionnaire. validated, standardized scales were used to measure marital adjustment (abbreviated dyadic adjustment scale), sexual functioning (abbreviated sexual functioning questionnaire) in cases and controls, and quality of life (FertiQol) in cases. Data from 106 women attending tertiary infertility centers who met the definition of primary infertility and 212 controls attending the medical outpatient department in the same centers was obtained. Body mass index and socioeconomic status were significant (P < 0.006 and < 0.0001 respectively) for infertility. Fertility-enhancing regimens and adoption had the highest acceptability with a wide dispersion of range for adoption and least acceptance for sperm, egg, embryo donation and surrogate motherhood. Logistic regression analysis revealed a significant effect size of infertility on marital adjustment (Nagelkerke R(2) 0.725, Cohen's D 0.86) and sexual functioning (Nagelkerke R(2) 0.73, Cohen's D 0.815). QoL showed a decrease in mean scores on the FertiQol scale similar to normative data. Effective counseling, reassurance and measures to reduce the impact of the condition on marital and sexual life, overall QoL are needed to impart a holistic treatment in infertility.

An evaluation of the effect of infertility on marital, sexual satisfaction indices and health-related quality of life in women

PubMed Central

Valsangkar, Sameer; Bodhare, Trupti; Bele, Samir; Sai, Surendranath

2011-01-01

BACKGROUND: The effect of infertility on marital and sexual functioning, health-related quality of life (QoL) and the acceptability of the treatment modalities is a poorly researched area in India. AIMS AND OBJECTIVES: To measure and compare the impact of infertility on marital adjustment, sexual functioning, QoL and the acceptability of various treatment modalities in infertility. DESIGN AND SETTING: Hospital-based cross-sectional controlled study. MATERIALS AND METHODS: Data regarding infertility, socio-demographic characteristics and treatment acceptability was obtained via a semi-structured questionnaire. validated, standardized scales were used to measure marital adjustment (abbreviated dyadic adjustment scale), sexual functioning (abbreviated sexual functioning questionnaire) in cases and controls, and quality of life (FertiQol) in cases. Data from 106 women attending tertiary infertility centers who met the definition of primary infertility and 212 controls attending the medical outpatient department in the same centers was obtained. RESULTS: Body mass index and socioeconomic status were significant (P < 0.006 and < 0.0001 respectively) for infertility. Fertility-enhancing regimens and adoption had the highest acceptability with a wide dispersion of range for adoption and least acceptance for sperm, egg, embryo donation and surrogate motherhood. Logistic regression analysis revealed a significant effect size of infertility on marital adjustment (Nagelkerke R2 0.725, Cohen's D 0.86) and sexual functioning (Nagelkerke R2 0.73, Cohen's D 0.815). QoL showed a decrease in mean scores on the FertiQol scale similar to normative data. CONCLUSIONS: Effective counseling, reassurance and measures to reduce the impact of the condition on marital and sexual life, overall QoL are needed to impart a holistic treatment in infertility. PMID:22065832

Testosterone dose-response relationships in hysterectomized women with or without oophorectomy: effects on sexual function, body composition, muscle performance and physical function in a randomized trial.

PubMed

Huang, Grace; Basaria, Shehzad; Travison, Thomas G; Ho, Matthew H; Davda, Maithili; Mazer, Norman A; Miciek, Renee; Knapp, Philip E; Zhang, Anqi; Collins, Lauren; Ursino, Monica; Appleman, Erica; Dzekov, Connie; Stroh, Helene; Ouellette, Miranda; Rundell, Tyler; Baby, Merilyn; Bhatia, Narender N; Khorram, Omid; Friedman, Theodore; Storer, Thomas W; Bhasin, Shalender

2014-06-01

This study aims to determine the dose-dependent effects of testosterone on sexual function, body composition, muscle performance, and physical function in hysterectomized women with or without oophorectomy. Seventy-one postmenopausal women who previously underwent hysterectomy with or without oophorectomy and had total testosterone levels less than 31 ng/dL or free testosterone levels less than 3.5 pg/mL received a standardized transdermal estradiol regimen during the 12-week run-in period and were randomized to receive weekly intramuscular injections of placebo or 3, 6.25, 12.5, or 25 mg of testosterone enanthate for 24 weeks. Total and free testosterone levels were measured by liquid chromatography-tandem mass spectrometry and equilibrium dialysis, respectively. The primary outcome was change in sexual function measured by the Brief Index of Sexual Functioning for Women. Secondary outcomes included changes in sexual activity, sexual distress, Derogatis Interview for Sexual Functioning, lean body mass, fat mass, muscle strength and power, and physical function. Seventy-one women were randomized; five groups were similar at baseline. Sixty-two women with analyzable data for the primary outcome were included in the final analysis. The mean on-treatment total testosterone concentrations were 19, 78, 102, 128, and 210 ng/dL in the placebo, 3-mg, 6.25-mg, 12.5-mg, and 25-mg groups, respectively. Changes in composite Brief Index of Sexual Functioning for Women scores, thoughts/desire, arousal, frequency of sexual activity, lean body mass, chest-press power, and loaded stair-climb power were significantly related to increases in free testosterone concentrations; compared with placebo, changes were significantly greater in women assigned to the 25-mg group, but not in women in the lower-dose groups. Sexual activity increased by 2.7 encounters per week in the 25-mg group. The frequency of androgenic adverse events was low. Testosterone administration in hysterectomized women with or without oophorectomy for 24 weeks was associated with dose and concentration-dependent gains in several domains of sexual function, lean body mass, chest-press power, and loaded stair-climb power. Long-term trials are needed to weigh improvements in these outcomes against potential long-term adverse effects.

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 impact of sleep on female sexual response and behavior: a pilot study.

PubMed

Kalmbach, David A; Arnedt, J Todd; Pillai, Vivek; Ciesla, Jeffrey A

2015-05-01

The etiological role of sleep disturbance in sexual difficulties has been largely overlooked. Research suggests that short sleep duration and poor sleep quality lead to poor female sexual response. However, prior research consists of cross-sectional studies, and the influence of sleep on sexual functioning and behavior has not been prospectively examined. We sought to examine the influence of nightly sleep duration, sleep quality, and sleep onset latency on daily female sexual response and activity. This study used a longitudinal design to study 171 women free of antidepressants and with reliable Internet access who were recruited from a university setting in the United States. Participants first completed baseline measures in a laboratory, and then completed web-delivered surveys at their habitual wake time for 14 consecutive days. All outcome measures were modified for daily recall. Participants completed the Profile of Female Sexual Function's desire, subjective arousal, and orgasmic functioning scales and the Female Sexual Function Index's genital arousal scale, and indicated whether they engaged in partnered sexual activity or self-stimulation in response to dichotomous items. Analyses revealed that longer sleep duration was related to greater next-day sexual desire (b = 0.32, P = 0.02), and that a 1-hour increase in sleep length corresponded to a 14% increase in odds of engaging in partnered sexual activity (odds ratio = 1.14, P < 0.05). In contrast, sleeping longer predicted poorer next-day genital arousal (b = -0.19, P < 0.01). However, results showed that women with longer average sleep duration reported better genital arousal than women with shorter average sleep length (b = 0.54, P = 0.03). Obtaining sufficient sleep is important to the promotion of healthy sexual desire and genital response, as well as the likelihood of engaging in partnered sexual activity. These relationships were independent of daytime affect and fatigue. Future directions may investigate sleep disorders as risk factors for sexual dysfunction. © 2015 International Society for Sexual Medicine.

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.

Effect of long-term intranasal oxytocin on sexual dysfunction in premenopausal and postmenopausal women: a randomized trial.

PubMed

Muin, Dana A; Wolzt, Michael; Marculescu, Rodrig; Sheikh Rezaei, Safoura; Salama, Mohamed; Fuchs, Carola; Luger, Anton; Bragagna, Elia; Litschauer, Brigitte; Bayerle-Eder, Michaela

2015-09-01

To assess the effect of on-demand intranasal oxytocin administration on female sexual function and activity. Randomized, prospective, double-blind, placebo-controlled, crossover trial with duration of 22 weeks. Academic medical center. Thirty pre-and postmenopausal women with sexual dysfunction. Over 8 weeks, intranasal oxytocin (32 IU) or placebo self-administered by women within 50 minutes before sexual intercourse; after a washout period of 2 weeks, crossover with patients switched to the alternate group for another 8 weeks. Primary outcome parameter: Female Sexual Function Index (FSFI); secondary outcome parameters: Female Sexual Distress Scale (FSDS), Sexual Quality of Life-Female (SQOL-F), Sexual Interest and Desire Inventory-Female (SIDI-F), and Hamilton depression scale (HDS). After oxytocin and placebo, the FSFI score increased by 26% and 31%, SQOL-F score by 144% and 125%, and SIDI-F score by 29% and 23%, respectively (repeated measures analysis of variance between groups). After oxytocin and placebo, the FSDS score decreased by 36% and 45%, respectively (repeated measures analysis of variance between groups). There was no statistically significant treatment, sequence (placebo first/second), or interaction effect. Long-term intranasal oxytocin and placebo administration both improved sexual function and symptoms of depression in women over time with no treatment, sequence (placebo first/second), or interaction effect. NCT02229721. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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.

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

Relationships of Social Context and Identity to Problem Behavior among High-Risk Hispanic Adolescents

PubMed Central

Schwartz, Seth J.; Mason, Craig A.; Pantin, Hilda; Wang, Wei; Brown, C. Hendricks; Campo, Ana; Szapocznik, José

2008-01-01

The present study was designed to examine the extent to which (a) family and school functioning and (b) personal and ethnic identity is associated with conduct problems, drug use, and sexual risk taking in a sample of 227 high-risk Hispanic adolescents. Adolescents participated in the study with their primary parents, who were mostly mothers. Adolescents completed measures of family and school functioning, personal and ethnic identity, conduct problems, and drug use. Parents completed measures of family functioning and adolescent conduct problems. Results indicated that school functioning and personal identity confusion were related to alcohol use, illicit drug use, and sexual risk taking indirectly through adolescent reports of conduct problems. Adolescent reports of family functioning were related to alcohol use, illicit drug use, and sexual risk taking through school functioning and conduct problems. Results are discussed in terms of the problem behavior syndrome and in terms of the finding of relative independence of contextual and identity variables vis-à-vis conduct problems, substance use, and sexual risk taking. PMID:19412356

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.

Sexual Well-Being of a Community Sample of High-Functioning Adults on the Autism Spectrum Who Have Been in a Romantic Relationship

ERIC Educational Resources Information Center

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

2013-01-01

This study explored factors (gender, age, relationship status, symptomatology) associated with the sexual well-being of 141 (56 men and 85 women) adults with high-functioning autism and Asperger syndrome (HFA/AS) living in the community. Participants completed an online survey consisting of a measure of autistic symptoms as well as measures of…

An education program about pelvic floor muscles improved women's knowledge but not pelvic floor muscle function, urinary incontinence or sexual function: a randomised trial.

PubMed

de Andrade, Roberta Leopoldino; Bø, Kari; Antonio, Flavia Ignácio; Driusso, Patricia; Mateus-Vasconcelos, Elaine Cristine Lemes; Ramos, Salvador; Julio, Monica Pitanguy; Ferreira, Cristine Homsi Jorge

2018-04-01

Does an educational program with instructions for performing 'the Knack' improve voluntary contraction of the pelvic floor muscles, reduce reports of urinary incontinence, improve sexual function, and promote women's knowledge of the pelvic floor muscles? Randomised, controlled trial with concealed allocation, intention-to-treat analysis and blinded assessors. Ninety-nine women from the local community. The experimental group (n=50) received one lecture per week for 4 weeks, and instructions for performing 'the Knack'. The control group (n=49) received no intervention. The primary outcome was maximum voluntary contraction of the pelvic floor muscles measured using manometry. Secondary outcomes were: ability to contract the pelvic floor muscles measured using vaginal palpation; severity of urinary incontinence measured by the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scored from 0 to 21; self-reported sexual function; and knowledge related to the pelvic floor. Outcomes were measured at baseline and after 4 weeks. The intervention did not significantly improve: maximum voluntary contraction (MD 2.7 cmH 2 O higher in the experimental group, 95% CI -0.5 to 5.9); ability to contract the pelvic floor muscles (RR 2.18, 95% CI 0.49 to 9.65); or self-reported severity of urinary incontinence (MD 1 point greater reduction in the experimental group, 95% CI -3 to 1). Sexual function did not significantly differ between groups, but very few of the women engaged in sexual activity during the study period. The educational program did, however, significantly increase women's knowledge related to the location, functions and dysfunctions of the pelvic floor muscles, and treatment options. Education and teaching women to perform 'the Knack' had no significant effect on voluntary contraction of the pelvic floor muscles, urinary incontinence or sexual function, but it promoted women's knowledge about the pelvic floor. Brazilian Registry of Clinical Trials, RBR-95sxqv. [de Andrade RL, Bø K, Antonio FI, Driusso P, Mateus-Vasconcelos ECL, Ramos S, Julio MP, Ferreira CHJ (2018) An education program about pelvic floor muscles improved women's knowledge but not pelvic floor muscle function, urinary incontinence or sexual function: a randomised trial. Journal of Physiotherapy 64: 91-96]. Copyright © 2018 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

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.

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.

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.

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

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

PubMed

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

2016-12-01

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

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.

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.

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.

Harmful or helpful: perceived solicitous and facilitative partner responses are differentially associated with pain and sexual satisfaction in women with provoked vestibulodynia.

PubMed

Rosen, Natalie O; Bergeron, Sophie; Glowacka, Maria; Delisle, Isabelle; Baxter, Mary Lou

2012-09-01

Provoked vestibulodynia (PVD) is a highly prevalent vulvovaginal pain condition that negatively affects women's emotional, sexual, and relationship well-being. Recent studies have investigated the role of interpersonal variables, including partner responses. We examined whether solicitous and facilitative partner responses were differentially associated with vulvovaginal pain and sexual satisfaction in women with PVD by examining each predictor while controlling for the other. One hundred twenty-one women (M age = 30.60, SD = 10.53) with PVD or self-reported symptoms of PVD completed the solicitous subscale of the spouse response scale of the Multidimensional Pain Inventory, and the facilitative subscale of the Spouse Response Inventory. Participants also completed measures of pain, sexual function, sexual satisfaction, trait anxiety, and avoidance of pain and sexual behaviors (referred to as "avoidance"). Dependent measures were the (i) Pain Rating Index of the McGill Pain Questionnaire with reference to pain during vaginal intercourse and (ii) Global Measure of Sexual Satisfaction Scale. Controlling for trait anxiety and avoidance, higher solicitous partner responses were associated with higher vulvovaginal pain intensity (β = 0.20, P = 0.03), and higher facilitative partner responses were associated with lower pain intensity (β = -0.20, P = 0.04). Controlling for sexual function, trait anxiety, and avoidance, higher facilitative partner responses were associated with higher sexual satisfaction (β = 0.15, P = 0.05). Findings suggest that facilitative partner responses may aid in alleviating vulvovaginal pain and improving sexual satisfaction, whereas solicitous partner responses may contribute to greater pain. © 2012 International Society for Sexual Medicine.

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.

[The use of acupuncture in combined balneotherapy of erectile dysfunction in patients with lumbosacral osteochondrosis].

PubMed

Zhuravlev, I E; Tereshin, A T

2010-01-01

The objective of the present study was to elucidate effects of therapeutic and preventive measures on restoration of compromised erectile function in patients with osteochondrosis of the lumbosacral spine segment (LSSS). The patients were treated using corporal and auricular acupuncture, Narzan mineral water baths, manual therapy, remedial gymnastics, and psychotherapeutic correction of sexual dysadaptation. This combined treatment resulted in the elimination of algic syndrome in 77.5% of the patients, restoration of sexual function in 62.5%, and normalization of hemodynamics in cavernous bodies in 65.2%. The functional activity of the hypothalamo-pituitary-testicular axis was normalized in 65% of the LSSS patients of strong and moderate sexual constitution. Introduction of acupuncture in the combined medicamentous therapy increased its efficiency by 15%. In 57.5% of the patients with strong and moderate sexual constitution, the restored sexual function persisted for at least 12 months.

Impact of robotic surgery on sexual and urinary functions after fully robotic nerve-sparing total mesorectal excision for rectal cancer.

PubMed

Luca, Fabrizio; Valvo, Manuela; Ghezzi, Tiago Leal; Zuccaro, Massimiliano; Cenciarelli, Sabina; Trovato, Cristina; Sonzogni, Angelica; Biffi, Roberto

2013-04-01

Urinary and sexual dysfunctions are recognized complications of rectal cancer surgery. Their incidence after robotic surgery is as yet unknown. The aim of this study was to prospectively evaluate the impact of robotic surgery for rectal cancer on sexual and urinary functions in male and female patients. From April 2008 to December 2010, 74 patients undergoing fully robotic resection for rectal cancer were prospectively included in the study. Urinary and sexual dysfunctions affecting quality of life were assessed with specific self-administered questionnaires in all patients undergoing robotic total mesorectal excision (RTME). Results were calculated with validated scoring systems and statistically analyzed. The analyses of the questionnaires completed by the 74 patients who underwent RTME showed that sexual function and general sexual satisfaction decreased significantly 1 month after intervention: 19.1 ± 8.7 versus 11.9 ± 10.2 (P < 0.05) for erectile function and 6.9 ± 2.4 versus 5.3 ± 2.5 (P < 0.05) for general satisfaction in men; 2.6 ± 3.3 versus 0.8 ± 1.4 (P < 0.05) and 2.4 ± 2.5 versus 0.7 ± 1.6 (P < 0.05) for arousal and general satisfaction, respectively, in women. Subsequently, both parameters increased progressively, and 1 year after surgery, the values were comparable to those measured before surgery. Concerning urinary function, the grade of incontinence measured 1 year after the intervention was unchanged for both sexes. RTME allows for preservation of urinary and sexual functions. This is probably due to the superior movements of the wristed instruments that facilitate fine dissection, coupled with a stable and magnified view that helps in recognizing the inferior hypogastric plexus.

Sexual functioning among early post-treatment breast cancer survivors.

PubMed

Avis, Nancy E; Johnson, Aimee; Canzona, Mollie Rose; Levine, Beverly J

2018-02-17

This study aims (1) to estimate percentages of partnered women who are sexually active over the first 2 years post-breast cancer diagnosis; (2) to identify factors related to sexual inactivity; and (3) to evaluate separately, among both sexually active and inactive survivors, the relation between sexual problems and treatment-related variables, symptoms, and psychosocial factors. Longitudinal observational study of breast cancer survivors recruited within 8 months of cancer diagnosis and followed for 18 months. The main outcome measures were (1) being sexually active/inactive in the past month and (2) sexual problems assessed with the four-item sexual problem domain of the Quality of Life in Adult Cancer Survivors (QLACS) scale. At baseline, 52.4% of women reported being sexually active in the past month. This percentage increased to 60.7% 18 months later. In multivariable repeated-measures analyses, age, past chemotherapy, depressive symptoms, and lower perceived attractiveness were related to inactivity. Sexually inactive women reported more problems on the QLACS than sexually active women. In stratified multivariable analyses, depressive symptoms were related to greater sexual problems for both sexually active and inactive women, as was vaginal dryness. Among the sexually active women, younger age at diagnosis, less illness intrusiveness, and lower perceived attractiveness were related to more problems. Research has shown that sexual functioning/sexual health are key aspects of quality of life for many cancer survivors, and are often not addressed by health care providers. Future studies should examine how such topics are handled by clinicians in their interactions with survivors.

Patient-provider communication about sexual concerns in cancer: a systematic review.

PubMed

Reese, Jennifer Barsky; Sorice, Kristen; Beach, Mary Catherine; Porter, Laura S; Tulsky, James A; Daly, Mary B; Lepore, Stephen J

2017-04-01

Cancer survivors' needs around sexual concerns are often unmet. The primary objective of this systematic review was to examine the prevalence of and factors associated with patient-provider communication about sexual concerns in cancer. Using PRISMA guidelines, we searched PubMed/MEDLINE, PsychInfo, and CINAHL databases for peer-reviewed quantitative research papers (2000-2015) in cancer samples. Search terms across three linked categories were used (sexuality, communication, and cancer). The National Comprehensive Cancer Network (NCCN) Sexual Function Guidelines were used as a framework to categorize communication reported in each study. Twenty-nine studies from 10 countries (29 % in USA) were included. Studies assessed patients only (21), providers only (4), and both (4). Communication measures differed across studies and many lacked validity data. When reported by patients or providers, the average prevalence of discussing potential treatment effects on sexual function was 50 (60 % for men and 28 % for women) and 88 %, respectively. As reported by patients or providers, respectively, assessing patients' sexual concerns (10 and 21 %) and offering treatments (22 and 17 %) were measured in fewer studies and were reported less frequently. Both patients and providers (28 and 32 %, respectively) reported a low prevalence of other non-specific communication. Greater prevalence of communication was associated with male patient gender and more years of provider experience. Sexual issues go unaddressed for many cancer survivors, particularly women. Both patient and provider interventions are needed. Enhancing patient-provider communication about sexual concerns through evidence-based interventions could improve patient sexual function and quality of life.

Improvement in sexual function after ovarian cancer: Effects of sexual therapy and rehabilitation after treatment for ovarian cancer.

PubMed

Bober, Sharon L; Recklitis, Christopher J; Michaud, Alexis L; Wright, Alexi A

2018-01-01

Sexual dysfunction is a distressing long-term effect after gynecological cancer and affects the majority of survivors for years after the completion of therapy. Despite its prevalence, treatment-related sexual dysfunction is underrecognized and undertreated for survivors. Thus, the aim of this study was to develop and test a brief psychoeducational intervention for managing sexual dysfunction for women who have undergone treatment for ovarian cancer (OC). Forty-six OC survivors with documented, treatment-related sexual dysfunction received a single half-day group intervention that included sexual health education and rehabilitation training, relaxation and cognitive behavioral therapy skills to address sexual symptoms, and a single tailored booster telephone call 4 weeks after the group. Assessment measures were completed at the baseline (baseline 1), after an 8-week no-treatment run-in period (baseline 2), and then again 2 and 6 months after the intervention. The Female Sexual Function Index (FSFI) was used to assess sexual functioning, and the Brief Symptom Inventory 18 (BSI-18) was used to capture psychological distress. Between baseline 1 and baseline 2, there were no significant changes in the study measures, and this indicated no natural improvement during the run-in period. In contrast, the total FSFI scores improved significantly from baseline 1 to the 2- (n = 45; P < .0005) and 6-month time points (n = 42; P < .05). The BSI-18 scores were also significantly improved at the 2- (P < .005) and 6-month time points (P < .01) in comparison with baseline 1. This brief behavioral intervention led to significant improvements in overall sexual functioning and psychological distress that were maintained at the 6-month follow-up. The results demonstrate the feasibility of this brief, low-intensity behavioral intervention and support the development of a larger randomized controlled trial. Cancer 2018;124:176-82. © 2017 American Cancer Society. © 2017 American Cancer Society.

Quality of Life, Psychological Functioning, and Treatment Satisfaction of Men Who Have Undergone Penile Prosthesis Surgery Following Robot-Assisted Radical Prostatectomy.

PubMed

Pillay, Brindha; Moon, Daniel; Love, Christopher; Meyer, Denny; Ferguson, Emma; Crowe, Helen; Howard, Nicholas; Mann, Sarah; Wootten, Addie

2017-12-01

Penile prosthesis surgery is last-line treatment to regaining erectile function after radical prostatectomy (RP) for localized prostate cancer. To assess quality of life, psychological functioning, and treatment satisfaction of men who underwent penile implantation after RP; the psychosocial correlates of treatment satisfaction and sexual function after surgery; and the relation between patients' and partners' ratings of treatment satisfaction. 98 consecutive patients who underwent penile implantation after RP from 2010 and 2015 and their partners were invited to complete a series of measures at a single time point. Of these, 71 patients and 43 partners completed measures assessing sexual function, psychological functioning, and treatment satisfaction. Proportions of patients who demonstrated good sexual function and satisfaction with treatment and clinical levels of anxiety and depression were calculated. Hierarchical regression analyses were conducted to determine psychosocial factors associated with patient treatment satisfaction and sexual function and patient-partner differences in treatment satisfaction. Patients completed the Expanded Prostate Cancer Index Composite Short Form (EPIC-26), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Prostate Cancer-Related Quality of Life Scale, Self-Esteem and Relationship Questionnaire (SEAR), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Partners completed the GAD-7, PHQ-9, EDITS (partner version), and SEAR. 94% of men reported satisfaction with treatment (EDITS score > 50). 77% of men reported good sexual function (EPIC-26 score > 60). Lower depression scores were associated with higher sexual confidence and sexual intimacy, and these were correlated with better treatment satisfaction and sexual function. Patients experienced higher sexual relationship satisfaction (median score = 90.6) than their partners (median score = 81.2), but there was no difference in treatment satisfaction between groups. Higher patient treatment satisfaction was more likely to be reported for couples whose depression scores were more similar. It is important to provide preoperative penile implant counseling and encourage patients to seek postoperative counseling if needed. This is one of the first Australian-based studies comprehensively assessing treatment satisfaction and psychosocial health of men after penile prosthesis surgery after RP. This was a retrospective cross-sectional study, so there is a possibility of recall bias, and causal associations could not be determined. Men in this Australian series who underwent penile prosthesis surgery after RP generally reported good sexual function and treatment satisfaction. Nevertheless, patient and partner mental health influenced their reported experience of the treatment. Pillay B, Moon D, Love C, et al. Quality of Life, Psychological Functioning, and Treatment Satisfaction of Men Who Have Undergone Penile Prosthesis Surgery Following Robot-Assisted Radical Prostatectomy. J Sex Med 2017;14:1612-1620. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

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.

Sexual communication, dyadic adjustment, and psychosexual well-being in premenopausal women with self-reported dyspareunia and their partners: a controlled study.

PubMed

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

2014-07-01

Although research that takes into account partner and relationship factors in dyspareunia is slowly emerging, little is known about how these couples communicate about their sexuality. Additionally, partner psychosexual adjustment has not been examined in a controlled fashion. This study aimed to compare dyadic sexual communication, dyadic adjustment, psychological adjustment, and sexual well-being of women with self-reported dyspareunia and their partners with those of pain-free control women and their partners. Premenopausal women (n = 38; mean [M] age = 24.92) with self-reported dyspareunia, their partners (n = 38; M age = 26.71), as well as pain-free control women (n = 44; M age = 25.86) and their partners (n = 44; M age = 27.95) completed an online survey measuring dyadic sexual communication, dyadic adjustment, anxiety, depression, sexual functioning, and sexual distress. Assessments of women and men's (i) dyadic sexual communication; (ii) dyadic adjustment; (iii) anxiety; (iv) depression; (v) sexual functioning; and (vi) women's sexual distress were the main outcome measures. Compared with pain-free controls, women with dyspareunia reported significantly poorer dyadic sexual communication, a difference not found between partners of women with dyspareunia and control partners. Compared with partners of control women, those of women with dyspareunia reported significantly more impaired sexual functioning. No differences in dyadic adjustment were found between women with dyspareunia and pain-free control women, or between their respective partners. Finally, compared with control women, those with dyspareunia reported significantly more impaired psychological and sexual well-being. Findings suggest that dyspareunia impacts not only the psychosexual adjustment of affected women but also that of their partners. It seems relevant to include both members of the couple in future research and treatment for dyspareunia. © 2014 International Society for Sexual Medicine.

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.

Attributions and Coping in Sexually Abused Adolescents Referred for Group Treatment

ERIC Educational Resources Information Center

Daigneault, Isabelle; Hebert, Martine; Tourigny, Marc

2006-01-01

This study aims to assess the predictive value of two sets of variables, self-attributions, and coping behaviors, on sexually abused (SA) teenagers' functioning, while controlling for abuse-related and family variables. A total of 103 female adolescents completed self-report measures to assess their psychological functioning in terms of anxiety,…

Predictors of sexual assertiveness: the role of sexual desire, arousal, attitudes, and partner abuse.

PubMed

Santos-Iglesias, Pablo; Sierra, Juan Carlos; Vallejo-Medina, Pablo

2013-08-01

This study was conducted to test interpersonal, attitudinal, and sexual predictors of sexual assertiveness in a Spanish sample of 1,619 men and 1,755 women aged 18-87 years. Participants completed measures of sexual assertiveness, solitary and dyadic sexual desire, sexual arousal, erectile function, sexual attitudes, and frequency of partner abuse. In men, higher sexual assertiveness was predicted by less non-physical abuse, more positive attitudes toward sexual fantasies and erotophilia, higher dyadic desire, and higher sexual arousal. In women, higher sexual assertiveness was predicted by less non-physical abuse, less solitary sexual desire and higher dyadic sexual desire, arousal, erotophilia, and positive attitudes towards sexual fantasies. Results were discussed in the light of prevention and educational programs that include training in sexual assertiveness skills.

Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer.

PubMed

Donovan, J L; Hamdy, F C; Lane, J A; Mason, M; Metcalfe, C; Walsh, E; Blazeby, J M; Peters, T J; Holding, P; Bonnington, S; Lennon, T; Bradshaw, L; Cooper, D; Herbert, P; Howson, J; Jones, A; Lyons, N; Salter, E; Thompson, P; Tidball, S; Blaikie, J; Gray, C; Bollina, P; Catto, J; Doble, A; Doherty, A; Gillatt, D; Kockelbergh, R; Kynaston, H; Paul, A; Powell, P; Prescott, S; Rosario, D J; Rowe, E; Davis, M; Turner, E L; Martin, R M; Neal, D E

2016-10-13

Robust data on patient-reported outcome measures comparing treatments for clinically localized prostate cancer are lacking. We investigated the effects of active monitoring, radical prostatectomy, and radical radiotherapy with hormones on patient-reported outcomes. We compared patient-reported outcomes among 1643 men in the Prostate Testing for Cancer and Treatment (ProtecT) trial who completed questionnaires before diagnosis, at 6 and 12 months after randomization, and annually thereafter. Patients completed validated measures that assessed urinary, bowel, and sexual function and specific effects on quality of life, anxiety and depression, and general health. Cancer-related quality of life was assessed at 5 years. Complete 6-year data were analyzed according to the intention-to-treat principle. The rate of questionnaire completion during follow-up was higher than 85% for most measures. Of the three treatments, prostatectomy had the greatest negative effect on sexual function and urinary continence, and although there was some recovery, these outcomes remained worse in the prostatectomy group than in the other groups throughout the trial. The negative effect of radiotherapy on sexual function was greatest at 6 months, but sexual function then recovered somewhat and was stable thereafter; radiotherapy had little effect on urinary continence. Sexual and urinary function declined gradually in the active-monitoring group. Bowel function was worse in the radiotherapy group at 6 months than in the other groups but then recovered somewhat, except for the increasing frequency of bloody stools; bowel function was unchanged in the other groups. Urinary voiding and nocturia were worse in the radiotherapy group at 6 months but then mostly recovered and were similar to the other groups after 12 months. Effects on quality of life mirrored the reported changes in function. No significant differences were observed among the groups in measures of anxiety, depression, or general health-related or cancer-related quality of life. In this analysis of patient-reported outcomes after treatment for localized prostate cancer, patterns of severity, recovery, and decline in urinary, bowel, and sexual function and associated quality of life differed among the three groups. (Funded by the U.K. National Institute for Health Research Health Technology Assessment Program; ProtecT Current Controlled Trials number, ISRCTN20141297 ; ClinicalTrials.gov number, NCT02044172 .).

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.

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.

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

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.

Interpersonal Sensitivity and Sexual Functioning in Young Men with Testicular Cancer: the Moderating Role of Coping.

PubMed

Hoyt, Michael A; McCann, Connor; Savone, Mirko; Saigal, Christopher S; Stanton, Annette L

2015-12-01

Interpersonal sensitivity is characterized by the predisposition to perceive and elicit criticism, rejection, and negative social evaluation. It may be linked to poorer physical or functional health outcomes, particularly in the interpersonal context (cancer-related sexual dysfunction). This study tested the association of interpersonal sensitivity with sexual functioning following testicular cancer in young men and whether this association is moderated by coping processes. Men ages 18 to 29 (N = 171; M age = 25.2, SD = 3.32) with a history of testicular cancer were recruited via the California State Cancer Registry and completed questionnaire measures including assessments of interpersonal sensitivity, sexual functioning, and approach and avoidance coping. Regression analysis controlling for education, age, partner status, ethnic status, and time since diagnosis revealed that higher interpersonal sensitivity was significantly related to lower sexual functioning (β = -0.18, p < 0.05). Cancer-related approach-oriented coping was associated with better sexual functioning (β = 0.19, p < 0.05). No significant association was observed for avoidance coping (β = -0.08, ns). Approach-oriented coping, but not avoidance, moderated the relationship with sexual functioning (β = 0.19, p < 0.05), such that higher interpersonal sensitivity was more strongly associated with lower functioning among men with relatively low use of approach coping. Interpersonal sensitivity may be an important individual difference in vulnerability to sexual dysfunction after testicular cancer. Enhancement of coping skills may be a useful direction for intervention development for interpersonally sensitive young men with cancer.

Self-Esteem, Confidence, and Relationships in Men Treated with Sildenafil Citrate for Erectile Dysfunction

PubMed Central

Althof, Stanley E; O' Leary, Michael P; Cappelleri, Joseph C; Glina, Sidney; King, Rosie; Tseng, Li-Jung; Bowler, Jessica L

2006-01-01

BACKGROUND Men with erectile dysfunction (ED) often have low self-esteem, confidence, and sexual relationship satisfaction. OBJECTIVE We evaluated the impact of sildenafil citrate and its generalizability across cultures on self-esteem, confidence, and sexual relationship satisfaction in men with ED using the Self-Esteem And Relationship (SEAR) questionnaire. DESIGN Pooled analysis of 2 double-blind, placebo-controlled, flexible-dose trials of sildenafil with identical protocols: 1 was conducted in the United States and the other in Mexico, Brazil, Australia, and Japan. PATIENTS Men ≥18 years old with ED. MEASUREMENTS The impact of treatment on psychosocial factors associated with ED was determined by patient responses to the SEAR questionnaire. Erectile function was determined using the International Index of Erectile Function (IIEF) and a global efficacy question. Successful sexual intercourse attempts were derived from event logs of sexual activity. Treatment effect sizes were calculated for all study outcomes. RESULTS Compared with patients who received placebo (n = 274), patients who received sildenafil (n = 279) reported significantly greater improvements (P<.0001) in self-esteem, confidence, sexual relationship satisfaction, and in all sexual function domains of the IIEF. Treatment effect sizes were large (range, 0.7 to 1.2) for all SEAR components, and improvement in psychosocial measures showed moderate to high correlations (range, 0.50 to 0.83, P<.0001) with improvement in erectile function, percentage of successful intercourse attempts, and global efficacy. CONCLUSIONS In men with ED from 5 different nations, sildenafil produced substantial improvements in self-esteem, confidence, and sexual relationship satisfaction. Improvements in these psychosocial factors were observed crossculturally and correlated significantly and tangibly with improvements in erectile function. PMID:16836626

Menstrual cycle-related changes in circulating androgens in healthy women with self-reported normal sexual function.

PubMed

Salonia, Andrea; Pontillo, Marina; Nappi, Rossella E; Zanni, Giuseppe; Fabbri, Fabio; Scavini, Marina; Daverio, Rita; Gallina, Andrea; Rigatti, Patrizio; Bosi, Emanuele; Bonini, Pier Angelo; Montorsi, Francesco

2008-04-01

There is currently neither a clinically useful, reliable and inexpensive assay to measure circulating levels of free testosterone (T) in the range observed in women, nor is there agreement on the serum free T threshold defining hypoandrogenism that is associated with female-impaired sexual function. Following the Clinical and Laboratory Standards Institute guidelines, we generated clinically applicable ranges for circulating androgens during specific phases of the menstrual cycle in a convenience sample of 120 reproductive-aged, regularly cycling healthy European Caucasian women with self-reported normal sexual function. All participants were asked to complete a semistructured interview and fill out a set of validated questionnaires, including the Female Sexual Function Index, the Female Sexual Distress Scale, and the 21-item Beck's Inventory for Depression. Between 8 am and 10 am, a venous blood sample was drawn from each participant during the midfollicular (day 5 to 8), the ovulatory (day 13 to 15), and the midluteal phase (day 19 to 22) of the same menstrual cycle. Serum levels of total and free testosterone, Delta(4)-androstenedione, dehydroepiandrosterone sulphate and sex hormone-binding globulin during the midfollicular, ovulatory and midluteal phase of the same menstrual cycle. Total and free T levels showed significant fluctuations, peaking during the ovulatory phase. No significant variation during the menstrual cycle were observed for Delta(4)-androstenedione and dehydroepiandrosterone sulphate. Despite the careful selection of participants that yielded an homogeneous group of women without sexual disorders, we observed a wide range of distribution for each of the circulating androgens measured in this study. This report provides clinically applicable ranges for androgens throughout the menstrual cycle in reproductive-aged, regularly cycling, young healthy Caucasian European women with self-reported normal sexual function.

Cognitive structures in women with sexual dysfunction: the role of early maladaptive schemas.

PubMed

Oliveira, Cátia; Nobre, Pedro J

2013-07-01

Cognitive schemas are often related to psychological problems. However, the role of these structures within sexual problems is not yet well established. The aim of this study was to evaluate the presence and importance of early maladaptive schemas on women's sexual functioning and cognitive schemas activated in response to negative sexual events. A total of 228 women participated in the study: a control sample of 167 women without sexual problems, a subclinical sample of 37 women with low sexual functioning, and a clinical sample of 24 women with sexual dysfunction. Participants completed several self-reported measures: the Schema Questionnaire, the Questionnaire of Cognitive Schema Activation in Sexual Context, the Brief Symptom Inventory, the Beck Depression Inventory, and the Female Sexual Function Index. Findings indicated that women with sexual dysfunction presented significantly more early maladaptive schemas from the Impaired Autonomy and Performance domain, particularly failure (P < 0.001, η(2) = 0.08), dependence/incompetence (P < 0.05, η(2) = 0.03), and vulnerability to danger (P < 0.05, η(2) = 0.04). Additionally, in response to negative sexual events, women with sexual dysfunction presented significantly higher scores on incompetence (P < 0.001, η(2) = 0.16), self-depreciation (P < 0.01, η(2) = 0.05), and difference/loneliness (P < 0.01, η(2) = 0.05) schemas. Results supported differences between women with and without sexual problems regarding cognitive factors. This may have implications for the knowledge, assessment, and treatment of sexual dysfunction in women. © 2012 International Society for Sexual Medicine.

Physical and sexual intimate partner violence, women's health and children's behavioural functioning: entry analysis of a seven-year prospective study.

PubMed

Symes, Lene; Maddoux, John; McFarlane, Judith; Nava, Angeles; Gilroy, Heidi

2014-10-01

To increase knowledge of physical and sexual intimate partner violence against women, its impact on women's health and children's behavioural functioning. Physical assault and sexual assault frequently co-occur. Women who experience both physical and sexual violence are at risk of poorer health outcomes than women who experience only physical violence. The behavioural functioning of children of women who experience partner violence may be adversely affected. Cross-sectional, using baseline data from a seven-year prospective study. Data related to severity of abuse (both physical and sexual) and the outcome measures of maternal (n = 300) mental health measures, risk of lethality, chronic pain and child (n = 300) behavioural functioning were analysed. Higher physical abuse scores were significantly correlated with higher sexual abuse scores, and higher levels of physical abuse were associated with higher maternal anxiety and higher child externalisation scores. Higher levels of sexual abuse were associated with higher maternal somatisation and post-traumatic stress disorder symptoms and higher child internalisation scores and total problems. These initial findings suggest that children have behavioural functioning and coping that is closely related to their mothers' functioning, which is based on the type of abuse experienced by the mothers. As we gain a greater understanding of these issues, we will be better able to develop effective policies and therapeutic interventions to help abused women and their children. Findings for the mental health functioning of women participating in this study add to the overwhelming evidence for the importance of screening for partner violence when women present for health care and for the need for effective assistance services for women who have or are currently experiencing partner violence. They also support emerging research that indicates the great need to provide effective services for the children of abused women. © 2014 John Wiley & Sons Ltd.

Reversal of SSRI-induced female sexual dysfunction by adjunctive bupropion in menstruating women: a double-blind, placebo-controlled and randomized study.

PubMed

Safarinejad, Mohammad R

2011-03-01

A significant number of patients undergoing treatment with selective serotonin reuptake inhibitors (SSRIs) report sexual dysfunction. SSRI-induced sexual dysfunction adversely affects quality of life and patient adherence to and compliance with treatment regimens. This trial examined the efficacy and safety of adjunctive bupropion in the treatment of SSRI-induced female sexual dysfunction. Sexual function was assessed by using the sexual function domains of the Female Sexual Function Index (primary efficacy outcome measure) and the Clinical Global Impression Scale adapted for sexual function (secondary efficacy outcome measure). End point treatment satisfaction was assessed using a Visual Analog Scale. A total of 218 women (25-45 years old) with SSRI-induced sexual dysfunction were randomized to receive 12 weeks of double-blind fixed dosed treatment with bupropion sustained release 150 mg b.i.d. (n = 109) or placebo (n = 109). The mean (SD) for Female Sexual Function Index total score was higher in the bupropion sustained release group (25.9 (5.12), 95% confidence interval (CI) 22.2-29.4) than in the placebo group (17.2 (4.9), 95% CI 15.8-20.1) (p = 0.001). Mean (SD) Clinical Global Impression Scale score for the bupropion group (2.4 (0.6), 95% CI 2.0-3.6) was significantly lower than that for the placebo group (4.2 (0.8), 95% CI 3.4-5.4) (p = 0.001). At the end of the trial the mean (SD) scores for desire (4.1 (0.7), 95% CI 3.5-4.8) (p = 0.001), arousal (4.4 (0.6), 95% CI 3.7-4.8) (p = 0.01), lubrication (4.4 (0.4), 95% CI 3.3-4.8) (p = 0.001), orgasm (4.4 (0.5), 95% CI 3.7-4.7) (p = 0.001), and satisfaction (4.2 (0.7), 95% CI 3.4-4.8) (p = 0.001) were significantly higher in the bupropion group. The highest improvement was observed in sexual desire, followed by lubrication. Compared with baseline, desire and lubrication domains increased by 86.4% (95% CI 64.9-102.2%, p = 0.001) and 69.2% (95% CI 44.7-82.6%, p = 0.001) in the bupropion group. Adjunctive treatment with bupropion sustained release during a 12-week period significantly improved key aspects of sexual function in women with SSRI-induced sexual dysfunction.

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.

A Longitudinal Study of Predictors of Sexual Dysfunction in Men on Active Surveillance for Prostate Cancer

PubMed Central

Pearce, Shane M; Wang, Chi-Hsiung E; Victorson, David E; Helfand, Brian T; Novakovic, Kristian R; Brendler, Charles B; Albaugh, Jeffrey A

2015-01-01

Aim The aim of this study was to examine the relationship between sexual dysfunction, repeat biopsies and other demographic and clinical factors in men on active surveillance (AS). Methods Patient-reported outcomes (PROs) measures were administered at enrollment and every 6 months to assess quality of life (QOL), psychosocial and urological health outcomes. Using mixed-effects models, we examined the impact of repeat biopsies, total number of cores taken, anxiety, age, and comorbidity on sexual function over the first 24 months of enrolling in AS. Main Outcome Measures PROs included the Expanded Prostate Cancer Index Composite-26 (EPIC-26) Sexual Function (SF) subscale, the American Urological Association-Symptom Index (AUA-SI), and the Memorial Anxiety Scale for Prostate Cancer (MAX-PC). Results At enrollment (n = 195), mean age was 66.5 ± 6.8 with a mean EPIC-26 SF score of 61.4 ± 30.4. EPIC-26 SF scores steadily decreased to 53.9 ± 30.7 at 24 months (P < 0.01). MAX-PC scores also progressively decreased over time (P = 0.03). Factors associated with lower EPIC-26 scores over time included age, unemployed status, diabetes, coronary artery disease, and hypertension (all P < 0.05). Higher prostate-specific antigen (PSA) was associated with a more rapid decline in EPIC-26 SF over time (P = 0.03). In multivariable analysis, age, diabetes, and PSA × time interaction remained significant predictors of diminished sexual function. Anxiety, number of biopsies, and total cores taken did not predict sexual dysfunction or change over time in our cohort. Conclusions Men on AS experienced a gradual decline in sexual function during the first 24 months of enrollment. Older age, PSA × time, and diabetes were all independent predictors of diminished sexual function over time. Anxiety, AUA-SI, the number of cores and the number of biopsies were not predictors of reduced sexual function in men in AS. PMID:26468379

Sexual selection gradients change over time in a simultaneous hermaphrodite

PubMed Central

Hoffer, Jeroen NA; Mariën, Janine; Ellers, Jacintha; Koene, Joris M

2017-01-01

Sexual selection is generally predicted to act more strongly on males than on females. The Darwin-Bateman paradigm predicts that this should also hold for hermaphrodites. However, measuring this strength of selection is less straightforward when both sexual functions are performed throughout the organism’s lifetime. Besides, quantifications of sexual selection are usually done during a short time window, while many animals store sperm and are long-lived. To explore whether the chosen time frame affects estimated measures of sexual selection, we recorded mating success and reproductive success over time, using a simultaneous hermaphrodite. Our results show that male sexual selection gradients are consistently positive. However, an individual’s female mating success seems to negatively affect its own male reproductive success, an effect that only becomes visible several weeks into the experiment, highlighting that the time frame is crucial for the quantification and interpretation of sexual selection measures, an insight that applies to any iteroparous mating system. DOI: http://dx.doi.org/10.7554/eLife.25139.001 PMID:28613158

Children's Sexual Thinking: A Comparative Study of Children Aged 5 to 15 Years in Australia, North America, Britain and Sweden.

ERIC Educational Resources Information Center

Goldman, Ronald; Goldman, Juliette

The purpose of this cross-national descriptive study is to measure the extent of children's sexual knowledge and sexual understanding at various ages and to identify what processes of thought children use in trying to explain biological functions and the phenomena of their own bodies as they grow and change. Sexual thinking is defined as thinking…

Cues Resulting in Desire for Sexual Activity in Women

PubMed Central

McCall, Katie; Meston, Cindy

2010-01-01

Introduction A number of questionnaires have been created to assess levels of sexual desire in women, but to our knowledge, there are currently no validated measures for assessing cues that result in sexual desire. A questionnaire of this nature could be useful for both clinicians and researchers, because it considers the contextual nature of sexual desire and it draws attention to individual differences in factors that can contribute to sexual desire. Aim The aim of the present study was to create a multidimensional assessment tool of cues for sexual desire in women that is validated in women with and without hypoactive sexual desire disorder (HSDD). Methods Factor analyses conducted on both an initial sample (N = 874) and a community sample (N = 138) resulted in the Cues for Sexual Desire Scale (CSDS) which included four factors: (i) Emotional Bonding Cues; (ii) Erotic/ Explicit Cues; (iii) Visual/Proximity Cues; and (iv) Implicit/Romantic Cues. Main Outcome Measures Scale construction of cues associated with sexual desire and differences between women with and without sexual dysfunction. Results The CSDS demonstrated good reliability and validity and was able to detect significant differences between women with and without HSDD. Results from regression analyses indicated that both marital status and level of sexual functioning predicted scores on the CSDS. The CSDS provided predictive validity for the Female Sexual Function Index desire and arousal domain scores, and increased cues were related to a higher reported frequency of sexual activity in women. Conclusions The findings from the present study provide valuable information regarding both internal and external triggers that can result in sexual desire for women. We believe that the CSDS could be beneficial in therapeutic settings to help identify cues that do and do not facilitate sexual desire in women with clinically diagnosed desire difficulties. PMID:16942529

Patients' Conceptions of Terms Related to Sexual Interest, Desire, and Arousal.

PubMed

DeLamater, John D; Weinfurt, Kevin P; Flynn, Kathryn E

2017-11-01

Measurement of sexual function typically uses self-report, which, to work as intended, must use language that is understood consistently by diverse respondents. Commonly used measures employ multiple terms, primarily (sexual) interest, desire, and arousal, that might not be understood in the same way by laypeople and professionals. To inform self-reported measurement efforts for research and clinical settings by examining how US men and women recruited from a health care setting understand and interpret different terms. We conducted 10 focus groups in Durham, NC (N = 57). Discussions were audio-recorded and transcribed, and the content of the discussions was systematically analyzed in 2 phases of coding by the research team, facilitated by Nvivo qualitative analysis software (QSR International, Doncaster, VIC, Australia). Patient focus group discussions about the meanings and connotations of multiple terms related to sexual function, especially interest, desire, and arousal. 5 groups included male participants and 5 included female participants. Participants characterized (sexual) interest as a cognitive phenomenon and a situational response to a specific person. Similarly, they characterized (sexual) desire as a situational person-specific experience with some support for it as a cognitive phenomenon but more support for it as a physical phenomenon. In contrast, participants characterized sexual arousal as a physical phenomenon occurring in response to physical or visual stimulation and not related to a specific person. These results can help us understand how laypeople are using and responding to these terms when they are used in clinical and research settings. Patient participants in these groups were diverse in age, gender, sexual orientation, and health, with the potential to voice diverse perspectives on sexual functioning; however, the sample was limited to a single city in the southeastern United States. The meanings of interest, desire, and arousal were defined, compared, and contrasted in the context of patient focus groups. Qualitative coding showed that interest was considered the most "cognitive," arousal the most "physical," and desire somewhere in between. DeLamater JD, Weinfurt KP, Flynn KE. Patients' Conceptions of Terms Related to Sexual Interest, Desire, and Arousal. J Sex Med 2017;14:1327-1335. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Limited role of body satisfaction and body image self-consciousness in sexual frequency and satisfaction in pregnant women.

PubMed

Radoš, Sandra Nakić; Vraneš, Hrvojka Soljačić; Šunjić, Marijana

2014-01-01

This cross-sectional study examined the role of maternal body image and body image self-consciousness in sexual satisfaction and intercourse frequency during pregnancy when controlling for satisfaction with partnership. Pregnant women in their third trimester of pregnancy (N = 150) participated in the study. Body image was measured by the Body Areas Satisfaction Scale (BASS) and Body Image Self-Consciousness Scale (BISC), while relationship satisfaction was measured by different subscales of the Perceived Quality of Marital Relationship (PQMR) Scale. Sexual satisfaction was also measured by one of the subscales of the PQMR (Intimate Relationship). The sexual behavior questionnaire comprised questions about frequency of sexual intercourse, desire, and other aspects of sexual functioning as well as the reasons that might prevent women from having intercourse during pregnancy. Findings suggested that satisfaction with body image and body image self-consciousness were related to sexual satisfaction. Nevertheless, other aspects of partnership, such as communication, appeared to be much more important predictors of sexual satisfaction than body image variables. The best predictor of sexual frequency was fear that intercourse might harm the fetus. Implications for education about sexuality issues in pregnancy are discussed.

Sexual Pleasure and Function, Coital Trauma, and Sex Behaviors After Voluntary Medical Male Circumcision Among Men in the Dominican Republic.

PubMed

Brito, Maximo O; Khosla, Shaveta; Pananookooln, Sheewin; Fleming, Paul J; Lerebours, Leonel; Donastorg, Yeycy; Bailey, Robert C

2017-04-01

Voluntary medical male circumcision (VMMC) is effective in decreasing the risk of HIV acquisition. As men resume sexual activity after circumcision, it will be important to study their satisfaction with the procedure, sexual pleasure and function, coital trauma, and risk compensation (RC), which can hamper or facilitate the long-term success of VMMC programs. To assess men's satisfaction with VMMC, sexual pleasure and function, coital trauma, and RC after VMMC. This is a cohort study of circumcised men who presented for follow-up 6 to 24 months after VMMC. Logarithmic binomial regression was performed to explore factors associated with any increase in the number of sex partners after VMMC as a measurement of RC. (i) Men's satisfaction with their VMMC; (ii) sexual pleasure and function after VMMC; (iii) coital trauma; and (iv) RC. Of 454 circumcised men, 362 (80%) returned for a follow-up visit 6 to 24 months after VMMC. Almost all (98%) were satisfied with the outcome of their VMMC; most (95%) reported that their female partners were satisfied with their circumcision. Two thirds (67%) reported enjoying sex more after VMMC and most were very satisfied or somewhat satisfied (94%) with sexual intercourse after VMMC. Sexual function improved and reported sex-induced coital injuries decreased significantly in most men after VMMC. There was an increase in the proportion of men who reported at least two sexual partners after VMMC compared with baseline. In multivariate analysis, having sex with a woman they met the same day (adjusted relative risk = 1.7, 95% CI = 1.2-2.4) and having at least two sexual partners at baseline (adjusted relative risk = 0.5, 95% CI = 0.3-0.8) were associated with the outcome of any increase in the number of partners after VMMC. VMMC can be offered to Dominican men for HIV prevention without adversely affecting sexual pleasure or function. The procedure substantially reduces coital trauma. This is the first report of long-term overall satisfaction, sexual pleasure/function and sex behaviors in the context of VMMC outside of Africa. Limitations of the study included the reliance on self-reported sex behaviors, the lack of physiologic measurement of penile sensitivity and the lack of follow up data beyond 24 months, which precludes the assessment of longer term RC. The study confirmed men's long-term satisfaction with the outcome of their VMMC. VMMC improved sexual pleasure and function for most men and significantly decreased coital injuries. There was mixed evidence of RC. Brito MO, Khosla S, Pananookooln S, et al. Sexual Pleasure and Function, Coital Trauma, and Sex Behaviors After Voluntary Medical Male Circumcision Among Men in the Dominican Republic. J Sex Med 2017;14:526-534. Published by Elsevier Inc.

Are depression and poor sexual health neglected comorbidities? Evidence from a population sample.

PubMed

Field, Nigel; Prah, Philip; Mercer, Catherine H; Rait, Greta; King, Michael; Cassell, Jackie A; Tanton, Clare; Heath, Laura; Mitchell, Kirstin R; Clifton, Soazig; Datta, Jessica; Wellings, Kaye; Johnson, Anne M; Sonnenberg, Pam

2016-03-23

To examine associations between sexual behaviour, sexual function and sexual health service use of individuals with depression in the British general population, to inform primary care and specialist services. British general population. 15,162 men and women aged 16-74 years were interviewed for the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), undertaken in 2010-2012. Using age-adjusted ORs (aAOR), relative to a comparator group reporting no treatment or symptoms, we compared the sexual health of those reporting treatment for depression in the past year. Sexual risk behaviour, sexual function, sexual satisfaction and sexual health service use. 1331 participants reported treatment for depression (5.2% men; 11.8% women). Relative to the comparator group, treatment for depression was associated with reporting 2 or more sexual partners without condoms (men aAOR 2.07 (95% CI 1.38 to 3.10); women 2.22 (1.68 to 2.92)), and concurrent partnerships (men 1.80 (1.18 to 2.76); women 2.06 (1.48 to 2.88)), in the past year. Those reporting depression treatment were more likely to be dissatisfied with their sex lives (men 2.32 (1.74 to 3.11); women 2.30 (1.89 to 2.79)), and to score in the lowest quintile on the Natsal-sexual function measure. They were also more likely to report a recent chlamydia test (men 1.92 (1.15 to 3.20)); women (1.27 (1.01 to 1.60)), and to have sought help regarding their sex life from a healthcare professional (men 2.92 (1.98 to 4.30); women (2.36 (1.83 to 3.04)), most commonly from a family doctor. Women only were more likely to report attending a sexual health clinic (1.91 (1.42 to 2.58)) and use of emergency contraception (1.98 (1.23 to 3.19)). Associations were broadly similar for individuals with depressive symptoms but not reporting treatment. Depression, measured by reported treatment, was strongly associated with sexual risk behaviours, reduced sexual function and increased use of sexual health services, with many people reporting help doing so from a family doctor. The sexual health of depressed people needs consideration in primary care, and mental health assessment might benefit people attending sexual health services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Sexual and reproductive health in rheumatic disease.

PubMed

Østensen, Monika

2017-08-01

Family size is reduced among patients with rheumatic diseases. The causes for the low number of children are multifactorial and include impaired sexual function, decreased gonadal function, pregnancy loss, therapy and personal choices. Sexuality contributes to quality of life in patients with rheumatic disease, but is often ignored by health professionals. Both disease-related factors and psychological responses to chronic disease can impair sexual functioning. Toxic effects of anti-inflammatory and immunosuppressive drugs can induce transient or permanent gonadal failure in women and men. Furthermore, permanent infertility can be a consequence of treatment with cyclophosphamide, whereas transient infertility can be caused by NSAIDs in women and sulfasalazine in men. These adverse effects must be communicated to the patients, and measures to preserve fertility should be initiated before the start of gonadotoxic therapy. Management of patients of both genders should include regular family planning, effective treatment of high disease activity, sexual counselling, and, if necessary, infertility treatment.

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

Diabetes Mellitus-Associated Functional Hypercortisolism Impairs Sexual Function in Male Late-Onset Hypogonadism.

PubMed

Tirabassi, G; Corona, G; Lamonica, G R; Lenzi, A; Maggi, M; Balercia, G

2016-01-01

Functional hypercortisolism is generated by conditions able to chronically activate hypothalamic-pituitary-adrenal axis and has been proven to have a negative role in several complications. However, no study has evaluated the possible influence of diabetes mellitus-associated functional hypercortisolism on male hypogonadism and sexual function. We aimed to identify any association of hypothalamic-pituitary-adrenal axis dysregulation measures with testosterone and sexual function in men simultaneously affected by diabetes mellitus and late-onset hypogonadism. Fifteen diabetes mellitus and late-onset hypogonadism subjects suffering from functional hypercortisolism and fifteen diabetes mellitus and late-onset hypogonadism subjects who were free of functional hypercortisolism were retrospectively reviewed. Clinical, hormonal, and sexual parameters were considered. Hypercortisolemic subjects showed higher values of body mass index, waist, and glycated hemoglobin and lower ones of testosterone compared to normocortisolemic ones. All sexual parameters, except for orgasmic function, were significantly worse in hypercortisolemic than in normocortisolemic subjects. Hypercortisolemic patients showed higher values of cortisol after dexamethasone and urinary free cortisol as well as a lesser ACTH response after corticotropin releasing hormone test (ACTH area under curve) compared to normocortisolemic ones. No significant association was found at Poisson regression analysis between hormonal and sexual variables in normocortisolemic patients. In hypercortisolemic subjects, negative and significant associations of cortisol response after corticotropin releasing hormone (cortisol area under curve) with erectile function (β: -0.0008; p: 0.015) and total international index of erectile function score (β: -0.0006; p: 0.001) were evident. This study suggests for the first time the impairing influence of the dysregulated hypothalamic-pituitary-adrenal axis on sexual function in diabetes mellitus-associated late-onset hypogonadism. © Georg Thieme Verlag KG Stuttgart · New York.

Inter-relationships between sexual abuse, female sexual function and childbirth.

PubMed

Gottfried, Ruth; Lev-Wiesel, Rachel; Hallak, Mordechai; Lang-Franco, Nessia

2015-11-01

the present quantitative longitudinal study focuses on the inter-relationships between sexual abuse, distressed female sexual function and childbirth. Additional variables studied include depression, mode of delivery, subjective birth experience and traumatic life events other than sexual abuse. data collection for the study was extended across three time periods: during the third trimester of pregnancy and approximately one and six months postpartum. Self-reported questionnaire responses of 300 women from two medical centres in Israel, as well as hospital records regarding their mode of childbirth, were included in the data analysis. Measures incorporated in the study included the Female Sexual Distress Scale-Revised, the Beck Depression Inventory and modified versions of the Traumatic Events Questionnaire, the Sexual Experiences Survey, and the Subjective Birth Experience Questionnaire. findings demonstrated that women with a lifetime history of sexual abuse compared to women without such history, are at an increased risk for distressed antenatal and postpartum female sexual function (Odds Ratio OR=2.66 and OR=2.26, respectively); and postpartum depression (OR=2.36). Antenatal depression was likewise shown to be significantly associated with antenatal and postpartum distressed female sexual function (OR=4.32 and OR=10.4, respectively), as well as with a more negatively experienced childbirth (T-Ratio, T=1.98, p<0.05). Moreover, distressed antenatal female sexual function was found to increase the risk for a more negatively experienced childbirth (T=2.04, p<0.05), and caesarean childbirth (OR=3.34). the current study enriches the understanding of the inter-relationships between the antenatal, childbirth and postpartum variables studied herein; and has implications for evidence based practice in both preventative and intervention efforts. Recommendations for future research are presented and discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sexual functioning in women with chronic pelvic pain: the role of anxiety and depression.

PubMed

ter Kuile, Moniek M; Weijenborg, Philomeen T M; Spinhoven, Philip

2010-05-01

Chronic pelvic pain (CPP) in women is a long lasting and often disabling condition. It seems reasonable to expect that as a result of the pain, extreme fatigue and/or emotional problems, women with CPP may report a variety of sexual problems. The present study investigated differences in the report of sexual problems in women with CPP compared with healthy controls, and whether the association of CPP with sexual problems was moderated or mediated by somatic and psychological factors as manifested in women suffering from CPP. One hundred fifty-four women with CPP and 58 age-matched controls completed self-report measures for sexual functioning, pain, physical impairment, anxiety, depression, and sexual and physical abuse. Golombok Rust Inventory of Sexual Satisfaction. Women with CPP reported higher levels of vaginistic complaints, sexual avoidance, nonsensuality and sexual dissatisfaction than healthy controls. Sexual problems were associated with anxiety, depression, and sexual abuse history but not with somatic factors as pain and physical impairment. Anxiety as well as depression, irrespective of the report of sexual abuse experiences, mediated the effect of CPP on sexual problems. Sexual abuse was a general predictor of sexual problems in both women with CPP and controls. Anxiety and depression constitute important factors in the evaluation of sexual problems in women with CPP.

Developing a Hypnotic Relaxation Intervention to Improve Body Image: A Feasibility Study.

PubMed

Cieslak, Alison; Elkins, Gary; Banerjee, Tanima; Marsack, Jessica; Hickman, Kimberly; Johnson, Alisa; Henry, Norah; Barton, Debra

2016-11-01

To determine the content, feasibility, and best outcome of a mind-body intervention involving self-directed hypnotic relaxation to target body image.
. A five-week, uncontrolled, unblinded feasibility intervention study.
. Behavioral therapy offices in Ann Arbor, Michigan, and Waco, Texas.
. 10 female breast cancer survivors and 1 breast and gynecologic cancer survivor. 
. Adult women with a history of breast and gynecologic cancer and no major psychiatric history were eligible. The intervention included four face-to-face sessions with a research therapist lasting 40-60 minutes, logged home practice, one telephone check-in call at week 5, and one intervention feedback telephone call to complete the study. Descriptive statistics and paired t-tests were used to test feasibility and content validity.
. Stress from body changes as measured by the Impact of Treatment Scale, sexual function as measured by the Female Sexual Function Index, and sexual self-image as measured by the Sexual Self-Schema Scale for women were the variables of interest.
. The intervention content was confirmed. Changes in scores from the baseline to week 5 suggested that stress from body changes decreased and sexual self-schema and function improved during the intervention. Nine of the 11 women were satisfied with the intervention, and all 11 indicated that their body image improved. 
. Hypnotic relaxation therapy shows promise for improving body image and, in doing so, improving sexual health in this population. Additional testing of this intervention is warranted.
. Hypnotic relaxation therapy is feasible to improve body image and sexual health in women diagnosed with cancer and may be an important intervention that could be offered by nurses and other behavioral therapists.

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.

A double-blind, randomized, placebo-controlled trial of the effect of testosterone cream on the sexual motivation of menopausal hysterectomized women with hypoactive sexual desire disorder.

PubMed

El-Hage, G; Eden, J A; Manga, R Zoa

2007-08-01

To assess the safety and efficacy of 10 mg topical testosterone therapy daily (2 cm Andro-Feme cream) as a treatment for low sexual desire in postmenopausal hysterectomized women who were already on transdermal estrogen. A double-blind, randomized, placebo-controlled, cross-over study (each period being of 3 months' duration) was performed in the research center of a tertiary referral women's hospital. Thirty-six menopausal healthy women were recruited who had undergone a hysterectomy, who were not depressed, were in a stable relationship and who fulfilled diagnostic criteria for low sexual desire, as measured by the Brief Index of Sexual Function for Women (BISF-W). The primary outcome measure was improvement in the sexuality score as measured by a validated tool (BISF-W); secondary measures were sub-scores of the BISF-W, effect on mood and energy, lipids and testosterone levels. Testosterone cream significantly improved sexual desire, frequency of sex, receptivity and initiation as measured by the BISF-W score. It did not change mood, energy, lipids, blood pressure or weight over the study period. Testosterone cream significantly improved sexual scores in menopausal women with low sexual desire. It was effective, easy to use and had no side-effects over the 3-month period of active treatment. It offers a novel and acceptable method of administering testosterone to menopausal women.

Sexual problems and post-traumatic stress disorder following sexual trauma: A meta-analytic review.

PubMed

O'Driscoll, Ciarán; Flanagan, Esther

2016-09-01

Difficulties with sex often develop following sexual trauma, yet are rarely targeted within treatment of post-traumatic stress disorder (PTSD). Where outcomes of sexual function are included, they are secondary to other measures. This review aimed to assess whether psychological treatment for PTSD (from sexual trauma) has an effect on sexual functioning. Systematic searches of MEDLINE, PsycINFO, EMBASE, and trial registers were performed. Five studies met inclusion criteria. Pre-post treatment effect sizes were also calculated. Data from four good-quality RCTs were included in the meta-analyses. These examined females (n = 799) who had experienced adult sexual trauma or child sexual abuse. Studies compared psychological treatment to control conditions, but no effect on outcomes of sexual concerns, standardized mean difference (SMD) = 0.03 and dysfunctional sexual behaviour, SMD = 0.02, was found. Pre-post treatment effect sizes were small to medium (SMD = 0.36 and 0.47, respectively). While firm conclusions cannot be drawn, the available evidence suggests that psychological treatment for PTSD has no effect on sexual problems. Pre-post effects indicate some improvement over the course of treatment, which may be strengthened if treatment actively targeted sexual problems. The paucity of evidence in this area suggests that there is substantial need for further research in order to establish a set of evidence-based guidelines for practitioners implementing treatment in this area. The measurement of sexual problems is overlooked in psychological treatment RCTs for sexual trauma. Current treatments for post-traumatic stress disorder (PTSD) from sexual trauma do not appear to be addressing sexual problems. Integrated treatments for comorbid sexual problems and PTSD treatment may be warranted. It is imperative that in future, RCTs that examine people with PTSD from sexual trauma use outcomes of sexual problems. © 2015 The British Psychological Society.

Couple Relationship Functioning as a Source or Mitigator of HIV Risk: Associations Between Relationship Quality and Sexual Risk Behavior in Peri-urban Uganda.

PubMed

Ruark, Allison; Kajubi, Phoebe; Ruteikara, Sam; Green, Edward C; Hearst, Norman

2018-04-01

Despite evidence that a greater focus on couples could strengthen HIV prevention efforts, little health-related research has explored relationship functioning and relationship quality among couples in Africa. Using data from 162 couples (324 individuals) resident in a peri-urban Ugandan community, we assessed actor and partner effects of sexual risk behaviors on relationship quality, using psychometric measures of dyadic adjustment, sexual satisfaction, commitment, intimacy, and communication. For women and men, poor relationship quality was associated with having concurrent sexual partners and suspecting that one's partner had concurrent sexual partners (actor effects). Women's poor relationship quality was also associated with men's sexual risk behaviors (partner effects), although the inverse partner effect was not observed. These findings suggest that relationship quality is linked to HIV risk, particularly through the pathway of concurrent sexual partnerships, and that positive relationship attributes such as sexual satisfaction, intimacy, and constructive communication can help couples to avoid risk.

Gender identification of Caspian Terns using external morphology and discriminant function analysis

USGS Publications Warehouse

Ackerman, Joshua T.; Takekawa, John Y.; Bluso, J.D.; Yee, J.L.; Eagles-Smith, Collin A.

2008-01-01

Caspian Tern (Sterna caspia) plumage characteristics are sexually monochromatic and gender cannot easily be distinguished in the field without extensive behavioral observations. We assessed sexual size dimorphism and developed a discriminant function to assign gender in Caspian Terns based on external morphology. We collected and measured Caspian Terns in San Francisco Bay, California, and confirmed their gender based on necropsy and genetic analysis. Of the eight morphological measurements we examined, only bill depth at the gonys and head plus bill length differed between males and females with males being larger than females. A discriminant function using both bill depth at the gonys and head plus bill length accurately assigned gender of 83% of terns for which gender was known. We improved the accuracy of our discriminant function to 90% by excluding individuals that had less than a 75% posterior probability of correctly being assigned to gender. Caspian Terns showed little sexual size dimorphism in many morphometries, but our results indicate they can be reliably assigned to gender in the field using two morphological measurements.

Sexual Health Concerns Among Cancer Survivors: Testing a Novel Information-Need Measure Among Breast and Prostate Cancer Patients.

PubMed

Crowley, Sheila A; Foley, Sallie M; Wittmann, Daniela; Jagielski, Christina H; Dunn, Rodney L; Clark, Patricia M; Griggs, Jennifer J; Peterson, Catherine; Leonard, Marcia; An, Lawrence C; Wei, John T; Montie, James E; Janz, Nancy K

2016-09-01

While it is recognized that cancer treatment can contribute to problems in sexual function, much less is currently known about the specific sexual health concerns and information needs of cancer survivors. This study tested a new instrument to measure cancer survivors' sexual health concerns and needs for sexual information after cancer treatment. The Information on Sexual Health: Your Needs after Cancer (InSYNC), developed by a multidisciplinary team of experts, is a novel 12-item questionnaire to measure sexual health concerns and information needs of cancer survivors. We tested the measure with a sample of breast and prostate cancer survivors. A convenience sample of 114 cancer survivors (58 breast, 56 prostate) was enrolled. Results of the InSYNC questionnaire showed high levels of sexual concern among cancer survivors. Areas of concern differed by cancer type. Prostate cancer survivors were most concerned about being able to satisfy their partners (57 %) while breast cancer survivors were most concerned with changes in how their bodies worked sexually (46 %). Approximately 35 % of all cancer survivors wanted more information about sexual health. Sexual health concerns and unmet information needs are common among breast and prostate cancer survivors, varying in some aspects by type of cancer. Routine screening for sexual health concerns should be included in comprehensive cancer survivorship care to appropriately address health care needs. The InSYNC questionnaire is one tool that may help clinicians identify concerns facing their patients.

To say or not to say: Dyadic ambivalence over emotional expression and its associations with pain, sexuality, and distress in couples coping with provoked vestibulodynia.

PubMed

Awada, Nayla; Bergeron, Sophie; Steben, Marc; Hainault, Victoria-Ann; McDuff, Pierre

2014-05-01

Provoked vestibulodynia (PVD) is a highly prevalent and taxing female genital pain condition. Despite the intimate nature of this pain and the fact that affective factors such as anxiety have been shown to modulate its manifestations, no study has yet explored the emotional regulation of couples in which the woman suffers from PVD. Ambivalence over emotional expression (AEE) is an emotional regulation variable that quantifies the extent to which a person is comfortable with the way she or he expresses emotions. We examined whether the dyadic AEE of couples in which the woman suffers from PVD was differentially associated with women's pain and couples' psychological, sexual, and relational functioning. Couples (N = 254), in which the woman suffered from PVD, completed the AEE questionnaire. A couple typology of dyadic AEE was created. Dependent measures for both members of the couple were the global measure of sexual satisfaction scale, the Beck depression inventory II, and the revised dyadic adjustment scale. The female sexual function index and the sexual history form were used to assess the sexual function of women and men, respectively. Women also completed the pain rating index of the McGill pain questionnaire. Couples, in which both partners were considered low on AEE, had the highest scores on sexual satisfaction (P = 0.02) and function (P < 0.01), the lowest depression scores (P < 0.01), and the best dyadic adjustment (P = 0.02). No difference in pain intensity was found between couples. Findings suggest that, for couples in which the woman suffers from PVD, an emotional regulation that is low in ambivalence in both partners is associated with better psychological, sexual, and relational outcomes. Results indicate that emotional regulation may be important to consider in the assessment and treatment of couples coping with PVD. © 2014 International Society for Sexual Medicine.

Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: results from a randomized clinical trial.

PubMed

Meston, Cindy M; Lorenz, Tierney A; Stephenson, Kyle R

2013-09-01

Women with a history of childhood sexual abuse (CSA) have high rates of depression, posttraumatic stress disorder, and sexual problems in adulthood. We tested an expressive writing-based intervention for its effects on psychopathology, sexual function, satisfaction, and distress in women who have a history of CSA. Seventy women with CSA histories completed five 30-minute sessions of expressive writing, either with a trauma focus or a sexual schema focus. Validated self-report measures of psychopathology and sexual function were conducted at posttreatment: 2 weeks, 1 month, and 6 months. Women in both writing interventions exhibited improved symptoms of depression and posttraumatic stress disorder (PTSD). Women who were instructed to write about the impact of the abuse on their sexual schema were significantly more likely to recover from sexual dysfunction. Expressive writing may improve depressive and PTSD symptoms in women with CSA histories. Sexual schema-focused expressive writing in particular appears to improve sexual problems, especially for depressed women with CSA histories. Both treatments are accessible, cost-effective, and acceptable to patients. © 2013 International Society for Sexual Medicine.

Effects of a Mindfulness Task on Women's Sexual Response.

PubMed

Velten, Julia; Margraf, Jürgen; Chivers, Meredith L; Brotto, Lori A

2017-12-20

Mindfulness-based interventions are effective at improving symptoms of sexual dysfunction in women. The mechanisms by which mindfulness improves sexual function are less clear. The main objective of our study was to investigate the impact of a mindfulness task on sexual response in women. Forty-one women (mean age = 27.2, SD = 5.6) participated in two laboratory sessions that each included two erotic films and one attention task that were presented in counterbalanced order. Both attention tasks consisted of a six-minute audio recording of either a modified body scan, focusing on genital arousal sensations (mindfulness condition), or a visualization exercise. Subjective and genital sexual arousal were measured continuously during stimulus presentation. The mindfulness task led to greater subjective and lower genital arousal. The agreement of subjective and genital sexual arousal (i.e., concordance) was greater in the mindfulness condition. Trait mindfulness was related to lower sexual arousal but also greater sexual concordance in women. Mindfulness-based interventions that encourage women to focus on physical arousal sensations in the here and now may be associated with women's improved sexual function by enhancing feelings of sexual arousal during sexual activity and by increasing concordance between subjective and genital sexual arousal.

Sexual arousal in East Asian and Euro-Canadian women: a psychophysiological study.

PubMed

Yule, Morag; Woo, Jane S T; Brotto, Lori A

2010-09-01

Studies of ethnic differences in self-report measures of sexuality have shown East Asian women to be more sexually conservative and less sexually experienced than Caucasian women. There is also strong evidence supporting the notion of ethnic group differences in general measures of nonsexual psychophysiological arousal; however, there have been no previous studies exploring ethnicity and physiological sexual arousal. The objective of this study was to explore group differences in self-reported and physiological sexual arousal in Euro-Canadian and East Asian women living in Canada; we also aimed to explore the association between level of acculturation (both mainstream and heritage) and sexual arousal in East Asian women only. Seventy-five women (N=38 Euro-Canadian, N=37 East Asian) completed a battery of questionnaires and underwent psychophysiological sexual arousal testing using the vaginal photoplethysmograph. They also completed a self-report measure of subjective arousal before and after erotic stimulus exposure. All women completed the Female Sexual Function Index, Vancouver Index of Acculturation, and Sexual Beliefs and Information Questionnaire. Change in genital sexual arousal (vaginal pulse amplitude; VPA), and change in subjective sexual arousal were measured during exposure to erotic stimuli. The groups did not differ in the percent increase in VPA induced by erotic stimuli, nor was there a correlation between VPA and subjective sexual arousal. Among East Asian women alone, neither heritage nor mainstream acculturation was correlated with change in VPA. East Asian and Euro-Canadian women who show similar ratings of sexual behaviors and self-reported sexual arousal do not differ in physiological or subjective arousal induced by erotic stimuli in the laboratory. © 2010 International Society for Sexual Medicine.

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

Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).

PubMed

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

2013-11-30

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. 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. 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. 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. 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. Copyright © 2013 Mitchell et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd. All rights reserved.

Direct and Indirect Links Between Childhood Maltreatment, Posttraumatic Stress Disorder, and Women’s Health

PubMed Central

Lang, Ariel J.; Aarons, Gregory A.; Gearity, James; Laffaye, Charlene; Satz, Leslie; Dresselhaus, Timothy R.; Stein, Murray B.

2008-01-01

The authors evaluated the relationships among childhood maltreatment, sexual trauma in adulthood, posttraumatic stress disorder (PTSD), and health functioning in women. Female Veterans’ Affairs (VA) primary care patients (N = 200) completed self-report measures of childhood maltreatment, adult sexual trauma, PTSD symptoms, and current health functioning. The authors used structural equation modeling to test models of the relationship among these variables. Childhood nonsexual maltreatment and adult sexual assault were positively associated with PTSD. Childhood nonsexual maltreatment (β = −.20) and PTSD (β = −.75) were significantly associated with poorer physical and mental health functioning. Adult sexual assault negatively affected health functioning through its association with PTSD. Thus, poor health outcomes associated with childhood maltreatment in women may be conveyed through PTSD. These findings should strengthen efforts directed at identifying and treating PTSD in female victims of childhood maltreatment with the aim of preventing or attenuating poor health outcomes. PMID:18316270

Do Adolescent Sexual Behavior and Intention to Engage in Sexual Behavior Change in High School Years in Hong Kong?

PubMed

Shek, D T L; Leung, H

2016-02-01

In this study we examined sexual behavior and intention to engage in sexual behavior among Chinese high school students in Hong Kong using 6 waves of data collected over 6 years. We also focused on the related sociodemographic and family correlates. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A 6-year longitudinal study was conducted. At each wave, a questionnaire was used to collect data on sociodemographic characteristics, positive youth development, and family functioning in the respondents. Individual growth curve models showed that adolescent sexual behavior and intention increased over time. Adolescents with higher levels of positive youth development reported lower levels of past sexual behavior. Youths from better-off and higher functioning families increased their sexual behavior at slower rates than did youths from families with economic disadvantage and poor family functioning. Regarding intention to have sex, older adolescents reported higher levels of intention. Youngsters with higher levels of perceived family functioning and positive youth development reported lower levels of initial intention. Adolescent boys increased their intention at a faster rate than did girls. Findings from the study identified risk factors (ie, age, gender, and economic disadvantage) and protective factors (ie, healthy family functioning, positive youth development) that influence the levels and growth rates of adolescent sexual behavior and intention. Implications for future research and interventions are discussed. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Chronic renal failure and sexual functioning: clinical status versus objectively assessed sexual response.

PubMed

Toorians, A W; Janssen, E; Laan, E; Gooren, L J; Giltay, E J; Oe, P L; Donker, A J; Everaerd, W

1997-12-01

Sexual dysfunctions are common among patients with chronic renal failure. The prevalence was assessed in a population of 281 patients (20-60 years), and it was attempted to determine whether their mode of treatment (haemodialysis, peritoneal dialysis, or kidney transplantation), or biochemical and endocrine variables and neuropathy affect sexual functioning. Patients with rheumatoid arthritis served as a comparison group. Assessment included clinical history, physical and laboratory examinations, questionnaires measuring erotosexual dysfunctions, and a psychophysiological test procedure. The latter is a laboratory method which measures, in a waking state, subjective and physiological sexual arousal. Men on haemodialysis or peritoneal dialysis suffered significantly more often from 'Hypoactive Sexual Desire Disorder', 'Sexual Aversion Disorder' and 'Inhibited Male Orgasm' than men with kidney transplantation or rheumatoid arthritis. Interestingly, the prevalence of 'Male Erectile Disorder' did not differ significantly between the four groups and ranged between 17 and 43%. Of the women, transplanted patients suffered significantly less from 'Hypoactive Sexual Desire Disorder' than the other three groups; the prevalence of other sexual dysfunctions did not differ between the groups. Although 'Male Erectile Disorder' and 'Female Sexual Arousal Disorder' had a relatively high prevalence there were no differences in the four groups of patients in genital responses during psychophysiological testing. Genital responses during psychophysiological assessment had no relationship to the duration of renal replacement treatment, biochemical/endocrine variables, or the presence/ absence of neuropathy. The prevalence of sexual dysfunction was high. Sexual dysfunction in men on haemodialysis or peritoneal dialysis was not so much due to erectile failure but largely to loss of sexual interest, subjectively ascribed to fatigue. The latter was also found in women on haemodialysis or peritoneal dialysis.

Prevalence and degree of sexual dysfunction in a sample of women seeking bariatric surgery

PubMed Central

Bond, Dale S.; Vithiananthan, Siva; Leahey, Tricia M.; Thomas, J. Graham; Sax, Harry C.; Pohl, Dieter; Ryder, Beth A.; Roye, G. Dean; Giovanni, Jeannine; Wing, Rena R.

2009-01-01

Background Sexual functioning is shown to be impaired in women who are obese, particularly those seeking bariatric surgery. However, most prior studies evaluating sexual function in these populations have not used validated measures. We used the validated Female Sexual Function Index (FSFI) to assess prevalence of female sexual dysfunction (FSD) in a sample of over 100 women evaluated for bariatric surgery. Methods The FSFI was administered to reportedly sexually active women during their preoperative evaluation. Scores for individual FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) ranging from 0(or 1.2) to 6 were summed to produce a FSFI-total score (range = 2-36). A FSFI-total cut-off score of ≤ 26.55 was used to identify participants with FSD. Participants' FSFI- total and domain scores were compared to previously published norms available for women diagnosed with female sexual arousal disorder (FSAD) and healthy controls. Results Sixty-one of the 102 participants (59.8%) had FSFI-total scores ≤ 26.55, indicative of FSD. Older age and menopause were associated with FSD. Compared to published norms, bariatric surgery candidates had FSFI domain scores that were lower than the control group (ps <0.0001) but higher than the FSAD group (ps <0.0001), except for desire where scores were similar. Conclusion Women seeking bariatric surgery are clearly a population with substantial sexual function impairment, with 60% of participants reporting FSD. These findings highlight the need to initiate routine assessment of sexual functioning in this population and examine whether weight loss following bariatric surgery contributes to reversal of FSD. PMID:19733514

Effects of velvet antler polypeptide on sexual behavior and testosterone synthesis in aging male mice

PubMed Central

Zang, Zhi-Jun; Tang, Hong-Feng; Tuo, Ying; Xing, Wei-Jie; Ji, Su-Yun; Gao, Yong; Deng, Chun-Hua

2016-01-01

Twenty-four-month-old male C57BL/6 mice with low serum testosterone levels were used as a late-onset hypogonadism (LOH) animal model for examining the effects of velvet antler polypeptide (VAP) on sexual function and testosterone synthesis. These mice received VAP for 5 consecutive weeks by daily gavage at doses of 100, 200, or 300 mg kg−1 body weight per day (n = 10 mice per dose). Control animals (n = 10) received the same weight-based volume of vehicle. Sexual behavior and testosterone levels in serum and interstitial tissue of testis were measured after the last administration of VAP. Furthermore, to investigate the mechanisms of how VAP affects sexual behavior and testosterone synthesis in vivo, the expression of steroidogenic acute regulatory protein (StAR), cytochrome P450 cholesterol side-chain cleavage enzyme (P450scc), and 3β-hydroxysteroid dehydrogenase (3β-HSD) in Leydig cells was also measured by immunofluorescence staining and quantitative real-time PCR. As a result, VAP produced a significant improvement in the sexual function of these aging male mice. Serum testosterone level and intratesticular testosterone (ITT) concentration also increased in the VAP-treated groups. The expression of StAR, P450scc, and 3β-HSD was also found to be enhanced in the VAP-treated groups compared with the control group. Our results suggested that VAP was effective in improving sexual function in aging male mice. The effect of velvet antler on sexual function was due to the increased expression of several rate-limiting enzymes of testosterone synthesis (StAR, P450scc, and 3β-HSD) and the following promotion of testosterone synthesis in vivo. PMID:26608944

Effects of velvet antler polypeptide on sexual behavior and testosterone synthesis in aging male mice.

PubMed

Zang, Zhi-Jun; Tang, Hong-Feng; Tuo, Ying; Xing, Wei-Jie; Ji, Su-Yun; Gao, Yong; Deng, Chun-Hua

2016-01-01

Twenty-four-month-old male C57BL/6 mice with low serum testosterone levels were used as a late-onset hypogonadism (LOH) animal model for examining the effects of velvet antler polypeptide (VAP) on sexual function and testosterone synthesis. These mice received VAP for 5 consecutive weeks by daily gavage at doses of 100, 200, or 300 mg kg-1 body weight per day (n = 10 mice per dose). Control animals (n = 10) received the same weight-based volume of vehicle. Sexual behavior and testosterone levels in serum and interstitial tissue of testis were measured after the last administration of VAP. Furthermore, to investigate the mechanisms of how VAP affects sexual behavior and testosterone synthesis in vivo, the expression of steroidogenic acute regulatory protein (StAR), cytochrome P450 cholesterol side-chain cleavage enzyme (P450scc), and 3β-hydroxysteroid dehydrogenase (3β-HSD) in Leydig cells was also measured by immunofluorescence staining and quantitative real-time PCR. As a result, VAP produced a significant improvement in the sexual function of these aging male mice. Serum testosterone level and intratesticular testosterone (ITT) concentration also increased in the VAP-treated groups. The expression of StAR, P450scc, and 3β-HSD was also found to be enhanced in the VAP-treated groups compared with the control group. Our results suggested that VAP was effective in improving sexual function in aging male mice. The effect of velvet antler on sexual function was due to the increased expression of several rate-limiting enzymes of testosterone synthesis (StAR, P450scc, and 3β-HSD) and the following promotion of testosterone synthesis in vivo.

Prevalence and degree of sexual dysfunction in a sample of women seeking bariatric surgery.

PubMed

Bond, Dale S; Vithiananthan, Siva; Leahey, Tricia M; Thomas, J Graham; Sax, Harry C; Pohl, Dieter; Ryder, Beth A; Roye, G Dean; Giovanni, Jeannine; Wing, Rena R

2009-01-01

Sexual functioning has been shown to be impaired in women who are obese, particularly those seeking bariatric surgery. However, most previous studies evaluating sexual function in these populations have not used validated measures. We used the validated Female Sexual Function Index (FSFI) to assess the prevalence of female sexual dysfunction (FSD) in a sample of >100 women evaluated for bariatric surgery. The FSFI was administered to reportedly sexually active women during their preoperative evaluation. The scores for the individual FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) ranging from 0 (or 1.2) to 6 were summed to produce a FSFI total score (range 2-36). A FSFI total cutoff score of

Polymorphisms in the dopamine D4 receptor gene (DRD4) contribute to individual differences in human sexual behavior: desire, arousal and sexual function.

PubMed

Ben Zion, I Z; Tessler, R; Cohen, L; Lerer, E; Raz, Y; Bachner-Melman, R; Gritsenko, I; Nemanov, L; Zohar, A H; Belmaker, R H; Benjamin, J; Ebstein, R P

2006-08-01

Although there is some evidence from twin studies that individual differences in sexual behavior are heritable, little is known about the specific molecular genetic design of human sexuality. Recently, a specific dopamine D4 receptor (DRD4) agonist was shown in rats to induce penile erection through a central mechanism. These findings prompted us to examine possible association between the well-characterized DRD4 gene and core phenotypes of human sexual behavior that included desire, arousal and function in a group of 148 nonclinical university students. We observed association between the exon 3 repeat region, and the C-521T and C-616G promoter region SNPs, with scores on scales that measure human sexual behavior. The single most common DRD4 5-locus haplotype (19%) was significantly associated with Desire, Function and Arousal scores. The current results are consistent with animal studies that show a role for dopamine and specifically the DRD4 receptor in sexual behavior and suggest that one pathway by which individual variation in human desire, arousal and function are mediated is based on allelic variants coding for differences in DRD4 receptor gene expression and protein concentrations in key brain areas.

Sexual dysfunction in multiple sclerosis: A 6-year follow-up study.

PubMed

Kisic-Tepavcevic, Darija; Pekmezovic, Tatjana; Trajkovic, Goran; Stojsavljevic, Nebojsa; Dujmovic, Irena; Mesaros, Sarlota; Drulovic, Jelena

2015-11-15

Sexual dysfunction (SD) is a common but often overlooked and undertreated symptom in multiple sclerosis (MS). The purpose of our longitudinal study was to explore the changes in the level of sexual functioning in MS cohort after a period of 3 and 6 years of follow-up, as well as to investigate the predictors of changes in SD during the period of observation. The study population comprise a cohort of 93 patients with MS (McDonald's criteria, 2001) who were assessed at three time points during the study (baseline, and at the 3- and 6-year follow-up). The presence and severity of SD was quantified by Szasz sexual functioning scale. Independent predictors of the ordinal-scaled measure of sexual problems were identified using a generalized linear mixed regression models. The number of reported SD symptoms increased markedly for both genders during the whole period of observation. Duration of follow-up, age, level of physical disability, depression and fatigue were identified as independent prognostic factors for deterioration of sexual functioning in patients with MS during the 6-year follow-up. Our study provides insight into dynamics of change in sexual function among patients with MS and predictors of change, over the period of 6 years. Copyright © 2015 Elsevier B.V. All rights reserved.

Effect of Sexual Education on Sexual Function of Iranian Couples During Pregnancy: A Quasi Experimental Study.

PubMed

Heidari, Masumeh; Aminshokravi, Farkhondeh; Zayeri, Farid; Azin, Seyed Ali

2018-01-01

The aim of this study was to evaluate the impact of husbands' participation in sexual education on sexual function during pregnancy. This quasi experimental study was conducted on 123 couples who were divided in two intervention (A: couples, B: pregnant women) and one control (C) groups. Group A couples received sex education, Group B women received sex education without their spouses, and Group C women received routine prenatal care without sex education. Sexual functions of couples were assessed by Female Sexual Function Index (FSFI) and International Index Erectile Function (IIEF) questionnaires, before sex education, four weeks after the intervention, at the end of the second trimester and at the end of the third trimester. Mean total scores of FSFI and IIEF were not different at baseline in three groups. Repeated measure analysis showed significant differences between groups (A and B with C) in the mean total scores of FSFI and IIEF during the third trimester. The mean total scores of the two intervention groups of A and B were not significant. According to the results of the present study, promoting the sexual function of pregnant women needs to include the sex education on prenatal care. Whereas spouses' participation was suggested to have a great role in the effectiveness and strengthening of the education in various studies, this study showed that the lack of spouses' participation for whatever reasons may lead to the same results of previous studies which emphasized the necessity of spouses' participation.

Sexual behavior of married young women: a preliminary study from north India.

PubMed

Avasthi, Ajit; Kaur, Rajinder; Prakash, Om; Banerjee, Anindya; Kumar, Lata; Kulhara, P

2008-07-01

There are significant gaps in the scientific literature concerning female sexual behavior and attitudes surrounding sexuality, which have definitive implications on public health and clinical work. To study the sexual behavior of young married Indian women. The study group comprised 100 consecutive women attending the Department of Pediatrics for the care of noncritical children in a multispecialty, tertiary care teaching hospital setting in North India. Current levels of sexual functioning and satisfaction were assessed by using the Brief Index of Sexual Functioning for Women (BISF-W). All participants were also administered a translated and culturally adapted instrument called Sex Knowledge and Attitude Questionnaire-II (SKAQ-II). Peno-vaginal sex continues to be considered the most desired and actually performed sexual activity for arousal and orgasm, followed by kissing and foreplay. Difficulties while performing sexual activity, in the form of physical problems, were faced by 17% of the participants. The participants displayed adequate sexual knowledge and favorable attitude towards sexuality as measured by SKAQ-II. The present study is a preliminary effort to understand the contemporary female sexual behavior, knowledge and attitude by employing standard instruments. Still further studies are required in this area.

Slimmer women's waist is associated with better erectile function in men independent of age.

PubMed

Brody, Stuart; Weiss, Petr

2013-10-01

Previous research has indicated that men generally rate slimmer women as more sexually attractive, consistent with the increased morbidity risks associated with even mild abdominal adiposity. To assess the association of women's waist size with a more tangible measure of perceived sexual attractiveness (as well as reward value for both sexes), we examined the association of women's age and waist circumference with an index of men's erectile function (IIEF-5 scores), frequency of penile-vaginal intercourse (PVI), and sexual satisfaction in a representative sample of Czechs (699 men and 715 women) aged 35-65 years. Multivariate analyses indicated that better erectile function scores were independently associated with younger age of self and partner and women's slimmer waist. PVI frequency was independently associated with women's younger age and women's slimmer waist. Sexual satisfaction was independently associated with men's younger age and slimmer waist for both sexes. Better erectile function, greater PVI frequency, and greater sexual satisfaction were associated with women's slimmer waist, independently of both sexes' ages. Possible reasons for the waist effects were discussed, including women's abdominal body fat decreasing their own desire through neurohormonal mechanisms and decreasing their partner's desire through evolutionarily-related decreased sexual attractiveness.

Comparing the effects of the second-and third-generation oral contraceptives on sexual functioning

PubMed Central

Shahnazi, Mahnaz; Bayatipayan, Somaye; Khalili, Azizeh Farshbaf; Kochaksaraei, Fatemeh Ranjbar; Jafarabadi, Mohammad Asghari; Banoi, Kamala Gaza; Nahaee, Jila

2015-01-01

Background: The aim of this study was to compare the effects of the second- and third-generation oral contraceptives on women's reproductive sexual function. Materials and Methods: 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. Results: 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. Conclusions: 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. PMID:25709690

Spirituality and sexual orientation: relationship to mental well-being and functional health status.

PubMed

Coleman, Christopher L

2003-09-01

Research has shown that spirituality has a positive effect on physical and mental health; however, few studies have explored the influence of spirituality and sexuality on mental well-being and functional health status in people with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). This descriptive cross-sectional study was designed to examine the relationships among spirituality, sexual orientation, mental well-being and aspects of functional health status (physical, role, social and cognitive functioning) in a sample of 117 African-American men and women living with HIV/AIDS. Spirituality was measured using the Spiritual Well-Being Scale. A demographic questionnaire gathered data on sexual orientation, age and gender. The Medical Outcomes Study Questionnaire-30 assessed aspects of functional health status and mental well-being. The HIV Symptom Checklist for Persons With HIV disease was used to collect data on HIV symptoms. The data were collected in 1996. The findings indicate that spirituality had a direct relationship with cognitive and social functioning and was inversely related to HIV symptoms. Sexual orientation had direct relationships with mental well-being, cognitive, physical, social and role functioning. t-Tests showed that heterosexual participants reported poorer mental well-being and functional health status compared with homosexual participants. Regression analysis showed that spirituality, sexual orientation, age and HIV symptoms contributed significantly to mental well-being and functional health status. The regression analysis showed that spirituality, sexual orientation, age and HIV symptoms contributed significantly to mental well-being and functional health status. Further research is needed to explore the various ways that sexual orientation influences health status findings in those with HIV disease in certain segments of the population. The findings support the inclusion of spirituality as a variable when examining mental well-being and physical health. Finally, given the limitations of the design, more rigorous methods should be employed to understand further the contribution of spirituality to the health status of African-Americans living with HIV, because of its social importance to this particular community.

Effects of Mediterranean diet on sexual function in people with newly diagnosed type 2 diabetes: The MÈDITA trial.

PubMed

Maiorino, Maria Ida; Bellastella, Giuseppe; Caputo, Mariangela; Castaldo, Filomena; Improta, Maria Rosaria; Giugliano, Dario; Esposito, Katherine

To assess the long-term effect of Mediterranean diet, as compared with low-fat diet, on sexual function in patients with newly diagnosed type 2 diabetes. In a randomized clinical trial, with a total follow-up of 8.1years, 215 men and women with newly diagnosed type 2 diabetes were assigned to Mediterranean diet (n=108) or a low-fat diet (n=107). The primary outcome measures were changes of erectile function (IIEF) in diabetic men and of female sexual function (FSFI) in diabetic women. There was no difference in baseline sexual function in men (n=54 vs 52) or women (n=54 vs 55) randomized to Mediterranean diet or low-fat diet, respectively (P=0.287, P=0.815). Over the entire follow-up, the changes of the primary outcomes were significantly lower in the Mediterranean diet group compared with the low-fat group: IIEF and FSFI showed a significantly lesser decrease (1.22 and 1.18, respectively, P=0.024 and 0.019) with the Mediterranean diet. Baseline C-reactive protein levels predicted erectile dysfunction in men but not female sexual dysfunction in women. Among persons with newly diagnosed type 2 diabetes, a Mediterranean diet reduced the deterioration of sexual function over time in both sexes. Copyright © 2016 Elsevier Inc. All rights reserved.

CLINICAL AUTONOMIC NEUROPHYSIOLOGY AND THE MALE SEXUAL RESPONSE: AN OVERVIEW

PubMed Central

Yang, Claire C.; Jiang, Xiaogang

2009-01-01

Introduction Clinical neurophysiology is the study of the human nervous system through the recording of bioelectrical activity. In the realm of male sexual functioning, this includes using electrophysiologic techniques to study the nerves subserving erection, emission, ejaculation, and orgasm. Aim To introduce the reader to the principles of clinical neurophysiology as they relate to the male sexual response, particularly erection. Methods We review the pertinent autonomic neuroanatomy and neurophysiology of reflexes relevant to the male sexual response, as well as summarize the genital electrodiagnostic tests that are being used to interrogate the autonomic innervation pertinent to male sexual functioning. Conclusions The male sexual response is a coordinated series of interactions between the somatic and the autonomic nervous systems. Measurement of the autonomically mediated portions of the sexual reflexes is of great clinical interest, particularly in relation to erection. Advances in clinical electrodiagnostics now allow for consistent recording of evoked and spontaneous intra-penile electrical activity. However, before broad and widespread use of these techniques is possible, more investigations are needed. PMID:19267845

Sexual Orientation and Gender Differences in Markers of Inflammation and Immune Functioning

PubMed Central

Everett, Bethany G.; Rosario, Margaret; McLaughlin, Katie A.; Austin, S. Bryn

2014-01-01

Background Sexual minorities have documented elevated risk factors that can lead to inflammation and poor immune functioning Purpose Investigate disparities in C-Reactive protein and Epstein Barr Virus by gender and sexual orientation. Methods We used the National Longitudinal Study of Adolescent Health to examine disparities in CRP (N=11,462) and EBV (N=11,812). Results Among heterosexuals, women had higher levels of CRP and EBV than men. However, sexual-minority men had higher levels of CRP and EBV than heterosexual men and sexual minority women. Lesbians had lower levels of CRP than heterosexual women. Conclusions Gender differences in CRP and EBV found between men and women who identify as 100% heterosexual were reversed among sexual minorities and not explained by known risk factors (e.g. victimization, alcohol and tobacco use, BMI). More nuanced approaches to addressing gender differences in sexual orientation health disparities that include measures of gender nonconformity and minority stress are needed. PMID:24347405

Sexual Function in Males After Radiotherapy for Rectal Cancer

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

Bruheim, Kjersti, E-mail: Kjersti.bruheim@medisin.uio.n; Guren, Marianne G.; Dahl, Alv A.

Purpose: Knowledge of sexual problems after pre- or postoperative radiotherapy (RT) with 50 Gy for rectal cancer is limited. In this study, we aimed to compare self-rated sexual functioning in irradiated (RT+) and nonirradiated (RT-) male patients at least 2 years after surgery for rectal cancer. Methods and Materials: Patients diagnosed with rectal cancer from 1993 to 2003 were identified from the Norwegian Rectal Cancer Registry. Male patients without recurrence at the time of the study. The International Index of Erectile Function, a self-rated instrument, was used to assess sexual functioning, and serum levels of serum testosterone were measured. Results:more » Questionnaires were returned from 241 patients a median of 4.5 years after surgery. The median age was 67 years at survey. RT+ patients (n = 108) had significantly poorer scores for erectile function, orgasmic function, intercourse satisfaction, and overall satisfaction with sex life compared with RT- patients (n = 133). In multiple age-adjusted analysis, the odds ratio for moderate-severe erectile dysfunction in RT+ patients was 7.3 compared with RT- patients (p <0.001). Furthermore, erectile dysfunction of this degree was associated with low serum testosterone (p = 0.01). Conclusion: RT for rectal cancer is associated with significant long-term effects on sexual function in males.« less

Sexual Health of Polish Athletes with Disabilities.

PubMed

Plinta, Ryszard; Sobiecka, Joanna; Drosdzol-Cop, Agnieszka; Nowak-Brzezińska, Agnieszka; Kobiołka, Agnieszka; Skrzypulec-Plinta, Violetta

2015-06-30

The purpose of this study was to determine sexual functioning of Polish athletes with disabilities (including paralympians). The study encompassed 218 people with physical disabilities, aged between 18 and 45 (149 men and 69 women). The entire research population was divided into three groups: Polish paralympians (n = 45), athletes with disabilities (n = 126) and non-athletes with disabilities (n = 47). The quality of sexual life of Polish paralympians was measured by using the Polish version of Female Sexual Function Index and International Index of Erectile Function. Clinically significant erectile dysfunctions were most often diagnosed in non-athletes (83.33%) with 50% result of severe erectile dysfunctions, followed by athletes and paralympians with comparable results of 56.98% and 54.17% respectively (p = 0.00388). Statistically significant clinical sexual dysfunctions concerned lubrication, orgasm as well as pain domains, and prevailed among female non-athletes (68.42%, 68.42% and 57.89%). Practising sports at the highest level has a favourable effect on the sexuality of men and women with physical disabilities. Men with physical disabilities manifest more sexual disorders than women, an aspect which should be considered by health-care professionals working with people with disabilities.

Sexuality and Physical Contact in National Social Life, Health, and Aging Project Wave 2

PubMed Central

McClintock, Martha K.; Waite, Linda J.

2014-01-01

Introduction. Wave 2 of the National Social Life, Health, and Aging Project (NSHAP) includes new measures of sexual interest and behavior, as well as new measures of the context of sexual experience and the frequency and appeal of physical contact. This is the first time many of these constructs have been measured in a nationally representative sample. Method. We describe the new measures and compare the distributions of each across gender and age groups, in some cases by partnership status. Results. Two components of sexuality decrease with age among both men and women: frequency of finding an unknown person sexually attractive and receptivity to a partner’s sexual overtures. In contrast, the inclination to make one’s self sexually attractive to others was a more complicated function of partner status, gender, and age: partnered women and unpartnered men made the most effort, with the more effortful gender’s effort decreasing with age. Both men and women find nonsexual physical contact appealing but sexual physical contact is more appealing to men than women. Finally, two fifths of men and women report dissatisfaction with their partner’s frequency of caring behaviors that make later sexual interactions pleasurable, and a fifth of women and a quarter of men who had vaginal sex in the past year report dissatisfaction with amount of foreplay. Discussion. These data offer the opportunity to characterize sexual motivation in older adulthood more precisely and richly and to examine how the context of sexual experience and the nonsexual aspects of physical intimacy correlate with sexual behavior, enjoyment, and problems. PMID:25360027

Switching to moclobemide to reverse fluoxetine-induced sexual dysfunction in patients with depression.

PubMed Central

Ramasubbu, R

1999-01-01

OBJECTIVE: To determine the efficacy of substituting moclobemide, a reversible monoamine oxidase-A inhibitor, for fluoxetine to reverse fluoxetine-induced sexual dysfunction in patients with depression. DESIGN: Prospective open trial. SETTING: Outpatient treatment. PARTICIPANTS: Five patients with depressive disorder who experienced sexual side effects during treatment with standard doses of fluoxetine (20 to 40 mg per day). INTERVENTION: Discontinuation of fluoxetine and replacement with moclobemide (300 to 600 mg per day) after a 2-week washout period. OUTCOME MEASURES: Libido, orgasmic function (in women) or erectile and ejaculatory function (in men), and overall improvement in sexual function during a follow-up period of 2 months to 3 years. RESULTS: Among patients receiving fluoxetine questioned about sexual side effects, 4 (1 man and 3 women) had treatment-related diminished libido with poor orgasmic response or partial erectile failure, and 1 female patient had enhanced sexual desire with intense clitoral stimulation. In all patients, sexual disturbances resolved completely after a 2-week washout period and a switch to treatment with moclobemide. Moclobemide was well tolerated. The antidepressant effect of moclobemide was comparable to that of fluoxetine. CONCLUSIONS: Moclobemide may be preferred as a treatment for depression in patients with fluoxetine-induced sexual dysfunction. PMID:9987207

Inflammatory Bowel Diseases Can Adversely Impact Domains of Sexual Function Such as Satisfaction with Sex Life.

PubMed

Eluri, Swathi; Cross, Raymond K; Martin, Christopher; Weinfurt, Kevin P; Flynn, Kathryn E; Long, Millie D; Chen, Wenli; Anton, Kristen; Sandler, Robert S; Kappelman, Michael D

2018-06-01

Aspects of sexual health, which can be adversely affected by chronic disease, have been inadequately explored in inflammatory bowel disease (IBD). We evaluated patient-reported interest in sexual activity and satisfaction with sex life in a large cohort of IBD patients. We conducted a cross-sectional study within the Crohn's and Colitis Foundation Partners Internet cohort. Sequential participants completed a 6-question supplemental online survey to examine sexual interest and satisfaction using the Patient-Reported Outcome Measurement Information System ® (PROMIS ® ) Sexual Function and Satisfaction measures. One-sample t tests were used to compare interest and satisfaction scores to general population norms. Among 2569 individuals, 1639 had Crohn's disease (CD), 930 had ulcerative colitis (UC) or indeterminate colitis, and 71% were women. Mean PROMIS scores for sexual interest were comparable to the general US population in men (CD: 49 and UC: 48 vs. population mean 50) and women (CD: 41 and UC: 40 vs. population mean 42). However, sexual satisfaction scores were lower than the US population in men (CD: 48 and UC: 48 vs. 51) and women (CD: 47 and UC: 46 vs. 49), p < 0.01 for both. Older age, disease activity, depression, anxiety, and pain were associated with lower interest and satisfaction and lowered IBD-specific quality of life. IBD patients in a large online survey had similar levels of sexual interest but decreased sexual satisfaction compared to the general population. Exploring these sexual health domains during clinical encounters can aid in improving IBD quality of life.

Ecodevelopmental trajectories of family functioning: Links with HIV/STI risk behaviors and STI among Black adolescents.

PubMed

Córdova, David; Heinze, Justin E; Mistry, Ritesh; Salas-Wright, Christopher P; Zimmerman, Marc A

2016-07-01

We examined the effects of family functioning trajectories on sexual risk behaviors and STI in adolescents. A sample of 850 predominantly (80%) Black adolescents from Michigan, United States, was assessed at baseline, 12, 24, and 36 months postbaseline. Adolescents were from working-class families with a mean age of 14.9 years (SD = .64, Range = 13.9 to 16.9) at baseline. Participants completed measures of family functioning at each time point. At 36 months postbaseline, levels of sexual risk behaviors, including sex initiation, unprotected sex, and alcohol or drug use before last sexual intercourse, and STIs were assessed. Latent class growth analysis (LCGA) yielded 4-class solutions for family conflict and parent support. Adolescents with high or increasing family conflict trajectories, and low or decreasing family support trajectories, were at relatively greater risk of sexual risk behaviors and STIs. Yet, the additional trajectories differ across outcomes highlighting the complexities of the role of family functioning on sexual risk behaviors and STIs over time. Multiple Group LCGA indicate some findings vary as a function of gender. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Correlates of sexual function in male and female patients with multiple sclerosis.

PubMed

Lew-Starowicz, Michal; Rola, Rafal

2014-09-01

Many factors have been suggested to contribute to sexual dysfunction (SD) in multiple sclerosis (MS) patients, but the research on their impact on sexual functioning (SF) and sexual quality of life (SQoL) remains scant. The aim of this study was to investigate correlates of SF and SQoL in MS patients, as well as possible gender differences. 204 MS patients were interviewed, completed the questionnaires, and underwent neurological assessment. Primary outcome measures included the International Index of Erectile Function, the Female Sexual Function Questionnaire, the Sexual Quality of Life Questionnaire, the Beck Depression Inventory, and the Expanded Disability Status Scale. The course and duration of the disease did not predict patients' SF. Negative correlations were found for brainstem symptoms with orgasmic function and overall satisfaction in men and between cognitive functioning and the partner domain in women. Interestingly, brainstem symptoms correlated positively with the arousal domain in women. More than half (52.1%) of patients fulfilled Beck Depression Inventory criteria for depression, and these patients showed more SD than nondepressive individuals. The strongest negative correlations with depressive symptoms were found for desire, erectile function, and overall satisfaction with sexual life in men and for orgasm and sexual enjoyment in women. Deterioration in particular domains of SF was clearly related with diminished SQoL. The main gender difference was a strong influence of decreased desire on SQoL in women and no such correlation in men. Negative assessment of the relationship with partner significantly affected all domains of SF and SQoL in MS women and the desire domain in MS men. Several correlates of SF in MS patients were found. The role of brainstem symptoms needs further investigation. Clinicians should pay close attention to depressive symptoms and relationship factors in MS patients who suffer from SD. © 2014 International Society for Sexual Medicine.

Sexual Function and Quality of Life Before and After Penile Prosthesis Implantation Following Radial Forearm Flap Phalloplasty.

PubMed

Young, Ezekiel E; Friedlander, Daniel; Lue, Kathy; Anele, Uzoma A; Khurgin, Jacob L; Bivalacqua, Trinity J; Burnett, Arthur L; Redett, Richard J; Gearhart, John P

2017-06-01

To provide sexual function and quality of life outcomes in patients with severe penile deficiency who underwent radial forearm flap phalloplasty with and without penile prosthesis implantation. Patients with history of severe penile deficiency who underwent microsurgical radial forearm flap phalloplasty with and without penile prosthesis implantation between 2007 and 2014 were identified. They completed a set of web-based validated questionnaires including the International Index of Erectile Function, the Pediatric Penile Perception Score, the Sexual Quality of Life for Men, and several items addressing general quality of life. Outcomes were compared between groups. Nine of the 12 identified patients who had prosthesis after phalloplasty and 4 out of the 7 phalloplasty-only patients completed the survey, resulting in an overall response rate of 68%. Among the phalloplasty-prosthesis patients, 66% reported current sexual activity and 78% reported regular masturbation, whereas 1 of the 4 phalloplasty-only patients reported both. Prosthesis patients scored notably higher in all domains of the International Index of Erectile Function except for sexual desire. In contrast, they demonstrated similar scores of penile perception, as well as general and sexual quality of life. Among patients who have undergone flap phalloplasty, the subsequent placement of penile prosthesis appears to effectively allow for both intercourse and masturbation, resulting in measurable improvements in orgasmic function, intercourse satisfaction, and overall sexual satisfaction. Despite these important benefits, prosthesis placement does not appear to result in improvements in penile perception scores, or general or sexual quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

Male sexual function and lower urinary tract symptoms after laparoscopic total mesorectal excision.

PubMed

Breukink, S O; van Driel, M F; Pierie, J P E N; Dobbins, C; Wiggers, T; Meijerink, W J H J

2008-12-01

The aim of this study was to investigate sexual function and the presence of lower urinary tract symptoms (LUTS) in male patients with rectal cancer following short-term radiotherapy and laparoscopic total mesorectal excision (LTME) by physical and psychological measurements. Sexual function and LUTS were assessed by the use of questionnaires [International Index of Erectile Function (IIEF), International Prostate Symptom Score]. Sexual function was further assessed by the use of pharmaco duplex ultrasonography of the cavernous arterial blood flow and nocturnal penile tumescence and rigidity monitoring (NPTR). All investigations were performed prior to the start of preoperative radiotherapy and 15 months after surgery. Nine patients (mean age 60 years) participated. Erectile function was maintained in 71% and ejaculation function in 89%. Compared with pre-operative scores on the IIEF, a significant deterioration in intercourse satisfaction was seen following radiotherapy and LTME (7.9 vs 10.3, p = 0.042), but overall satisfaction remained unchanged (8.0 vs 7.0, p = 0.246). NPTR parameters (duration of erectile episodes, duration of tip rigidity > or =60%) decreased following radiotherapy and LTME. Patients reported a deterioration in micturition frequency (2.0 vs 1.0, p = 0.034) and quality of life due to urinary symptoms (8.0 vs 1.8, p = 0.018). Based on these first preliminary findings, data suggest that 15 months after short-term radiotherapy and LTME in men with rectal cancer, objectively assessed sexual dysfunction was considerable, but overall sexual satisfaction had not changed.

Health-Related Quality of Life and Quality of Sexual Life in Obese Subjects

PubMed Central

Di Lazzaro, Luca; Pinto, Alessandro; Migliaccio, Silvia; Lenzi, Andrea; Donini, Lorenzo M.

2014-01-01

The increased prevalence of obesity represents, currently, one of the major public health issues, due to its consequences on physical and psychological health status as well as on the psychosocial functioning. As defined by the World Health Organization, sexual health is “a state of physical, emotional, mental, and social well-being in relation to sexuality.” The aim of the present study was to explore the relationship between sexual life in obese subjects and quality of life, psychological status, and disability. Methods. 95 obese subjects were recruited from June 2012 to February 2013 and underwent physical examination and measures for the assessment of quality of life, sexual life, psychological status, and disability. Results. In obese subjects sexual life was related to gender, age, psychological status, disability, and quality of life. Conclusion. As obesity is a multifactorial disease, and is accompanied by multiple comorbidities, it is difficult to identify a single causative factor responsible for the impairment of sexual life in obese subjects; thus, a thorough, multidimensional evaluation including sexual function assessment should be performed in obese people. PMID:24707290

Handgrip Strength as a Darwinian Fitness Indicator in Men.

PubMed

Gallup, Andrew C; Fink, Bernhard

2018-01-01

Handgrip strength (HGS) is a robust measure of overall muscular strength and function, and has long been predictive of a multitude of health factors and physical outcomes for both men and women. The fact that HGS represents such a ubiquitous measure of health and vitality may reflect the significance of this trait during human evolution. This trait is also highly sexually dimorphic due to influences of androgenic hormones and fat-free body mass, suggesting that it has been further elaborated through sexual selection. Consistent with this view, research within evolutionary psychology and related fields has documented distinct relationships between HGS and measures of social and sexual behavior, especially in men. Here, we review studies across different societies and cultural contexts showing that male HGS predicts measures of aggression and social dominance, perceived formidability, male-typical body morphology and movement, courtship display, physical attractiveness, and sexual behavior and reproductive fitness. These findings underscore the value of including HGS as an independent measure within studies examining human sexual selection, and corroborate existing research suggesting that specific features of physical strength have and continue to be under positive directional selection in men.

Human tears contain a chemosignal.

PubMed

Gelstein, Shani; Yeshurun, Yaara; Rozenkrantz, Liron; Shushan, Sagit; Frumin, Idan; Roth, Yehudah; Sobel, Noam

2011-01-14

Emotional tearing is a poorly understood behavior that is considered uniquely human. In mice, tears serve as a chemosignal. We therefore hypothesized that human tears may similarly serve a chemosignaling function. We found that merely sniffing negative-emotion-related odorless tears obtained from women donors induced reductions in sexual appeal attributed by men to pictures of women's faces. Moreover, after sniffing such tears, men experienced reduced self-rated sexual arousal, reduced physiological measures of arousal, and reduced levels of testosterone. Finally, functional magnetic resonance imaging revealed that sniffing women's tears selectively reduced activity in brain substrates of sexual arousal in men.

A prospective 2-year examination of cognitive and behavioral correlates of provoked vestibulodynia outcomes.

PubMed

Davis, Seth N P; Bergeron, Sophie; Bois, Katy; Sadikaj, Gentiana; Binik, Yitzchak M; Steben, Marc

2015-04-01

Provoked vestibulodynia (PVD) is a common genital pain disorder in women that is associated with sexual dysfunction and lowered sexual satisfaction. A potentially applicable cognitive-behavioral model of chronic pain and disability is the fear-avoidance model (FAM) of pain. The FAM posits that cognitive variables, such as pain catastrophizing, fear, and anxiety lead to avoidance of pain-provoking behaviors (eg, intercourse), resulting in continued pain and disability. Although some of the FAM variables have been shown to be associated with PVD pain and sexuality outcomes, the model as a whole has never been tested in this population. An additional protective factor, pain self-efficacy (SE), is also associated with PVD, but has not been tested within the FAM model. Using a 2-year longitudinal design, we examine (1) whether initial levels (T1) of the independent FAM variables and pain SE were associated with changes in pain, sexual function, and sexual satisfaction over the 2-year time period; (2) the prospective contribution of changes in cognitive-affective (FAM) variables to changes in pain, and sexuality outcomes; and (3) whether these were mediated by behavioral change (avoidance of intercourse). A sample of 222 women with PVD completed self-report measures of FAM variables, SE, pain, sexual function, and sexual satisfaction at time 1 and at a 2-year follow-up. Structural equation modeling with Latent Difference Scores was used to examine changes and to examine mediation between variables. Questionnaires included the Pain Catastrophizing Scale, McGill Pain Questionnaire, Trait Anxiety Inventory, Pain Self-Efficacy Scale, and Global Measure of Sexual Satisfaction, Female Sexual Function Index. Participants who reported higher SE at T1 reported greater declines in pain, greater increases in sexual satisfaction, and greater declines in sexual function over the 2 time points. The overall change model did not support the FAM using negative cognitive-affective variables. Only increases in pain SE were associated with reductions in pain intensity. The relationship between changes in SE and changes in pain was partially mediated through changes in avoidance (more intercourse attempts). The same pattern of results was found for changes in sexual satisfaction as the outcome, and a partial mediation effect was found. There were no significant predictors of changes in sexual function other than T1 SE. Changes in both cognitive and behavioral variables were significantly associated with improved pain and sexual satisfaction outcomes. However, it was the positive changes in SE that better predicted changes in avoidance behavior, pain, and sexual satisfaction. Cognitive-behavior therapy is often focused on changing negative pain-related cognitions to reduce avoidance and pain, but the present results demonstrate the potential importance of bolstering positive self-beliefs as well. Indeed, before engaging in exposure therapies, SE beliefs should be assessed and potentially targeted to improve adherence to exposure strategies.

Quality of life and sexual function of patients following radical hysterectomy and vaginal extension.

PubMed

Ye, Shuang; Yang, Jiaxin; Cao, Dongyan; Zhu, Lan; Lang, Jinghe; Chuang, Linus T; Shen, Keng

2014-05-01

Radical hysterectomy (RH) has negative consequences on sexual function due to a shortened vagina, vaginal dryness, and dyspareunia. Peritoneovaginoplasty aims to extend vagina by vesical peritoneum and anterior rectal wall to improve postoperative sexual function. The aim of this study was to investigate whether vaginal extension can improve sexual function and quality of life and the problem of sexual dysfunction in early-stage cervical cancer survivors (CCSs) in China. Case-control and questionnaire-based methods were employed. Thirty-one patients who had undergone vaginal extension following RH and 28 patients with matching factors after RH alone were enrolled in the study. Both groups were assessed retrospectively by questionnaires at least 6 months after treatment. The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire cervical cancer module and the Sexual Function Vaginal Changes Questionnaire are validated measurements for disease- and treatment-specific issues. Vaginal length was 10.03 ± 1.26 cm and 5.92 ± 1.05 cm in study and control group, respectively (P < 0.05). In the study group, 67.7% patients and 64.3% of control group resumed sexual activity at the time of interview, averaging 6 months between treatment and sexual activity. While difficulty emptying bladder, incomplete emptying, and constipation were the most commonly reported symptoms, no significant difference was observed regarding pelvic floor symptoms. Reduced vagina size and shortened vagina was significantly more prominent in the control group, whereas both group presented with hypoactive sexual desire (88.1%), orgasm dysfunction (71.8%), and low enjoyment or relaxation after sex (51.3%). Shortened vagina was significantly less reported in study group, while no difference was observed in other sex-related dimensions. Vaginal extension does not worsen pelvic floor symptoms. Sexual rehabilitation interventions are of significance and should be paid more attention to the CCSs in China. © 2014 International Society for Sexual Medicine.

PERINEAL BODY STRETCH DURING LABOR DOES NOT PREDICT PERINEAL LACERATION, POSTPARTUM INCONTINENCE, OR POSTPARTUM SEXUAL FUNCTION: A COHORT STUDY

PubMed Central

MERIWETHER, Kate V.; ROGERS, Rebecca G.; DUNIVAN, Gena C.; ALLDREDGE, Jill K.; QUALLS, Clifford; MIGLIACCIO, Laura; LEEMAN, Lawrence

2017-01-01

Introduction The perineum stretches naturally during obstetrical labor, but it is unknown if this stretch has a negative impact on pelvic floor outcomes after a vaginal birth (VB). We aimed to evaluate whether perineal stretch was associated with postpartum pelvic floor dysfunction. Materials and Methods This was a prospective cohort study of primiparous women who had a VB. Perineal body (PB) length was measured antepartum, during labor, and 6 months postpartum. We determined the maximum PB (PB Max) measurements during the second stage of labor and PB change (ΔPB) between time points. Women completed functional questionnaires and had a POP-Q exam 6 months postpartum. We analyzed the relationship of PB measurements to perineal lacerations and postpartum outcomes including urinary, anal, or fecal incontinence, sexual activity and function, and POP-Q measurements. Results 448 women with VB had a mean age of 24 ± 5.0 years and rare (5%) third or fourth degree lacerations. During the second stage of labor, 270/448 (60%) had perineal measurements. Mean antepartum PB length was 3.7 ± 0.8 cm with a maximum mean PB length (PB Max) during the second stage of 6.1 ± 1.5 cm, an increase of 65%. The change in PB length (ΔPB) from antepartum to 6 months postpartum was a net decrease (−0.39 ± 1.02 cm). PB at any time point and PB Max were not associated with perineal lacerations or outcomes postpartum (all p>0.05). Discussion PB stretch during labor is unrelated to perineal laceration or postpartum incontinence, sexual activity, or sexual function. PMID:26874524

Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study

PubMed Central

Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Wylie, Kevan; Muir, Gordon

2015-01-01

Introduction Little is known about the sexual functioning and behavior of men anxious about the size of their penis and the means that they might use to try to alter the size of their penis. Aim To compare sexual functioning and behavior in men with body dysmorphic disorder (BDD) concerning penis size and in men with small penis anxiety (SPA without BDD) and in a control group of men who do not have any concerns. Methods An opportunistic sample of 90 men from the community were recruited and divided into three groups: BDD (n = 26); SPA (n = 31) and controls (n = 33). Main Outcome Measures The Index of Erectile Function (IEF), sexual identity and history; and interventions to alter the size of their penis. Results Men with BDD compared with controls had reduced erectile dysfunction, orgasmic function, intercourse satisfaction and overall satisfaction on the IEF. Men with SPA compared with controls had reduced intercourse satisfaction. There were no differences in sexual desire, the frequency of intercourse or masturbation across any of the three groups. Men with BDD and SPA were more likely than the controls to attempt to alter the shape or size of their penis (for example jelqing, vacuum pumps or stretching devices) with poor reported success. Conclusion Men with BDD are more likely to have erectile dysfunction and less satisfaction with intercourse than controls but maintain their libido. Further research is required to develop and evaluate a psychological intervention for such men with adequate outcome measures. PMID:26468378

Evaluating and Refining the Construct of Sexual Quality With Item Response Theory: Development of the Quality of Sex Inventory.

PubMed

Shaw, Amanda M; Rogge, Ronald D

2016-02-01

This study took a critical look at the construct of sexual quality. The 65 items of four well-validated self-report measures of sexual satisfaction (the Index of Sexual Satisfaction [ISS], Hudson, Harrison, & Crosscup, 1981; the Global Measure of Sexual Satisfaction [GMSEX], Lawrance & Byers, 1995; the Pinney Sexual Satisfaction Inventory [PSSI], Pinney, Gerrard, & Denney, 1987; the Young Sexual Satisfaction Scale [YSSS], Young, Denny, Luquis, & Young, 1998) and an additional 74 potential sexual quality items were given to 3060 online participants. Using Item Response Theory (IRT), we demonstrated that the ISS, YSSS, and PSSI scales provided suboptimal levels of precision in assessing sexual quality, particularly given the length of those scales. Exploratory factor analyses, IRT, differential item functioning analyses, and longitudinal responsiveness analyses were used to develop and evaluate the Quality of Sex Inventory. Results suggested that, in comparison to existing scales, the QSI (1) offers investigators and clinicians more theoretically focused scales, (2) distinguishes sexual satisfaction from sexual dissatisfaction, and (3) offers greater precision and power for detecting differences with (4) comparably high levels of responsiveness for detecting change over time despite being notably shorter than most of the existing scales. The QSI-satisfaction subscales demonstrated strong convergent validity with other measures of sexual satisfaction and excellent construct validity with anchor scales from the nomological net surrounding that construct, suggesting that they continue to assess the same theoretical construct as prior scales. Implications for research are discussed.

Sexual Satisfaction and Sexual Reactivity in Infertile Women: The Contribution of The Dyadic Functioning and Clinical Variables.

PubMed

Czyżkowska, Anna; Awruk, Katarzyna; Janowski, Konrad

2016-01-01

Infertility is a factor which has been linked to higher prevalence of sexual dysfunctions in women; however, ambiguous results have been reported about the impact of infertility on women's sexual satisfaction. The purpose of this study was to compare sexual and dyadic functioning in infertile and fertile women. Furthermore, the associations between sexual variables and clinical variables (depressive symptoms, period trying to conceive, and treatment period) were assessed in infertile women sample. The cross-sectional study involved 50 women with the history of infertility and 50 fertile women recruited from the general population. The Sexual Satisfaction Scale (SSS), Mell-Krat Scale (women's version), Family Assessment Measure (FAM-III), and Beck Depression Inventory (BDI) were administered to all participants. Infertile women reported lower sexual satisfaction and more maladaptive patterns of dyadic functioning in comparison to the control group. As many as 45 (90%) of infertile women, compared to 13 (26%) of the control group, reported the scores on the Mell-Krat Scale indicative of the presence of dysfunctions in sexual reactivity (P≤0.001). Infertile women reported significantly higher levels of depressive symptoms than the women from the control group (P≤0.001). Negative correlations were observed between sexual satisfaction and dyadic functioning in both groups (P≤0.05); however, the patterns of these associations were different in infertile and fertile women. For example, negative correlations were found between satisfaction with control and task accomplishment, role performance, affective involvement, and values and norms in infertile women. However, these relationships were not observed in the control group. No correlations were revealed between sexual reactivity and dyadic functioning in infertile women and the control group. Negative correlations were observed between satisfaction with control and relationship duration and treatment period as well as between sexual reactivity and period of trying to conceive. Multiple regression analyses also revealed different predictors of sexual satisfaction in both groups: affective involvement (P≤0.05) and relationship duration (P≤0.05) in infertile women, whereas communication (P≤0.05), affective expression (P≤0.05) and depressive symptoms (P≤0.05) in the control group. Infertility is an important factor affecting sexual and dyadic functioning and is linked to higher depressive symptoms in infertile women.

Sleep disturbances and sexual function among men aged 45–75 years in an urban area of Iran

PubMed Central

Charandabi, Sakineh Mohammadalizadeh; Rezaei, Nazanin; Hakimi, Sevil; Khatami, Shiva; valizadeh, Reza; Azadi, Arman

2016-01-01

Background and aims Aging in men is associated with various physical and mental symptoms, including sleep problems and sexual dysfunction. The aim of this study was to determine the status of sleep disorders and sexual dysfunction in men aged 45–75 years in Ilam, Iran. Materials and methods In this population-based cross-sectional study, 390 men aged 45–75 years were selected by cluster randomization in Ilam–Iran. Data were collected using 0–100 brief sexual function inventory and the sleep disorder questionnaires. Results Totally, 34.6% of men complained about sleep disorders: 17.4% about falling asleep, 12.8% about frequent nocturnal awakenings, 12.8% about waking up in the early hours in the morning and problem in falling asleep again, and 24.9% about fatigue and tiredness despite getting enough sleep. There was a significant relationship between all aspects of sexual function and the common problems related to sleep (p<0.001). The older, unemployed, illiterate men, those with inadequate income, those affected by chronic diseases, and/or urinary incontinence had significantly inferior sexual function compared with the others. Conclusion According to the high prevalence of sleep disorders in men as well as its association with sexual dysfunction, adopting health measures in this regard is necessary. PMID:27217906

The effectiveness of the Permission, Limited Information, Specific suggestions, Intensive Therapy (PLISSIT) model based sexual counseling on the sexual function of women with Multiple Sclerosis who are sexually active.

PubMed

Khakbazan, Zohreh; Daneshfar, Fatemeh; Behboodi-Moghadam, Zahra; Nabavi, Seyed Massood; Ghasemzadeh, Sogand; Mehran, Abbas

2016-07-01

This study was conducted to evaluate the effectiveness of sexual counseling based on the Permission, Limited Information, Specific Suggestion, Intensive Therapy (PLISSIT) model on the Sexual Dysfunction (SD) of married sexually active women who suffer from Multiple Sclerosis (MS). This is the first sexual intervention applied by a midwife as a health professional on MS patients in Iran where the cultural and religious limitations are important challenging issues. This randomized clinical trial was carried out in Iranian Community of Support for MS Patients in Tehran, Iran. The participating women who had a definite diagnosis of MS and SD, Expanded Disability Status Scale (EDSS) scores <7, and aged 18-55 years were randomly assigned to experimental (EG, n=43) and control group (CG, n=45). Participants in the EG group received 4 weekly sexual counseling sessions based on the PLISSIT model (90-120min per session). Sexual function was assessed three times (before the intervention, and 2 months and 3 months after the intervention) using the Female Sexual Function Index (FSFI). Chi-square test, Fisher's exact test, and Repeated Measures ANOVA were employed to analyze the data. The mean total FSFI score of the women in EG improved at 2 and 3 months after the intervention when it was compared with the FSFI score before the intervention (p<0.05). There was no significant difference in the total FSFI score when the data of 3 evaluations was compared in CG. A significant increase in the mean score of 6 subgroups was seen in EG (p<0.05) but not in CG. According to this study, utilizing the PLISSIT model as a framework for sexual counseling can improve sexual function in women who are sexually active and suffer from SD due to MS. Copyright © 2016 Elsevier B.V. All rights reserved.

Correlates of men's sexual interest: a cross-cultural study.

PubMed

Carvalheira, Ana; Traeen, Bente; Štulhofer, Aleksandar

2014-01-01

Low sexual desire has been studied more extensively in women than in men. The study aims to analyze the correlates of distressing lack of sexual interest and the self-assessed reasons for the lack of sexual interest among heterosexual men from three countries. A web-based survey was completed by 5,255 men aged 18-75 years from Portugal, Croatia, and Norway. We used an item that assesses lack of sexual interest from the British NATSAL 2000. Anxiety and depression were measured with the SCL-ANX4 and SCL-DEP6. Relationship intimacy was measured using a five-item version of the Emotional Intimacy Scale. A shortened version of the Sexual Boredom Scale was used to assess proneness to sexual boredom in relation to the duration of relationship, and personal distress was evaluated using an item created for this study. Distressing lack of sexual interest lasting at least 2 months in the previous year was reported by 14.4% of the participants. The most prevalent comorbidity among these men was erectile difficulty (48.7%). Men with low confidence levels in erectile function, not feeling attracted to the partner, and those in long-term relationships were more likely to have experienced lack of sexual interest than were men with high confidence levels and those who felt attracted to their partner and those in shorter-term relationships. Professional stress was the most frequently reported reason for lack of sexual interest. Sexual boredom as a result of a long-term relationship was significantly and negatively correlated with the level of intimacy (r = -0.351, P < 0.001) and sexual satisfaction (r = -0.497, P < 0.001). Distressing lack of sexual interest in heterosexual men was associated with a number of intrapersonal (self-confidence in erectile function, stress), interpersonal (relationship duration, partner attractiveness), and sociocultural variables. © 2013 International Society for Sexual Medicine.

Safety and long-term efficacy of fractional CO2 laser treatment in women suffering from genitourinary syndrome of menopause.

PubMed

Behnia-Willison, Fariba; Sarraf, Sara; Miller, Joseph; Mohamadi, Behrang; Care, Alison S; Lam, Alan; Willison, Nadia; Behnia, Leila; Salvatore, Stefano

2017-06-01

To evaluate the safety and long-term efficacy of fractional CO 2 laser treatment in reducing the severity of symptoms of genitourinary syndrome of menopause (GSM) in menopausal women. 102 women presenting with symptomatic GSM were treated with the fractional CO 2 laser (MonaLisa Touch, DEKA) system across a series of treatments delivered at intervals of six or more weeks. The Australian Pelvic Floor Questionnaire was used to gather data on sexual function and side-effects at three time-points across the study period (prospective panel design study). Wilcoxon signed-rank tests were used to detect statistically and clinically significant changes in sexual function and side-effects occurring from pre- to post-treatment. The primary outcome of this study was an improvement of the symptoms of GSM. The secondary outcome included bladder function and prolapse symptoms. A total of 102 women suffering from moderate to severe GSM were recruited. Eighty-four percent experienced significant improvement in their symptoms after CO 2 laser treatment. Scores on measures of sexual function, dyspareunia, and bothersomeness of sexual issues were improved from pre-treatment to long-term (12-24 month) follow-up. Furthermore, there were improvements on measures of bladder function (P=0.001), prolapse (P=0.001), vaginal sensation (P=0.001), vaginal lubrication (P<0.001) and urge incontinence (P=0.003) from the pre-treatment assessment to the second assessment (i.e. after the third treatment). In this study, fractional microablative CO 2 laser treatment was associated with an improvement in symptoms of GSM and sexual function. Copyright © 2017. Published by Elsevier B.V.

The Clitoral Photoplethysmograph: A Pilot Study Examining Discriminant and Convergent Validity.

PubMed

Suschinsky, Kelly D; Shelley, Amanda J; Gerritsen, Jeroen; Tuiten, Adriaan; Chivers, Meredith L

2015-12-01

The clitoral photoplethysmograph (CPP) is a relatively new device used to measure changes in clitoral blood volume (CBV); however, its construct validity has not yet been evaluated. To evaluate the discriminant and convergent validity of the CPP. For discriminant validity, CBV responses should differ between sexual and nonsexual emotional films if the CPP accurately assesses clitoral vasocongestion associated with sexual arousal; for convergent validity, CBV responses should significantly correlate with subjective reports of sexual arousal. Twenty women (M age = 21.2 years, SD = 3.4) watched neutral, anxiety-inducing, exhilarating, and sexual (female-male sex) audiovisual stimuli while their genital responses were measured simultaneously using vaginal and clitoral photoplethysmographs and CPPs. Most of these participants continuously reported sexual arousal throughout each stimulus (n = 16), and all reported their sexual and nonsexual affect before and after each stimulus; subjective responses were recorded via button presses using a keypad. Vaginal pulse amplitude (VPA), CBV, and self-reported sexual arousal and nonsexual affect were used as main outcome measures. CBV demonstrated both discriminant and convergent validity. CBV responses were similar to VPA responses and self-reported sexual arousal; all responses differed significantly as a function of stimulus content, with the sexual stimulus eliciting greater relative changes than nonsexual stimuli. CBV, but not VPA, was significantly (negatively) correlated with continuous self-reported sexual arousal during the shorter sexual stimulus. CBV was significantly negatively correlated with VPA for the shorter sexual stimulus. CBV may be a valid measure of women's genital sexual arousal that provides complementary information to VPA and correlates with self-reported sexual arousal. Given our relatively small sample size, and that this is among the first research to use the CPP, the current findings must be replicated. More research using the CPP and other devices is required for a more comprehensive description of women's physiological sexual arousal. © 2015 International Society for Sexual Medicine.

Profiles of Executive Functioning: Associations with Substance Dependence and Risky Sexual Behavior

PubMed Central

Golub, Sarit A.; Starks, Tyrel J.; Kowalczyk, William J.; Thompson, Louisa I.; Parsons, Jeffrey T.

2012-01-01

The present investigations applied a theoretical perspective regarding the impact of executive functioning (EF) on sexual risk among substance users, by using a methodological approach designed to examine whether EF subtypes differentially predict behavior patterns. Participants included 104 substance-using HIV-negative gay and bisexual men. Participants completed five neuropsychological assessment tasks selected to tap discrete EF components, and these data were linked to data on substance dependence and behavioral reports of substance use and sexual risk in the past 30 days. Cluster analysis identified three EF subtypes: a) High-performing (good performance across all measures); b) Low Performing (poor performance across all measures); and c) Poor IGT Performance (impairment on the Iowa Gambling Task (IGT) and its variant, but good performance on all other tasks). The three subtypes did not differ in amount of substance use, but the Low-Performing subtype was associated with greater rates of substance dependence. The Low-Performing subtype reported the highest rates of sexual behavior and risk, while the Poor IGT-Performance subtype reported the lowest rates of sexual risk-taking. Global associations between substance use and sexual risk were strongest among the Low-Performing subtype, but event-level associations appeared strongest among individuals in the High-Performing subtype. These data suggest complex associations between EF and sexual risk among substance users, and suggest that the relationship between substance use and sexual risk may vary by EF subtypes. PMID:22775771

Profiles of executive functioning: associations with substance dependence and risky sexual behavior.

PubMed

Golub, Sarit A; Starks, Tyrel J; Kowalczyk, William J; Thompson, Louisa I; Parsons, Jeffrey T

2012-12-01

The present investigations applied a theoretical perspective regarding the impact of executive functioning (EF) on sexual risk among substance users, using a methodological approach designed to examine whether EF subtypes differentially predict behavior patterns. Participants included 104 substance-using HIV-negative gay and bisexual men. Participants completed 5 neuropsychological assessment tasks selected to tap discrete EF components, and these data were linked to data on substance dependence and behavioral reports of substance use and sexual risk in the past 30 days. Cluster analysis identified 3 EF subtypes: (a) high performing (good performance across all measures); (b) low performing (poor performance across all measures); and (c) poor IGT performance (impairment on the Iowa Gambling Task [IGT] and its variant, but good performance on all other tasks). The 3 subtypes did not differ in amount of substance use, but the low-performing subtype was associated with greater rates of substance dependence. The low-performing subtype reported the highest rates of sexual behavior and risk, while the poor-IGT-performance subtype reported the lowest rates of sexual risk taking. Global associations between substance use and sexual risk were strongest among the low-performing subtype, but event-level associations appeared strongest among individuals in the high-performing subtype. These data suggest complex associations between EF and sexual risk among substance users, and suggest that the relationship between substance use and sexual risk may vary by EF subtypes. 2013 APA, all rights reserved

The impact of genital self-image on sexual function in women with pelvic floor disorders.

PubMed

Handelzalts, Jonathan E; Yaakobi, Tal; Levy, Sigal; Peled, Yoav; Wiznitzer, Arnon; Krissi, Haim

2017-04-01

There is conflicting evidence regarding the impact of urinary incontinence and pelvic organ prolapse on overall sexual function. However, psychological variables thought to be associated with sexual function, have not been fully explored. We assessed the sexual functioning of women with pelvic floor disorders while measuring for psychological factors such as distress and genital self-image. In a cross-sectional study, 155 women in an urogynecology outpatient clinic of a tertiary health center completed a demographic questionnaire, the Brief Symptom Index-18 (BSI-18), Pelvic Floor Distress Inventory-20 (PFDI-20), Genital Self-Image Scale-20 (GSIS-20) and the Female Sexual Function Index (FSFI). Linear regression showed that when controlling for age and depression, GSIS significantly predicted FSFI total score (Beta=0.38, p<0.001) and the Desire subscale (Beta=0.55, p<0.001). Due to the low response rate in the GSIS and FSFI questionnaires, a preliminary analysis was conducted to characterize the responders. On univariate logistic regression, response to the GSIS was negatively correlated with age (OR=0.94, p=0.02) and being in a relationship (OR=2.3, p=0.016), yet the effect of being in a relationship was diminished in a multivariate model that included age. The main variable associated with overall sexual function in women with pelvic floor disorders was low genital self-image. This variable is more important than self-reported symptoms, type of specific disorder or other demographic variables. Older women tended not to complete the scales concerning more intimate matters. We suggest that urogynecologists should inquire about genital self-image as well as sexual function in this population. Copyright © 2017 Elsevier B.V. All rights reserved.

Satisfaction with sex life in sexually active heterosexual couples dealing with breast cancer: a nationwide longitudinal study.

PubMed

Rottmann, Nina; Gilså Hansen, Dorte; dePont Christensen, René; Hagedoorn, Mariët; Frisch, Morten; Nicolaisen, Anne; Kroman, Niels; Flyger, Henrik; Johansen, Christoffer

2017-02-01

A breast cancer (BC) diagnosis can profoundly affect the sex life of patient and partner within a couple. The purpose of the present study is to examine whether individual and partner sexual functioning, affectionate behavior, emotional closeness and depressive symptoms are associated with change over time in satisfaction with sex life of sexually active heterosexual couples dealing with BC and to explore whether the associations differ between patients and partners after adjustment for basic sociodemographic characteristics, comorbidity and BC treatment. Women with BC and their male partners participated in a longitudinal study (Time 1, ≤4 months after surgery; Time 2, 5 months later). Participants completed items from the PROMIS ® Sexual Function and Satisfaction measure (version 1.0), two items measuring affectionate behavior, a single item measuring emotional closeness and the Center for Epidemiologic Studies-Depression Scale. Registers provided sociodemographic and medical information. Multilevel models were used, which take the interdependency of couples' scores into account. A total of 287 sexually active couples were included in the analyses. Less vaginal discomfort and more vaginal lubrication were associated with increases in patients' satisfaction with sex life. Patients' and partners' satisfaction increased with higher ratings of their own orgasm ability and of partners' timing of ejaculation. Patients' reports of affectionate behavior were positively associated with their partners' satisfaction, and vice versa for partners. Patients' satisfaction increased the more emotional closeness their partner experienced. Partners' depressive symptoms were negatively associated with their satisfaction. Sociodemographic factors and BC treatment were not significantly associated with change in satisfaction. Satisfaction with sex life in sexually active couples dealing with BC needs to be seen as a couple issue. Health professionals should take the partner into account when addressing sexuality issues. Couples' functioning and relationship-related factors may be promising targets for couple interventions.

Correlation between investment in sexual traits and valve sexual dimorphism in Cyprideis species (Ostracoda)

PubMed Central

Hunt, Gene; Lockwood, Rowan; Swaddle, John P.; Horne, David J.

2017-01-01

Assessing the long-term macroevolutionary consequences of sexual selection has been hampered by the difficulty of studying this process in the fossil record. Cytheroid ostracodes offer an excellent system to explore sexual selection in the fossil record because their readily fossilized carapaces are sexually dimorphic. Specifically, males are relatively more elongate than females in this superfamily. This sexual shape difference is thought to arise so that males carapaces can accommodate their very large copulatory apparatus, which can account for up to one-third of body volume. Here we test this widely held explanation for sexual dimorphism in cytheroid ostracodes by correlating investment in male genitalia, a trait in which sexual selection is seen as the main evolutionary driver, with sexual dimorphism of carapace in the genus Cyprideis. We analyzed specimens collected in the field (C. salebrosa, USA; C. torosa, UK) and from collections of the National Museum of Natural History, Washington, DC (C. mexicana). We digitized valve outlines in lateral view to obtain measures of size (valve area) and shape (elongation, measured as length to height ratio), and obtained several dimensions from two components of the hemipenis: the muscular basal capsule, which functions as a sperm pump, and the section that includes the intromittent organ (terminal extension). In addition to the assessment of this primary sexual trait, we also quantified two dimensions of the male secondary sexual trait—where the transformed right walking leg functions as a clasping organ during mating. We also measured linear dimensions from four limbs as indicators of overall (soft-part) body size, and assessed allometry of the soft anatomy. We observed significant correlations in males between valve size, but not elongation, and distinct structural parts of the hemipenis, even after accounting for their shared correlation with overall body size. We also found weak but significant positive correlation between valve elongation and the degree of sexual dimorphism of the walking leg, but only in C. torosa. The correlation between the hemipenis parts, especially basal capsule size and male valve size dimorphism suggests that sexual selection on sperm size, quantity, and/or efficiency of transfer may drive sexual size dimorphism in these species, although we cannot exclude other aspects of sexual and natural selection. PMID:28678866

Sexuality and physical contact in National Social Life, Health, and Aging Project Wave 2.

PubMed

Galinsky, Adena M; McClintock, Martha K; Waite, Linda J

2014-11-01

Wave 2 of the National Social Life, Health, and Aging Project (NSHAP) includes new measures of sexual interest and behavior, as well as new measures of the context of sexual experience and the frequency and appeal of physical contact. This is the first time many of these constructs have been measured in a nationally representative sample. We describe the new measures and compare the distributions of each across gender and age groups, in some cases by partnership status. Two components of sexuality decrease with age among both men and women: frequency of finding an unknown person sexually attractive and receptivity to a partner's sexual overtures. In contrast, the inclination to make one's self sexually attractive to others was a more complicated function of partner status, gender, and age: partnered women and unpartnered men made the most effort, with the more effortful gender's effort decreasing with age. Both men and women find nonsexual physical contact appealing but sexual physical contact is more appealing to men than women. Finally, two fifths of men and women report dissatisfaction with their partner's frequency of caring behaviors that make later sexual interactions pleasurable, and a fifth of women and a quarter of men who had vaginal sex in the past year report dissatisfaction with amount of foreplay. These data offer the opportunity to characterize sexual motivation in older adulthood more precisely and richly and to examine how the context of sexual experience and the nonsexual aspects of physical intimacy correlate with sexual behavior, enjoyment, and problems. © The Author 2014. 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.

Sexual function and quality of life in genitourinary medicine (GUM) outpatients and preliminary validation of a self-report questionnaire measure.

PubMed

Daker-White, Gavin; Crowley, Tessa

2003-05-01

A cross-sectional questionnaire survey of 216 men and 191 women attending a genitourinary medicine (GUM) clinic was undertaken to explore the relationship between sexual symptoms and quality of sexual life, and to test the psychometric validity of a pilot self-report measure of Sexual Function and Quality of Sexual Life (SFQoSL). Statistical comparisons were made with three reference groups: volunteers attending GUM for psychosexual counselling, outpatients at an Obstetrics and Gynaecology Department, and staff. Exploratory principal components analysis (with varimax rotation) of questionnaire item responses suggested an 11 (in women) and 13 (in men) factor solution, incorporating four multi-item scales. Internal consistency (Cronbach's alpha) of core items was 0.84 in 186 women (19 items) and 0.87 in 210 men (22 items). Construct validity was supported in comparisons with reference groups using one-way analysis of variance and post-hoc Scheffé testing. Overall, 116 (54%) male and 132 (69%) female GUM outpatients had scores indicating sexual dysfunction. Thirty-seven (17%) men reported erectile dysfunction; 54 (28%) women reported vaginal dryness affecting sex; 48 (25%) women reported genital changes affecting sex; 45 (21%) men and 64 (34%) women reported problems reaching orgasm.

Predictors of sexual bother in a population of male North American medical students.

PubMed

Smith, James F; Breyer, Benjamin N; Shindel, Alan W

2011-12-01

The prevalence and associations of sexual bother in male medical students has not been extensively studied. The aim of this study is to analyze predictors of sexual bother in a survey of male North American medical students. Students enrolled in allopathic and osteopathic medical schools in North America between February 2008 and July 2008 were invited to participate in an internet-based survey of sexuality and sexual function. The principle outcome measure was a single-item question inquiring about global satisfaction with sexual function. The survey also consisted of a questionnaire that included ethnodemographic factors, student status, sexual history, and a validated scale for the assessment of depression. Respondents completed the International Index of Erectile Function, the premature ejaculation diagnostic tool, and the Self-Esteem and Relationship Quality survey (SEAR). Descriptive statistics, analysis of variance, and multivariable logistic regression were utilized to analyze responses. There were 480 male subjects (mean age 26.3 years) with data sufficient for analysis. Forty-three (9%) reported sexual bother. Sexual bother was significantly more common in men with erectile dysfunction (ED), high risk of premature ejaculation (HRPE), depressive symptoms, and lower sexual frequency. However, after multivariate analysis including SEAR scores, ED, and HRPE were no longer independently predictive of sexual bother. Higher scores for all domains of the SEAR were associated with lower odds of sexual bother. ED and HRPE are associated with sexual bother in this young and presumably healthy population. However, after controlling for relationship factors neither ED nor HRPE independently predicted sexual bother. It is plausible to hypothesize that sexual dysfunction from organic causes is rare in this population and is seldom encountered outside of relationship perturbations. Attention to relationship and psychological factors is likely of key importance in addressing sexual concerns in this population. © 2011 International Society for Sexual Medicine.

[Female sexual dysfunction: a systematic overview of classification, pathophysiology, diagnosis and treatment].

PubMed

Marthol, H; Hilz, M J

2004-03-01

Sexual dysfunction is defined as "disturbances in sexual desire and in the psychophysiological changes that characterize the sexual response cycle and cause marked distress and interpersonal difficulty". The female sexual response cycle consists of three phases: desire, arousal, and orgasm. Various organs of the external and internal genitalia, e.g. vagina, clitoris, labia minora, vestibular bulbs, pelvic floor muscles and uterus, contribute to female sexual function. During sexual arousal, genital blood flow and sensation are increased. The vaginal canal is moistened (lubrication). During orgasm, there is rhythmical contraction of the uterus and pelvic floor muscles. Within the central nervous system, hypothalamic, limbic-hippocampal structures play a central role for sexual arousal. Sexual arousal largely depends on the sympathetic nervous system. Moreover, nonadrenergic/noncholinergic neurotransmitters (NANC), e.g. vasoactive intestinal polypeptide (VIP) and nitric oxide (NO), are involved in smooth muscle relaxation and enhancement of genital blood flow. Furthermore, various hormones may influence female sexual function. Estrogen has a significant role in maintaining vaginal mucosal epithelium as well as sensory thresholds and genital blood flow. Androgens primarily affect sexual desire, arousal, orgasm and the overall sense of well-being. The internationally accepted classification of female sexual dysfunction consists of hypoactive sexual desire disorders, sexual aversion disorders, sexual arousal disorders, orgasmic disorders and sexual pain disorders. Vascular insufficiency, e.g. due to atherosclerosis, and neurologic diseases, e.g. diabetic neuropathy, are major causes of sexual dysfunction. Additionally, sexual dysfunction may be due to changes in hormonal levels, medications with sexual side effects or of psychological origin. For the diagnosis of female sexual dysfunction, a detailed history should be taken initially, followed by a physical examination and laboratory studies. Physiologic monitoring of parameters of arousal potentially allows to diagnose organic diseases. Recordings at baseline and following sexual stimulation are recommended to determine pathologic changes that occur with arousal. Duplex Doppler sonography, photoplethysmography or the measurement of vaginal and minor labial oxygen tension may help to evaluate genital blood flow. Moreover, measurements of vaginal pH and compliance should be performed. Neurophysiological examination, e.g. measurement of the bulbocavernosus reflex and pudendal evoked potentials, genital sympathetic skin response (SSR), warm, cold and vibratory perception thresholds as well as testing of the pressure and touch sensitivity of the external genitalia, should be performed to evaluate neurogenic etiologies. Medical management of female sexual dysfunction so far is primarily based on hormone replacement therapy. Application of estrogen results in decreased pain and burning during intercourse. The efficacy of various other medications, e.g. sildenafil, L-arginine, yohimbine, phentolamine, apomorphine and prostaglandin E1, in the treatment of female sexual dysfunction is still under investigation.

How does adjuvant chemotherapy affect menopausal symptoms, sexual function, and quality of life after breast cancer?

PubMed

Marino, Jennifer L; Saunders, Christobel M; Emery, Laura I; Green, Helena; Doherty, Dorota A; Hickey, Martha

2016-09-01

The aim of the study was to determine the association between adjuvant chemotherapy for breast cancer and menopausal symptoms, sexual function, and quality of life. Participants attended a menopause clinic with a dedicated service for cancer survivors at a large tertiary women's hospital. Information about breast cancer treatments including adjuvant chemotherapy was collected from medical records. Menopausal symptoms were recorded with the Greene Climacteric Scale and Functional Assessment of Cancer Therapy, Breast Cancer, and Endocrine Symptom Subscales. Sexual symptoms were recorded using Fallowfield's Sexual Activity Questionnaire. Quality of life was measured with Functional Assessment of Cancer Therapy scales. The severity of vasomotor, psychological, or sexual symptoms (apart from pain) did not differ between those who had received adjuvant chemotherapy (n = 339) and other breast cancer survivors (n = 465). After adjustment for current age, time since menopause, and current use of antiestrogen endocrine therapy, the risk of "severe pain" with sexual intercourse was twice as common after chemotherapy (31.6% vs 20.0%, odds ratio [OR] 2.18, 95% CI 1.25-3.79). Those treated with chemotherapy were more likely to report "severe problems" with physical well-being (OR 1.92, 95% CI 1.12-3.28) and lower breast cancer-specific quality of life (OR 1.89 95% CI 1.13-3.18), but did not differ in other quality of life measures. In this large study of breast cancer patients presenting to a specialty menopause clinic, previous chemotherapy was not associated with current vasomotor or psychological symptoms. Severe pain with intercourse was significantly more common in those treated with adjuvant chemotherapy.

Personality characteristics and sexual functioning of 188 cross-dressing men.

PubMed

Brown, G R; Wise, T N; Costa, P T; Herbst, J H; Fagan, P J; Schmidt, C W

1996-05-01

The literature on cross-dressing men has been primarily limited to self-identified patients at psychiatric clinics who are in distress. To understand the personality trait characteristics and sexual functioning of nonpatient cross-dressers, 188 non-treatment-seeking male cross-dressers completed the NEO Personality Inventory (NEO-PI) and the Derogatis Sexual Functioning Inventory (DSFI). Respondents were classified as transvestites (TV; N = 83), transgenderists (TG; N = 61), or transsexuals (TS; N = 44) based on self-report and the nature of their cross-gender activities (e.g., use of female hormones, desire for sex reassignment, and amount of time spent in female role). These diagnostic groups did not differ on the five broad personality domains of the NEO-PI, but TS men scored higher than TV and TG men on the Aesthetics facet scale of Openness to Experience (O). In terms of the DSFI scales, TS men reported lower sexual drive than TV and TG men, and TS and TG men exhibited greater psychiatric symptoms and feminine gender role, and poorer body image than TV men. Upon exclusion of a group of 49 respondents who previously sought treatment for psychological problems, no significant differences emerged among the three diagnostic groups on the NEO-PI domain and facet scales. Consideration of the DSFI scales showed that TS men experienced less sexual drive, more psychiatric symptoms, and a greater feminine gender role than TV or TG men. This study suggests that cross-dressers not seen for clinical reasons are virtually indistinguishable from non-cross-dressing men using a measure of personality traits, a sexual functioning inventory, and measures of psychological distress. These results emphasize the importance of using clinical significance criteria as required by DSM-IV guidelines before diagnosing men who cross-dress with an axis I disorder.

Sexual Modes Questionnaire (SMQ): Translation and Psychometric Properties of the Italian Version of the Automatic Thought Scale.

PubMed

Nimbi, Filippo Maria; Tripodi, Francesca; Simonelli, Chiara; Nobre, Pedro

2018-03-01

The Sexual Modes Questionnaire (SMQ) is a validated and widespread used tool to assess the association among negative automatic thoughts, emotions, and sexual response during sexual activity in men and women. To test the psychometric characteristics of the Italian version of the SMQ focusing on the Automatic Thoughts subscale (SMQ-AT). After linguistic translation, the psychometric properties (internal consistency, construct, and discriminant validity) were evaluated. 1,051 participants (425 men and 626 women, 776 healthy and 275 clinical groups complaining about sexual problems) participated in the present study. 2 confirmatory factor analyses were conducted to test the fit of the original factor structures of the SMQ versions. In addition, 2 principal component analyses were performed to highlight 2 new factorial structures that were further validated with confirmatory factor analyses. Cronbach α and composite reliability were used as internal consistency measures and differences between clinical and control groups were run to test the discriminant validity for the male and female versions. The associations with emotions and sexual functioning measures also are reported. Principal component analyses identified 5 factors in the male version: erection concerns thoughts, lack of erotic thoughts, age- and body-related thoughts, negative thoughts toward sex, and worries about partner's evaluation and failure anticipation thoughts. In the female version 6 factors were found: sexual abuse thoughts, lack of erotic thoughts, low self-body image thoughts, failure and disengagement thoughts, sexual passivity and control, and partner's lack of affection. Confirmatory factor analysis supported the adequacy of the factor structure for men and women. Moreover, the SMQ showed a strong association with emotional response and sexual functioning, differentiating between clinical and control groups. This measure is useful to evaluate patients and design interventions focused on negative automatic thoughts during sexual activity and to develop multicultural research. This study reports on the translation and validation of the Italian version of a clinically useful and widely used measure (assessing automatic thoughts during sexual activity). Limits regarding sampling technique and use of the Automatic Thoughts subscale are discussed in the article. The present findings support the validity and the internal consistency of the Italian version of the SMQ-AT and allow the assessment of negative automatic thoughts during sexual activity for clinical and research purposes. Nimbi FM, Tripodi F, Simonelli C, Nobre P. Sexual Modes Questionnaire (SMQ): Translation and Psychometric Properties of the Italian Version of the Automatic Thought Scale. J Sex Med 2018;15:396-409. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

A Longitudinal Study of Predictors of Sexual Dysfunction in Men on Active Surveillance for Prostate Cancer.

PubMed

Pearce, Shane M; Wang, Chi-Hsiung E; Victorson, David E; Helfand, Brian T; Novakovic, Kristian R; Brendler, Charles B; Albaugh, Jeffrey A

2015-09-01

The aim of this study was to examine the relationship between sexual dysfunction, repeat biopsies and other demographic and clinical factors in men on active surveillance (AS). Patient-reported outcomes (PROs) measures were administered at enrollment and every 6 months to assess quality of life (QOL), psychosocial and urological health outcomes. Using mixed-effects models, we examined the impact of repeat biopsies, total number of cores taken, anxiety, age, and comorbidity on sexual function over the first 24 months of enrolling in AS. PROs included the Expanded Prostate Cancer Index Composite-26 (EPIC-26) Sexual Function (SF) subscale, the American Urological Association-Symptom Index (AUA-SI), and the Memorial Anxiety Scale for Prostate Cancer (MAX-PC). At enrollment (n = 195), mean age was 66.5 ± 6.8 with a mean EPIC-26 SF score of 61.4 ± 30.4. EPIC-26 SF scores steadily decreased to 53.9 ± 30.7 at 24 months (P < 0.01). MAX-PC scores also progressively decreased over time (P = 0.03). Factors associated with lower EPIC-26 scores over time included age, unemployed status, diabetes, coronary artery disease, and hypertension (all P < 0.05). Higher prostate-specific antigen (PSA) was associated with a more rapid decline in EPIC-26 SF over time (P = 0.03). In multivariable analysis, age, diabetes, and PSA × time interaction remained significant predictors of diminished sexual function. Anxiety, number of biopsies, and total cores taken did not predict sexual dysfunction or change over time in our cohort. Men on AS experienced a gradual decline in sexual function during the first 24 months of enrollment. Older age, PSA × time, and diabetes were all independent predictors of diminished sexual function over time. Anxiety, AUA-SI, the number of cores and the number of biopsies were not predictors of reduced sexual function in men in AS.

Sexual function before and 1 year after laparoscopic sacrocolpopexy.

PubMed

Salamon, Charbel G; Lewis, Christa M; Priestley, Jennifer; Culligan, Patrick J

2014-01-01

This study aimed to compare sexual function before and 1 year after laparoscopic sacrocolpopexy using a porcine dermis or a polypropylene mesh material. This was a secondary analysis of sexual function measured before and 1 year after laparoscopic sacrocolpopexy in a group of 81 sexually active women participating in a randomized controlled trial comparing porcine dermis and polypropylene mesh. Sexual function was assessed using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Responses to individual questions from the physical domain of the PISQ-12 were also analyzed. Additional information included the type of mesh material used and whether a concomitant suburethral sling or perineorrhaphy was performed. There was a significant postoperative improvement in total PISQ-12 scores for the entire cohort (33.2 vs 38.3, P < 0.01). Similarly, PISQ-12 scores were significantly improved in both groups (33.2 preoperative vs 37.4 one year postoperative in the porcine dermis, P < 0.01 and 33.2 vs 39.2 in the polypropylene mesh, P < 0.01). There were no differences between the 2 graft material groups. Preoperatively, 63.0% (48/76) of women reported avoiding sexual intercourse because of bulging in vagina (PISQ12-question #8), at 1 year postoperatively only 4% (3/76) had a positive response (P < 0.01). We observed a significant decrease in the number of women who reported pain during intercourse at 12 months as evidenced by the responses to the PISQ12-question #5, 47.4% (36/76) versus 26.3% (20/76) (P < 0.01). The addition of a suburethral sling or a perineorrhaphy did not negatively impact sexual function at 1 year. Laparoscopic sacrocolpopexy had a positive impact on sexual function at 1 year regardless of whether a porcine dermis or a polypropylene mesh material was used.

Translation, Adaptation, and Preliminary Validation of the Female Sexual Function Index into Spanish (Colombia).

PubMed

Vallejo-Medina, Pablo; Pérez-Durán, Claudia; Saavedra-Roa, Alejandro

2018-04-01

The Female Sexual Function Index (FSFI) subjectively explores the dimensions of female sexual functioning. This research undertook to adapt and validate the FSFI to Spanish language in a Colombian sample. To this effect, this study was conducted in two steps, namely: (1) cultural adaptation of the scale with the collaboration of seven experts; and (2) preliminary validation of the scale in a sample of 925 participants. Reliability indices were appropriate in this sample, and external validity in relation to other measures showed significant relationships. Findings suggest that the FSFI is reliable and valid in Spanish for a Colombian population. Further research is needed to establish the test-retest reliability and discriminant validity of this Spanish version.

Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya

PubMed Central

Krieger, John N.; Mehta, Supriya D.; Bailey, Robert C.; Agot, Kawango; Ndinya-Achola, Jeckoniah O.; Parker, Corette; Moses, Stephen

2010-01-01

Introduction Male circumcision is being promoted for HIV prevention in high-risk heterosexual populations. However, there is a concern that circumcision may impair sexual function. Aim To assess adult male circumcision’s effect on men’s sexual function and pleasure. Methods Participants in a controlled trial of circumcision to reduce HIV incidence in Kisumu, Kenya were uncircumcised, HIV negative, sexually active men, aged 18–24 years, with a hemoglobin ≥9.0 mmol/L. Exclusion criteria included foreskin covering less than half the glans, a condition that might unduly increase surgical risks, or a medical indication for circumcision. Participants were randomized 1:1 to either immediate circumcision or delayed circumcision after 2 years (control group). Detailed evaluations occurred at 1, 3, 6, 12, 18, and 24 months. Main Outcome Measures (i) Sexual function between circumcised and uncircumcised men; and (ii) sexual satisfaction and pleasure over time following circumcision. Results Between February 2002 and September 2005, 2,784 participants were randomized, including the 100 excluded from this analysis because they crossed over, were not circumcised within 30 days of randomization, did not complete baseline interviews, or were outside the age range. For the circumcision and control groups, respectively, rates of any reported sexual dysfunction decreased from 23.6% and 25.9% at baseline to 6.2% and 5.8% at month 24. Changes over time were not associated with circumcision status. Compared to before they were circumcised, 64.0% of circumcised men reported their penis was “much more sensitive,” and 54.5% rated their ease of reaching orgasm as “much more” at month 24. Conclusions Adult male circumcision was not associated with sexual dysfunction. Circumcised men reported increased penile sensitivity and enhanced ease of reaching orgasm. These data indicate that integration of male circumcision into programs to reduce HIV risk is unlikely to adversely effect male sexual function. PMID:18761593

Sexual Function in Women on Estradiol or Venlafaxine for Hot Flushes: A Randomized Controlled Trial

PubMed Central

Reed, Susan D.; Mitchell, Caroline M.; Joffe, Hadine; Cohen, Lee; Shifren, Jan L.; Newton, Katherine M.; Freeman, Ellen W.; Larson, Joseph C.; Manson, JoAnn E.; LaCroix, Andrea Z.; Guthrie, Katherine A.

2014-01-01

Objective To evaluate sexual function in midlife women taking low-dose oral estradiol or venlafaxine for hot flushes. Methods In an 8-week randomized controlled trial among women aged 40-62 years, sexual function was compared between oral estradiol 0.5 mg/day or venlafaxine 75 mg/day (both compared with placebo). Measures included composite and 6 domain scores from the Female Sexual Function Index (FSFI) and sexually related personal distress. Results Participants were aged 54.6 (standard deviation [SD] 3.8) years, 59% Caucasian, with 8.1 (SD 5.3) daily hot flushes. Median composite baseline FSFI score was 16.3 (SD 11.9, n=256) for all women and 21.7 (SD 9.3, n=198) among sexually active women. Composite mean FSFI change from baseline to week-8 was 1.4 (95% Confidence Interval [CI] -0.4, 3.2) for estradiol, 1.1 (95% CI -0.5, 2.7) for venlafaxine and -0.3 (95% CI -1.6, 1.0) for placebo. Composite FSFI and sexually-related distress change from baseline did not differ between estradiol and placebo (p= 0.38, p=0.30) or venlafaxine and placebo (p=0.79, p=0.48). Among sexually active women, FSFI domain score change from baseline differences (active compared with placebo) in desire was 0.3 (95% CI 0.0, 0.6) for estradiol; -0.6 (95% CI -1.2, 0.0) in orgasm for venlafaxine, and 0.9 (95% CI 0.2, 1.6) in penetration pain for venlafaxine. No women reported adverse events related to sexual dysfunction. Conclusions Overall sexual function among nondepressed midlife women experiencing hot flushes did not change over 8-weeks with low-dose oral estradiol or venlafaxine (compared with placebo), although subtle increase in desire (estradiol), and decreases in orgasm and pain (venlafaxine) may exist. PMID:25004335

Identifying the needs of penile cancer sufferers: a systematic review of the quality of life, psychosexual and psychosocial literature in penile cancer.

PubMed

Maddineni, Satish B; Lau, Maurice M; Sangar, Vijay K

2009-08-08

Penile cancer is an uncommon malignancy with an incidence of 1 per 100,000. Conservative and radical treatments can be disfiguring and may have an impact on sexual function, quality of life (QOL), social interactions, self-image and self-esteem. Knowledge of how this disease affects patients is paramount to developing a global, multi-disciplinary approach to treatment. A Medline/PubMed literature search was conducted using the terms "sexual function penis cancer"; "quality of life penis cancer" and "psychological effects penis cancer" from 1985 to 2008. Articles containing quantitative data on QOL, sexual function or psychological well-being were included. 128 patients from 6 studies were included. 5 studies contained retrospective data whilst 1 study collected prospective data on erectile function. In the 6 studies 13 different quantitative tools were used to assess psychological well-being, QOL and sexual function. The General Health Questionnaire (GHQ) showed impaired well-being in up to 40% in 2 studies. Patients undergoing more mutilating treatments were more likely to have impaired well-being. The Hospital Anxiety and Depression Score (HADS) demonstrated pathological anxiety up to 31% in 2 studies. 1 study used the Diagnostic and Statistical Manual of Mental Disorders of psychiatric illness (DSM III-R) with 53% exhibiting mental illness, 25% avoidance behaviour and 40% impaired well-being. 12/30 suffered from post-traumatic stress disorder. The IIEF-15 was the commonest tool used to assess sexual function. The results varied from 36% in 1 study with no sexual function to 67% in another reporting reduced sexual satisfaction to 78% in another reporting high confidence with erections. The treatment of penile cancer results in negative effects on well-being in up to 40% with psychiatric symptoms in approximately 50%. Up to two-thirds of patients report a reduction in sexual function. This study demonstrates that penile cancer sufferers can exhibit significant psychological dysfunction, yet no standardised tools or interventional pathways are available. Therefore, there is a need to identify and assess adequate tools to measure psychological and sexual dysfunction in this group of patients.

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.

Clinical and Patient-reported Outcomes of 1-sided Anterior Urethroplasty for Long-segment or Panurethral Strictures.

PubMed

Spencer, Jeffrey; Blakely, Stephen; Daugherty, Michael; Angulo, Javier C; Martins, Francisco; Venkatesan, Krishnan; Nikolavsky, Dmitriy

2018-01-01

To evaluate clinical and patient-reported urinary and sexual outcomes after a long-segment stricture repair using the 1-sided urethral dissection, penile invagination, and dorsal buccal mucosa graft onlay technique described by Kulkarni et al. Patients from 4 institutions after single-stage repairs for long-segment urethral strictures (>8 cm) from January 2002 to April 2016 were reviewed. Technique described by Kulkarni et al was used in all cases. Clinical outcomes included uroflowmetry (Qmax) and post-void residuals. Patient-reported outcome measures included International Prostate Symptom Score survey, Sexual Health Inventory for Men, Male Sexual Health Questionnaire, and Global Response Assessment questionnaire to measure voiding, sexual, ejaculatory symptoms, and overall improvement, respectively. Seventy-three patients with a minimum of 12 months' follow-up were included. The mean age and stricture length were 56 (21-80) years and 13.6 (8-21) cm, respectively. At a mean follow-up of 44 (12-162) months, 9 of 73 (12%) strictures recurred. The mean baseline International Prostate Symptom Score of 23 (7-24) decreased to 10 (1-17) on follow-up (P <.001). Eight of 42 patients (21.4%) reported an increase, and 6 of 42 patients (14.3%) decreased in Sexual Health Inventory for Men following urethroplasty. Ejaculatory function on Male Sexual Health Questionnaire improved after urethroplasty from 8 preoperatively to 11 postoperatively (P <.004). All patients reported improvement after urethroplasty on Global Response Assessment questionnaire. Post-void dribbling and chordee occurred in 45% and 25% of patients, respectively. Durable patency in most patients is demonstrated in this study. PROMs indicate an improvement in urinary function and moderate effect on sexual function. Transient penile chordee was evident in 25% of patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Sexual Function and Health-Related Quality of Life in Long-Term Rectal Cancer Survivors

PubMed Central

Sun, Virginia; Grant, Marcia; Wendel, Christopher S.; McMullen, Carmit K.; Bulkley, Joanna E.; Herrinton, Lisa J.; Hornbrook, Mark C.; Krouse, Robert S.

2016-01-01

Introduction Sexual dysfunction is a treatment sequela in rectal cancer (RC) survivors. Differences in health-related quality of life (HRQOL) may occur based on ostomy status (permanent ostomy versus anastomosis). Aim To describe alterations in sexual function and HRQOL based on ostomy status in long-term (≥ 5 years) RC survivors. Methods RC survivors with an ostomy (N=181) or anastomosis (N=394) were surveyed using validated HRQOL and functional status tools. We compared sexuality outcomes between the ostomy and anastomosis group, and reported differences adjusted for clinical and demographic characteristics. Qualitative data from one open-ended question on survivors’ greatest challenges since their surgery were analyzed to explore sexuality, symptoms, and relationships. Main Outcome Measures Whether sexually active, satisfaction with sexual activity, and select sexual dysfunction items from the Modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O). Results Survivors with a permanent ostomy were more likely to have been sexually inactive after surgery if it occurred before year 2000, and experience dissatisfaction with appearance, interference with personal relationships and intimacy, and lower overall HRQOL. Female RC survivors with an ostomy were more likely to have problems with vaginal strictures and vaginal pain after surgery that persisted at the time of survey (5+ years later). Radiation treatment, tumor stage, soilage of garments in bed, and higher Charlson-Deyo co-morbidity scores were negatively associated with outcomes. Six qualitative themes emerged: loss of and decreased sexual activity; psychological issues with sexual activity, physical issues with sexual activity; partner rejection; ostomy interference with sexual activity; and positive experiences with sexuality. Conclusions Sexual dysfunction is a common long-term sequela of RC treatment, with more problems observed in survivors with a permanent ostomy. This warrants widespread implementation of targeted interventions to manage sexual dysfunction and improve HRQOL for these survivors. PMID:27318020

Phases of female sexual response cycle among Malaysian women with infertility: a factor analysis study.

PubMed

Seen Heng, Yeoh; Sidi, Hatta; Nik Jaafar, Nik Ruzyanei; Razali, Rosdinom; Ram, Hari

2013-04-01

This cross-sectional study aimed to determine the construct of the phases of the female sexual response cycle (SRC) among women attending an infertility clinic in a Malaysian tertiary center. The sexual response phases were measured with a validated Malay version of the Female Sexual Function Index (FSFI). The correlation structure of the items of the SRC phases (i.e. desire, arousal, orgasm, satisfaction and pain) was determined using principal component analysis (PCA), with varimax rotation method. The number of factors obtained was decided using Kaiser's criteria. A total of 150 married women with a mean age of 32 years participated in this study. Factor loadings using PCA with varimax rotation divided the sexual domains into three components. The first construct comprised sexual arousal, lubrication and pain (suggesting a mechanical component). The second construct were orgasm and sexual satisfaction (suggesting a physical achievement). Sexual desire, suggesting a psychological component, stood on its own as the third. The findings suggest that three constructs could be identified and in favor of the Basson model (a non-linear concept of SRC) for Malaysian women's sexual functioning. Understanding this would help clinicians to strategize the treatment approach of sexual dysfunction in women with infertility. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Need fulfillment in the sexual relationships of HIV-infected men who have sex with men.

PubMed

Craft, Shonda M; Smith, Sarah A; Serovich, Julianne M; Bautista, Dianne T

2005-06-01

This article explores the associations among sexual need fulfillment, partner selection, and risky sexual behavior, using a functional/motivational perspective. The authors suggest that sexual needs influence partner selection (e.g., steady versus nonsteady), and engaging in UAI is influenced by sexual needs and partner selection. A sample of 108 HIV-positive gay men completed measures of sexual frequency, sexual risk-taking behaviors, and sexual need fulfillment. Results indicated support for both objectives. These men were more likely to choose a steady partner when they possessed greater relationship needs, whereas while men with higher substitution and pleasure needs were more likely to select nonsteady partners. In addition, only men who reported greater substitution needs were more likely to engage in UAI. The results suggest that certain sexual needs influence partner selection, but that sexual needs also influence what activities occur in the encounter.

Measuring Sexual Motives: A Test of the Psychometric Properties of the Sexual Motivations Scale.

PubMed

Jardin, Charles; Garey, Lorra; Zvolensky, Michael J

2017-01-01

Sexual motives refer to functions served by sexual behavior. The Sex Motivations Scale (SMS) has frequently been used to assess sexual motives. At its development, the SMS demonstrated good internal consistency; convergent, divergent, and criterion validity; and configural invariance across sex, age, and Caucasians and African Americans. Yet the metric and scalar invariance of the SMS has not been examined, nor has the measurement invariance of the SMS across Hispanic and Asian Americans, sexual minority status, and relationship status been tested. The criterion validity of the SMS also has yet to be examined for nonintercourse sexual behaviors, such as sexting. The present study aimed to address these gaps in a diverse sample of 2,201 college students (77.60% female; M age  = 22.06; 27.84% Caucasian). Results further affirmed the configural, metric, and scalar invariance of the SMS. The convergent and divergent validity of the SMS was supported in relation to positive and negative affect and attachment patterns; and specific SMS subscales demonstrated associations with sexual intercourse behaviors and sexting, supporting the criterion validity of the SMS. These findings suggest the relevance of the SMS in assessing sexual motives across diverse populations and behaviors.

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

PubMed

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

2017-03-01

The female sexual response is complex and influenced by several biological, psychological, and social factors. Testosterone is believed to modulate a woman's sexual response and desire, because low levels are considered a risk factor for impaired sexual function, but previous studies have been inconclusive. To investigate how androgen levels and psychosocial factors are associated with female sexual dysfunction (FSD), including hypoactive sexual desire disorder (HSDD). The cross-sectional study included 428 premenopausal women 19 to 58 years old who completed a questionnaire on psychosocial factors and had blood sampled at days 6 to 10 in their menstrual cycle. Logistic regression models were built to test the association among hormone levels, psychosocial factors, and sexual end points. Five different sexual end points were measured using the Female Sexual Function Index and the Female Sexual Distress Scale: impaired sexual function, sexual distress, FSD, low sexual desire, and HSDD. Serum levels of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate, and androsterone glucuronide were analyzed using mass spectrometry. After adjusting for psychosocial factors, women with low sexual desire had significantly lower mean levels of free testosterone and androstenedione compared with women without low sexual desire. None of the androgens were associated with FSD in general or with HSDD in particular. Relationship duration longer than 2 years and mild depressive symptoms increased the risk of having all the sexual end points, including FSD in general and HSDD in particular in multivariate analyses. In this large cross-sectional study, low sexual desire was significantly associated with levels of free testosterone and androstenedione, but FSD in general and HSDD in particular were not associated with androgen levels. Length of relationship and depression were associated with FSD including HSDD. Wåhlin-Jacobsen S, Kristensen E, Tønnes Pedersen A, et al. Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women. J Sex Med 2017;14:366-379. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The Relationship Between Sexual Function and Quality of Sleep in Caregiving Mothers of Sons with Duchenne Muscular Dystrophy

PubMed Central

Nozoe, Karen T; Hachul, Helena; Hirotsu, Camila; Polesel, Daniel N; Moreira, Gustavo A; Tufik, Sergio; Andersen, Monica L

2014-01-01

Introduction The task of the caregiver, especially a caregiving mother of a son with a chronic and fatal disease, may interfere with their quality of sleep, sexuality, and some hormone levels. Aim The aim of this study was to evaluate the sexual function and the quality of sleep of caregiving mothers of sons with Duchenne muscular dystrophy (DMD). Methods We evaluated 20 caregiving mothers of sons with DMD and 20 caregiving mothers of sons without any neuromuscular or chronic disease. All of them voluntarily responded to the evaluating questionnaires about their sexuality and their quality of sleep, and gave blood samples to evaluate their hormonal levels. Main Outcome Measures All mothers were evaluated using the questionnaire of Female Sexual Function Index (FSFI) and the Pittsburgh questionnaire (PSQI). The blood samples were tested to determine serum levels of testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone, progesterone, adrenocorticotropic hormone, and cortisol. Results Caregiving mothers of sons with DMD had significantly lower scores in the FSFI questionnaire, suggesting a higher risk for sexual dysfunction. The PSQI demonstrated that these caregiving mothers present increased sleep latency, reduced sleep efficiency, daytime dysfunction, and poor sleep quality. Blood tests showed a rise in cortisol levels, which correlated with the compromised sexuality and quality of sleep. Conclusions This study indicates that caregiving mothers of sons with DMD show major risk for sexual dysfunction and a reduction in their quality of sleep mediated in part by the hormonal changes related to stress. Nozoe KT, Hachul H, Hirotsu C, Polesel DN, Moreira GA, Tufik S, and Andersen ML. The relationship between sexual function and quality of sleep in caregiving mothers of sons with Duchenne muscular dystrophy. Sex Med 2014;2:133–140. PMID:25356310

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.

Childhood sexual abuse: long-term effects on psychological and sexual functioning in a nonclinical and nonstudent sample of adult women.

PubMed

Greenwald, E; Leitenberg, H; Cado, S; Tarran, M J

1990-01-01

The purpose of this study was to explore how the experience of childhood sexual abuse is related to long-term psychological and sexual functioning in a nonclinical and nonstudent community sample of women. Questionnaires were distributed to 1,500 nurses and returned anonymously. Fifty-four women who had been sexually abused as children (age 15 or younger) responded. These subjects were then matched with 54 nonabused control subjects. Although there was no difference on a measure of self-esteem, the abused group reported more symptoms of distress on the Global Severity Index and on seven out of nine subscales of the Derogatis Brief Symptom Inventory. They also reported more disturbance on a scale which examined psychological symptoms that have been commonly reported in the literature to be particularly associated with sexual abuse. These differences between the abused and nonabused groups were evident even after controlling for differences in subjects' perceptions of parental emotional support. Unlike the results for psychological adjustment, however, the abused subjects did not differ from the control subjects on self-reported levels of sexual satisfaction or sexual dysfunction.

Sexual activity, erectile dysfunction and their correlates among 1,566 older Chinese men in Southern China.

PubMed

Wong, Samuel Yeung Shan; Leung, Jason Chi Shun; Woo, Jean

2009-01-01

Few studies on sexuality and its correlates in adults have been conducted in Asia; most studies in Asia have focused instead on erectile dysfunction in men rather than sexuality or sexual activities. This study was conducted to evaluate the prevalence and factors associated with sexual activity and erectile dysfunction in elderly Chinese men aged 65 years and above. Sexual activity and sexual functions were assessed using the International Index of Erectile Function-5. Depressive symptoms were measured by the Chinese version of the Geriatric Depression Scale. Lower urinary tract symptoms (LUTS) were measured by the International Prostatic Symptom Score. Cross-sectional data from a large prospective cohort study of Chinese elderly men were used in this study. A questionnaire that included demographic, lifestyle, and medical risk factors and physical examination were administered to 1566 Chinese men aged between 65 to 92 years in Hong Kong. Only 30.7% of men were sexually active in the previous 6 months in this sample and among those who were sexually active, 88% had some form of erectile dysfunction. Being sexually inactive in the previous 6 months was associated with being older (odds ratio [OR] = 1.80; confidence interval [CI]: 1.56-2.09), single (OR = 1.87; CI = 1.19-2.94) and the presence of peripheral arterial disease (OR = 2.43; CI: 1.25-4.71). In multiple multinomial logistic regression, having clinically relevant depressive symptoms (OR = 3.37; CI: 1.31-8.70) and having moderate to severe LUTS (OR = 1.63; CI: 1.01-2.64) were independently associated with increased risk of having erectile dysfunction. We showed that a large proportion of elderly men were not sexually active in Hong Kong. For those who were sexually active, most suffered from some degree of erectile dysfunction. Having clinically relevant depressive symptoms and LUTS were independently associated with increased risk of erectile dysfunction.

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.

Validation of a single summary score for the Prolapse/Incontinence Sexual Questionnaire-IUGA revised (PISQ-IR).

PubMed

Constantine, Melissa L; Pauls, Rachel N; Rogers, Rebecca R; Rockwood, Todd H

2017-12-01

The Prolapse/Incontinence Sexual Questionnaire-International Urogynecology Association (IUGA) Revised (PISQ-IR) measures sexual function in women with pelvic floor disorders (PFDs) yet is unwieldy, with six individual subscale scores for sexually active women and four for women who are not. We hypothesized that a valid and responsive summary score could be created for the PISQ-IR. Item response data from participating women who completed a revised version of the PISQ-IR at three clinical sites were used to generate item weights using a magnitude estimation (ME) and Q-sort (Q) approaches. Item weights were applied to data from the original PISQ-IR validation to generate summary scores. Correlation and factor analysis methods were used to evaluate validity and responsiveness of summary scores. Weighted and nonweighted summary scores for the sexually active PISQ-IR demonstrated good criterion validity with condition-specific measures: Incontinence Severity Index = 0.12, 0.11, 0.11; Pelvic Floor Distress Inventory-20 = 0.39, 0.39, 0.12; Epidemiology of Prolapse and Incontinence Questionnaire-Q35 = 0.26 0,.25, 0.40); Female Sexual Functioning Index subscale total score = 0.72, 0.75, 0.72 for nonweighted, ME, and Q summary scores, respectively. Responsiveness evaluation showed weighted and nonweighted summary scores detected moderate effect sizes (Cohen's d > 0.5). Weighted items for those NSA demonstrated significant floor effects and did not meet criterion validity. A PISQ-IR summary score for use with sexually active women, nonweighted or calculated with ME or Q item weights, is a valid and reliable measure for clinical use. The summary scores provide value for assesing clinical treatment of pelvic floor disorders.

Handgrip Strength as a Darwinian Fitness Indicator in Men

PubMed Central

Gallup, Andrew C.; Fink, Bernhard

2018-01-01

Handgrip strength (HGS) is a robust measure of overall muscular strength and function, and has long been predictive of a multitude of health factors and physical outcomes for both men and women. The fact that HGS represents such a ubiquitous measure of health and vitality may reflect the significance of this trait during human evolution. This trait is also highly sexually dimorphic due to influences of androgenic hormones and fat-free body mass, suggesting that it has been further elaborated through sexual selection. Consistent with this view, research within evolutionary psychology and related fields has documented distinct relationships between HGS and measures of social and sexual behavior, especially in men. Here, we review studies across different societies and cultural contexts showing that male HGS predicts measures of aggression and social dominance, perceived formidability, male-typical body morphology and movement, courtship display, physical attractiveness, and sexual behavior and reproductive fitness. These findings underscore the value of including HGS as an independent measure within studies examining human sexual selection, and corroborate existing research suggesting that specific features of physical strength have and continue to be under positive directional selection in men. PMID:29681871

Coital incontinence and vaginal symptoms and the relationship to pelvic floor muscle function in primiparous women at 12 months postpartum: a cross-sectional study.

PubMed

Tennfjord, Merete Kolberg; Hilde, Gunvor; Stær-Jensen, Jette; Siafarikas, Franziska; Engh, Marie Ellström; Bø, Kari

2015-04-01

Symptoms related to sexual dysfunction postpartum are scarcely addressed in the literature, and the relationship to pelvic floor muscle (PFM) function is largely unknown. The aim of this study was to investigate primiparous women 12 months postpartum and study: (i) prevalence and bother of coital incontinence, vaginal symptoms, and sexual matters; and (ii) whether coital incontinence and vaginal symptoms were associated with vaginal resting pressure (VRP), PFM strength, and endurance. International Consultation on Incontinence Modular Questionnaire (ICIQ) sexual matters module and ICIQ-Vaginal Symptoms Questionnaire were used for questions on coital incontinence, vaginal symptoms, and sexual matters, respectively. PFM function was assessed by manometer (Camtech AS, Sandvika, Norway). Coital incontinence, vaginal symptoms, and PFM function were the main outcome measures. One hundred seventy-seven primiparous women, mean age 28.7 (standard deviation [SD] 4.3) participated. Of the 94% of women having sexual intercourse, coital incontinence was found for 1.2% whereas 34.5% reported at least one vaginal symptom interfering with the sexual life of primiparous women. Of the symptoms investigated, "vagina feels dry," "vagina feels sore," and "vagina feels loose or lax" were most prevalent, but the overall impact on the woman's sexual life was minimally bothersome, mean 1.4 out of 10 (SD 2.5). Women reporting "vagina feels loose or lax" had lower VRP, PFM strength, and endurance when compared with women without the symptom. Twelve-month postpartum coital incontinence was rare, whereas the prevalence of vaginal symptoms interfering with sexual life was more common. The large majority of primiparous women in our study had sexual intercourse at 12 months postpartum and the reported overall bother on sexual life was low. Women reporting "vagina feels loose or lax" had lower VRP, PFM strength, and endurance when compared with women without the symptom. © 2015 International Society for Sexual Medicine.

Sexual dysfunction in obese women is more affected by psychological domains than that of non-obese.

PubMed

Carrilho, Paulo José Faria; Vivacqua, Carla Almeida; Godoy, Eudes Paiva de; Bruno, Selma Sousa; Brígido, Alexandra Régia Dantas; Barros, Felipe Chaves Duarte; Sousa, Maria Bernardete Cordeiro de

2015-12-01

To compare differences in the occurrence and changed domains of sexual dysfunction in obese and non-obese Brazilian women. Female Sexual Function Index, based on six domains, to investigate 31 sexual dysfunction incidence for obese compared to 32 non-obese women, was used. Statistical analysis using ANOVA and MANOVA were performed to compare total scores of Female Sexual Function Index among groups and to identify the differences among domains, Student t -test was used. Statistical significant level was established for all tests for p<0.05. No difference in female sexual dysfunction frequency between obese (25.8%) and non-obese women (22.5%) was found. However, an important distinction in which aspects of sexual life were affected was found. While the obese group was impaired in three domains of sexual life (desire, orgasm, and arousal), in the control group five aspects were dysfunctional (desire, orgasm, arousal, pain and lubrication). Future research exploring psychological outcomes in obese females, such as body image and measures of positive and negative effect, might better characterize the female sexual dysfunction in this group. Obesity does not appear to be an independent factor for allow quality of female sexual life. However, disturbance associated to obesity indicates a low frequency of disorder in physical domains, suggesting that psychological factors seem to be mainly involved in the sexual dysfunction in obese women.

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

Couple-based treatment for sexual problems following breast cancer: A review and synthesis of the literature.

PubMed

Carroll, Allison J; Baron, Shirley R; Carroll, Richard A

2016-08-01

Although there are many physical and psychological impacts on women's sexuality following breast cancer diagnosis and treatment, sexual problems often remain unaddressed in these cancer survivors. Given the crucial role of the partner in sexual issues, couple-based sex therapy would appear to be a logical first-line treatment for this population, but there is scant research on the efficacy of couple-based treatments and/or sex therapy in breast cancer survivors. A review of the literature was conducted using the PMC, PsycINFO, EMBASE, and MEDLINE databases. Articles were included that presented the results of an experimental or quasi-experimental clinical trial evaluating a psychosexual intervention for couples, targeted women diagnosed with breast cancer and their partners, and included outcome measures of sexual function and sexuality. Studies were excluded if the primary intervention was not focused on sexual problems or if they were published in a language other than English. From 2231 records, five articles met criteria for inclusion in the present review. Couple-based sex therapy appears to be an effective and highly accepted treatment for addressing sexual problems in breast cancer patients. These interventions were associated with improvements in sexual physiology, sexual functioning, sexual self-image, and sexual relationships, as well as improved psychological well-being of both breast cancer patients and their partners. Based on this review, the authors address clinical implications, particularly incorporating psychological treatment for sexual problems in comprehensive cancer care, and provide recommendations for further study.

The effect of perineal lacerations on pelvic floor function and anatomy at six months postpartum in a prospective cohort of nulliparous women

PubMed Central

Lawrence, Leeman; Rebecca, Rogers; Noelle, Borders; Dusty, Teaf; Clifford, Qualls

2016-01-01

Objective Determine the effect of perineal lacerations on pelvic floor outcomes including urinary and anal incontinence, sexual function and perineal pain in a nulliparous cohort with low incidence of episiotomy. Methods Nulliparous women were prospectively recruited from a midwifery practice. Pelvic floor symptoms were assessed with validated questionnaires, physical examination and objective measures in pregnancy and 6 months postpartum. Two trauma groups were compared, those with an intact perineum or only 1st degree lacerations and those with 2nd, 3rd or 4th degree lacerations. Results 448 women had vaginal deliveries. 151 sustained second degree or deeper perineal trauma and 297 had an intact perineum or minor trauma. 336 (74.8%) presented for 6-month follow-up. Perineal trauma was not associated with urinary or fecal incontinence, decreased sexual activity, perineal pain, or pelvic organ prolapse. Women with trauma had similar rates of sexual activity however they had slightly lower sexual function scores (27.3 vs. 29.1, p=0.01). Objective measures of pelvic floor strength, rectal tone, urinary incontinence, and perineal anatomy were equivalent. The subgroup of women with deeper (> 2cm) perineal trauma demonstrated increased likelihood of perineal pain (15.5 vs. 6.2 %) and weaker pelvic floor muscle strength (61.0 vs. 44.3%); p=0.03 compared to women with more superficial trauma Conclusion: Women having second degree lacerations are not at increased risk for pelvic floor dysfunction other than increased pain, and slightly lower sexual function scores at 6 months postpartum. PMID:27797099

Evidence for a curvilinear relationship between sympathetic nervous system activation and women's physiological sexual arousal.

PubMed

Lorenz, Tierney Ahrold; Harte, Christopher B; Hamilton, Lisa Dawn; Meston, Cindy M

2012-01-01

There is increasing evidence that women's physiological sexual arousal is facilitated by moderate sympathetic nervous system (SNS) activation. Literature also suggests that the level of SNS activation may play a role in the degree to which SNS activity affects sexual arousal. We provide the first empirical examination of a possible curvilinear relationship between SNS activity and women's genital arousal using a direct measure of SNS activation in 52 sexually functional women. The relationship between heart rate variability (HRV), a specific and sensitive marker of SNS activation, and vaginal pulse amplitude (VPA), a measure of genital arousal, was analyzed. Moderate increases in SNS activity were associated with higher genital arousal, while very low or very high SNS activation was associated with lower genital arousal. These findings imply that there is an optimal level of SNS activation for women's physiological sexual arousal. Copyright © 2011 Society for Psychophysiological Research.

The relationship of "passionate attachment" for pornography with sexual compulsivity, frequency of use, and craving for pornography.

PubMed

Rosenberg, Harold; Kraus, Shane

2014-05-01

We recruited a sample of 221 undergraduate males who used pornography regularly to complete a series of questionnaires assessing their "passionate attachment" to pornography, pornography use history, sexual compulsivity, subjective craving to use pornography, compulsive Internet use, social desirability and non-sexual sensation seeking. Both Harmonious Passion and Obsessive Passion subscale scores varied as a function of typical weekly frequency of pornography use, and both subscales were positively significantly associated with sexual compulsivity, current craving to use pornography, and compulsive Internet use. However, neither subtype of passionate attachment to pornography was significantly associated with non-sexual sensation seeking or with the tendency to present oneself in a socially desirable manner. Trait-like sexual compulsivity and presumably transient craving to use pornography appear related to, but are not substitute measures for, passionate attachment for pornography. Further research could evaluate the clinical utility of this questionnaire to measure clients' preoccupation with and inclination to use pornography during assessment and psychotherapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

Topography in the preoptic region: Differential regulation of appetitive and consummatory male sexual behaviors

PubMed Central

Balthazart, Jacques; Ball, Gregory F.

2007-01-01

Several studies have suggested dissociations between neural circuits underlying the expression of appetitive (i.e. sexual motivation) and consummatory components (i.e., copulatory behavior) of vertebrate male sexual behavior. The medial preoptic area (mPOA) clearly controls the expression of male copulation but, according to a number of experiments, is not necessarily implicated in the expression of appetitive sexual behavior. In rats for example, lesions to the mPOA eliminate male-typical copulatory behavior but have more subtle or no obvious effects on measures of sexual motivation. Rats with such lesions still pursue and attempt to mount females. They also acquire and perform learned instrumental responses to gain access to females. However, recent lesions studies and measures of the expression of the immediate early gene c-fos demonstrate that, in quail, sub-regions of the mPOA, in particular of its sexually dimorphic component the medial preoptic nucleus, can be specifically linked with either the expression of appetitive or consummatory sexual behavior. In particular more rostral regions can be linked to appetitive components while more caudal regions are involved in consummatory behavior. This functional sub-region variation is associated with neurochemical and hodological specializations (i.e. differences in chemical phenotype of the cells or in their connectivity), especially those related to the actions of androgens in relation to the activation of male sexual behavior, that are also present in rodents and other species. It could thus reflect general principles about POA organization and function in the vertebrate brain. PMID:17624413

Sexuality of men with fibromyalgia: what are the factors that cause sexual dysfunction?

PubMed

Batmaz, Ibrahim; Sarıyıldız, Mustafa Akif; Dilek, Banu; Inanır, Ahmet; Demircan, Zeynep; Hatipoğlu, Namık; Atar, Murat; Cevik, Remzi

2013-05-01

The purpose of the present study is to compare male patients with the fibromyalgia syndrome (FMS) with healthy individuals in terms of the sexual function. For the purposes of this study, 37 sexually active male FMS patients and 30 healthy controls were enrolled. The demographic data of the patients were recorded, and the widespread pain observed in FMS was graded with the help of the visual analogue scale (VAS 0-100 mm). Sexual function was assessed according to the international index of erectile function (IIEF) scoring system. The disease-related quality of life was measured with the help of the Short Form-36 quality of life questionnaire (SF-36 QoL). Levels of anxiety and depression observed in the patients were graded through the Hospital Anxiety and Depression Scale (HADS). Patients with FMS had significantly lower scores in each of the five domains of the IIEF in comparison with the healthy control group (p < 0.001). Patients' age and widespread pain were negatively correlated with the IIEF scores (p < 0.05). The SF-36 scores (physical functioning, role limitations due to physical problems, pain and general health perception) were observed to be positively correlated with the IIEF scores (p < 0.05). No significant relationship has been observed between the scores obtained from the domains of IIEF and the psychological status (p > 0.05). FMS leads to an impairment in the sexual function in male patients, which is especially strongly associated with the age, widespread pain and the quality of life.

Effects of Mindfulness Training on Body Awareness to Sexual Stimuli: Implications for Female Sexual Dysfunction

PubMed Central

Silverstein, R. Gina; Brown, Anne-Catharine H.; Roth, Harold D.; Britton, Willoughby B.

2013-01-01

Objectives Treatments of female sexual dysfunction have been largely unsuccessful because they do not address the psychological factors that underlie female sexuality. Negative self-evaluative processes interfere with the ability to attend and register physiological changes (interoceptive awareness). This study explores the effect of mindfulness meditation training on interoceptive awareness and the three categories of known barriers to healthy sexual functioning: attention, self-judgment, and clinical symptoms. Methods Forty-four college students (30 women) participated in either a 12-week course containing a “meditation laboratory” or an active control course with similar content or laboratory format. Interoceptive awareness was measured by reaction time in rating physiological response to sexual stimuli. Psychological barriers were assessed with self-reported measures of mindfulness and psychological well-being. Results Women who participated in the meditation training became significantly faster at registering their physiological responses (interoceptive awareness) to sexual stimuli compared with active controls (F(1,28) = 5.45, p = .03, ηp2 = 0.15). Female meditators also improved their scores on attention (t = 4.42, df = 11, p = .001), self-judgment, (t = 3.1, df = 11, p = .01), and symptoms of anxiety (t = −3.17, df = 11, p = .009) and depression (t = −2.13, df = 11, p < .05). Improvements in interoceptive awareness were correlated with improvements in the psychological barriers to healthy sexual functioning (r = −0.44 for attention, r = −0.42 for self-judgment, and r = 0.49 for anxiety; all p < .05). Conclusions Mindfulness-based improvements in interoceptive awareness highlight the potential of mindfulness training as a treatment of female sexual dysfunction. PMID:22048839

Self-Reported Sexual Function Measures Administered to Female Cancer Patients: A Systematic Review, 2008–2014

PubMed Central

Jeffery, Diana D.; Barbera, Lisa; Andersen, Barbara L.; Siston, Amy K.; Jhingran, Anuja; Baron, Shirley R.; Reese, Jennifer Barsky; Coady, Deborah J.; Carter, Jeanne; Flynn, Kathryn E.

2016-01-01

Background A systematic review was conducted to identify and characterize self-reported sexual function (SF) measures administered to women with a history of cancer. Methods Using 2009 PRISMA guidelines, we searched electronic bibliographic databases for quantitative studies published January 2008–September 2014 that used a self-reported measure of SF, or a quality of life (QOL) measure that contained at least one item pertaining to SF. Results Of 1,487 articles initially identified, 171 were retained. The studies originated in 36 different countries with 23% from U.S.-based authors. Most studies focused on women treated for breast, gynecologic, or colorectal cancer. About 70% of the articles examined SF as the primary focus; the remaining examined QOL, menopausal symptoms, or compared treatment modalities. We identified 37 measures that assessed at least one domain of SF, eight of which were dedicated SF measures developed with cancer patients. Almost one-third of the studies used EORTC QLQ modules to assess SF, and another third used the Female Sexual Function Inventory. There were few commonalities among studies, though nearly all demonstrated worse SF after cancer treatment or compared to healthy controls. Conclusions QOL measures are better suited to screening while dedicated SF questionnaires provide data for more in depth assessment. This systematic review will assist oncology clinicians and researchers in their selection of measures of SF and encourage integration of this quality of life domain in patient care. PMID:25997102

Linguistic Changes in Expressive Writing Predict Psychological Outcomes in Women With History of Childhood Sexual Abuse and Adult Sexual Dysfunction

PubMed Central

Pulverman, Carey S.; Lorenz, Tierney A.; Meston, Cindy M.

2015-01-01

An expressive writing treatment was recently reported to reduce depressive symptoms and improve sexual function and satisfaction in a sample of female survivors of childhood sexual abuse (Meston, Lorenz, & Stephenson, 2013). We conducted a linguistic analysis of this data to determine whether pre-to posttreatment changes in participants’ language use were associated with the improvements in sexuality and depression. Linguistic Inquiry and Word Count (LIWC), a program that counts the use of word categories within a text, was used to evaluate the impact of several word categories, previously associated with changes in mental health (Frattaroli, 2006), and shown to differ between childhood sexual abuse survivors and nonabused women (Lorenz & Meston, 2012), on treatment outcomes. A reduction in the use of the word “I” and an increase in positive emotion words were associated with decreased depression symptoms. A reduction in the use of “I” and negative emotion words were associated with improvement in sexual function and sexual satisfaction. The findings suggest that, because language may serve as an implicit measure of depression and sexual health, monitoring language changes during treatment may provide a reliable indicator of treatment response free of the biases of traditional self-report assessments. PMID:25793593

Sexual function and postpartum depression 6 months after attempted operative vaginal delivery according to fetal head station: A prospective population-based cohort study

PubMed Central

Hamel, Jean-François; Brun, Stéphanie; Madar, Hugo; Merlot, Benjamin; Sentilhes, Loïc

2017-01-01

Objective To evaluate the effect of the fetal head station at attempted operative vaginal delivery (aOVD), and specifically midpelvic or low aOVD, on female and male sexual function and symptoms of postpartum depression (PPD) at 6 months. Design Prospective population-based cohort study. Setting 1,941 women with singleton term fetuses in vertex presentation with midpelvic or low aOVD between 2008 and 2013 in a tertiary care university hospital. Methods Symptoms of female sexual dysfunction using the Pelvic Organ Prolapse/Urinary Incontinence/Sexual Function Short Form Questionnaire (PISQ-12), symptoms of PPD using the Edinburgh Postnatal Depression Scale (EPDS) score, symptoms of male sexual dysfunction using the International Index of Erectile Function (IIEF-15) and perineal pain were assessed 6 months after aOVD. We measured the association between midpelvic or low aOVD and symptoms of female and male sexual function and symptoms of PPD at 6 months using multiple regression and adjusting for demographics, and risk factors of sexual dysfunction, symptoms of PPD and perineal pain with adjusted odds ratios (aORs) and 95% confidence intervals (95% CI). Results The study included 907 women (46.7%) who responded to the questionnaire; 18.4% (167/907) had midpelvic aOVD, and 81.6% (740/907) low. Most women (873/907 [96.3%]) of those with partners reported sexual activity at 6 months. No significant difference was observed for PISQ-12, EPDS, IIEF-15 scores and perineal pain between mid and low pelvic groups. Compared with low pelvic aOVD, midpelvic aOVD was not significantly associated with either female or male sexual dysfunction (p = 0.89 and p = 0.76, respectively), or maternal symptoms of PPD (p = 0.83). Perineal pain significantly increased the risk of male and female sexual dysfunction and maternal symptoms of PPD at 6 months (p = 0.02, p = 0.006, and p = 0.02, respectively). Conclusion Midpelvic compared with low pelvic aOVD was not associated with an increase in sexual dysfunction, nor with symptoms of PPD at 6 months. PMID:28591209

Does ligation of internal iliac artery for postpartum hemorrhage affect clitoral artery blood flow and postpartum sexual functions?

PubMed

Kaya, B; Usluogullari, B; Yurttutan, N; Sahan, M H; Güralp, O; Malik, E

2017-12-01

To investigate whether internal iliac artery ligation (IIAL) for postpartum hemorrhage (PPH) affects the sexual life in the postpartum period or significantly reduces the clitoral artery blood flow. The women who underwent IIAL due to PPH during cesarean section (CS) were compared with healthy postpartum women delivered by CS between October 2014 and February 2016 in the Gaziantep Women's Health and Maternity Hospital, Gaziantep, Turkey. Clitoral Doppler flow measurements and the Female Sexual Function Index questionnaire (FSFIQ) were performed in all women in the 3rd and 6th postpartum months. This study was registered at ClinicalTrials.gov with the identification number NCT02409602. Mean age, gravidity and parity, body mass index (BMI), first sexual intercourse after childbirth, and education years were similar in both groups. There was no statistically significant difference in the measurements of RI, PI, PSV, EDV, and S/D between the study and control groups in the 3rd month. Lack of statistical significance was also noted between the study and control groups values in the 6th month, as well as between the 3rd and 6th month's values within both the study group and the control group. Additionally, there were no statistically significant differences in the total FSFI scores including sexual desire, sexual arousal, lubrication, orgasm, sexual satisfaction, and pain domain scores between the study and control groups in the 3rd month; between the study and control groups 6th months; whereas all scores were higher in the 6th month compared to the 3rd month within each group. IIAL does not affect the blood flow of the dorsal clitoral artery between the 3rd and 6th months postpartum and between the women who underwent IIAL due to PPH and healthy postpartum women. The sexual function scores were significantly higher in the 6th month compared to the 3rd month in both groups. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

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.

The relationship between health and mating success in humans

PubMed Central

Rhodes, Gillian 

2017-01-01

Health has been claimed to play an important role in human sexual selection, especially in terms of mate choice. Our preferences for attractive individuals are said to represent evolved adaptations for finding high-quality, healthy mates. If this is true, then we expect health to predict mating success in humans. We tested this hypothesis using several important physiological indicators of health, including immune function, oxidative stress and semen quality, and self-reported measures of sexual behaviour that contribute to mating success. In contrast to our hypothesis, we did not find a relationship between the physiological measures of health and sexual behaviour. Our results provide little support for claims that health, at least the health measures we used, increases mating success in relatively healthy humans. PMID:28280558

Stressful Life Events in Children With Functional Defecation Disorders.

PubMed

Philips, Elise M; Peeters, Babette; Teeuw, Arianne H; Leenders, Arnold G E; Boluyt, Nicole; Brilleslijper-Kater, Sonja N; Benninga, Marc A

2015-10-01

The aim of the study was to determine the prevalence of stressful life events including (sexual) abuse in children with functional defecation disorders by performing a systematic review. We searched MEDLINE, EMBASE, and PsycINFO for cohort, case-control and cross-sectional studies investigating the prevalence of stressful life events, including (sexual) abuse in children with functional defecation disorders. The search yielded 946 articles, of which 8 were included with data from 654 children with functional constipation and 1931 children with (constipation-associated) fecal incontinence (FI). Overall, children with functional defecation disorders had been significantly more exposed to stressful life events than healthy children, with prevalence rates ranging from 1.6% to 90.9%. Being bullied, being a relational victim, interruption of toilet training, punishment by parents during toilet training, and hospitalization were significantly related to FI, whereas separation from the best friend, failure in an examination, severe illness in a close family member, loss of job by a parent, frequent punishment, and living in a war-affected area were significantly related to constipation. Only 1 study measured the prevalence of child abuse, which reported a significantly higher prevalence of child (sexual) abuse in children with FI compared with controls. The prevalence of stressful life events, including (sexual) abuse is significantly higher in children with functional defecation disorders compared with healthy children. To gain more insight into the true prevalence of child (sexual) abuse in children with functional defecation disorders, more studies are clearly needed.

IGF-1 levels are significantly correlated with patient-reported measures of sexual function.

PubMed

Pastuszak, A W; Liu, J S; Vij, A; Mohamed, O; Sathyamoorthy, K; Lipshultz, L I; Khera, M

2011-01-01

Growth hormone (GH) supplementation may help to preserve erectile function. We assessed whether serum insulin-like growth factor 1 (IGF-1) levels, a surrogate for GH levels, correlate with sexual function scores in 65 men who completed the Sexual Health Inventory for Men (SHIM) and Expanded Prostate Cancer Index Composite (EPIC) questionnaires, and had serum IGF-1 and testosterone levels determined. Median±s.d. IGF-1 level, SHIM and EPIC scores were 235.0±86.4, 19.5±8.7 and 56.4±28.3 mg ml(-1), respectively. IGF-1 levels and total SHIM score correlate significantly (r=0.31, P=0.02), as do IGF-1 levels and all individual SHIM question scores, and IGF-1 levels and the sexual domain of the EPIC questionnaire (r=0.30, P=0.02). No correlation was observed between IGF-1 levels and Gleason score, IGF-1 and testosterone level or SHIM score and testosterone level. These data support a potential role for the GH axis in erectile function.

Creation and Validation of the Self-esteem/Self-image Female Sexuality (SESIFS) Questionnaire

PubMed Central

Lordello, Maria CO; Ambrogini, Carolina C; Fanganiello, Ana L; Embiruçu, Teresa R; Zaneti, Marina M; Veloso, Laise; Piccirillo, Livia B; Crude, Bianca L; Haidar, Mauro; Silva, Ivaldo

2014-01-01

INTRODUCTION Self-esteem and self-image are psychological aspects that affect sexual function. AIMS To validate a new measurement tool that correlates the concepts of self-esteem, self-image, and sexuality. METHODS A 20-question test (the self-esteem/self-image female sexuality [SESIFS] questionnaire) was created and tested on 208 women. Participants answered: Rosenberg’s self-esteem scale, the female sexual quotient (FSQ), and the SESIFS questionnaire. Pearson’s correlation coefficient was used to test concurrent validity of the SESIFS against Rosenberg’s self-esteem scale and the FSQ. Reliability was tested using the Cronbach’s alpha coefficient. RESULT The new questionnaire had a good overall reliability (Cronbach’s alpha r = 0.862, p < 0.001), but the sexual domain scored lower than expected (r = 0.65). The validity was good: overall score r = 0.38, p < 0.001, self-esteem domain r = 0.32, p < 0.001, self-image domain r = 0.31, p < 0.001, sexual domain r = 0.29, p < 0.001. CONCLUSIONS The SESIFS questionnaire has limitations in measuring the correlation among self-esteem, self-image, and sexuality domains. A new, revised version is being tested and will be presented in an upcoming publication. PMID:25574149

Creation and Validation of the Self-esteem/Self-image Female Sexuality (SESIFS) Questionnaire.

PubMed

Lordello, Maria Co; Ambrogini, Carolina C; Fanganiello, Ana L; Embiruçu, Teresa R; Zaneti, Marina M; Veloso, Laise; Piccirillo, Livia B; Crude, Bianca L; Haidar, Mauro; Silva, Ivaldo

2014-01-01

Self-esteem and self-image are psychological aspects that affect sexual function. To validate a new measurement tool that correlates the concepts of self-esteem, self-image, and sexuality. A 20-question test (the self-esteem/self-image female sexuality [SESIFS] questionnaire) was created and tested on 208 women. Participants answered: Rosenberg's self-esteem scale, the female sexual quotient (FSQ), and the SESIFS questionnaire. Pearson's correlation coefficient was used to test concurrent validity of the SESIFS against Rosenberg's self-esteem scale and the FSQ. Reliability was tested using the Cronbach's alpha coefficient. The new questionnaire had a good overall reliability (Cronbach's alpha r = 0.862, p < 0.001), but the sexual domain scored lower than expected (r = 0.65). The validity was good: overall score r = 0.38, p < 0.001, self-esteem domain r = 0.32, p < 0.001, self-image domain r = 0.31, p < 0.001, sexual domain r = 0.29, p < 0.001. The SESIFS questionnaire has limitations in measuring the correlation among self-esteem, self-image, and sexuality domains. A new, revised version is being tested and will be presented in an upcoming publication.

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.

Fluoxetine and premature ejaculation: a double-blind, crossover, placebo-controlled study.

PubMed

Haensel, S M; Klem, T M; Hop, W C; Slob, A K

1998-02-01

The purpose of this study was to investigate the effect of fluoxetine on sexual function in men with premature ejaculation and/or erectile dysfunction and control subjects in a prospective, double-blind, placebo-controlled, crossover study. There were four groups: (1) premature ejaculation (PE, N = 9); (2) premature ejaculation and erectile dysfunction (PE/ED, N = 9); (3) erectile dysfunction (ED, N = 7); and (4) healthy, sexually functional control subjects (N = 15). The study consisted of three 4-week periods: fluoxetine, washout, and placebo (or vice versa). Fluoxetine began at 5 mg/day for 2 weeks, followed by 10 mg/day for 2 weeks. At weeks 0, 4, 8, and 12, subjects visited the laboratory for evaluation of sexual function and assessment of erectile response, ejaculation, and sexual arousal to visual erotic stimulation without and with concomitant vibrotactile stimulation to the penis. At home, daily logs for sexual activities and feelings of well-being were maintained, and nocturnal penile tumescence was measured. The latency to ejaculation increased significantly in the PE/ED group (p = 0.03) and in the PE and the PE/ED group taken together (p = 0.007) but not in the PE group alone. Fluoxetine stimulated objectively but not subjectively measured erectile response during laboratory assessment in all groups. No major side effects were reported. In conclusion, fluoxetine (5-10 mg/day) was effective in increasing latency to ejaculation in patients with PE (PE and PE/ED groups combined).

Comparing Sildenafil alone vs. Sildenafil plus brief couple sex therapy on erectile dysfunction and couples' sexual and marital quality of life: a pilot study.

PubMed

Aubin, Sylvie; Heiman, Julia R; Berger, Richard E; Murallo, A V; Yung-Wen, Liu

2009-01-01

Treatment options for managing erectile dysfunction (ED) include medical and psychological interventions. The present study examined the effectiveness of a drug-only vs. combined treatment approach on erectile function as well as other domains of sexual function and cognition, couple intimacy and adaptation, and treatment satisfaction. Couples with ED were randomly assigned to either Viagra-only (VO) or Viagra plus sex therapy (VST). Sexual and relationship variables were measured at specific time points. Despite limitations, study findings extend previous conclusions and provide empirical support for the effectiveness and satisfaction with the combined treatment approach for treating men with ED of mixed etiology.

Sexual functioning of people with rheumatoid arthritis: a multicenter study.

PubMed

van Berlo, Willy T M; van de Wiel, Harry B M; Taal, Erik; Rasker, Johannes J; Weijmar Schultz, Willibrord C M; van Rijswijk, Martin H

2007-01-01

The objective of this study is to compare men and women with rheumatoid arthritis (RA) to controls regarding sexual motivation, activity, satisfaction, and specific sexual problems, and to determine the correlation of physical aspects of the disease with sexual functioning. Questionnaire for screening sexual dysfunctions (QSD), self-constructed questionnaire on experienced distress with joints during sexual activities, arthritis impact measurements scales 2 (AIMS2), and the modified disease activity score 28 (DAS 28) were the methods used. RA patients were recruited from a registration base in three Dutch hospitals. Controls were age and sex matched healthy volunteers. A completed questionnaire was sent back by 271 patients (response 23%). Forty-seven men and 93 women were clinically examined to obtain the DAS 28. Male patients felt less sexual desire, and female patients masturbated and fantasized less than controls. Differences in satisfaction were not found. Male and female patients did not experience more sexual problems than controls. Among the women, correlations were predominantly found between age and sexual motivation and activities, among the men between physical health and sexual problems. Up to 41% of the men (4-41 depending on the joints), and up to 51% of the women (10-51 depending on the joints) have troubles with several joints during sexual activities. Medications influencing ejaculation in men correlated with distress with orgasm. Conclusions are that patients are less sexually active than controls and a considerable number of both male and female patients have trouble with their joints during sexual activities. However, patients do not differ from controls regarding sexual satisfaction. Physiological changes due to RA are apparently independent from those on psychological level. It is argued that sexual satisfaction also depends on personal and social factors. In men, physical health and disease activity are more related with sexual problems than in women.

Effect of fennel vaginal cream on sexual function in postmenopausal women: A double blind randomized controlled trial

PubMed Central

Abedi, Parvin; Najafian, Mahin; Yaralizadeh, Masumeh; Namjoyan, Foroogh

2018-01-01

Objective: The aim of this study was to assess the effect of fennel on sexual function in postmenopausal women. It was a randomized controlled trial in 60 postmenopausal women with sexual dysfunction who were randomly assigned to two groups receiving either fennel vaginal cream (n=30) or placebo (n=30). Vaginal atrophy in the women was assessed using symptoms such as pallor, dryness, dyspareunia, itching and burning. The pH of the vagina and cytology of the vaginal mucosa were also measured at baseline and 8 weeks after the intervention. All participants were requested to fill out the Female Sexual Function Index (FSFI) at baseline and after 8 weeks. The intervention group was requested to use fennel vaginal cream (5 grams) every night, while the control group used placebo each night for 8 weeks. The data were analyzed using the independent t-test and Chi-square, Mann-Whitney and Wilcoxon tests. All areas of sexual function including arousal, lubrication, orgasm, sexual satisfaction and pain improved in both fennel and placebo groups after 8 weeks; however, the differences in the fennel group were more evident (p<0.05). The total FSFI score was significantly higher in the fennel group compared to the control group (8.2 ±9.4 and 8.03±10.36 before the intervention and changing to 33.79±0.7 and 18.99±1.09 after the intervention in the fennel and placebo groups, respectively; p<0.001). Discussion: According to our results, fennel vaginal cream is an effective means of improving sexual activity in postmenopausal women. The use of this product in women who have sexual dysfunction and contraindications for hormone therapy is recommended. PMID:29696061

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

Spinal cord injury and women's sexual life: case-control study.

PubMed

Merghati-Khoei, E; Emami-Razavi, S H; Bakhtiyari, M; Lamyian, M; Hajmirzaei, S; Ton-Tab Haghighi, S; Korte, J E; Maasoumi, R

2017-03-01

Study design :This is a case-control study. The objective of this study was to estimate the magnitude of association between spinal cord injury (SCI) and women's quality of sexual life and sexual function. This study was conducted in the Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. From the referral university-based clinics, we used simple random sampling to recruit 62 women: 31 women with SCI and 31 women without SCI. Socio-demographic and reproductive traits questionnaire, Sexual Quality of life-Female (SQOL-F), Female Sexual Function Index (FSFI) and Spinal Cord Independence Measure (SCIM) were completed using telephone and face-to-face interviews in the cases and controls. After univariate analyses, multivariate linear and proportional odds regression models were conducted to investigate the relation between SCI and women's quality of sexual life, as well as sexual function. The mean age of cases and controls was 35.42±6.51 and 33.77±4.02 years. Most women were high school-educated and housewives. Adjusting for probable confounders, the proportional odds regression model showed a significant relationship between the spinal cord injury (AOR=4.2, 95% CI: 1.8-9.2), non-college-educated (AOR=3.1, 95% CI: 1.2-5.9) and employed (AOR=1.8, 95% CI: 1.1-1.8) variables and being in one of the moderate or poor quality of life classes. Scores of SQOL-F and FSFI domains, except satisfaction, were significantly worse in cases versus controls (P<0.001). Although our participants showed low sexual dysfunction, they tended to report moderate to poor quality of sexual life. Our findings support the implication that sexual rehabilitation must be provided for women with SCI soon after injury.

TheInternational Index of Erectile Function (IIEF-15): psychometric properties of the Portuguese version.

PubMed

Quinta Gomes, Ana Luísa; Nobre, Pedro

2012-01-01

The International Index of Erectile Function (IIEF) is a brief, reliable, and multidimensional scale for assessing sexual function in men in both research and clinical trials. The objective of the present study was to determine the psychometric properties of the Portuguese version of the IIEF. A total of 1,363 Portuguese men participated in this study (a clinical sample of 37 men and a community sample of 1,326 men). All participants completed a questionnaire regarding demographic information and the IIEF. Principal component analysis using varimax rotation indicated a two-factor structure explaining approximately 55% of the total variance (one factor encompassing erection and orgasmic function domains of the original IIEF, and a second factor corresponding to sexual desire, intercourse, and overall satisfaction). The differentiated factor structure with five separate domains of sexual function was not replicated in the Portuguese version. The two-factor model and the original five-factor model of male sexual function were assessed with confirmatory factor analysis (CFA), and overall acceptable fits were demonstrated for both models. However, despite a non-optimal performance, CFA provided a better support for the five-factor solution as the model that best fitted the data. An important lack of discriminant validity evidenced by high intercorrelations among dimensions was detected in both models, suggesting a substantial overlap among factors. Reliability studies showed good internal consistency for the five subscales, and test-retest reliability analysis supported the stability of the measure over time. Discriminant validity confirmed the ability of both subscales to differentiate men with erectile dysfunction from matched controls. Results suggested that the Portuguese version of the IIEF has adequate psychometric properties, and its use is recommended for clinical and research purposes. Further studies are needed in order to elucidate the association among dimensions of male sexual function and, ultimately, to offer a clearer conceptualization of male's sexual response. © 2011 International Society for Sexual Medicine.

Perineal body stretch during labor does not predict perineal laceration, postpartum incontinence, or postpartum sexual function: a cohort study.

PubMed

Meriwether, Kate V; Rogers, Rebecca G; Dunivan, Gena C; Alldredge, Jill K; Qualls, Clifford; Migliaccio, Laura; Leeman, Lawrence

2016-08-01

The perineum stretches naturally during obstetrical labor, but it is unknown whether this stretch has a negative impact on pelvic floor outcomes after a vaginal birth (VB). We aimed to evaluate whether perineal stretch was associated with postpartum pelvic floor dysfunction, and we hypothesized that greater perineal stretch would correlate with worsened outcomes. This was a prospective cohort study of primiparous women who had a VB. Perineal body (PB) length was measured antepartum, during labor, and 6 months postpartum. We determined the maximum PB (PBmax) measurements during the second stage of labor and PB change (ΔPB) between time points. Women completed functional questionnaires and had a Pelvic Organ Prolapse Quantification (POP-Q) system exam 6 months postpartum. We analyzed the relationship of PB measurements to perineal lacerations and postpartum outcomes, including urinary, anal, and fecal incontinence, sexual activity and function, and POP-Q measurements. Four hundred and forty-eight women with VB and a mean age of 24 ± 5.0 years with rare (5 %) third- or fourth-degree lacerations were assessed. During the second stage of labor, 270/448 (60 %) had perineal measurements. Mean antepartum PB length was 3.7 ± 0.8 cm, with a maximum mean PB length (PBmax) during the second stage of 6.1 ± 1.5 cm, an increase of 65 %. The change in PB length (ΔPB) from antepartum to 6 months postpartum was a net decrease (-0.39 ± 1.02 cm). PB change and PBmax were not associated with perineal lacerations or outcomes postpartum (all p > 0.05). PB stretch during labor is unrelated to perineal laceration, postpartum incontinence, sexual activity, or sexual function.

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.

Change to either a nonandrogenic or androgenic progestin-containing oral contraceptive preparation is associated with improved sexual function in women with oral contraceptive-associated sexual dysfunction.

PubMed

Davis, Susan R; Bitzer, Johannes; Giraldi, Annamaria; Palacios, Santiago; Parke, Susanne; Serrani, Marco; Mellinger, Uwe; Nappi, Rossella E

2013-12-01

It is a commonly held belief that combined oral contraceptive (COC) pills containing an androgenic progestin may be less likely to impair sexual function than COCs containing an anti-androgenic progestin. The study aims to compare the effects of a COC containing a progestin with an anti-androgenic profile (estradiol valerate [E2 V]/dienogest [DNG]) to that of one with an androgenic progestin (ethinyl estradiol [EE]/levonorgestrel [LNG]) on sexual function in women with COC-associated sexual dysfunction. In this multicenter, randomized, double-blind, noninferiority study, women with COC-associated female sexual dysfunction (FSD) were randomized to E2 V/DNG or EE/LNG for six cycles. The primary outcome was the change in the sum of Female Sexual Function Index (FSFI) desire and arousal component scores between baseline and cycle 6. Secondary outcome measures included changes to the FSFI domains, the Female Sexual Distress Scale (FSDS-R), Vaginal Health Assessment, the Atrophy Symptom Questionnaire, and the Psychological General Well Being Index over six treatment cycles. The main outcome is the change in the sum of FSFI desire and arousal component scores between baseline and cycle 6. Of 276 women screened, 213 received treatment and 191 completed the study. The mean increase in the sum of FSFI desire and arousal component scores was 5.90 (standard deviation [SD] 5.45) for E2 V/DNG and 5.79 (SD 6.17) for EE/LNG (change from baseline P < 0.0001, both groups). Both treatments showed equal efficacy and were associated with improvements in all domains of the FSFI, with no between-group differences. Both COCs reduced the distress associated with FSD, as indicated by reduced FSDS-R scores. In women with COC-associated FSD, switching to either E2 V/DNG or EE/LNG was associated with equivalent improvements in symptoms, challenging the perception that COCs containing anti-androgenic progestins have a detrimental effect on sexual function relative to those containing androgenic progestins. © 2013 International Society for Sexual Medicine.

Sexual communication, sexual satisfaction, and relationship quality in people with multiple sclerosis.

PubMed

Valvano, Abbey K; Rollock, Michael J D; Hudson, William H; Goodworth, Marie-Christine Rutter; Lopez, Eliot; Stepleman, Lara

2018-05-01

This study sought to explore relationships between sexual satisfaction, sexual communication and relationship satisfaction in people living with multiple sclerosis (MS). Specifically, sexual satisfaction was evaluated as a moderator between sexual communication and relationship satisfaction. Individuals diagnosed with MS and being treated in a hospital-based MS clinic in the southeastern United States (n = 58) completed measures of sexual satisfaction, sexual communication, sexual dysfunction, relationship quality, depression, level of disability, and frequency of sex-related communication and behaviors in a cross-sectional survey design. Sexual satisfaction moderated the relationship between quality of sexual communication and relationship quality, controlling for depression and frequency of sexual behavior and sexual communication. Directionality was examined in a 2nd regression analysis, in which the predictor and outcome variables were switched, which was also significant. Additionally, depression most strongly predicted relationship dissatisfaction. Findings help to establish sexual satisfaction as a moderator between sexual communication and relationship satisfaction, although directionality cannot be supported. Results also highlight the role of depression in overall relationship functioning and support the biopsychosocial model of care for treatment of sexual dysfunction in people living with MS. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Does the Severity of Overactive Bladder Symptoms Correlate With Risk for Female Sexual Dysfunction?

PubMed

Juliato, Cássia Raquel Teatin; Melotti, Iane Glauce Ribeiro; Junior, Luiz Carlos Santos; Britto, Luiz Gustavo Oliveira; Riccetto, Cássio Luiz Zanettini

2017-07-01

Several studies have associated overactive bladder (OAB) with female sexual dysfunction (FSD); however, there are no reports using a quantitative approach to measure OAB severity and to relate OAB to the risk of FSD. To evaluate women with OAB and to correlate the severity of their urinary symptoms with their sexual function. This cross-sectional study included 267 women older than 18 years with untreated OAB. All subjects completed the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) and the Female Sexual Function Index (FSFI). Linear regression was used to analyze the association between variables and the numeric FSFI score, and categorical FSFI scores were analyzed using logistic regression. Spearman rank correlation coefficient was used to assess the correlation between ICIQ-OAB results and the different FSFI domains. The significance level was 5%. Subjects' mean age was 50.2 ± 11.9 years. Most women were married, had at least three children, and were postmenopausal (54.3%). Mean FSFI total score was 19.2 ± 9.8. For menopausal status, 65.6% of premenopausal women had a risk for FSD vs 86.2% of postmenopausal women. Mean ICIQ-OAB score was 10 ± 3.17. Postmenopausal women had the following risk factors statistically associated with sexual dysfunction: age, ICIQ score, and marital status. For these women, greater OAB severity, especially those with urgency and/or urge incontinence, was associated with worse scores in the arousal, lubrication, orgasm, and sexual pain domains. However, there was no statistically significant association for premenopausal women. Health professionals have to pay attention to OAB in women because of the greater risk for FSD in these patients. The strength was using a quantitative approach to measure OAB severity in a larger population. Limitations include a convenience sample with no power calculation; exclusion of women who did not have sexual intercourse in the past month; unmeasured distress caused by sexual disorders; and the impossibility of establishing causality between OAB and sexual dysfunction. Women with OAB frequently have a risk for sexual dysfunction. In the postmenopausal group, women with scores indicating severe OAB had worse sexual function, mainly in the arousal, lubrication, orgasm, pain, and total domains. Juliato CRT, Melotti IGR, Junior LCS, et al. Does the Severity of Overactive Bladder Symptoms Correlate With Risk for Female Sexual Dysfunction? J Sex Med 2017;14:904-909. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The effect of circumcision on young adult sexual function.

PubMed

Yang, Ming-Hsin; Tsao, Chih-Wei; Wu, Sheng-Tang; Chuang, Feng-Ping; Meng, En; Tang, Shou-Hung; Sun, Guang-Huan; Yu, Dah-Shyong; Chang, Sun-Yran; Cha, Tai-Lung

2014-06-01

Whether sexual function is affected by circumcision is a subject of considerable debate among advocate and opponent opinions. We analyzed the sexual function of young men, and the differences between those who were uncircumcised and circumcised, in Taiwan. A total of 506 patients who received circumcision between January 2009 and March 2011 at the urology department in our center were enrolled. Before circumcision, the patients' sexual performances were evaluated using the International Index of Erectile Function-5 (IIEF-5), and the Brief Male Sexual Function Inventory (BMSFI) questionnaires. They were evaluated using the questionnaires again, after a postoperative interval of 90 days. Furthermore, intravaginal ejaculation latency times (IELT) of the patients were also measured. The IELT and scores in five main domains of the BMSFI, and IIEF, before and after circumcision, were analyzed. A total of 442 patients were available for follow up. The mean age was 25.14 ± 4.46 years (range = 19-35 years). The differences in the BMSFI scores were statistically significant (p < 0.001), especially in increasing sex drive after circumcision (p < 0.001). The IIEF-5 score showed no statistically difference before and after circumcision (p = 0.141). However, after the circumcision, the participants had more erection confidence (p < 0.001), more difficulty in maintaining erections in completing intercourse (p = 0.01), and showed lower IELT scores (p = 0.06). The sexual performance, especially with regards to sex drive and mental erection confidence, seemed to have improved among the patients after circumcision. Our findings may help urologists to better counsel young men receiving circumcisions. Copyright © 2013. Published by Elsevier B.V.

Associations Between Positive Body Image, Sexual Liberalism, and Unconventional Sexual Practices in U.S. Adults.

PubMed

Swami, Viren; Weis, Laura; Barron, David; Furnham, Adrian

2017-11-01

While studies have documented robust relationships between body image and sexual health outcomes, few studies have looked beyond sexual functioning in women. Here, we hypothesized that more positive body image would be associated with greater sexual liberalism and more positive attitudes toward unconventional sexual practices. An online sample of 151 women and 164 men from the U.S. completed measures of sexual liberalism, attitudes toward unconventional sexual practices, and indices of positive body image (i.e., body appreciation, body acceptance by others, body image flexibility, and body pride), and provided their demographic details. Regression analyses indicated that, once the effects of sexual orientation, relationship status, age, and body mass index had been accounted for, higher body appreciation was significantly associated with greater sexual liberalism in women and men. Furthermore, higher body appreciation and body image flexibility were significantly associated with more positive attitudes toward unconventional sexual practices in women and men. These results may have implications for scholars working from a sex-positive perspective, particularly in terms of understanding the role body image plays in sexual attitudes and behaviors.

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 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.

Sexual function in F-111 maintenance workers: the study of health outcomes in aircraft maintenance personnel.

PubMed

Brown, Anthony; Gibson, Richard; Tavener, Meredith; Guest, Maya; D'Este, Catherine; Byles, Julie; Attia, John; Horsley, Keith; Harrex, Warren; Ross, James

2009-06-01

In Australia, four formal F-111 fuel tank deseal/reseal (DSRS) repair programs were implemented over more than two decades, each involving different processes and using a range of hazardous substances. However, health concerns were raised by a number of workers. The "Study of Health Outcomes in Aircraft Maintenance Personnel" was commissioned by the Australian Department of Defence to investigate potential adverse health outcomes as a result of being involved in the deseal/reseal processes. To compare measures of sexual function in F-111 aircraft fuel tank DSRS maintenance workers, against two appropriate comparison groups. Exposed and comparison participants completed a postal questionnaire which included general questions of health and health behavior, and two specific questions on sexual functioning. They also completed the International Index of Erectile Function (IIEF) questionnaire. Logistic regression was used to explore exposure status and outcome while adjusting for potential confounders. The three outcomes of interest for this study were the proportion of participants with erectile dysfunction (ED) according to the IIEF, the proportion with self-reported loss of interest in sex, and the proportion with self-reported problems with sexual functioning. Compared with each of the comparison groups, a larger proportion of the exposed group reported sexual problems and were classified as having ED according to the IIEF. In logistic regression, the odds of all three outcomes were higher for exposed participants relative to each comparison group and after adjustment for potentially confounding variables including anxiety and depression. There was a consistent problem with sexual functioning in the exposed group that is not explained by anxiety and depression, and it appears related to DSRS activities.

Development and validation of a five-factor sexual satisfaction and distress scale for women: the Sexual Satisfaction Scale for Women (SSS-W).

PubMed

Meston, Cindy; Trapnell, Paul

2005-01-01

This article presents data based on the responses of over 800 women who contributed to the development of the Sexual Satisfaction Scale for Women (SSS-W). The aim of this study was to develop a comprehensive, multifaceted, valid, and reliable self-report measure of women's sexual satisfaction and distress. Phase I involved the initial selection of items based on past literature and on interviews of women diagnosed with sexual dysfunction and an exploratory factor analysis. Phase II involved an additional administration of the questionnaire, factor analyses, and refinement of the questionnaire items. Phase III involved administration of the final questionnaire to a sample of women with clinically diagnosed sexual dysfunction and controls. Psychometric evaluation of the SSS-W conducted in a sample of women meeting DSM-IV-TR criteria for female sexual dysfunction and in a control sample provided preliminary evidence of reliability and validity. The ability of the SSS-W to discriminate between sexually functional and dysfunctional women was demonstrated for each of the SSS-W domain scores and total score. The SSS-W is a brief, 30-item measure of sexual satisfaction and sexual distress, composed of five domains supported by factor analyses: contentment, communication, compatibility, relational concern, and personal concern. It exhibits sound psychometric properties and has a demonstrated ability to discriminate between clinical and nonclinical samples.

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

Sexual health in patients with rheumatoid arthritis and the association between physical fitness and sexual function: a cross-sectional study.

PubMed

Dorner, Thomas Ernst; Berner, Carolin; Haider, Sandra; Grabovac, Igor; Lamprecht, Thomas; Fenzl, Karl Heinrich; Erlacher, Ludwig

2018-06-01

The aim of this study was to examine sexual health in patients with rheumatoid arthritis (RA), and to analyse factors associated with sexual health with a focus on physical fitness. One hundred RA patients aged between 18 and 65 years were included in a cross-sectional study. Handgrip strength and knee extensor strength were measured with a dynamometer, and physical performance with the Short Physical Performance Battery (SPPB). Fifty-four patients, mean age 47.8 (SD 10.6) years, 61% female, answered a questionnaire about sexual health. Fifty-seven percent reported, at least, sometimes having difficulty with sexual intercourse (27.8% due to joint stiffness, 24.1% due to fatigue, 18.5% due to pain). Handgrip strength and knee extensor strength significantly correlated with the desire to engage in sexual intercourse, frequency of sexual contact and satisfaction with overall sex life. The SPPB total score correlated with satisfaction with overall sex life, and the SPPB repeated chair stands test with the desire to have sexual intercourse and satisfaction with overall sex life. After adjusting for age, gender, disease activity, comorbidity, co-medication and pain intensity, the repeated chair stands test remained significantly associated with the frequency of sexual contact (0.53; 0.01-1.05) and with satisfaction with overall sex life (1.39; 0.28-2.51). The results of this study show that problems with sexual health are highly prevalent in patients with RA. The ability to rise from a chair is associated with sexual function, independent of disease activity and pain intensity.

Sexual inactivity in partnered female cancer survivors.

PubMed

Marino, Jennifer L; Saunders, Christobel M; Hickey, Martha

2017-11-01

To measure sexual activity in a clinic population of partnered female cancer survivors, and to better understand reasons for sexual inactivity in this population. Partnered peri- or post-menopausal cancer survivors seen at a specialty clinic for menopause symptoms after cancer completed Fallowfield's Sexual Activity Questionnaire, quality of life measures (the Functional Assessment of Cancer Therapy General, Breast Cancer, and Endocrine Symptom Scales), and the Greene Climacteric Scale. Responses were compared between those who were sexually active and those who were not. Of 316 partnered women who reported sexual activity status, most were breast cancer survivors (n=268, 85%) and were sexually active (n=227, 72%). Women who were not sexually active (n=89, 28%) were slightly older than those who were active (53.1v 51.0 years, p=0.049) but did not differ in menopausal status, time since cancer diagnosis, or treatment with chemotherapy, anti-estrogenic endocrine therapy or menopausal hormone therapy. Loss of interest in sex (78%) and being too tired (44%) were the most common reasons for sexual inactivity. Those who were not sexually active were more likely to be dissatisfied with their sex lives (adjusted odds ratio (aOR) 3.52, 95% CI 1.66-7.48) and to have lost interest in sex (aOR 2.12, 95% CI 1.22-3.67). Compared with sexually active women, sexually inactive women were significantly less likely to feel sexually attractive or "able to feel like a woman" (respectively, aOR 2.51, 95% CI 1.01-6.24; aOR 2.21, 95% CI 1.32-3.71) and more likely to feel bothered by a weight change and self-conscious about the way they dressed, and to be bothered by hair loss (respectively, aOR 1.84, 95% CI 1.10-3.05; aOR 2.75, 95% CI 1.63-4.64; aOR 1.85, 95% CI 1.04-3.29). Those who were not sexually active had significantly lower average scores on breast-cancer-related quality of life than sexually active women but did not differ in physical, social or functional well-being or menopause-related quality of life. Pain with intercourse and vaginal dryness were equally common in both groups (respectively, sexually inactive 45.5% v. active 38.3%, aOR 1.28, 95%CI 0.75-2.18; 48.8% v. 49.5%, aOR 0.94, 95% CI 0.57-1.56). Over one-quarter of partnered cancer survivors in this clinic-based sample were not sexually active. Sexually inactive women were more dissatisfied with their sex lives, felt less attractive and more self-conscious about their appearance. The reasons for sexual inactivity in cancer survivors are multifaceted and complex and rates of vaginal dryness and dyspareunia did not differ between sexually active and inactive women, suggesting that interventions to improve sexual function which are limited to treating vaginal dryness are unlikely to be effective. Copyright © 2017 Elsevier B.V. All rights reserved.

Sexual concerns among kidney transplant recipients.

PubMed

Muehrer, Rebecca J; Lanuza, Dorothy M; Brown, Roger L; Djamali, Arjang

2014-11-01

Little is known about the specific sexual concerns of kidney transplant (KTx) recipients. The primary objectives of this study were to: (i) describe the importance of sexuality to KTx recipients; (ii) investigate the sexual concerns of KTx recipients; and (iii) examine the relationship between sexual concerns and quality of life (QOL). A secondary objective was to examine potential sexual concern differences by gender, pre-transplant dialysis status, and donor type. This study employed a cross-sectional, descriptive, correlational design. Sexual concerns were identified using the Sexual Concerns Questionnaire, which contains seven subscales. QOL was measured with the SF-8 and the QOL Uniscale. Nearly 73% of subjects rated sexuality as important. Subscales indicating highest area of sexual concerns were communication with healthcare providers about sexuality (Mean (M) = 2.70) and sexual pleasure concerns (M = 2.45). Higher concern ratings regarding health consequences of sexual activity, quality of sexual relationship, sexual pleasure, sexual functioning problems, and pessimistic beliefs about treatment were significantly, inversely related to QOL. Women had significantly higher scores on the Sexual Pleasure and Communication with Healthcare Providers subscales than men. This study reports the sexual concerns of KTx recipients' who are an average of four yr since surgery, and the relationship of these concerns to QOL. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of a sexual rehabilitation intervention program on stroke patients and their spouses.

PubMed

Song, HoSook; Oh, HyunSoo; Kim, HwaSoon; Seo, WhaSook

2011-01-01

The present study was conducted to examine whether a sexual rehabilitation intervention program, which was developed during the present study and designed for stroke patients and their spouses, was effective in terms of sexual knowledge and satisfaction and frequency of sexual activity at 1 month after intervention. The study subjects were conveniently selected from stroke patients admitted to the neurology department at a university hospital located in Incheon, South Korea. A total of 46 subjects (12 couples for the experimental group and 11 couples for the control group) were included. Sexual knowledge, sexual satisfaction, frequency of sexual activity, level of cognitive function, and performance with respect to daily living activities were measured. The results obtained demonstrated that the devised sexual rehabilitation intervention program significantly increased sexual satisfaction and frequency of sexual activity, but that it did not promote sexual knowledge. The present study has meaning because the intervention program could be used as a practical guideline for post-stroke sexual rehabilitation. In addition, the findings of this study provide evidence regarding the usefulness of sexual education and counseling on the sexual health of post-stroke patients and their spouses.

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.

Overall satisfaction, sexual function, and the durability of neophallus dimensions following staged female to male genital gender confirming surgery: the Institute of Urology, London U.K. experience

PubMed Central

Christopher, Nim A.; De Luca, Francesco; Spilotros, Marco; Ralph, David J.

2014-01-01

Background and purpose What factors influence transgender men’s decisions to undergo (and to not undergo) specific genital gender confirming surgeries (GCS) has not been described in the literature. Sexual function outcomes related to clitoral transposition and penile prosthesis placement is also not well described. Durability of neophallus dimensions after phalloplasty has not been described. A better understanding of these factors is necessary for pre-op counseling. We sought to assess patient genital-GCS related satisfaction, regret, pre/post-op sexual function, genital preferences, and genital measurements post-op. Materials and methods We evaluated ten female to male transgender patients who had previously undergone suprapubic pedicle-flap phalloplasty [suprapubic phalloplasty (SP); N=10] and 15 who had undergone radial artery forearm-flap phalloplasty [(RAP); N=15; 5/15 without and 10/15 with cutaneous nerve to clitoral nerve anastomosis] at our center (UK). We queried patients’ surgery related preferences and concerns, satisfaction, and sexual function pre/post-surgery, and accounted for whether patients had undergone clitoral transposition and/or cutaneous-to-clitoral nerve anastomosis. We measured flaccid and (where applicable) erect length and girth using a smart-phone app we designed. Results Mean age at surgery and follow-up for those that underwent SP was 35.1 and 2.23 years, and 34 and 6.8 for those that underwent RAP. Mean satisfaction scores were 9.1/10 and 9/10 for those that underwent SP and RAP, respectively. No patient (0%) regretted starting genital-GCS surgery. All (100%) patients that could achieve orgasm before GCS with clitoral transposition could achieve orgasm after surgery, and the vast majority reported preserved quality of erogenous sensation by our transposition technique. All (100%) RAP and 9/10 SP patients reported masturbation with their phallus. Inflatable penile prosthesis placement was not associated with decreased erogenous sensation/orgasm. Penile dimensions were relatively stable through follow-up for both groups. Our App length measurements correlated with a ruler within ±<4.5%. Conclusions Female-to-male genital-GCS offered in 3-stages was associated with high overall satisfaction and no regret among our sample. Sexual function appears to be preserved after both clitoral transposition and inflatable prosthesis placement, and consolidation of erogenous sensation to the phallus was described as important to all subjects. Discussion of patient’s pre-op sexual function, as well as specific concerns and preferences related to specific genital-GCS surgeries is important. PMID:26816764

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.

Sexuality and Body Image After Uterine Artery Embolization and Hysterectomy in the Treatment of Uterine Fibroids: A Randomized Comparison

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

Hehenkamp, Wouter J. K.; Volkers, Nicole A.; Bartholomeus, Wouter

In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There wasmore » a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE.« less

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.

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.

Developmental Trajectories of Acculturation in Hispanic Adolescents: Associations With Family Functioning and Adolescent Risk Behavior

PubMed Central

Schwartz, Seth J.; Rosiers, Sabrina Des; Huang, Shi; Zamboanga, Byron L.; Unger, Jennifer B.; Knight, George P.; Pantin, Hilda; Szapocznik, José

2012-01-01

The present study examined longitudinal acculturation patterns, and their associations with family functioning and adolescent risk behaviors, in Hispanic immigrant families. A sample of 266 Hispanic adolescents (mean age 13.4) and their primary parents completed measures of acculturation, family functioning, and adolescent conduct problems, substance use, and sexual behavior at five timepoints. Mixture models yielded three trajectory classes apiece for adolescent and parent acculturation. Assimilated adolescents reported the poorest family functioning, but adolescent assimilation negatively predicted adolescent cigarette smoking, sexual activity, and unprotected sex indirectly through family functioning. Follow-up analyses indicated that discrepancies between adolescent and parent family functioning reports predicted these adolescent outcomes. Results are discussed regarding acculturation trajectories, adolescent risk behavior, and the mediating role of family functioning. PMID:23848416

Testosterone replacement therapy with long-acting testosterone undecanoate improves sexual function and quality-of-life parameters vs. placebo in a population of men with type 2 diabetes.

PubMed

Hackett, Geoffrey; Cole, Nigel; Bhartia, Mithun; Kennedy, David; Raju, Jessie; Wilkinson, Peter

2013-06-01

Sexual dysfunction, particularly erectile dysfunction (ED), is common in men with type 2 diabetes, occurring in up to 75% of cases. The prevalence of hypogonadism is also high in men with diabetes and low testosterone is associated with both sexual dysfunction and a reduced response to oral therapy for ED. This study aimed to determine the effect of testosterone replacement with long-acting Testosterone Undecanoate (TU) on sexual function, mood and quality of life vs. placebo over a treatment period of 30 weeks followed by 52 weeks of open-label medication. The study was conducted in a primary care population of men with type 2 diabetes attending their primary care physician for routine visits. The male diabetic populations of seven general practices were screened at routine diabetes visits to detect symptomatic men with total testosterone levels of 12 nmol/L or less or with free testosterones of 250 pmol/L or less. Two hundred eleven men were screened. A double-blind placebo-controlled study was conducted in 199 men with type 2 diabetes and hypogonadism treated for 30 weeks with either 1,000 mg of TU or matching placebo followed by 52-week open-label follow on. The primary outcome measure, International Index of Erectile Function (IIEF), was used to evaluate sexual dysfunction, and the Ageing Male Symptom (AMS), Hospital Anxiety and Depression Scale, and Global Efficacy Question were used as secondary outcome measures to assess mood and self-reported quality of life. Testosterone replacement therapy with long-acting TU improved all domains of sexual function at 30 weeks (erectile function [EF], P = 0.005; intercourse satisfaction, P = 0.015; sexual desire, P = 0.001; overall satisfaction, P = 0.05; and orgasm, P = 0.04), with benefit as early as 6 weeks. Improvements in AMS score were significant in men without depression (P = 0.02) and the presence of depression at baseline was associated with marked reduction in response to both sexual function and psychological scores. All responses in sexual function continued to improve significantly up to 18 months with an improvement in EF score of 4.31 from baseline. In a small cohort of 35 men taking phosphodiesterase type 5 inhibitors, there was no change during the double-blind phase but a nine-point improvement in EF domain during 52-week open-label treatment. After 30 weeks, 46% vs. 17% of patients on active therapy vs. placebo felt that the treatment had improved their health, reaching 70% after open-label therapy. Less obese and older patients responded better to testosterone therapy. There were no significant adverse events. TU significantly improved all domains of the IIEF and patient reported quality of life at 30 weeks and more significantly after 52-week open-label extension. Improvement was most marked in less obese patient and those without coexisting depression. In men with type 2 diabetes, trials of therapy may need to be given for much longer than 3-6 months suggested in current guidelines. © 2013 International Society for Sexual Medicine.

The impact of endocrine therapy on sexual dysfunction in postmenopausal women with early stage breast cancer: encouraging results from a prospective study.

PubMed

Frechette, Dominique; Paquet, Lise; Verma, Shailendra; Clemons, Mark; Wheatley-Price, Paul; Gertler, Stan Z; Song, Xinni; Graham, Nadine; Dent, Susan

2013-08-01

The goal of this project was to investigate the contentious issue of a possible effect of endocrine therapy (ET) on sexual dysfunction (SD) in postmenopausal early stage breast cancer survivors. To date, few studies have assessed sexual functioning prior to initiating ET and none have taken sexual distress into account when reporting the prevalence of ET-induced SD. We report the findings of a study on the change in SD (defined as experiencing sexual problems causing distress) during the first 6 months of ET usage. Between January 2009 and May 2011, 118 patients entered the study and 66 completed questionnaires prior to initiation of ET and after 6 months of use. Sexual functioning (SF) was evaluated with the female sexual function index while sexual distress was assessed with the female sexual distress scale (FSDS-R). Gynecological symptoms were measured with the FACT-B ES subscale. Over time, the level of gynecological symptoms increased (p < 0.001), whereas no decline in SF was observed. The percentage of women who reported experiencing at least one sexual problem (85 %) and the percentage who were sexually distressed (30 %) remained the same across time. Importantly, the change in the prevalence of SD between baseline (24 %) and 6 months (29 %) was not statistically significant. Women experiencing SD at baseline were more likely to experience SD after 6 months of ET usage (OR = 7.4, 95 % CI = 1.5-36.9) than women who had no SD prior to initiating ET. The observation that SF remained stable across time is encouraging news. However, longer follow-up and the inclusion of women who were premenopausal at diagnosis are needed to determine the potential influence of extended duration of ET (e.g., at least 5 years) on SD. Further studies, including assessing the impact of early identification of patients at risk of developing SD and timely intervention, are warranted.

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 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.

Kisspeptin modulates sexual and emotional brain processing in humans.

PubMed

Comninos, Alexander N; Wall, Matthew B; Demetriou, Lysia; Shah, Amar J; Clarke, Sophie A; Narayanaswamy, Shakunthala; Nesbitt, Alexander; Izzi-Engbeaya, Chioma; Prague, Julia K; Abbara, Ali; Ratnasabapathy, Risheka; Salem, Victoria; Nijher, Gurjinder M; Jayasena, Channa N; Tanner, Mark; Bassett, Paul; Mehta, Amrish; Rabiner, Eugenii A; Hönigsperger, Christoph; Silva, Meire Ribeiro; Brandtzaeg, Ole Kristian; Lundanes, Elsa; Wilson, Steven Ray; Brown, Rachel C; Thomas, Sarah A; Bloom, Stephen R; Dhillo, Waljit S

2017-02-01

Sex, emotion, and reproduction are fundamental and tightly entwined aspects of human behavior. At a population level in humans, both the desire for sexual stimulation and the desire to bond with a partner are important precursors to reproduction. However, the relationships between these processes are incompletely understood. The limbic brain system has key roles in sexual and emotional behaviors, and is a likely candidate system for the integration of behavior with the hormonal reproductive axis. We investigated the effects of kisspeptin, a recently identified key reproductive hormone, on limbic brain activity and behavior. Using a combination of functional neuroimaging and hormonal and psychometric analyses, we compared the effects of kisspeptin versus vehicle administration in 29 healthy heterosexual young men. We demonstrated that kisspeptin administration enhanced limbic brain activity specifically in response to sexual and couple-bonding stimuli. Furthermore, kisspeptin's enhancement of limbic brain structures correlated with psychometric measures of reward, drive, mood, and sexual aversion, providing functional significance. In addition, kisspeptin administration attenuated negative mood. Collectively, our data provide evidence of an undescribed role for kisspeptin in integrating sexual and emotional brain processing with reproduction in humans. These results have important implications for our understanding of reproductive biology and are highly relevant to the current pharmacological development of kisspeptin as a potential therapeutic agent for patients with common disorders of reproductive function. National Institute for Health Research (NIHR), Wellcome Trust (Ref 080268), and the Medical Research Council (MRC).

Assessment of female sexual function among women with pelvic organ prolapse or urinary incontinence via an Arabic validated short-form sexual questionnaire.

PubMed

Shaaban, Mohamed M; Abdelwahab, Hassan A; Ahmed, Magdy R; Shalaby, Essam

2014-01-01

To assess female sexual function among women with pelvic organ prolapse or urinary incontinence via an Arabic, validated, short-form sexual questionnaire (PISQ-12). The present study was conducted among women attending Suez Canal University Hospital, Ismailia, Egypt, between September 2009 and August 2011. In the pilot study, 42 women completed the final version of the Arabic PISQ-12 at recruitment and then 2 weeks later, and the data were compared to evaluate reliability and internal consistency. The formal comparative study included 154 premenopausal sexually active women: 80 control women, and 74 women with some degree of pelvic prolapse with or without stress incontinence. All participants had a vaginal examination and completed the questionnaire. The main outcome measures were the mean questionnaire scores within its 3 domains (behavioral, physical, and partner-related). The test-retest reliability and internal consistency of the Arabic PISQ-12 were excellent. Validity was approved by an expert panel. The case group had a significantly lower mean total questionnaire score (31.07 ± 4.2 vs 34.7 ± 6.2; P<0.05) but a higher partner-related score (9.0 ± 2.4 vs 8.4 ± 2.5; P<0.05). The Arabic version of PISQ-12 was shown to be an effective and objective method of evaluating sexual function among patients with pelvic organ prolapse. © 2013.

Cognitive functioning and its influence on sexual behavior in normal aging and dementia.

PubMed

Hartmans, Carien; Comijs, Hannie; Jonker, Cees

2014-05-01

Motivational aspects, emotional factors, and cognition, all of which require intact cognitive functioning may be essential in sexual functioning. However, little is known about the association between cognitive functioning and sexual behavior. The aim of this article is to review the current evidence for the influence of cognitive functioning on sexual behavior in normal aging and dementia. A systematic literature search was conducted in PubMed, Ovid, Cochrane, and PsycINFO databases. The databases were searched for English language papers focusing on human studies published relating cognitive functioning to sexual behavior in the aging population. Keywords included sexual behavior, sexuality, cognitive functioning, healthy elderly, elderly, aging and dementia. Eight studies fulfilled our inclusion criteria. Of these studies, five included dementia patients and/or their partners, whereas only three studies included healthy older persons. Although not consistently, results indicated a trend that older people who are not demented and continue to engage in sexual activity have better overall cognitive functioning. Cognitive decline and dementia seem to be associated with diminished sexual behavior in older persons. The association between cognitive functioning and sexual behavior in the aging population is understudied. The results found are inconclusive. Copyright © 2013 John Wiley & Sons, Ltd.

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.

A prospective study on association of prostatic calcifications with sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

PubMed

Zhao, Zhigang; Xuan, Xujun; Zhang, Jingwei; He, Jun; Zeng, Guohua

2014-10-01

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common debilitating condition of unclear etiology. Sexual dysfunction is an important component of the clinical phenotype of CP/CPPS. Patients often have prostatic calcifications, but a link to sexual dysfunction is unknown. The aim of this study was to evaluate the association of prostatic calcifications with sexual dysfunction in this condition. A total of 358 males with CP/CPPS were consecutively enrolled, and a prospectively maintained database of these patients was analyzed. Calcifications were diagnosed using ultrasound imaging of the prostate. Symptom severity was measured using the National Institutes of Health Chronic Prostatitis Symptom Index (CPSI). Sexual dysfunction was evaluated using the validated 15-item International Index of Erectile Function (IIEF-15) questionnaire and 5-item Premature Ejaculation Diagnostic Tool scales. The variables were compared between patients with prostatic calcifications and those without using the Student's t-test, Wilcoxon unpaired test, or chi-square test. Logistic regression models were developed to explore a possible association between prostatic calcifications and sexual dysfunction. Measurable calcifications in the prostate were found in 175 (48.9%) of the 358 patients. Patients with calcifications were more likely to have higher white blood cell counts or positive bacteria cultures in their prostatic fluid, longer symptoms duration, and lower scores for the total IIEF-15, IIEF-erectile function, and IIEF-intercourse satisfaction domains (P < 0.001 for each). However, the scores for CPSI, premature ejaculation, and IIEF-orgasmic function, IIEF-sexual desire, and IIEF-overall satisfaction domains were identical between men with and without calcifications (P > 0.05 for each). Furthermore, logistic regression analyses revealed that intraprostatic calcification is significantly associated with self-assessed erectile dysfunction (ED) (odds ratio:3.632, 95% confidence interval: 2.405-5.822, P < 0.001). Our results showed that prostatic calcifications are significantly associated with the presence of ED in CP/CPPS males. © 2014 International Society for Sexual Medicine.

Clinical factors are not the best predictors of quality of sexual life and sexual functioning in women with early stage breast cancer.

PubMed

Den Oudsten, Brenda L; Van Heck, Guus L; Van der Steeg, Alida F W; Roukema, Jan A; De Vries, Jolanda

2010-06-01

Few studies have prospectively assessed the impact of breast cancer (BC) on women's sexual lives. Therefore, this study examines the determinants of quality of sexual life (QOSL), sexual functioning (SF), and sexual enjoyment (SE) at 6 and 12 months after surgical treatment. All participants completed a measure of QOSL (The World Health Organization Quality of Life assessment instrument-100 (WHOQOL-100)-facet Sexual Activity) before diagnosis (Time-1), and 1 (Time-2), 3 (Time-3), 6 (Time-4) and 12 months (Time-5) after surgical treatment. At Time-1, women also completed questionnaires on personality (The State Trait Anxiety Inventory-trait, NEO-FFI), body image and self-esteem (WHOQOL-100), depressive symptoms (Center for Epidemiological Studies-Depression Scale), and fatigue (Fatigue Assessment Scale). Furthermore, SF and SE (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer module) were measured from Time-2 onwards. At baseline, the analysis included 223 women with early stage BC. Clinical factors did not predict QOSL, SF or SE. In the final analyses, trait anxiety predicted QOSL and SF at Time-4 (p's<0.01). At Time-5, agreeableness predicted QOSL and SE (p's<0.05). Having a partner and age predicted SF, while SE was predicted by educational level (Time-4). In addition, fatigue predicted SE at Time-4 (p<0.05). In general, QOSL diminished across time, while SF improved. However, women with a mastectomy did not differ from women with breast conserving therapy. Mainly personality and psychological factors affect patients' sexuality after surgical treatment. Clinical factors did not predict QOSL, SF or SE. More knowledge in this field will help professionals to identify women who are at risk of experiencing sexual problems and consequently will contribute to provide adequate support. (c) 2009 John Wiley & Sons, Ltd.

Patterns in Vulvodynia Treatments and 6-Month Outcomes for Women Enrolled in the National Vulvodynia Registry-An Exploratory Prospective Study.

PubMed

Lamvu, Georgine; Alappattu, Meryl; Witzeman, Kathryn; Bishop, Mark; Robinson, Michael; Rapkin, Andrea

2018-05-01

Vulvodynia is a poorly characterized condition with multiple treatment options that have been described as largely ineffective in research settings. To describe treatment patterns in women enrolled in the National Vulvodynia Registry and determine if there is an association between selected treatments and patient-reported outcomes such as pain, sexual function, and psychological distress after 6 months of treatment. Participants completed questionnaires on general medical history and patient-reported outcomes using the short-form McGill Pain Questionnaire, the Female Sexual Function Index, the Short Form-12 quality-of-life questionnaire, the Coping Strategies Questionnaire, and the State-Trait Anxiety Inventory. The evaluation also included pain sensitivity assessment of the vaginal mucosa using a cotton-tipped applicator and the vaginal muscles using a single-digit. In this prospective cohort study, all measurements were collected at baseline and again at 6 months after treatment. Type of treatment, number of treatments, self-reported pain intensity, dyspareunia, and pain-related psychological distress measures are reported at baseline and 6 months. Of 344 women enrolled, 282 received treatment; 78 different treatments were identified and categorized by type (eg, topical, oral, physical therapy) and number. The most commonly used treatments were topical (85%, n = 241), physical therapy (52%, n = 147), and oral medications (45%, n = 128). Notably, 73% of participants received ≥2 treatments. There was no association between type or number of treatments and patient characteristics. At 6 months, women reported improvements in general pain (P = .001), pain during intercourse (P = .001), catastrophizing (P = .000), and anxiety (P = .000). The Short Form-12 quality-of-life questionnaire showed improvements in physical limitations (P = .024), emotional limitations (P = .003), well-being (P = .025), and social function (P = .010). However, all domains of the Female Sexual Function Index indicated worsening in sexual function (P = .000) except for pain. Multi-modal treatments were most commonly used in clinical practice and improvements in patient-reported outcomes such as quality of life, distress, and pain were noted; however, participants who returned at 6 months continued to report poor sexual function. Strengths include a prospective and long-term study design that evaluated women in clinical settings. Limitations include a high rate of loss to follow-up for certain measures and inability to evaluate efficacy of individual treatments. In a setting where women were receiving highly specialized care, we found wide variation in the type and number of treatments used to treat vulvodynia. Despite this heterogeneity in treatment selection, women reported significant improvements in all study measures except sexual function. Lamvu G, Alappattu M, Witzeman K, et al. Patterns in Vulvodynia Treatments and 6-Month Outcomes for Women Enrolled in the National Vulvodynia Registry-An Exploratory Prospective Study. J Sex Med 2018;15:705-715. Published by Elsevier Inc.

Disgust and contamination sensitivity in vaginismus and dyspareunia.

PubMed

de Jong, Peter J; van Overveld, Mark; Schultz, Willibrord Weijmar; Peters, Madelon L; Buwalda, Femke M

2009-04-01

This study examined the potential role of disgust propensity and contamination sensitivity in vaginismus. Women suffering from vaginismus (n = 20) or dyspareunia (n = 22), and a group of women without sexual complaints (n = 30) completed self report measures indexing their (1) general dispositional disgust propensity, and (2) sensitivity for (ideational) contamination by sexual stimuli as a function of its source (self, partner, unknown). In support of the idea that disgust may be involved in vaginismus, women with vaginistic complaints displayed a generally enhanced dispositional disgust propensity. The sensitivity for contamination by sexual stimuli did not vary across groups. However, especially when the source was the participant's partner, the willingness ratings might have been influenced by demand and may, therefore, not accurately reflect participant's actual sensitivity for contamination by sexual stimuli. Future studies using more implicit or behavioral measures are necessary to more definitely test the role of disgust in vaginismus.

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.

The strength of sexual arousal as a function of the age of the sex offender: comparisons among pedophiles, hebephiles, and teleiophiles.

PubMed

Blanchard, Ray; Barbaree, Howard E

2005-10-01

Previous research has shown that sexual arousability in human males declines from its peak in early adolescence until old age. This study compared the rates of decline in three groups of males: those most attracted sexually to prepubescent children (pedophiles), those most attracted to pubescent children (hebephiles), and those most attracted to physically mature persons (teleiophiles). The participants were 2,028 patients referred to Toronto's Centre for Addiction and Mental Health from 1995 to 2004 for evaluation of criminal or otherwise disturbing sexual behavior, but not for erectile or ejaculatory problems. All underwent phallometric assessment for erotic age-preference. This is a psychophysiological technique in which an individual's penile blood volume is monitored while he is presented with a standardized set of laboratory stimuli depicting male and female children, pubescents, and adults. The experimental measure of sexual arousability was the average of the participant's three greatest penile responses to any stimulus category, expressed in cubic cm of blood volume increase. The results showed that sexual arousability was an inverse function of age, and that there were no differences between the pedophiles, hebephiles, and teleiophiles in the rate at which arousability declined.

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.

Light availability affects sex lability in a gynodioecious plant.

PubMed

Varga, Sandra; Kytöviita, Minna-Maarit

2016-11-01

Sex lability (i.e., gender diphasy) in plants is classically linked to the larger resource needs associated with the female sexual function (i.e., seed production) compared to the male function (i.e., pollen production). Sex lability in response to the environment is extensively documented in dioecious species, but has been largely overlooked in gynodioecious plants. Here, we tested whether environmental conditions induce sex lability in the gynodioecious Geranium sylvaticum. We conducted a transplantation experiment in the field where plants with different sex expression were reciprocally transplanted between high light and low light habitats. We measured plants' reproductive output and sex expression over four years. Our results show that sex expression was labile over the study period. The light level at the destination habitat had a significant effect on sexual expression and reproductive output, because plants decreased their reproductive output when transplanted to the low light habitat. Transplantation origin did not affect any parameter measured. This study shows that sex expression in Geranium sylvaticum is labile and related to light availability. Sexually labile plants did not produce more seeds or pollen, and thus, there was no apparent fitness gain in sexually labile individuals. Sex lability in gynodioecious plants may be more common than previously believed because detection of sex lability necessitates data on the same individuals over time, which is rare in sexually dimorphic herbaceous plants. © 2016 Botanical Society of America.

Sexual function after cervical spine surgery: Independent predictors of functional impairment.

PubMed

Keefe, Malla K; Zygourakis, Corinna C; Theologis, Alexander A; Canepa, Emma; Shaw, Jeremy D; Goldman, Lauren H; Burch, Shane; Berven, Sigurd; Chou, Dean; Tay, Bobby; Mummaneni, Praveen; Deviren, Vedat; Ames, Christopher P

2017-02-01

Sexual function (SF) is an important component of patient-focused health related quality of life (HRQoL), but it has not been well studied in spine surgery. This study aims to assess SF after cervical spine surgery and identify predictors of SF. This single-center retrospective study evaluates SF of adults who underwent cervical spine surgery 2007-2012. Predictor variables included demographics, medical/surgical history, operative information, HRQoL measures (Neck Disability Index, SF-12), validated SF surveys [Female Sexual Function Index (FSFI) and Brief Sexual Function Inventory (BSFI) for males], and a study-specific SF questionnaire. 59 patients (31M, 28F; mean age=56±8.4) had significantly lower SF scores compared to age-matched peers: average BSFI = 2.26±1.22 (vs. 06±0.74), average FSFI=13.05±11.42 (<26.55 indicating sexual dysfunction). In men, lower mental SF-12 and higher NDI, back pain, and number of operated levels were associated with lower BSFI scores (all p<0.05). In women, higher total number of medications and pain medications were associated with lower FSFI scores (both p<0.05). 46% of patients reported difficulty performing a sexual position after surgery that they had previously enjoyed. 39% of men had difficulty on top during intercourse, and 32% of participants reported difficulty performing oral sex. 39% of patients reported worse SF, while only 5% reported an improvement in postoperative SF. Men and women who underwent cervical spine surgery had lower SF scores than age-matched peers, likely attributable to general mental health, regional neck disability, back pain, and medications. A large portion of patients reported subjectively worsened SF after surgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sexual dysfunction in premenopausal women could be related to hormonal profile.

PubMed

Vale, Fabiene Bernardes Castro; Coimbra, Bruna Barbosa; Lopes, Gerson Pereira; Geber, Selmo

2017-02-01

Female sexual dysfunction (FSD) is a public health problem that affects women's quality of life. Although the relationship between some hormones and the FSD has been described, it is not well established for all hormones. Therefore, the aim of our study was to evaluate the association between hormonal dysfunction and sexual dysfunction in premenopausal women. We performed a cross-sectional study with 60 patients with regular menstrual cycles, with age ranging from 18 to 44 years, with previous diagnosis of FSD. All patients were evaluated using the female sexual function index (FSFI) questionnaire and had the levels of total testosterone, prolactin (PRL), thyroid-releasing hormone and free testosterone index measured. Among the 60 patients, 43 (71.7%) were diagnosed with hypoactive sexual desire disorder (HSDD), 9 (15%) had anorgasmy and 8 (3.3%) had sexual pain dysfunction. Hormonal evaluation, demonstrated that 79.1% of patients with HSDD, 78.4% of patients with anorgasmy and 50% of patients with sexual pain dysfunction had female androgen insensitivity. We can conclude that there is an important association between low levels of total and free testosterone and FSD. This finding offers a new alternative for diagnosis and treatment of HSDD. Moreover, given the potential role of androgens in sexual function, randomized controlled trials with adequate long-term follow-up are essential to confirm its possible effect.

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.

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.

Quality of Life and Sexual Function Benefits of Long-Term Testosterone Treatment: Longitudinal Results From the Registry of Hypogonadism in Men (RHYME).

PubMed

Rosen, Raymond C; Wu, Frederick; Behre, Hermann M; Porst, Hartmut; Meuleman, Eric J H; Maggi, Mario; Romero-Otero, Javier; Martinez-Salamanca, Juan I; Jones, Thomas Hugh; Debruyne, Frans M J; Kurth, Karl-Heinz; Hackett, Geoff I; Quinton, Richard; Stroberg, Peter; Reisman, Yacov; Pescatori, Edoardo S; Morales, Antonio; Bassas, Lluis; Cruz, Natalio; Cunningham, Glenn R; Wheaton, Olivia A

2017-09-01

The benefits and risks of long-term testosterone administration have been a topic of much scientific and regulatory interest in recent years. To assess long-term quality of life (QOL) and sexual function benefits of testosterone replacement therapy (TRT) prospectively in a diverse, multinational cohort of men with hypogonadism. A multinational patient registry was used to assess long-term changes associated with TRT in middle-age and older men with hypogonadism. Comprehensive evaluations were conducted at 6, 12, 24, and 36 months after enrollment into the registry. QOL and sexual function were evaluated by validated measures, including the Aging Males' Symptom (AMS) Scale and the International Index of Erectile Function (IIEF). A total of 999 previously untreated men with hypogonadism were enrolled at 25 European centers, 750 of whom received TRT at at least one visit during the period of observation. Patients on TRT reported rapid and sustained improvements in QOL, with fewer sexual, psychological, and somatic symptoms. Modest improvements in QOL and sexual function, including erectile function, also were noted in RHYME patients not on TRT, although treated patients showed consistently greater benefit over time in all symptom domains compared with untreated patients. AMS total scores for patients on TRT were 32.8 (95% confidence interval = 31.3-34.4) compared with 36.6 (95% confidence interval = 34.8-38.5) for untreated patients (P < .001). Small but significant improvements in IIEF scores over time also were noted with TRT. Approximately 25% of treated and untreated men also used phosphodiesterase type 5 inhibitors, with notable differences in the frequency of phosphodiesterase type 5 inhibitor prescription use according to physician specialty and geographic site location. TRT-related benefits in QOL and sexual function are well maintained for up to 36 months after initiation of treatment. The major strengths are the large, diverse patient population being treated in multidisciplinary clinical settings. The major limitation is the frequency of switching from one formulation to another. Overall, we confirmed the broad and sustained benefits of TRT across major QOL dimensions, including sexual, somatic, and psychological health, which were sustained over 36 months in our treatment cohort. Rosen RC, Wu F, Behre H, et al. Quality of Life and Sexual Function Benefits Effects of Long-Term Testosterone Treatment: Longitudinal Results From the Registry of Hypogonadism in Men (RHYME). J Sex Med 2017;14:1104-1115. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The vagina dialogues: genital self-image and communication with physicians about sexual dysfunction and dissatisfaction among Jewish patients in a women's health clinic in southern Israel.

PubMed

Yulevitch, Aviva; Czamanski-Cohen, Johanna; Segal, David; Ben-Zion, Izhak; Kushnir, Talma

2013-12-01

The health-care system offers a variety of solutions for problems related to sexual dysfunction. To gain access to treatment options, women must be willing to discuss these issues with their physicians. To examine the extent to which women discuss issues of sexual dysfunction with their physicians and to examine the contribution of aspects of sexual dysfunction, level of satisfaction, body image, and genital self-image to their comfort with communicating with physicians about these issues. One hundred ten secular-appearing, Hebrew-speaking Jewish women waiting for a routine gynecological appointment at a clinic in southern Israel responded to a self-report questionnaire. The Female Sexuality Function Index was used to assess sexual dysfunction, Gray's Modified Questionnaire to assess body image, and the Genital Self-Image Scale to assess genital self-image. We compiled a new measure to assess level of comfort in discussing sexual functioning and satisfaction with a physician. Forty-four percent of the women had discussed sexual functioning issues with a gynecologist. Of those, 91.7% reported that the gynecologist initiated the discussion. The proportion of participants who would consult a gynecologist about sexual dysfunction was 74.5%, but only 41% would consult a family physician. Half of the women would expect a gynecologist to initiate such consultations, but only 20% would expect a family physician to do so. In a multivariate regression analysis, genital self-image was the only significant predictor of women's comfort level with discussing sexual dysfunction with a gynecologist. The respondents perceived the gynecologist, rather than the family physician, as an appropriate professional to consult regarding sexual dysfunction. However, they expected the gynecologist to initiate the discussion. Women with a positive genital self-image are more comfortable in consulting about sexual dysfunction. Gynecologists should be made aware of their significant role in eliciting women's cooperation in such consultations and in contributing to improving women's genital perception. © 2013 International Society for Sexual Medicine.

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.

Influence of religion on sexual self-perception and sexual satisfaction in patients suffering from schizophrenia and depression.

PubMed

Peitl, Marija Vucic; Peitl, Vjekoslav; Pavlovic, Eduard

2009-01-01

It is well documented that religion has an impact on mental health of both healthy people and mental health patients. However, scientific research regarding the influence of religion on sexual experiences and sexual self-perception in mental health patients and healthy people is very scarce. Therefore, our goal was to research how and in what measure religious and atheistic views of patients suffering from depression and schizophrenia and healthy people influence their sexual functions and sexual self-perception. This research was conducted on 100 patients suffering from schizophrenia and 100 patients suffering from depression, while 100 healthy individuals served as a control group. DMS-IV criteria were used when diagnosing schizophrenia and depression. In order to research the aspects of sexual self-perception we used Bezinović's questionnaire and Arizona sexual experience scale (ASEX) to research the aspects of sexual intercourse. Results show that Roman-Catholic patients suffering from schizophrenia experience greater sexual satisfaction than Eastern-Orthodox or atheist schizophrenic patients. Among patients suffering from depression in regard to their differing religious views there were no significant differences regarding sexual satisfaction or the aspects of sexual self-perception. Furthermore, there is a significant difference among healthy individuals when taking into consideration religious views. We established that Muslims have a significantly stronger sexual drive then atheists, Roman-Catholic or Eastern-Orthodox individuals. Compared to Roman-Catholic and Eastern-Orthodox individuals, atheists have better consciousness of their own sexuality. We can conclude that religious views have an influence on sexual functioning and sexual self-perception of patients suffering from depression and schizophrenia and also healthy individuals. Thus, further research on a bigger sample of participants--not only of those religious denominations covered in this research, but also of those that are less present in our society and of other mental health disorders and illnesses--is needed.

Assessment of sexual orientation using the hemodynamic brain response to visual sexual stimuli.

PubMed

Ponseti, Jorge; Granert, Oliver; Jansen, Olav; Wolff, Stephan; Mehdorn, Hubertus; Bosinski, Hartmut; Siebner, Hartwig

2009-06-01

The assessment of sexual orientation is of importance to the diagnosis and treatment of sex offenders and paraphilic disorders. Phallometry is considered gold standard in objectifying sexual orientation, yet this measurement has been criticized because of its intrusiveness and limited reliability. To evaluate whether the spatial response pattern to sexual stimuli as revealed by a change in blood oxygen level-dependent (BOLD) signal can be used for individual classification of sexual orientation. We used a preexisting functional MRI (fMRI) data set that had been acquired in a nonclinical sample of 12 heterosexual men and 14 homosexual men. During fMRI, participants were briefly exposed to pictures of same-sex and opposite-sex genitals. Data analysis involved four steps: (i) differences in the BOLD response to female and male sexual stimuli were calculated for each subject; (ii) these contrast images were entered into a group analysis to calculate whole-brain difference maps between homosexual and heterosexual participants; (iii) a single expression value was computed for each subject expressing its correspondence to the group result; and (iv) based on these expression values, Fisher's linear discriminant analysis and the kappa-nearest neighbor classification method were used to predict the sexual orientation of each subject. Sensitivity and specificity of the two classification methods in predicting individual sexual orientation. Both classification methods performed well in predicting individual sexual orientation with a mean accuracy of >85% (Fisher's linear discriminant analysis: 92% sensitivity, 85% specificity; kappa-nearest neighbor classification: 88% sensitivity, 92% specificity). Despite the small sample size, the functional response patterns of the brain to sexual stimuli contained sufficient information to predict individual sexual orientation with high accuracy. These results suggest that fMRI-based classification methods hold promise for the diagnosis of paraphilic disorders (e.g., pedophilia).

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.

Psychological Symptoms of Sexually Victimized Children and Adolescents Compared With Other Maltreatment Subtypes.

PubMed

Münzer, Annika; Fegert, Jörg M; Goldbeck, Lutz

2016-04-01

The differential effects of sexual victimization and other forms of maltreatment on psychological functioning are not well understood. A sample of sexually victimized children and adolescents (N = 70; 6.3-17.9 years) and a group of youth with a history of nonsexual maltreatment (N = 108; 6.7-16.9 years) were compared using measures of mental health and psychosocial functioning. Assessments included standardized clinical interviews on individual maltreatment history and current psychopathology as well as questionnaires on behavioral and emotional symptoms, including posttraumatic stress symptoms. The results from this study suggest that the risk of experiencing any current mental disorders was independent of type of maltreatment. The risk of meeting the criteria for a current diagnosis of major depression, however, is greater among youth with a history of maltreatment that includes sexual victimization. The significant impact of sexual victimization on posttraumatic stress symptoms was found to be nonsignificant after controlling for age and gender effects. The results indicate that the outcomes of child maltreatment depend on type of maltreatment, but age and gender must be taken into account.

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.

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.

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.

Long-term effects of self-control on alcohol use and sexual behavior among urban minority young women.

PubMed

Griffin, Kenneth W; Scheier, Lawrence M; Acevedo, Bianca; Grenard, Jerry L; Botvin, Gilbert J

2012-01-01

High risk alcohol use and sexual behaviors peak in young adulthood and often occur in the same individuals. Alcohol use has been found to impair decision-making and contribute to high risk sexual activity. However, the association between alcohol use and risky sexual behavior may also reflect enduring individual differences in risk taking, sociability, self-control, and related variables. Both behaviors can serve similar functions related to recreation, interpersonal connection, and the pursuit of excitement or pleasure. The present study examined the extent to which high risk drinking and sexual behavior clustered together in a sample of urban minority young adult women, a demographic group at elevated risk for negative outcomes related to sexual health. We tested whether psychosocial functioning measured at the beginning of high school predicted classes of risk behaviors when girls were tracked longitudinally into young adulthood. Latent class analysis indicated three distinct profiles based on high risk drinking and sexual behavior (i.e., multiple sex partners) in young adulthood. The largest class (73% of the sample) reported low levels of risky drinking and sexual behavior. The next largest class (19%) reported high risk drinking and low risk sexual behavior, and the smallest class (8%) reported high levels of both behaviors. Compared to women from other racial/ethnic groups, black women were more likely to be categorized in the high risk drinking/low risk sex class. Multinomial logistic regression indicated that self-control in adolescence had a broad and enduring protective effect on risk behaviors eight years later and was associated with a greater probability of being in the low risk drinking/low risk sex class. Findings are discussed in terms of understanding the phenotypic expressions of risk behavior as they relate to early psychosocial development and the long-term protective function of self-control in reducing high risk drinking and sexual behaviors.

Long-Term Effects of Self-Control on Alcohol Use and Sexual Behavior among Urban Minority Young Women

PubMed Central

Griffin, Kenneth W.; Scheier, Lawrence M.; Acevedo, Bianca; Grenard, Jerry L.; Botvin, Gilbert J.

2011-01-01

High risk alcohol use and sexual behaviors peak in young adulthood and often occur in the same individuals. Alcohol use has been found to impair decision-making and contribute to high risk sexual activity. However, the association between alcohol use and risky sexual behavior may also reflect enduring individual differences in risk taking, sociability, self-control, and related variables. Both behaviors can serve similar functions related to recreation, interpersonal connection, and the pursuit of excitement or pleasure. The present study examined the extent to which high risk drinking and sexual behavior clustered together in a sample of urban minority young adult women, a demographic group at elevated risk for negative outcomes related to sexual health. We tested whether psychosocial functioning measured at the beginning of high school predicted classes of risk behaviors when girls were tracked longitudinally into young adulthood. Latent class analysis indicated three distinct profiles based on high risk drinking and sexual behavior (i.e., multiple sex partners) in young adulthood. The largest class (73% of the sample) reported low levels of risky drinking and sexual behavior. The next largest class (19%) reported high risk drinking and low risk sexual behavior, and the smallest class (8%) reported high levels of both behaviors. Compared to women from other racial/ethnic groups, black women were more likely to be categorized in the high risk drinking/low risk sex class. Multinomial logistic regression indicated that self-control in adolescence had a broad and enduring protective effect on risk behaviors eight years later and was associated with a greater probability of being in the low risk drinking/low risk sex class. Findings are discussed in terms of understanding the phenotypic expressions of risk behavior as they relate to early psychosocial development and the long-term protective function of self-control in reducing high risk drinking and sexual behaviors. PMID:22470274

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

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

Increasing Orgasm and Decreasing Dyspareunia by a Manual Physical Therapy Technique

PubMed Central

Wurn, Lawrence J; Wurn, Belinda F; Roscow, Amanda S; King, C Richard; Scharf, Eugenia S; Shuster, Jonathan J

2004-01-01

Context Female sexual pain and dysfunction Objective To evaluate the effectiveness of a new site-specific, manual soft-tissue therapy in increasing orgasm and reducing dyspareunia (painful intercourse) in women with histories indicating abdominopelvic adhesion formation. Design and Intervention A total of 29 new patients presenting with infertility or abdominopelvic pain-related problems, and also indicating sexual pain or dysfunction, received a series of treatments (mean, 19.5 hours) designed to address biomechanical dysfunction and restricted mobility due to adhesions affecting the reproductive organs and adjacent structures. Outcome Measures Primary outcome measures were post-test vs pretest scores on: (1) the Female Sexual Function Index (FSFI) full scale, orgasm domain, and pain domain; and (2) 3 supplemental 10-point rating scales of sexual pain levels. Secondary outcome measures were post-test vs pretest scores in the other 4 FSFI domains (desire, arousal, lubrication, and satisfaction). The Wilcoxon signed-rank test was used for all statistical analyses. Results For the 23 patients available for follow-up, the paired FSFI post-test vs pretest scores were significant (P ≤ .003) on all measures. Of the 17 patients who completed the 3 sexual pain scales, the paired post-test vs pretest scores were significant (P ≤ .002) Conclusions Many cases of inhibited orgasm, dyspareunia, and other aspects of sexual dysfunction seem to be treatable by a distinctive, noninvasive manual therapy with no risks and few, if any, adverse effects. The therapy should be considered a new adjunct to existing gynecologic and medical treatments. PMID:15775874

Buspirone Reduces Sexual Risk-Taking Intent but not Cocaine Self-Administration

PubMed Central

Bolin, B. Levi; Lile, Joshua A.; Marks, Katherine R.; Beckmann, Joshua S.; Rush, Craig R.; Stoops, William W.

2016-01-01

Impulsive sexual decision-making may underlie sexual risk-taking behavior that contributes to the disproportionately high prevalence of HIV infection among cocaine users. Delay-discounting procedures measure impulsive decision-making and may provide insight into the underlying mechanisms of sexual risk-taking behavior. The anxiolytic drug buspirone reduces delay discounting in rats and blunts the reinforcing effects of cocaine in some preclinical studies suggesting that it might have utility in the treatment of cocaine-use disorders. This study determined whether buspirone mitigates impulsive risky sexual decision-making in cocaine users on a sexual delay-discounting procedure. The effects of buspirone maintenance on the abuse-related and physiological effects of cocaine were also tested. Nine (N = 9) current cocaine users completed a repeated-measures, inpatient protocol in which sexual delay discounting was assessed following three days of maintenance on placebo and buspirone (30 mg/day) in counterbalanced order. The reinforcing, subject-rated, and physiological effects of placebo and intranasal cocaine (15 and 45 mg) were also assessed during buspirone and placebo maintenance. Buspirone increased the likelihood of condom use for hypothetical sexual partners that were categorized as most likely to have a sexually transmitted infection and least sexually desirable. Cocaine functioned as a reinforcer and increased positive subjective effects ratings, but buspirone maintenance did not impact these effects of cocaine. Buspirone was also safe and tolerable when combined with cocaine and may have blunted some its cardiovascular effects. The results from the sexual delay-discounting procedure indicate that buspirone may reduce preference for riskier sex in cocaine users. PMID:27254258

Self-assessment of genital anatomy, sexual sensitivity and function in women: implications for genitoplasty.

PubMed

Schober, Justine M; Meyer-Bahlburg, Heino F L; Ransley, Philip G

2004-09-01

To assess the perceptions of healthy women of their genital anatomy and sexual sensitivity, and to provide suggestions for genitoplasty based on this information, as the success of genitoplasty has historically relied upon the surgeon's perception of the patient's anatomy and function, rather than the patient's perception of outcome in terms of appearance and erotic sensitivity. Fifty healthy, sexually active, adult women (aged 20-56 years) with no history of genital surgery completed the female version of the Self-Assessment of Genital Anatomy and Sexual Function. This self- report questionnaire comprises written text and images enabling women to rate the appearance, size and position of clitoris and vagina, as well as the intensity of orgasm and effort required for achieving orgasm in specified areas around the clitoris and within the vagina. Anatomical locations were compared for these ratings by repeated-measures analysis of variance. Anatomically, 46% of women described their clitoris as 'moderate-sized and raised', 42% as 'small and raised', and 78% reported that their vaginal opening was adequate for sexual penetration. The women reported the strongest orgasm and least effort to obtain an orgasm with stimulation of the area on and above the clitoris. For vaginal sensitivity, scores for orgasm intensity increased, and for orgasm effort decreased, with increasing vaginal depth, and they indicated less sexual sensitivity for the vagina than for the external genitalia. The skin above the clitoris, and the clitoris itself, appeared to be the most sexually sensitive. During genitoplasty, attention to preserving skin-flap integrity in this area seems appropriate.

Alterations in grip strength during male sexual arousal.

PubMed

Jiao, C; Turman, B; Weerakoon, P; Knight, P

2006-01-01

Although it is known that alterations in grip strength occur under a number of conditions, little is known about relationships between grip strength and sexual arousal. This relationship was investigated in 30 healthy heterosexual males, who viewed both erotic and nonerotic videos. A questionnaire was used to assess the extent of sexual arousal. The grip strengths of both hands were measured with a five-position (P1-P5) dynamometer, before and after watching the videos. After watching the erotic video, there was a statistically significant reduction in grip strength for the P2 position, with nonsignificant overall reductions in grip strength for all other positions tested. No such effect was observed in control tests. The results indicate that during sexual arousal, the neural system is likely to reduce the output to muscles not directly related to sexual function, presumably to enhance the physiological responses of sexual arousal.

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.

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.

Abnormal sexuality in Parkinson's disease: fact or fancy?

PubMed

Ferrucci, Roberta; Panzeri, Marta; Ronconi, Lucia; Ardolino, Gianluca; Cogiamanian, Filippo; Barbieri, Sergio; Barone, Paolo; Bertolasi, Laura; Padovani, Alessandro; Priori, Alberto

2016-10-15

Patients with Parkinson's disease (PD) variably report sexual dysfunctions. We assessed sexuality in PD by comparing sexual function between a large group of patients with idiopathic PD and a group of subjects without PD. We recruited 121 patients with mild-to-moderate PD (aged 40-80years) from four Italian Movement Disorder Clinics and 123 non-Parkinsonian controls (NPC) (aged 40-80years). Sexual function was assessed with four scales: the Brief Index of Sexual Functioning (BISF-M for men; BISF-W for women), the International Index of Erectile Function (IIEF), and the Female Sexual Function Index (FSFI). Both groups also underwent assessment with the Beck Depression Inventory (BDI) and the Mini Mental State Examination (MMSE), and patients were assessed with the Parkinson's Disease Questionnaire-8 (PDQ-8). No differences in total score were found between PD and NPC for any sexual function scale (BISF-M, BISF-W, IIEF, FSFI: p>0.05). However, the Orgasm/Pleasure Domain (BISF, D5) was significantly lower in male patients than in controls. Our findings fail to confirm previous findings that PD is associated with a significant sexual impairment. NPC and patients with PD have comparable sexual function in both sexes. Thus, rather than dismissing sexual dysfunction as a normal parkinsonian symptom, physicians should refer patients to sexual medicine specialists who can investigate and discuss problems fully, diagnose possible comorbidities, and suggest appropriate treatments. Copyright © 2016. Published by Elsevier B.V.

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.

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

Effects of hyperthyroidism, hypothyroidism, and thyroid autoimmunity on female sexual function.

PubMed

Oppo, A; Franceschi, E; Atzeni, F; Taberlet, A; Mariotti, S

2011-06-01

Thyroid hormones affect male and female sexual functions, but data in hypo- and hyperthyroid women are scanty. To investigate sexual function in hypo- and hyperthyroid women before and immediately after restoration of euthyroidism and in women with euthyroid Hashimoto's thyroiditis (HT). Fifty-six women with thyroid diseases (age 19-50 yr; 22 with hyperthyroidism, 17 with hypothyroidism, and 17 with euthyroid HT) and 30 age-matched healthy women. Hypoactive sexual desire, disorders of sexual arousal, vaginal lubrication, orgasm, satisfaction, and sexual pain (SPD) were assessed by Female Sexual Function Index. Serum TSH, free T4 (FT4) and thyroid autoantibodies (anti-thyroglobulin, anti-thyroperoxidase, and TSH-receptor antibodies) were assessed at the diagnosis; FT4 and TSH were repeated after treatment to confirm normalization of thyroid function. All sexual domains scores were significantly reduced (p ranging <0.0001-<0.05) in both hypo- and hyperthyroid women. Correction of hypothyroidism was associated to normalization of desire, satisfaction, and pain, while arousal and orgasm remained unchanged. In hyperthyroid women therapy normalized sexual desire, arousal/lubrication, satisfaction, and pain, while orgasm remained significantly impaired. Interestingly, euthyroid HT women displayed a significant decrease in sexual desire (p<0.0005), with no changes in the other sexual domains. Both hypo- and hyperthyroidism markedly impair female sexual function. A rapid improvement is observed with the restoration of euthyroidism, although a longer period of time may be needed for full normalization. Preliminary data suggest that thyroid autoimmunity may selectively impair sexual desire, independently from thyroid function.

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

Responsibility/Threat Overestimation Moderates the Relationship Between Contamination-Based Disgust and Obsessive-Compulsive Concerns About Sexual Orientation.

PubMed

Ching, Terence H W; Williams, Monnica T; Siev, Jedidiah; Olatunji, Bunmi O

2018-05-01

Disgust has been shown to perform a "disease-avoidance" function in contamination fears. However, no studies have examined the relevance of disgust to obsessive-compulsive (OC) concerns about sexual orientation (e.g., fear of one's sexual orientation transforming against one's will, and compulsive avoidance of same-sex and/or gay or lesbian individuals to prevent that from happening). Therefore, we investigated whether the specific domain of contamination-based disgust (i.e., evoked by the perceived threat of transmission of essences between individuals) predicted OC concerns about sexual orientation, and whether this effect was moderated/amplified by obsessive beliefs, in evaluation of a "sexual orientation transformation-avoidance" function. We recruited 283 self-identified heterosexual college students (152 females, 131 males; mean age = 20.88 years, SD = 3.19) who completed three measures assessing disgust, obsessive beliefs, and OC concerns about sexual orientation. Results showed that contamination-based disgust (β = .17), responsibility/threat overestimation beliefs (β = .15), and their interaction (β = .17) each uniquely predicted OC concerns about sexual orientation, ts = 2.22, 2.50, and 2.90, ps < .05. Post hoc probing indicated that high contamination-based disgust accompanied by strong responsibility/threat overestimation beliefs predicted more severe OC concerns about sexual orientation, β = .48, t = 3.24, p < .001. The present study, therefore, provided preliminary evidence for a "sexual orientation transformation-avoidance" process underlying OC concerns about sexual orientation in heterosexual college students, which is facilitated by contamination-based disgust, and exacerbated by responsibility/threat overestimation beliefs. Treatment for OC concerns about sexual orientation should target such beliefs.

Psychometric Properties of the Sexual Event Diary in a Sample of Dutch Women With Female Sexual Interest/Arousal Disorder.

PubMed

van Nes, Yvonne; Bloemers, Jos; Kessels, Rob; van der Heijden, Peter G M; van Rooij, Kim; Gerritsen, Jeroen; DeRogatis, Leonard; Tuiten, Adriaan

2018-05-01

Efficacy of on-demand drugs for women with hypoactive sexual desire disorder or female sexual interest/arousal disorder (FSIAD) should be assessed using a validated instrument that assesses the discrete sexual events during which the on-demand drug is taken, because this type of assessment is more proximate to an on-demand drug's efficacy compared to instruments that assess sexual function over longer periods of time. The aim of this study was to assess the psychometric properties of the Dutch translation of the previously validated 11-item Sexual Event Diary (SED) for measuring sexual satisfaction and sexual functioning during discrete sexual events. Psychometric assessment was performed on data of 1,840 SEDs from 139 women with hypoactive sexual desire disorder/FSIAD, collected during a randomized clinical cross-over trial conducted in the Netherlands. Item scores of the SED at the event level, and at subject level, summarized item scores during the placebo run-in period (PRI) and active treatment period, and score changes from PRI to active treatment period. Reliability and convergent validity were confirmed. All item scores showed the ability to discriminate between known groups. Larger mean score changes from PRI were observed in groups with known benefit from the medication, as compared to those with no benefit. Guyatt effect sizes ranged from 0.51-1.02, thereby demonstrating ability to detect change. The Dutch version of the SED is an excellent instrument for assessing female sexual functioning and sexual satisfaction during discrete sexual events and for assessing these concepts over longer periods of time. Data were collected in a randomized, well-controlled trial. The large number of data points gave high statistical power, and the results confirmed previous findings. However, care is needed when generalizing the SED's validity to other areas of research, eg, recreational drug use and sexual risky behaviors, since the current validation study has not used such data. Consistent with the US-English version, the Dutch version of the SED is a reliable, valid, and responsive instrument, and suitable for use in evaluating effects of on-demand drugs in women with FSIAD. van Nes Y, Bloemers J, Kessels R, et al. Psychometric Properties of the Sexual Event Diary in a Sample of Dutch Women With Female Sexual Interest/Arousal Disorder. J Sex Med 2018;15:722-731. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

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.

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.

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

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.

Kisspeptin modulates sexual and emotional brain processing in humans

PubMed Central

Comninos, Alexander N.; Wall, Matthew B.; Demetriou, Lysia; Shah, Amar J.; Clarke, Sophie A.; Narayanaswamy, Shakunthala; Nesbitt, Alexander; Izzi-Engbeaya, Chioma; Prague, Julia K.; Abbara, Ali; Ratnasabapathy, Risheka; Salem, Victoria; Nijher, Gurjinder M.; Jayasena, Channa N.; Tanner, Mark; Bassett, Paul; Mehta, Amrish; Rabiner, Eugenii A.; Hönigsperger, Christoph; Silva, Meire Ribeiro; Brandtzaeg, Ole Kristian; Wilson, Steven Ray; Brown, Rachel C.; Thomas, Sarah A.; Bloom, Stephen R.; Dhillo, Waljit S.

2017-01-01

BACKGROUND. Sex, emotion, and reproduction are fundamental and tightly entwined aspects of human behavior. At a population level in humans, both the desire for sexual stimulation and the desire to bond with a partner are important precursors to reproduction. However, the relationships between these processes are incompletely understood. The limbic brain system has key roles in sexual and emotional behaviors, and is a likely candidate system for the integration of behavior with the hormonal reproductive axis. We investigated the effects of kisspeptin, a recently identified key reproductive hormone, on limbic brain activity and behavior. METHODS. Using a combination of functional neuroimaging and hormonal and psychometric analyses, we compared the effects of kisspeptin versus vehicle administration in 29 healthy heterosexual young men. RESULTS. We demonstrated that kisspeptin administration enhanced limbic brain activity specifically in response to sexual and couple-bonding stimuli. Furthermore, kisspeptin’s enhancement of limbic brain structures correlated with psychometric measures of reward, drive, mood, and sexual aversion, providing functional significance. In addition, kisspeptin administration attenuated negative mood. CONCLUSIONS. Collectively, our data provide evidence of an undescribed role for kisspeptin in integrating sexual and emotional brain processing with reproduction in humans. These results have important implications for our understanding of reproductive biology and are highly relevant to the current pharmacological development of kisspeptin as a potential therapeutic agent for patients with common disorders of reproductive function. FUNDING. National Institute for Health Research (NIHR), Wellcome Trust (Ref 080268), and the Medical Research Council (MRC). PMID:28112678

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 Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study.

PubMed

Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Wylie, Kevan; Muir, Gordon

2015-09-01

Little is known about the sexual functioning and behavior of men anxious about the size of their penis and the means that they might use to try to alter the size of their penis. To compare sexual functioning and behavior in men with body dysmorphic disorder (BDD) concerning penis size and in men with small penis anxiety (SPA without BDD) and in a control group of men who do not have any concerns. An opportunistic sample of 90 men from the community were recruited and divided into three groups: BDD (n = 26); SPA (n = 31) and controls (n = 33). The Index of Erectile Function (IEF), sexual identity and history; and interventions to alter the size of their penis. Men with BDD compared with controls had reduced erectile dysfunction, orgasmic function, intercourse satisfaction and overall satisfaction on the IEF. Men with SPA compared with controls had reduced intercourse satisfaction. There were no differences in sexual desire, the frequency of intercourse or masturbation across any of the three groups. Men with BDD and SPA were more likely than the controls to attempt to alter the shape or size of their penis (for example jelqing, vacuum pumps or stretching devices) with poor reported success. Men with BDD are more likely to have erectile dysfunction and less satisfaction with intercourse than controls but maintain their libido. Further research is required to develop and evaluate a psychological intervention for such men with adequate outcome measures.

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.

Psychosocial characteristics of nonoffending mothers of sexually abused girls: findings from a prospective, multigenerational study.

PubMed

Kim, Kihyun; Noll, Jennie G; Putnam, Frank W; Trickett, Penelope K

2007-11-01

This study examined psychosocial characteristics of nonoffending mothers of sexually abused girls. The sample consisted of 72 ethnically diverse mothers of sexually abused girls aged 6 to 16 years, and 55 mothers of girls who were demographically similar with the abused girls on age, socioeconomic status, and family constellation. The variables examined included measures of the mothers' childhood developmental histories and current functioning (e.g., depression, parenting), as well as their current family environment. The specific questions addressed were (a) whether mothers of sexually abused girls could be distinguished from mothers of comparison girls on various psychosocial characteristics and (b) whether three subgroups of mothers (i.e., mother and daughter sexually abused, daughter-only abused, neither mother nor daughter abused) would exhibit different patterns of psychosocial characteristics. Results show that nonoffending mothers of sexually abused girls may confront considerable psychosocial challenges following the disclosure of their daughters' sexual abuse and that mother's own childhood abuse experiences may be an important factor to understand these challenges.

Recent and lifelong sexual dysfunction in a female UK population sample: prevalence and risk factors.

PubMed

Burri, Andrea; Spector, Timothy

2011-09-01

To date, no studies have tried to explore the prevalence and risk factors of recent and lifelong female sexual dysfunction (FSD) in the United Kingdom using validated questionnaires for the assessment of symptom severity and levels of associated sexual distress. To estimate the prevalence and comorbidity of recent and lifelong FSD and to further identify potential psychosocial and behavioral risk factors in a nationally representative sample of UK women. One thousand four hundred eighty-nine unselected female twin individuals aged 18-85 years. Validated questionnaires, such as the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale, were used for the assessment of symptom severity and degree of sexual distress. Prevalence and comorbidity of recent and lifelong FSD according to the FSFI cutoff points and the existence of sexual distress. Lifelong FSD refers to an individual's average sexual function ever since they have been sexually active. We further calculated odds ratios (ORs) with 95% confidence interval for FSD. We found that 5.8% of women reported any recent sexual dysfunction and 15.5% reported any lifelong sexual dysfunction. Hyposexual desire was the most prevalent recent and lifelong sexual complaint (21.4% and 17.3%, respectively). High intercorrelations were found for both recent and lifelong FSD (r=0.3-0.7). The most common independent, clinical predictor of recent and lifelong FSD diagnosis was relationship dissatisfaction (OR 1.2-4.5). Experience of abuse (OR 1.6-2.1), increased anxiety, and obsessive compulsive behavior were the most common predictors for lifelong FSD. The study provides the first UK population-based assessment of recent and lifelong FSD using validated outcome measures and accounting for sexual distress. Our results indicate that FSD is common in the general population and is influenced by psychosocial factors with different pathoetiologies underlying recent and lifelong FSD. © 2011 International Society for Sexual Medicine.

Effect of Prostate Cancer Severity on Functional Outcomes After Localized Treatment: Comparative Effectiveness Analysis of Surgery and Radiation Study Results.

PubMed

Tyson, Mark Douglas; Koyama, Tatsuki; Lee, Dan; Hoffman, Karen E; Resnick, Matthew J; Wu, Xiao-Cheng; Cooperberg, Matthew R; Goodman, Michael; Greenfield, Sheldon; Hamilton, Ann S; Hashibe, Mia; Paddock, Lisa E; Stroup, Antoinette; Chen, Vivien; Conwill, Ralph; McCollum, Dan; Penson, David F; Barocas, Daniel A

2018-07-01

Whether prostate cancer severity modifies patient-reported functional outcomes after radical prostatectomy (RP) or external beam radiotherapy (EBRT) for localized cancer is unknown. The purpose of this study was to determine whether differences in predicted function over time between RP and EBRT varied by risk group. The Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study is a prospective, population-based, observational study that enrolled men with localized prostate cancer in 2011-2012. Among 2117 CEASAR participants who underwent RP or EBRT, 817 had low-risk, 902 intermediate-risk, and 398 high-risk disease. Patient-reported, disease-specific function was measured using the 26-item Expanded Prostate Index Composite (at baseline and 6, 12, and 36 mo). Predicted function was estimated using regression models and compared by disease risk. Low-risk EBRT patients reported 3-yr sexual function scores 12 points higher than those of low-risk RP patients (RP, 39 points [95% confidence interval {CI}, 37-42] vs EBRT, 52 points [95% CI, 47-56]; p<0.001). The difference in 3-yr scores for high-risk patients was not clinically significant (RP, 32 points [95% CI, 28-35] vs EBRT, 38 points [95% CI, 33-42]; p=0.03). However, when using a commonly used binary definition of sexual function (erections firm enough for intercourse), no major differences were noted between RP and EBRT at 3 yr across low-, intermediate-, and high-risk disease strata. No clinically significant interactive effects between treatment and cancer severity were observed for incontinence, bowel, irritative voiding, and hormone domains. The primary limitation is the lack of firmly established thresholds for clinically significant differences in Expanded Prostate Index Composite domain scores. For men with low-risk prostate cancer, EBRT was associated with higher sexual function scores at 3 yr than RP; however, for men with high-risk prostate cancer, no clinically significant difference was noted. Men with high-risk prostate cancer should be counseled that EBRT and RP carry similar sexual function outcomes at 3 yr. In this report, we studied the urinary, sexual, bowel, and hormonal functions of patients 3 yr after undergoing prostate cancer surgery or radiation. We found that for patients with high-risk disease, sexual function was similar between surgery and radiation. We conclude that high-risk patients undergoing radiation therapy should be counseled that sexual function may not be as good as low-risk patients undergoing radiation. Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.

WHAT WE DON’T TALK ABOUT WHEN WE DON’T TALK ABOUT SEX1: RESULTS OF A NATIONAL SURVEY OF UNITED STATES OBSTETRICIAN/GYNECOLOGISTS

PubMed Central

SOBECKI, Janelle N.; CURLIN, Farr A.; RASINSKI, Kenneth A.; LINDAU, Stacy Tessler

2012-01-01

Introduction Sexuality is a key aspect of women’s physical and psychological health. Research shows both patients and physicians face barriers to communication about sexuality. Given their expertise and training in addressing conditions of the female genital tract across the female life course, obstetrician/gynecologists (ob/gyns) are well-positioned among all physicians to address sexuality issues with female patients. New practice guidelines for management of female sexual dysfunction and the importance of female sexual behavior and function to virtually all aspects of ob/gyn care, and to women’s health more broadly, warrant up-to-date information regarding ob/gyns’ sexual history-taking routine. Aims To determine obstetrician/gynecologists’ practices of communication with patients about sexuality, and to examine the individual and practice-level correlates of such communication. Methods A population-based sample of 1154 practicing U.S. obstetrician/gynecologists (53% male; mean age 48 years) was surveyed regarding their practices of communication with patients about sex. Main Outcome Measures Self-reported frequency measures of ob/gyns’ communication practices with patients including whether or not ob/gyns discuss patients’ sexual activities, sexual orientation, satisfaction with sexual life, pleasure with sexual activity, and sexual problems or dysfunction, as well as whether or not one ever expresses disapproval of or disagreement with patients’ sexual practices. Multivariable analysis was used to correlate physicians’ personal and practice characteristics with these communication practices. Results Survey response rate was 65.6%. Sixty-three percent of ob/gyns reported routinely assessing patients’ sexual activities; 40% routinely asked about sexual problems. Fewer asked about sexual satisfaction (28.5%), sexual orientation/identity (27.7%), or pleasure with sexual activity (13.8%). A quarter of ob/gyns reported they had expressed disapproval of patients’ sexual practices. Ob/gyns practicing predominately gynecology were significantly more likely than other ob/gyns to routinely ask about each of the five outcomes investigated. Conclusion The majority of U.S. ob/gyns report routinely asking patients about their sexual activities, but most other areas of patients’ sexuality are not routinely discussed. PMID:22443146

Quality of life among women with sexual dysfunction undergoing hemodialysis: a cross-sectional observational study.

PubMed

Santos, Paulo Roberto; Capote, José Roberto Frota Gomes; Cavalcanti, Juliana Uchoa; Vieira, Cyntia Brito; Rocha, Ana Rochelle Mesquita; Apolônio, Natália Alves Mineiro; de Oliveira, Elaine Barbosa

2012-08-31

Sexual function among women undergoing hemodialysis (HD) is under-studied and there is no consensus about the effect of sexual dysfunction (SD) on their quality of life (QoL). We aimed to determine the prevalence of SD and to compare QoL between women undergoing maintenance HD with and without SD. We included female end-stage renal disease (ESRD) patients undergoing HD during June 2011 in the only renal unit in the north of Ceará state, northeastern Brazil. The criteria for inclusion were age between 18 and 55, at least three months on dialysis and being sexually active. Women using antidepressant medication were excluded. We used the Female Sexual Function Index (FSFI), which evaluates six domains of sexual function, including desire, arousal, lubrication, orgasm, satisfaction and pain. The patients were classified as presenting SD if the total FSFI score was less than 26. For QoL evaluation, we used the validated Brazilian version of SF-36. This is a widely used 36-item questionnaire covering eight dimensions of QoL. Demographic data, time on dialysis, underlying etiology of ESRD, and laboratory measures were assessed in unit records. Of a total of 58 women, 46 (79.3%) presented SD. There were lower scores related to physical functioning (48.2 vs. 71.2; p = 0.007), bodily pain (45 vs. 67.5; p = 0.010), vitality (52.1 vs. 69.1; p = 0.026) and social functioning (57.2 vs. 76.1; p = 0.034) among women with SD compared to women without SD. Physical functioning and role-physical presented positive linear correlation with FSFI scores, respectively, r = 0.322 (p = 0.013) and r = 0.345 (p = 0.007). The prevalence of SD among women on HD is very high, reaching nearly 80%. Women on HD with SD had worse QoL, especially physical aspects of QoL, when compared to women without SD. Therefore, approaches aiming to improve QoL among women undergoing HD should be considered.

Female guppies agree to differ: phenotypic and genetic variation in mate-choice behavior and the consequences for sexual selection.

PubMed

Brooks, R; Endler, J A

2001-08-01

Variation among females in mate choice may influence evolution by sexual selection. The genetic basis of this variation is of interest because the elaboration of mating preferences requires additive genetic variation in these traits. Here we measure the repeatability and heritability of two components of female choosiness (responsiveness and discrimination) and of female preference functions for the multiple ornaments borne by male guppies (Poecilia reticulata). We show that there is significant repeatable variation in both components of choosiness and in some preference functions but not in others. There appear to be several male ornaments that females find uniformly attractive and others for which females differ in preference. One consequence is that there is no universally attractive male phenotype. Only responsiveness shows significant additive genetic variation. Variation in responsiveness appears to mask variation in discrimination and some preference functions and may be the most biologically relevant source of phenotypic and genetic variation in mate-choice behavior. To test the potential evolutionary importance of the phenotypic variation in mate choice that we report, we estimated the opportunity for and the intensity of sexual selection under models of mate choice that excluded and that incorporated individual female variation. We then compared these estimates with estimates based on measured mating success. Incorporating individual variation in mate choice generally did not predict the outcome of sexual selection any better than models that ignored such variation.

Psychological burden, sexual satisfaction and erectile function in men whose partners experience recurrent pregnancy loss in China: a cross-sectional study.

PubMed

Zhang, Yi-Xiang; Zhang, Xue-Qi; Wang, Qing-Rong; Yuan, Ye-Qing; Yang, Jiang-Gen; Zhang, Xiao-Wei; Li, Qing

2016-06-13

The aim of this study was to elucidate recurrent pregnancy loss (RPL)-associated psychosocial effects and sexual functions of Chinese men whose partners experience a history of RPL. Questionnaire data from a total of 236 men whose partners experience RPL(RPL group) and another 236 non-RPL male volunteers(control group) were analyzed. The self-administered questionnaires included anxiety and depression measures (SAS & SDS), the Index of Sexual Satisfaction (ISS) and the International Index of Erectile Function (IIEF-5) for evaluating psychological burden, sexual satisfaction and erectile function, respectively. The mean age of the RPL group and control group was 29.8 ± 8.6 and 28.2 ± 7.3, respectively. The incidence of erectile dysfunction was significantly higher in the RPL group than in the control group (19.07 % vs. 7.63 %, P < 0.001). Anxiety and depression were also more prevalent in RPL group than in the control group (anxiety: 36.90 % vs. 19.08 %, P < 0.001; depression: 26.30 % vs. 7.63 %, P < 0.001). Furthermore, after adjusting for age in the RPL group, negative relationships were observed between the IIEF-5 score and anxiety and depression (P < 0.001), and a positive correlation was found between the ISS and anxiety and depression (P < 0.001). In addition, history of RPL, anxiety and depressive symptoms were significantly associated with a higher risk of ED. Psychological functioning, sexual satisfaction and erectile function are impaired in infertile men with RPL partners. These men should be targeted for psychological consultation.

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…

Predictive Factors of Patients' and Their Partners' Sexual Function Improvement After Collagenase Clostridium Histolyticum Injection for Peyronie's Disease: Results From a Multi-Center Single-Arm Study.

PubMed

Cocci, Andrea; Russo, Giorgio Ivan; Salonia, Andrea; Cito, Gianmartin; Regis, Federica; Polloni, Gaia; Giubilei, Gianluca; Cacciamani, Giovanni; Capece, Marco; Falcone, Marco; Greco, Isabella; Timpano, Massimiliano; Minervini, Andrea; Gacci, Mauro; Cai, Tommaso; Garaffa, Giulio; Giammusso, Bruno; Arcaniolo, Davide; Mirone, Vincenzo; Mondaini, Nicola

2018-05-01

Collagenase Clostridium histolyticum (CCH; Xiapex) injections represent the only licensed medical treatment for Peyronie's disease (PD). To evaluate the efficacy and safety of CCH injections in men with stable PD, using a modified treatment protocol and to assess partners' bother improvement in a large cohort of White-European sexually active heterosexual men treated in a single tertiary-referral center. All the 135 patients enrolled underwent a thorough assessment, which included history taking, physical examination, and pharmacologically induced artificial erection test (intra-cavernous injection) to assess the degree of penile curvature (PC) at baseline and after the completion of the treatment. Patients with calcified plaque and/or ventral curvature were excluded. All patients underwent a modified treatment protocol, which consisted of 3 intra-lesional injections of 0.9 mg of CCH performed at 4-week intervals at the point of maximum curvature. After each injection, patients were instructed to follow a strict routine involving daily penile stretching in the intervals between injections. International Index of Erectile Function (IIEF)-15, Global Assessment of PD, PD questionnaires (PDQ), and Female Sexual Function Index (FSFI) questionnaire were performed at baseline and at the end of treatment. Overall, 135 patients completed the study protocol. Before treatment, 18 (13.33%) partners showed a degree of sexual dysfunction. Baseline median IIEF-15, FSFI, and PDQ scores were, respectively, 59.0, 35.0, and 23.0. Overall, both IIEF-total and all domains significantly improved after treatment (all P < .01). A PC mean change of 19.07 (P = .00) was measured. At the univariate linear regression analysis, IIEF-15, IIEF-erectile function, IIEF-sexual desire, and IIEF-intercourse satisfaction were positively associated with FSFI (all P ≤ .03); conversely, PDQ-penile pain, PDQ-symptom bother, and post-treament penile curvature (P ≤ .04) were associated with a decreased FSFI score. Furthermore, median change of PC was significantly associated with median change of FSFI (r = 0.25; 95% CI 0.02-0.11; P = .004). Global satisfaction after treatment was 89.6% (121/135). This modified CCH treatment protocol could improve both patients' and partner's sexual function. This was an open-label, single-arm clinical study, without placebo. where only heterosexual couples in stable relationships were included. Furthermore, no real assessment of female sexual distress was carried out and long-term sexual function in both patients and female partners were not taken into account. The modified treatment schedule with CCH injections for stable PD has a positive impact on both patients' and partners' sexual function in heterosexual couples with a stable sexual relationship. Cocci A, Russo GI, Salonia A, et al. Predictive Factors of Patients' and Their Partners' Sexual Function Improvement After Collagenase Clostridium Histolyticum Injection for Peyronie's Disease: Results From a Multi-Center Single-Arm Study. J Sex Med 2018;15:716-721. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Quality of sexual life of women using the contraceptive vaginal ring in extended cycles: preliminary report.

PubMed

Caruso, Salvatore; Cianci, Stefano; Malandrino, Chiara; Cicero, Carla; Lo Presti, Lucia; Cianci, Antonio

2014-08-01

To evaluate the quality of the sexual life of healthy women who are using a contraceptive vaginal ring (CVR) in extended cycles. Fifty-two women (18 to 32 years old) seeking hormonal contraception were enrolled in this prospective study. Women were to use a CVR releasing daily 15 μg of ethinylestradiol (EE) and 120 μg of etonogestrel (ENG) for 63 days, followed by a four-day hormone-free interval, for two such extended cycles. At baseline and at the first (day 63-73) and second (day 126-134) follow-ups the Female Sexual Function Index (FSFI) and the Short Form-36 (SF-36) questionnaires were administered to investigate, respectively, sexual behaviour and the quality of life (QoL). The Female Sexual Distress Scale (FSDS) was used to verify whether sexual dysfunction caused significant personal distress to the woman. The FSFI and FSDS scores obtained at the first and second follow-up appointments detected an improvement with respect to the baseline score (p < 0.05). QoL measures of body pain, general health and emotional role improved at the first follow-up visit (p < 0.05); at the second one, all variables showed improvement (p < 0.05). According to these preliminary data the CVR in extended cycles could improve the sexual function and the QoL of women.

Comparing effects of a low-energy diet and a high-protein low-fat diet on sexual and endothelial function, urinary tract symptoms, and inflammation in obese diabetic men.

PubMed

Khoo, Joan; Piantadosi, Cynthia; Duncan, Rae; Worthley, Stephen G; Jenkins, Alicia; Noakes, Manny; Worthley, Matthew I; Lange, Kylie; Wittert, Gary A

2011-10-01

Abdominal obesity and type 2 diabetes mellitus are associated with sexual and endothelial dysfunction, lower urinary tract symptoms (LUTS), and chronic systemic inflammation. To determine the effects of diet-induced weight loss and maintenance on sexual and endothelial function, LUTS, and inflammatory markers in obese diabetic men. Weight, waist circumference (WC), International Index of Erectile Function (IIEF-5) score, Sexual Desire Inventory (SDI) score, International Prostate Symptom Scale (IPSS) score, plasma fasting glucose and lipids, testosterone, sex hormone binding globulin (SHBG), inflammatory markers (high-sensitivity C-reactive protein [CRP] and interleukin-6 [IL-6]) and soluble E-selectin, and brachial artery flow-mediated dilatation (FMD) were measured at baseline, 8 weeks, and 52 weeks. Over 8 weeks, 31 abdominally obese (body mass index ≥ 30 kg/m(2) , WC ≥ 102 cm), type 2 diabetic men (mean age 59.7 years) received either a meal replacement-based low-calorie diet (LCD) ∼1,000 kcal/day (N = 19) or low-fat, high-protein, reduced-carbohydrate (HP) diet (N = 12) prescribed to decrease intake by ∼600 kcal/day. Subjects continued on, or were switched to, the HP diet for another 44 weeks. At 8 weeks, weight and WC decreased by ∼10% and ∼5% with the LCD and HP diet, respectively. Both diets significantly improved plasma glucose, low-density lipoprotein (LDL), SHBG, IIEF-5, SDI and IPSS scores, and endothelial function (increased FMD, reduced soluble E-selectin). Erectile function, sexual desire, and urinary symptoms improved by a similar degree with both diets. CRP and IL-6 decreased with the HP diet. At 52 weeks, reductions in weight, WC, and CRP were maintained. IIEF-5, SDI, and IPSS scores improved further. Diet-induced weight loss induces rapid improvement of sexual, urinary, and endothelial function in obese diabetic men. A high-protein, carbohydrate-reduced, low-fat diet also reduces systemic inflammation and sustains these beneficial effects to 1 year. © 2011 International Society for Sexual Medicine.

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.

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.

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.

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.

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.

Development of a comprehensive survey of sexuality issues including a self-report version of the International Spinal Cord Injury sexual function basic data sets.

PubMed

New, P W; Currie, K E

2016-08-01

Questionnaire development, validation and completion. Develop comprehensive survey of sexuality issues including validated self-report versions of the International Spinal Cord Injury male sexual function and female sexual and reproductive function basic data sets (SR-iSCI-sexual function). People with spinal cord damage (SCD) living in the community, Australia from August 2013 to June 2014. An iterative process involving rehabilitation medicine clinicians, a nurse specialising in sexuality issues in SCD and people with SCD who developed a comprehensive survey that included the SR-iSCI-sexual function. Participants recruitment through spinal rehabilitation review clinic and community organisations that support people with SCD. Surveys completed by 154 people. Most were male (n=101, 65.6%). Respondents' median age was 50 years (interquartile range (IQR) 38-58), and they were a median of 10 years (IQR 4-20) after the onset of SCD. Sexual problems unrelated to SCD were reported by 12 (8%) respondents, and 114 (n=75.5%) reported sexual problems because of SCD. Orgasms were much less likely (χ(2)=13.1, P=0.006) to be normal in males (n=5, 5%) compared with females (n=11, 22%). Males had significantly worse (χ(2)=26.0, P=0.001) psychogenic genital functioning (normal n=9, 9%) than females (normal n=13, 26%) and worse (χ(2)=10.8, P=0.013) reflex genital functioning. Normal ejaculation was reported in only three (3%) men. Most (n=26, 52%) women reported reduced or absent menstruation pattern since SCD. The SR-iSCI-sexual function provides a useful tool for researchers and clinicians to collect information regarding patient-reported sexual functioning after SCD and to facilitate comparative studies.

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.

Effects of a Family Intervention in Reducing HIV Risk Behaviors Among High-Risk Hispanic Adolescents

PubMed Central

Prado, Guillermo; Pantin, Hilda; Huang, Shi; Cordova, David; Tapia, Maria I.; Velazquez, Maria-Rosa; Calfee, Meghan; Malcolm, Shandey; Arzon, Margaret; Villamar, Juan; Jimenez, Giselle Leon; Cano, Nicole; Brown, C. Hendricks; Estrada, Yannine

2013-01-01

Objective To determine the efficacy of a family intervention in reducing human immunodeficiency virus (HIV) risk behaviors among Hispanic delinquent adolescents. Design Randomized controlled trial. Setting Miami–Dade County Public School System and Miami–Dade County’s Department of Juvenile Services, Florida. Participants A total of 242 Hispanic delinquent youth aged 12 to 17 years and their primary caregivers completed outcome assessments at baseline and 3 months after intervention. Intervention Participants were randomized to either Familias Unidas (120 participants), a Hispanic-specific, family intervention designed to reduce HIV risk behaviors among Hispanic youth, or a community practice control condition (122 participants). Main Outcome Measures Self-reported measures included unprotected sexual behavior, engaging in sex while under the influence of alcohol and/or drugs, number of sexual partners, and incidence of sexually transmitted diseases. Family functioning (eg, parent-adolescent communication, positive parenting, and parental monitoring) was also assessed via self-report measures. Results Compared with community practice, Familias Unidas was efficacious in increasing condom use during vaginal and anal sex during the past 90 days, reducing the number of days adolescents were under the influence of drugs or alcohol and had sex without a condom, reducing sexual partners, and preventing unprotected anal sex at the last sexual intercourse. Familias Unidas was also efficacious, relative to community practice, in increasing family functioning and most notably in increasing parent-adolescent communication and positive parenting. Conclusion These results suggest that culturally tailored, family-centered prevention interventions may be appropriate and efficacious in reducing HIV risk behaviors among Hispanic delinquent adolescents. Trial Registration clinicaltrials.gov Identifier: NCT01257022 PMID:21969363

Sadism and Violent Reoffending in Sexual Offenders.

PubMed

Eher, Reinhard; Schilling, Frank; Hansmann, Brigitte; Pumberger, Tanja; Nitschke, Joachim; Habermeyer, Elmar; Mokros, Andreas

2016-02-01

A diagnosis of sadism in sexual offenders is commonly regarded as indicative of high risk for violent reoffending. The purpose of the current two studies was to evaluate whether sadism is indeed associated with higher rates of violent (including sexual) reoffending. In Study 1 (meta-analysis), the rate of violent and sexual recidivism was assessed across seven samples of male sex offenders (total N = 2,169) as a function of diagnoses of sexual sadism. In Study 2 (N = 768) the outcome (violent recidivism yes/no) was regressed on sadism, along with behavioral indicators of sexually sadistic offending, and scores from violence risk assessment instruments. In Study 1 (meta-analysis), the overall risk of sadists compared with nonsadists with respect to violent (including sexual contact) reoffending was slightly elevated (by a factor of 1.18), yet not significantly increased. Similarly, the risk of sexual reoffending among sadists was slightly, but not significantly, higher than among nonsadists (factor 1.38). According to Study 2, only a measure of sadistic behavior, not the clinical diagnosis, was associated with violent reoffending. This association, however, was not present once age and customary risk assessment instruments for violence risk were included in the regression. A clinical diagnosis of sexual sadism and behavioral measures of sadism are related to the risk of violent reoffending in sexual offenders. These associations, however, are weak and do not hold once variables relevant for the prediction of violence are controlled for. At the individual level, the risk for future violence in sadists can therefore be adequately described by customary risk assessment instruments. © The Author(s) 2015.

Impact of educational seminars on women with provoked vestibulodynia.

PubMed

Brotto, Lori A; Sadownik, Leslie; Thomson, Sydney

2010-02-01

Provoked vestibulodynia (PVD) is a common genital pain condition characterized by severe pain upon vaginal penetration. The treatment of women with PVD suggests variable efficacy across modalities. The emotional toll of PVD, because of the intimate and interpersonal nature of this sexually-provoked pain, and the relationship between PVD and anxiety, depression, and a host of subclinical emotional symptoms that may interfere with treatment, has been well documented. The role of the gynaecologist in identifying and managing these psychological symptoms has never been addressed. The goal of this study was to examine the efficacy of a brief, gynaecologist-led educational seminar on measures of psychological symptoms and sexual health. Twenty-nine women with PVD participated in three one-hour educational seminars led by a gynaecologist with expertise in the management of PVD. Participants completed questionnaires before, immediately after, and six months after the third session. There were significant improvements in psychological symptoms of depression, anxiety, somatization, hostility, paranoid ideation, psychoticism, and the global severity index, both immediately post-seminar and at the six-month follow-up. Sexual arousal, orgasm, overall sexual function, and sexual distress also significantly improved in response to the seminars. Gynaecologist-led educational seminars delivered in a group format have a significant positive impact on psychological symptoms and sexual functioning in women who suffer from PVD.

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.

Affective and cognitive determinants of women's sexual response to erotica.

PubMed

Vilarinho, Sandra; Laja, Pedro; Carvalho, Joana; Quinta-Gomes, Ana Luísa; Oliveira, Cátia; Janssen, Erick; Nobre, Pedro J

2014-11-01

The specific cognitive-affective mechanisms involved in the activation and regulation of the subjective and genital components of sexual arousal are not fully understood yet. The aim of the present study was to investigate the contribution of self-reported thoughts and affect to the prediction of women's subjective and genital responses to erotica. Twenty-eight sexually functional women (mean age = 32, SD = 6.29) were presented with sexually explicit and nonexplicit romantic films. Genital responses, subjective sexual arousal, state affect, and self-reported thoughts were assessed. Vaginal pulse amplitude was measured using a vaginal photoplethysmograph. Subjective sexual arousal, thoughts, and affective responses were assessed through self-report scales. Correlations between subjective and physiological sexual arousal were low (r = -0.05, P > 0.05). Self-reported thoughts and affect were significant predictors of subjective sexual arousal. The strongest single predictor of subjective arousal was sexual arousal thoughts (e.g., "I'm getting excited") (β = 0.63, P < 0.01). None of the cognitive or affective variables predicted women's genital responses. Overall, results support the role of cognitive (self-reported thoughts) and affective dimensions in women's subjective sexual arousal to erotica and, consistent with previous findings, suggest that subjective and physiological sexual arousal may be impacted by different processes. © 2014 International Society for Sexual Medicine.

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 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.

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.

Non-ablative Er:YAG laser therapy effect on stress urinary incontinence related to quality of life and sexual function: A randomized controlled trial.

PubMed

Blaganje, Mija; Šćepanović, Darija; Žgur, Lidija; Verdenik, Ivan; Pajk, Franja; Lukanović, Adolf

2018-05-01

Stress urinary incontinence (SUI) is a common complaint in women after childbirth. It affects their quality of life and sexual satisfaction and is one of the major reasons for gynaecological surgery. There is a need for effective non-invasive treatment alternatives. The aim of this study was to evaluate the efficacy and safety of non-ablative Er:YAG laser therapy in the treatment of SUI and improvement of sexual gratification in parous women. 114 premenopausal parous women with SUI were randomized in two groups of 57 women; a laser intervention group and sham group. Both groups were treated according to the IncontiLase ® clinical treatment protocol for SUI with non-ablative thermal-only Er:YAG laser, except that there was no energy output when treating the sham group. Patients were blinded to the allocation. At baseline and 3 months after treatment patients were clinically examined, answered questionnaires for SUI severity and sexual function assessment and their pelvic floor muscle (PFM) function was assessed with perineometry. Validated International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF) was used as the primary outcome measure. The Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire short form (PISQ-12) and The Female Sexual Function Index (FSFI) were used to assess the sexual function. Patients were monitored for discomfort and side-effects during treatment and follow-up period. 3 months after treatment the ICIQ-UI SF (p < 0.001), PISQ-12 (p = 0.014) and FSFI (p = 0.025) scores were significantly more improved in the laser group than in the sham control group. All perineometry variables improved in the laser group after treatment; duration and maximum pressure had statistically significantly better improvement than the sham group, whereas average pressure did not. 21% of laser treated patients were dry (ICIQ-UI SF = 0) at follow up compared to only 4% of the sham control patients. No serious adverse effects were observed or reported. The treatment was well tolerated by patients. The non-ablative Er:YAG laser therapy improves the impact of SUI symptoms on quality of life and sexual function in premenopausal parous women significantly better than placebo. It provides a promising minimally-invasive safe treatment alternative for SUI. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

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.

Impaired Attentional Control in Pedophiles in a Sexual Distractor Task.

PubMed

Jordan, Kirsten; Fromberger, Peter; von Herder, Jakob; Steinkrauss, Henrike; Nemetschek, Rebekka; Witzel, Joachim; Müller, Jürgen L

2016-01-01

Pedophilic disorder, a subtype of paraphilia, is defined as a recurrent sexual interest in prepubescent children, which is characterized by persistent thoughts, fantasies, urges, sexual arousal, or behavior. Besides a deviant sexual preference, sexual preoccupation was found to be a dynamic risk factor for reoffending. Thus, it is conceivable that sex offenders and especially sex offenders against children have difficulties to control their responses to sexual stimuli. In the current study pedophiles, forensic and non-forensic control subjects had to solve a cognitive task, while sexual distractors were presented simultaneously. This kind of task also requires control functions. Therefore, data were analyzed with respect to attentional control while comparing eye movements toward sexual distractors and toward the cognitive task. We were mainly interested in how early (fixation latency) and late (relative fixation time) attentional processes were allocated to both, the cognitive target stimuli and the sexual distractors. Pedophiles demonstrated significantly lower attentional control in the sexual distractor task than both control groups (non-pedophiles). They showed a shorter fixation latency and longer fixation time for sexual distractors than non-pedophiles. Furthermore, pedophiles demonstrated a longer fixation latency and shorter fixation time for cognitive target stimuli. For classification analyses, an attentional control index (ACI) was built, i.e., the difference between eye movements on cognitive target stimuli and sexual distractors. For the ACI of early attentional processes, i.e., fixation latency, a good classification between pedophiles and non-pedophiles was found. We assumed that the measured attentional control represents inhibitory executive functions, specifically interference control. Further studies should examine if low attentional control in pedophiles is due to low motivation to solve the task or rather to a lack of ability to control attention with respect to sexual and/or neutral distractors. Prospectively, this design could be useful to generate hypotheses about clinical important aspects of controllability, the capacity of self-control, and the severity of a paraphilic disorder.

Impaired Attentional Control in Pedophiles in a Sexual Distractor Task

PubMed Central

Jordan, Kirsten; Fromberger, Peter; von Herder, Jakob; Steinkrauss, Henrike; Nemetschek, Rebekka; Witzel, Joachim; Müller, Jürgen L.

2016-01-01

Pedophilic disorder, a subtype of paraphilia, is defined as a recurrent sexual interest in prepubescent children, which is characterized by persistent thoughts, fantasies, urges, sexual arousal, or behavior. Besides a deviant sexual preference, sexual preoccupation was found to be a dynamic risk factor for reoffending. Thus, it is conceivable that sex offenders and especially sex offenders against children have difficulties to control their responses to sexual stimuli. In the current study pedophiles, forensic and non-forensic control subjects had to solve a cognitive task, while sexual distractors were presented simultaneously. This kind of task also requires control functions. Therefore, data were analyzed with respect to attentional control while comparing eye movements toward sexual distractors and toward the cognitive task. We were mainly interested in how early (fixation latency) and late (relative fixation time) attentional processes were allocated to both, the cognitive target stimuli and the sexual distractors. Pedophiles demonstrated significantly lower attentional control in the sexual distractor task than both control groups (non-pedophiles). They showed a shorter fixation latency and longer fixation time for sexual distractors than non-pedophiles. Furthermore, pedophiles demonstrated a longer fixation latency and shorter fixation time for cognitive target stimuli. For classification analyses, an attentional control index (ACI) was built, i.e., the difference between eye movements on cognitive target stimuli and sexual distractors. For the ACI of early attentional processes, i.e., fixation latency, a good classification between pedophiles and non-pedophiles was found. We assumed that the measured attentional control represents inhibitory executive functions, specifically interference control. Further studies should examine if low attentional control in pedophiles is due to low motivation to solve the task or rather to a lack of ability to control attention with respect to sexual and/or neutral distractors. Prospectively, this design could be useful to generate hypotheses about clinical important aspects of controllability, the capacity of self-control, and the severity of a paraphilic disorder. PMID:27994559

Sexuality and quality of life in women with a prior diagnosis of breast cancer after risk-reducing salpingo-oophorectomy.

PubMed

Tucker, Paige E; Saunders, Christobel; Bulsara, Max K; Tan, Jason Jit-Sun; Salfinger, Stuart G; Green, Helena; Cohen, Paul A

2016-12-01

To investigate the prevalence of sexual dysfunction in women with a history of breast cancer following risk-reducing salpingo-oophorectomy (RRSO). A secondary objective was to examine the effect of a prior diagnosis of breast cancer, and other factors, on sexuality and quality of life (QoL) outcomes. Cross-sectional study of 119 women who underwent RRSO between 2009 and 2014. Data were collected via a questionnaire comprising demographic information and validated measures of sexual function, sexual distress, relationship satisfaction, body image, psychological stress, menopause symptoms and general quality of life. Sixty out of 119 participants who underwent RRSO had a history of breast cancer. Eighty percent of women with breast cancer had female sexual dysfunction (FSD) and 82% had hypoactive sexual desire disorder (HSDD) after RRSO. Bilateral mastectomy was associated with higher rates of HSDD (p = 0.028) and higher body image self-consciousness (BISC) during sexual activity (p = 0.011). Breast reconstruction was associated with higher relationship satisfaction (RAS) scores (p = 0.004). Compared to Tamoxifen, aromatase inhibitors (AI) were significantly associated with reduced lubrication (p = 0.041), arousal (p = 0.004), orgasm (p = 0.002) and greater dyspareunia (p = 0.027). Prior diagnosis of breast cancer was not associated with the prevalence of FSD (p = 0.532). High rates of FSD and HSDD occur in women with breast cancer following RRSO. Low relationship satisfaction, bodily pain, bilateral mastectomy and the use of aromatase inhibitors were associated with poorer sexual function. Women had similar sexual outcomes and QoL after RRSO, regardless of breast cancer history. Copyright © 2016 Elsevier Ltd. All rights reserved.

Prediction of Erectile Function Following Treatment for Prostate Cancer

PubMed Central

Alemozaffar, Mehrdad; Regan, Meredith M.; Cooperberg, Matthew R.; Wei, John T.; Michalski, Jeff M.; Sandler, Howard M.; Hembroff, Larry; Sadetsky, Natalia; Saigal, Christopher S.; Litwin, Mark S.; Klein, Eric; Kibel, Adam S.; Hamstra, Daniel A.; Pisters, Louis L.; Kuban, Deborah A.; Kaplan, Irving D.; Wood, David P.; Ciezki, Jay; Dunn, Rodney L.; Carroll, Peter R.; Sanda, Martin G.

2013-01-01

Context Sexual function is the health-related quality of life (HRQOL) domain most commonly impaired after prostate cancer treatment; however, validated tools to enable personalized prediction of erectile dysfunction after prostate cancer treatment are lacking. Objective To predict long-term erectile function following prostate cancer treatment based on individual patient and treatment characteristics. Design Pretreatment patient characteristics, sexual HRQOL, and treatment details measured in a longitudinal academic multicenter cohort (Prostate Cancer Outcomes and Satisfaction With Treatment Quality Assessment; enrolled from 2003 through 2006), were used to develop models predicting erectile function 2 years after treatment. A community-based cohort (community-based Cancer of the Prostate Strategic Urologic Research Endeavor [CaPSURE]; enrolled 1995 through 2007) externally validated model performance. Patients in US academic and community-based practices whose HRQOL was measured pretreatment (N = 1201) underwent follow-up after prostatectomy, external radiotherapy, or brachytherapy for prostate cancer. Sexual outcomes among men completing 2 years’ follow-up (n = 1027) were used to develop models predicting erectile function that were externally validated among 1913 patients in a community-based cohort. Main Outcome Measures Patient-reported functional erections suitable for intercourse 2 years following prostate cancer treatment. Results Two years after prostate cancer treatment, 368 (37% [95% CI, 34%–40%]) of all patients and 335 (48% [95% CI, 45%–52%]) of those with functional erections prior to treatment reported functional erections; 531 (53% [95% CI, 50%–56%]) of patients without penile prostheses reported use of medications or other devices for erectile dysfunction. Pretreatment sexual HRQOL score, age, serum prostate-specific antigen level, race/ethnicity, body mass index, and intended treatment details were associated with functional erections 2 years after treatment. Multivariable logistic regression models predicting erectile function estimated 2-year function probabilities from as low as 10% or less to as high as 70% or greater depending on the individual’s pretreatment patient characteristics and treatment details. The models performed well in predicting erections in external validation among CaPSURE cohort patients (areas under the receiver operating characteristic curve, 0.77 [95% CI, 0.74–0.80] for prostatectomy; 0.87 [95% CI, 0.80–0.94] for external radiotherapy; and 0.90 [95% CI, 0.85–0.95] for brachytherapy). Conclusion Stratification by pretreatment patient characteristics and treatment details enables prediction of erectile function 2 years after prostatectomy, external radiotherapy, or brachytherapy for prostate cancer. PMID:21934053

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.

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.

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…

Histological Correlates of Penile Sexual Sensation: Does Circumcision Make a Difference?

PubMed Central

Cox, Guy; Krieger, John N; Morris, Brian J

2015-01-01

Introduction The question of whether removal of sensory receptors in the prepuce by circumcision affects sensitivity and/or sexual pleasure is often debated. Aims To examine histological correlates relevant to penile sensitivity and sexual pleasure. Methods Systematic review of the scientific literature on penile structures that might affect sensitivity and sexual sensation. Articles were included if they contained original data on human male penile histology or anatomy. Individual articles, including reference lists, were evaluated. They were then considered in relation to physiological data from articles retrieved by a previous systematic review. Results We retrieved 41 publications on penile structure. Considered in the light of 12 reporting physiological measurements, our evaluation finds that sexual response is unlikely to involve Meissner’s corpuscles, whose density in the prepuce diminishes at the time of life when male sexual activity is increasing. Free nerve endings also show no correlation with sexual response. Because tactile sensitivity of the glans decreases with sexual arousal, it is unrelated to sexual sensation. Thermal sensitivity seems part of the reward mechanism of intercourse. Vibrational sensitivity is not related to circumcision status. Observations that penile sexual sensation is higher post circumcision are consistent with greater access of genital corpuscles to sexual stimuli after removal of the prepuce. This is based on the distribution of these corpuscles (which are located in the glans) and, in uncircumcised men, the position of the retracted prepuce during intercourse, rather than any change in the number of genital corpuscles. The scientific literature suggests that any sexual effect of circumcised men may depend solely on exposure of the glans and not on the absence of the prepuce. Conclusion Based on histological findings and correlates of sexual function, loss of the prepuce by circumcision would appear to have no adverse effect on sexual pleasure. Our evaluation supports overall findings from physiological measurements and survey data. PMID:26185672

Chronic stress and sexual function in women

PubMed Central

Hamilton, Lisa Dawn; Meston, Cindy M.

2014-01-01

Introduction Chronic stress is known to have negative effects on reproduction, but little is known about how it affects the sexual response cycle. The present study examined the relationship between chronic stress and sexual arousal and the mechanisms that mediate this relationship. Aim To test the relationship between chronic stress and sexual arousal and identify mechanisms that may explain this relationship. We predicted that women experiencing high levels of chronic stress would show lower levels of genital arousal & DHEAS and higher levels of cortisol and cognitive distraction compared to women with average levels of stress. Methods Women who were categorized as high in chronic stress (high stress group, n = 15) or average in chronic stress (average stress group; n = 15) provided saliva samples and watched an erotic film while having their genital and psychological arousal measured. Main Outcome Measures Main outcome measures were vaginal pulse amplitude, psychological arousal, salivary cortisol, salivary DHEAS, and heart rate and compared them between women with high and average levels of chronic stress. Results Women in the high stress group had lower levels of genital, but not psychological arousal, had higher levels of cortisol, and reported more distraction during the erotic film than women in the average stress group. The main predictor of decreased genital sexual arousal was participants’ distraction scores. Conclusions High levels of chronic stress were related to lower levels of genital sexual arousal. Both psychological (distraction) and hormonal (increased cortisol) factors were related to the lower levels of sexual arousal seen in women high in chronic stress, but distraction was the only significant predictor when controlling for other variables. PMID:23841462

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.

Sexual function of premature ejaculation patients assayed with Chinese Index of Premature Ejaculation.

PubMed

Yuan, Yi-Ming; Xin, Zhong-Cheng; Jiang, Hui; Guo, Yan-Jie; Liu, Wu-Jiang; Tian, Long; Zhu, Ji-Chuan

2004-06-01

To assess the psychometric properties of the Chinese Index of Premature Ejaculation (CIPE). The sexual function of 167 patients with and 114 normal controls without premature ejaculation (PE) were evaluated with CIPE. All subjects were married and had regular sexual activity. The CIPE has 10 questions, focusing on libido, erectile function, ejaculatory latency, sexual satisfaction and difficulty in delaying ejaculation, self-confidence and depression. Each question was responded to on a 5 point Likert-type scale. The individual question score and the total scale score were analyzed between the two groups. There were no significant differences between the age, duration of marriage and educational level (P> 0.05) of patients with and without PE and normal controls. The mean latency of patients with PE and normal controls were 1.6 +/- 1.2 and 10.2 +/- 9.5 minutes, respectively. Significant differences between patients with (26.7 +/- 4.6) PE and normal controls (41.9 +/- 4.0) were observed on the total score of CIPE (P< 0.01). Using binary logistic regression analysis, PE was significantly related to five questions of the original measure. They are the so-called the CIPE-5 and include: ejaculatory latency, sexual satisfaction of patients and sexual partner, difficulty in delaying ejaculation, anxiety and depression. Receiver Operating Characteristic (ROC) curve analysis of CIPE-5 questionnaire indicated that the sensitivity and specificity of CIPE were 97.60 % and 94.74 %, respectively. Employing the total score of CIPE-5, patients with PE could be divided into three groups: mild (>15 point) 19.8 %, moderate (10-14 point) 62.8 % and severe (< 9 point) 16.7 %. The CIPE-5 is a useful method for the evaluation of sexual function of patients with PE and can be used as a clinical endpoint for clinical trials studying the efficacy of pharmacological intervention.

A phase 2a multicenter, double-blind, placebo-controlled, crossover trial to investigate the efficacy, safety, and toleration of CP-866,087 (a high-affinity mu-opioid receptor antagonist) in premenopausal women diagnosed with female sexual arousal disorder (FSAD).

PubMed

Orri, Miguel; Abraham, Lucy; Giraldi, Annamaria

2013-10-01

Female sexual arousal disorder (FSAD) is a condition that can affect women of all ages and have a significant negative impact on emotional well-being. The aim of this study is to prospectively evaluate the effects of CP-866,087, a selective mu-opioid receptor antagonist, in premenopausal women with FSAD. The study included 51 women (20-45 years of age) with FSAD. All women received placebo and two of three planned doses of CP-866,087 (1, 3, and 10 mg) for 6 weeks in each of three double-blind treatment periods. Efficacy was determined through a series of measures to assess sexual functioning, sexual activity, sexual distress, and perceived meaningful benefit as a result of treatment. In addition, a semi-structured exit interview was conducted at the end of the fourth treatment period or withdrawal to provide a more in-depth, qualitative description of the participants' symptoms, response to treatment, and treatment satisfaction to augment the quantitative assessments. The within-subject differences from placebo in the change from baseline were compared across a range of measures of sexual function. Summary statistics and 90% confidence intervals were calculated. A qualitative analysis of the exit interview was conducted based on grounded theory methods. Although improvements were seen with CP-866,087 in the key efficacy end points, there was no clinical treatment benefit over placebo. The exit interview analysis suggested that being part of the study and taking positive action to search for a solution to the women's sexual disorder may have been a significant factor in the behavioral changes that were seen, as opposed to the drug treatment itself. Discerning the potential benefit of pharmacotherapy in a heterogeneous condition such as FSAD is challenging. Participation in a clinical trial combined with a commitment to actively engage in sexual activity may in itself create an environment that is conducive to symptom improvement. © 2013 International Society for Sexual Medicine.

Prevalence and correlates of self-reported sexual dysfunction in CKD: a meta-analysis of observational studies.

PubMed

Navaneethan, Sankar D; Vecchio, Mariacristina; Johnson, David W; Saglimbene, Valeria; Graziano, Giusi; Pellegrini, Fabio; Lucisano, Giuseppe; Craig, Jonathan C; Ruospo, Marinella; Gentile, Giorgio; Manfreda, Valeria Maria; Querques, Marialuisa; Stroumza, Paul; Torok, Marietta; Celia, Eduardo; Gelfman, Ruben; Ferrari, Juan Nin; Bednarek-Skublewska, Anna; Dulawa, Jan; Bonifati, Carmen; Hegbrant, Jörgen; Wollheim, Charlotta; Jannini, Emmanuele A; Strippoli, Giovanni F M

2010-10-01

Sexual dysfunction is an under-recognized problem in men and women with chronic kidney disease (CKD). The prevalence, correlates, and predictors of this condition in patients with CKD have not been evaluated comprehensively. Systematic review and meta-analysis. Patients treated using dialysis (dialysis patients), patients treated using transplant (transplant recipients), and patients with CKD not treated using dialysis or transplant (nondialysis nontransplant patients with CKD). Observational studies conducted in patients with CKD only or including a control group without CKD. Type of study population. Sexual dysfunction in men and women with CKD using validated tools, such as the International Index of Erectile Function, the Female Sexual Function Index (FSFI), or other measures as reported by study investigators. 50 studies (8,343 patients) of variable size (range, 16-1,023 patients) were included in this review. Almost all studies explored sexual dysfunction in men and specifically erectile dysfunction. The summary estimate of erectile dysfunction in men with CKD was 70% (95% CI, 62%-77%; 21 studies, 4,389 patients). Differences in reported prevalence rates of erectile dysfunction between different studies were attributable primarily to age, study populations, and type of study tool used to assess the presence of erectile dysfunction. In women, the reported prevalence of sexual dysfunction was assessed in only 306 patients from 2 studies and ranged from 30%-80%. Compared with the general population, women with CKD had a significantly lower overall FSFI score (8 studies or subgroups, 407 patients; mean difference, -9.28; 95% CI, -12.92 to -5.64). Increasing age, diabetes mellitus, and depression consistently were found to correlate with sexual dysfunction in 20 individual studies of patients with CKD using different methods. Suboptimal and lack of uniform assessment of outcome measures. Sexual dysfunction is highly prevalent in both men and women with CKD, especially among those on dialysis. Larger studies enrolling different ethnic groups, using validated study tools, and analyzing the influence of various factors on the development of sexual dysfunction are needed. Copyright © 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

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.

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.

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.

Viva La Diferencia! Segundo Modulo de una Serie para Maestros de Escuela Elemental (Long Live the Difference! Second Module of a Series for Elementary School Teachers).

ERIC Educational Resources Information Center

Molina, Carmen Eneida, Ed.; And Others

This guide, in English and Spanish, is designed to provide teachers with a scientific basis for identifying myths and distortions about men and women. A pre-test and post-test are included to measure the user's awareness of stereotypes. Object lessons address the following areas: (1) common sexual stereotypes; (2) sexual functions; (3) the…

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.

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

PubMed

Munoz, Valentina; Stravynski, Ariel

2010-03-01

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

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.

Behavioral Assessment: Questionnaires.

ERIC Educational Resources Information Center

Wilson, C. Chrisman

1980-01-01

This is a general discussion of the validity, reliability, function, and format of questionnaires designed to measure problem behavior, noncompliance, anxiety, social interaction, hyperactivity, drug use, and sexual behavior. Commonly used questionnaires are cited. (CP)

Influence of season of birth on growth and reproductive development of Brahman bulls.

PubMed

Tatman, Shawn R; Neuendorff, Don A; Wilson, Timothy W; Randel, Ronald D

2004-07-01

Seasonal effects on reproduction are more dramatic in Bos indicus than Bos taurus cattle. This experiment evaluated reproductive development of fall- (n=7) versus spring- (n = 10) born Brahman bulls to determine if season of birth affects reproductive development. Measurements of growth and reproductive development began after weaning and continued at bi-weekly intervals until each bull reached sexual maturity. Different stages of sexual development were classified according to characteristics of the ejaculate and included first sperm in the ejaculate, puberty (> 50 x 10(6) sperm/ejaculate), and sexual maturity (two ejaculates with > 500 = 10(6) sperm/ejaculate). Average daily increases in all measured traits were similar in fall- and spring-born bulls and there were no differences in age, body weight, scrotal circumference, or paired testis volume between groups at first sperm or puberty. However, fall-born bulls were older (P < 0.05) than spring-born bulls at sexual maturity (553 days versus 481 days, respectively) as the interval between puberty and sexual maturity was longer (P < 0.05) in fall- than in spring-born bulls (82 days versus 54 days, respectively). The prolonged interval between puberty and sexual maturity in fall-born calves coincided with a short photoperiod (winter) whereas the short interval between puberty and sexual maturity in spring-born calves coincided with a long photoperiod (summer). In conclusion, season of birth affected sexual development; photoperiod might be involved in regulating testicular function immediately after puberty in Brahman bulls.

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

Sexual arousal in men: a review and conceptual analysis.

PubMed

Janssen, Erick

2011-05-01

Sexual arousal is an emotional/motivational state that can be triggered by internal and external stimuli and that can be inferred from central (including verbal), peripheral (including genital), and behavioral (including action tendencies and motor preparation) responses. This article, while focusing on sexual arousal in men, provides a conceptual analysis of this construct, reviews models of sexual arousal, and discusses the usefulness of perspectives derived from motivation and emotion research in improving our understanding of its determinants and behavioral correlates. In this, it considers the role of genital feedback in men's subjective sexual arousal and the connections between sexual arousal and sexual desire. Future research and definitions may increasingly focus on its central integrative functions (as opposed to its input and output characteristics). Yet, the study of sexual arousal can be expected to continue to benefit from the measurement of its genital, verbal, and behavioral components. Instances of discordance between response components suggest that they are, at least in part, under the control of different mechanisms, and it is proposed that a better understanding of sexual arousal will prove contingent on a better understanding of such mechanisms and the conditions under which they converge and diverge. Copyright © 2011 Elsevier Inc. All rights reserved.

Gender and sexual health in clinical practice in Lebanon

PubMed Central

El-Kak, F.; Jurdi, R.; Kaddour, A.; Zurayk, H.

2006-01-01

This study examines the readiness of obstetricians/gynecologists (Ob/Gyns) in Lebanon to provide sexual consultation, their degree of comfort when discussing issues of sexual health, and their attitudes regarding assessment, treatment, and referral. Data on these concepts were collected through face-to-face interviews with 286 randomly selected Ob/Gyns. Most Ob/Gyns reported feeling comfortable discussing sexuality during consultations, which they attributed much more to professional experience than to training. Most Ob/Gyns reported giving proper time for management of sexual health issues and follow-up, as these issues are brought up frequently by their women clients. However, results suggest that only one-third (31%) of Lebanese Ob/Gyns nearly always take the initiative in asking patients about their sexual health. Moreover, almost 45% of participating Ob/Gyns did not recognize a strong relationship between reproductive health and sexual functioning. Gender was not found to be an important predictor for any of the indicators measured in the present study. Ob/Gyns in Lebanon are significant consultants on various sexual issues, and they need better postgraduate training, continuing medical education, and access to medical congress resources on the topic of sexuality and its relationship to reproductive health. PMID:15548405

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.

Psychometric Properties of the Sexual Excitation/Sexual Inhibition Inventory for Women in a German Sample.

PubMed

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

2016-02-01

The Sexual Excitation Sexual/Inhibition Inventory for Women (SESII-W) is a self-report questionnaire for assessing propensities of sexual excitation (SE) and sexual inhibition (SI) in women. According to the dual control model of sexual response, these two factors differ between individuals and influence the occurrence of sexual arousal in given situations. Extreme levels of SE and SI are postulated to be associated with sexual problems or risky sexual behaviors. Psychometric evaluation of the original scale yielded two higher order and eight lower order factors as well as satisfactory to good construct validity and reliability. The present study was designed to assess the psychometric properties of a German version of the SESII-W utilizing a large convenience sample of 2206 women. Confirmatory factor analysis showed a satisfactory overall model fit, with support for the five lower order factors of SE (Arousability, Sexual Power Dynamics, Smell, Partner Characteristics, Setting) and the three lower order factors of SI (Relationship Importance, Arousal Contingency, and Concerns about Sexual Function). Additionally, the scale demonstrated good convergent and discriminant validity, internal consistency, and test-retest-reliability. The German SESII-W is a sufficiently reliable and valid measure for assessing SE and SI in women. Hence, its use can be recommended for future research in Germany that investigates women's sexual behaviors and experiences.

Prevalence of dating violence among sexual minority youth: variation across gender, sexual minority identity and gender of sexual partners.

PubMed

Martin-Storey, Alexa

2015-01-01

Dating violence during adolescence negatively influences concurrent psychosocial functioning, and has been linked with an increased likelihood of later intimate partner violence. Identifying who is most vulnerable for this negative outcome can inform the development of intervention practices addressing this problem. The two goals of this study were to assess variations in the prevalence of dating violence across different measures of sexual minority status (e.g., sexual minority identity or same-sex sexual behavior), and to assess whether this association was mediated by bullying, the number of sexual partners, binge drinking or aggressive behaviors. These goals were assessed by employing the Massachusetts Youth Risk Behavior Survey (N = 12,984), a regionally representative sample of youth ages 14-18. In this sample, a total of 540 girls and 323 boys reported a non-heterosexual identity, and 429 girls and 230 boys reported having had one or more same-sex sexual partners. The results generally supported a higher prevalence of dating violence among sexual minority youth. This vulnerability varied considerably across gender, sexual minority identity and the gender of sexual partners, but generally persisted when accounting for the mediating variables. The findings support investigating dating violence as a mechanism in the disparities between sexual minority and heterosexual youth, and the importance of addressing sexual minority youth specifically in interventions targeting dating violence.

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.

Inhibition of Aromatase Induces Partial Sex Change in a Cichlid Fish: Distinct Functions for Sex Steroids in Brains and Gonads.

PubMed

Göppert, Carolin; Harris, Rayna M; Theis, Anya; Boila, Anna; Hohl, Simon; Rüegg, Attila; Hofmann, Hans A; Salzburger, Walter; Böhne, Astrid

2016-01-01

Sex steroids are major drivers of sexual development and also responsible for the maintenance of the established gender. Especially fishes exhibit great plasticity and less conservation in sex determination and sexual development compared to other vertebrate groups. In addition, fishes have a constant sex steroid production throughout their entire lifespan, which makes them particularly susceptible to interferences with the endogenous sex steroid system. This susceptibility has recently been used to show that inhibition of the key enzyme of estrogen synthesis, aromatase Cyp19a1, can induce functional sex reversal even in adult fish. Here, we investigated the impact of the aromatase inhibitor (AI) fadrozole in adult females of the East African cichlid fish Astatotilapia burtoni. Using gene expression, phenotypic measurements, behavioral experiments, and hormone measurements, we assessed if females treated with fadrozole develop a male-like phenotype. We found that AI treatment has a different effect on gene expression in the gonad compared to the brain, the 2 tissues mostly implicated in sexual development. In contrast to observations in other gonochoristic species, A. burtoni ovaries cannot be transformed into functional testis by AI. However, rapid changes towards a male-like phenotype can be induced with AI in coloration, hormone levels, and behavior. © 2016 S. Karger AG, Basel.

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.

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…

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.

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.

Effect of testosterone supplementation on sexual functioning in aging men: a 6-month randomized controlled trial.

PubMed

Emmelot-Vonk, M H; Verhaar, H J J; Nakhai-Pour, H R; Grobbee, D E; van der Schouw, Y T

2009-01-01

Serum testosterone levels decline significantly with aging and this has been associated with reduced sexual function. We have conducted a double-blind, randomized, placebo-controlled trial to investigate the effect of testosterone supplementation on sexual function in 237 elderly men with a testosterone level <13.7 nmol l(-1). Participants were randomly assigned to receive oral testosterone undecanoate or a placebo for 6 months. A total of 207 men completed the study. After treatment, there were no differences in scores on sexual function between the groups. Subanalysis showed that although a baseline testosterone level in the lowest tertile was associated with significantly lower scores for sexual fantasies, desire of sexual contact and frequency of sexual contact, supplementation of testosterone did not result in improvement on any of these items in this group. In conclusion, the findings do not support the view that testosterone undecanoate supplementation for 6 months to elderly men with low-normal testosterone concentrations favorably affects sexual function.

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

Effects of Aversive Classical Conditioning on Sexual Response in Women With Dyspareunia and Sexually Functional Controls.

PubMed

Both, Stephanie; Brauer, Marieke; Weijenborg, Philomeen; Laan, Ellen

2017-05-01

In dyspareunia-a somatically unexplained vulvovaginal pain associated with sexual intercourse-learned pain-related fear and inhibited sexual arousal are supposed to play a pivotal role. Based on research findings indicating that enhanced pain conditioning is involved in the etiology and maintenance of chronic pain, in the present study it was hypothesized that enhanced pain conditioning also might be involved in dyspareunia. To test whether learned associations between pain and sex negatively affect sexual response; whether women with dyspareunia show stronger aversive learning; and whether psychological distress, pain-related anxiety, vigilance, catastrophizing, and sexual excitation and inhibition were associated with conditioning effects. Women with dyspareunia (n = 36) and healthy controls (n = 35) completed a differential conditioning experiment, with one erotic picture (the CS + ) paired with a painful unconditional stimulus and one erotic picture never paired with pain (the CS - ). Genital sexual response was measured by vaginal photoplethysmography, and ratings of affective value and sexual arousal in response to the CS + and CS - were obtained. Psychological distress, pain cognitions, and sexual excitation and inhibition were assessed by validated questionnaires. The two groups showed stronger negative affect and weaker subjective sexual arousal to the CS + during the extinction phase, but, contrary to expectations, women with dyspareunia showed weaker differential responding. Controls showed more prominent lower genital response to the CS + during acquisition than women with dyspareunia. In addition, women with dyspareunia showed stronger expectancy for the unconditional stimulus in response to the safe CS - . Higher levels of pain-related fear, pain catastrophizing, and sexual inhibition were associated with weaker differential conditioning effects. Pairing of sex with pain negatively affects sexual response. The results indicate that a learned association of sex with pain and possibly deficient safety learning play a role in dyspareunia. Both S, Brauer M, Weijenborg P, Laan E. Effects of Aversive Classical Conditioning on Sexual Response in Women With Dyspareunia and Sexually Functional Controls. J Sex Med 2017;14:687-701. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Feasibility of a Sexual Health Clinic Within Cancer Care: A Pilot Study Using Qualitative Methods.

PubMed

Tracy, Myrna; McDivitt, Karmen; Ryan, Maureen; Tomlinson, Jamie; Brotto, Lori A

2016-01-01

As cancer survival rates increase, so does the imperative for a satisfying quality of life, including a fulfilling sexual life. The feasibility and effectiveness of a newly formed Sexual Health Clinic were determined using a nurse-led format, which provided support to survivors in a cancer care setting. Twenty-one cancer survivors received assessment, education, and tailored sexual health support by an oncology nurse with specialized skills in sexual health. Two months later, semistructured interviews focused on patients' personal experiences. Questionnaires were also administered to healthcare providers involved in providing the follow-up care. Participants presented with sexual concerns that were psychological, physical, and/or relational. Scores on validated measures of sexual functioning were in the range comparable to those with a sexual dysfunction. Participants were open to being asked about sexual health and wanted professionals available who were skilled in dealing with sexual health services. Most participants experienced an improvement in their well-being and/or sexual life following participation. Some noted more confidence when speaking with their partner about sexual concerns. Our pilot Sexual Health Clinic was feasible, and evidence for its effectiveness was based on qualitative feedback. Participants and providers identified a strong need for the inclusion of sexual health services in cancer care. Oncology nurses are in a key position to initiate discussions surrounding sexual health issues related to cancer treatment. Self-awareness, sensitivity, and a nonjudgmental approach are required to address this dimension of holistic cancer care.

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.…

Examining links between sexual risk behaviors and dating violence involvement as a function of sexual orientation

PubMed Central

Hipwell, A.E.; Stepp, S.D.; Keenan, K.; Allen, A.; Hoffmann, A.; Rottingen, L.; McAloon, R.

2013-01-01

Study Objective To examine the association between dating violence perpetration and victimization and sexually risky behaviors among sexual minority and heterosexual adolescent girls. Design Adolescent girls reported on sexual orientation, sexual behaviors and risk-taking, and their use of and experience with dating violence in the past year. Data were analyzed using multinomial regression adjusted for race, poverty, living in a single parent household, and gender of current partner to examine (1) whether sexual minority status was associated with sexual risk behaviors after sociodemographic correlates of sexual risk were controlled; and (2) whether dating violence context accounted for elevated risk. Setting Urban, population-based sample of girls interviewed in the home. Participants 1,647 adolescent girls (38% European American, 57% African American, and 5% other) aged 17 years. Over one third of the sample lived in poverty. Interventions None. Main Outcome Measure Sexual risk-taking. Results Sexual minority status differentiated girls engaging in high sexual risk-taking from those reporting none, after controlling for sociodemographic and relationship characteristics. Dating violence perpetration and victimization made unique additional contributions to this model, and did not account for the elevated risk conferred by sexual minority status. Conclusions Sexual minority girls (SMGs) were more likely than heterosexual girls to report high sexual risk-taking and teen dating violence victimization. As with heterosexual girls, sexual risk-taking among SMGs was compounded by dating violence, which was not explained by partner gender. Adolescent girls’ risky sexual behavior may be reduced by interventions for teen dating violence regardless of sexual minority status. PMID:23726138

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.

Transcutaneous electrical nerve stimulation as an additional treatment for women suffering from therapy-resistant provoked vestibulodynia: a feasibility study.

PubMed

Vallinga, Marleen S; Spoelstra, Symen K; Hemel, Inge L M; van de Wiel, Harry B M; Weijmar Schultz, Willibrord C M

2015-01-01

The current approach to women with provoked vestibulodynia (PVD) comprises a multidimensional, multidisciplinary therapeutic protocol. As PVD is considered to be a chronic pain disorder, transcutaneous electrical nerve stimulation (TENS) can be used as an additional therapy for women with otherwise therapy-resistant PVD. The aims of this study were to evaluate whether TENS has a beneficial effect on vulvar pain, sexual functioning, and sexually-related personal distress in women with therapy-resistant PVD and to assess the effect of TENS on the need for vestibulectomy. A longitudinal prospective follow-up study was performed on women with therapy-resistant PVD who received additional domiciliary TENS. Self-report questionnaires and visual analog scales (VASs) were completed at baseline (T1), post-TENS (T2), and follow-up (T3). Vulvar pain, sexual functioning, and sexually-related personal distress were the main outcome measures. Thirty-nine women with therapy-resistant PVD were included. Mean age was 27 ± 5.6 years (range: 19 to 41); mean duration between TENS and T3 follow-up was 10.1 ± 10.7 months (range: 2 to 32). Vulvar pain VAS scores directly post-TENS (median 3.4) and at follow-up (median 3.2) were significantly (P < 0.01) lower than at baseline (median 8.0). Post-TENS, sexual functioning scores on the Female Sexual Functioning Index questionnaire had improved significantly (P = 0.2); these scores remained stable at follow-up. Sexually-related personal distress scores had improved significantly post-TENS (P = 0.01). Only 4% of the women who received TENS needed to undergo vestibulectomy vs. 23% in our previous patient population. The addition of self-administered TENS to multidimensional treatment significantly reduced the level of vulvar pain and the need for vestibulectomy. The long-term effect was stable. These results not only support our hypothesis that TENS constitutes a feasible and beneficial addition to multidimensional treatment for therapy-resistant PVD, but also the notion that PVD can be considered as a chronic pain syndrome. © 2014 International Society for Sexual Medicine.

Status and Mating Success Amongst Visual Artists

PubMed Central

Clegg, Helen; Nettle, Daniel; Miell, Dorothy

2011-01-01

Geoffrey Miller has hypothesized that producing artwork functions as a mating display. Here we investigate the relationship between mating success and artistic success in a sample of 236 visual artists. Initially, we derived a measure of artistic success that covered a broad range of artistic behaviors and beliefs. As predicted by Miller’s evolutionary theory, more successful male artists had more sexual partners than less successful artists but this did not hold for female artists. Also, male artists with greater artistic success had a mating strategy based on longer term relationships. Overall the results provide partial support for the sexual selection hypothesis for the function of visual art. PMID:22059085

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.

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.

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

Sexual Well-Being Among Partnered Women With Breast Cancer Recurrence

PubMed Central

Andersen, Barbara L.; Carpenter, Kristen M.; Yang, Hae-Chung; Shapiro, Charles L.

2007-01-01

Purpose A woman’s risk for sexual disruption after breast cancer recurrence has received little clinical or research attention. Patients and Methods Breast cancer patients recently diagnosed with recurrence (n = 60) were initially assessed at baseline and completed follow-ups at 4, 8, and 12 months. They were compared by age, stage, and duration and frequency of follow-up with matched patients who remained disease free (n = 120). Using linear mixed modeling, the groups were compared in their trajectories of change on measures of sexuality, relationship satisfaction, cancer-specific stress, and physical functioning. Recurrence subgroups, those with locoregional versus distant disease and those younger versus older than 52 years, were also compared. Results At baseline, the recurrence group had significantly lower intercourse frequency and physical functioning compared with the disease-free group and these differences were maintained. There were no significant differences in the frequencies of kissing or sexual and relationship satisfactions. For the recurrence group patients, the heightened stress of the diagnostic/early recurrence treatment period declined to the lower disease-free levels by 12 months. This effect was largely due to improvement of the patients with distant disease. Finally, sexual changes were most notable for younger patients. Conclusion To our knowledge, this is the first longitudinal, controlled study of sexuality—sexuality in the context of other quality of life domains—for women coping with recurrence. Despite disruption, patients maintained their sexual lives. Younger and distant recurrence patients, however, may have greatest risk of sexual disruption. The factors contributing to sexual disruption remain unknown, and studies investigating strategies to help patients maintain this aspect of quality of life are needed. PMID:17634495

Assessment of pedophilia using hemodynamic brain response to sexual stimuli.

PubMed

Ponseti, Jorge; Granert, Oliver; Jansen, Olav; Wolff, Stephan; Beier, Klaus; Neutze, Janina; Deuschl, Günther; Mehdorn, Hubertus; Siebner, Hartwig; Bosinski, Hartmut

2012-02-01

Accurately assessing sexual preference is important in the treatment of child sex offenders. Phallometry is the standard method to identify sexual preference; however, this measure has been criticized for its intrusiveness and limited reliability. To evaluate whether spatial response pattern to sexual stimuli as revealed by a change in the blood oxygen level-dependent signal facilitates the identification of pedophiles. During functional magnetic resonance imaging, pedophilic and nonpedophilic participants were briefly exposed to same- and opposite-sex images of nude children and adults. We calculated differences in blood oxygen level-dependent signals to child and adult sexual stimuli for each participant. The corresponding contrast images were entered into a group analysis to calculate whole-brain difference maps between groups. We calculated an expression value that corresponded to the group result for each participant. These expression values were submitted to 2 different classification algorithms: Fisher linear discriminant analysis and κ -nearest neighbor analysis. This classification procedure was cross-validated using the leave-one-out method. Section of Sexual Medicine, Medical School, Christian Albrechts University of Kiel, Kiel, Germany. We recruited 24 participants with pedophilia who were sexually attracted to either prepubescent girls (n = 11) or prepubescent boys (n = 13) and 32 healthy male controls who were sexually attracted to either adult women (n = 18) or adult men (n = 14). Sensitivity and specificity scores of the 2 classification algorithms. The highest classification accuracy was achieved by Fisher linear discriminant analysis, which showed a mean accuracy of 95% (100% specificity, 88% sensitivity). Functional brain response patterns to sexual stimuli contain sufficient information to identify pedophiles with high accuracy. The automatic classification of these patterns is a promising objective tool to clinically diagnose pedophilia.

Sexuality and psychopathological aspects in premenopausal women with metabolic syndrome.

PubMed

Alvisi, Stefania; Baldassarre, Maurizio; Lambertini, Martina; Martelli, Valentina; Berra, Marta; Moscatiello, Simona; Marchesini, Giulio; Venturoli, Stefano; Meriggiola, Maria Cristina

2014-08-01

Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors that have been suggested to impact female sexual function. This study aims to assess the prevalence of female sexual dysfunction (FSD) in premenopausal women with MetS compared with healthy controls (HC). Psychopathological aspects and the relationship to FSD were also evaluated in both groups. Two hundred four premenopausal women, of whom 98 had diagnosis of MetS, were asked to complete the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale (FSDS), and the Middlesex Hospital Questionnaire (MHQ). Routine laboratory tests and anthropometric measurements were routinely performed. FSFI and FSDS questionnaires, prevalence of FSD, and MHQ scores. In the MetS group compared with the HC group, we found: a lower global FSFI score (P=0.005), higher prevalence of pathological scores compared with HC group, and lower scores in the desire, arousal, lubrication, and orgasm domains. An inverse correlation between the FSFI score and the number of risk factors for MetS was detected. MetS women reported significantly higher total scores in the somatization and depression domains when compared with the HC group. The logistic regression showed that high triglycerides (odds ratio [OR] 3.097; 95% confidence interval [CI] 1.272-7.542; P=0.026) and somatization (OR 7.068; CI 95% 2.291-21.812; P=0.001) are independently associated with FSD in premenopausal women. Our results indicate a higher prevalence of sexual dysfunction in MetS women. A number of risk factors for MetS are positively associated with FSD and higher triglycerides seem to be the strongest predictors of sexual dysfunction. Psychopathological dimensions such as somatization are strongly associated with sexual dysfunction. © 2014 International Society for Sexual Medicine.

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.

An investigation of the clinical use of the house-tree-person projective drawings in the psychological evaluation of child sexual abuse.

PubMed

Palmer, L; Farrar, A R; Valle, M; Ghahary, N; Panella, M; DeGraw, D

2000-05-01

Identification and evaluation of child sexual abuse is an integral task for clinicians. To aid these processes, it is necessary to have reliable and valid psychological measures. This is an investigation of the clinical validity and use of the House-Tree-Person (HTP) projective drawing, a widely used diagnostic tool, in the assessment of child sexual abuse. HTP drawings were collected archivally from a sample of sexually abused children (n = 47) and a nonabused comparison sample (n = 82). The two samples were grossly matched for gender, ethnicity, age, and socioeconomic status. The protocols were scored using a quantitative scoring system. The data were analyzed using a discriminant function analysis. Group membership could not be predicted based on a total HTP score.

[Construct validity of a Portuguese version of the Female Sexual Function Index].

PubMed

Pacagnella, Rodolfo de Carvalho; Martinez, Edson Zangiacomi; Vieira, Elisabeth Meloni

2009-11-01

This study aimed to evaluate the construct validity of a version of the Female Sexual Function Index (FSFI). The version was inserted into a multidimensional questionnaire and applied face-to-face to 235 sterilized women. Non-response rate was 1.7%. The sample proved to be highly homogeneous, with low income and education. Cronbach's alpha of 0.948 indicated high internal consistency. Factor analysis showed that the instrument was measuring four factors: desire/arousal, lubrication, orgasm/satisfaction, and pain. This may reflect characteristics of the instrument itself, female sexual response, or even the sample's cultural peculiarities, which can affect understanding of the questions or concepts with which the instrument deals. This study emphasizes the need for further research in the general population to determine the psychometric properties of the FSFI, such as its factor composition and definition of appropriate cut-off points for the Brazilian population.

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.

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.

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…

[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.

Sildenafil citrate improves self-esteem, confidence, and relationships in men with erectile dysfunction: Results from an international, multi-center, double-blind, placebo-controlled trial.

PubMed

Althof, Stanley E; O'leary, Michael P; Cappelleri, Joseph C; Hvidsten, Kyle; Stecher, Vera J; Glina, Sidney; King, Rosie; Siegel, Richard L

2006-05-01

Erectile dysfunction (ED) can significantly impact a man's relationships and well-being. We assessed changes in self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction in men with ED using the validated Self-Esteem And Relationship questionnaire (SEAR). This was a 12-week, double-blind, placebo-controlled, flexible-dose (25, 50, 100 mg, as needed) international study of sildenafil in men > or =18 years of age in Mexico, Brazil, Australia, and Japan. The primary study outcome was change in self-esteem from baseline to the end of treatment. Secondary study measures were changes in other SEAR components, International Index of Erectile Function (IIEF) domains, percentage of intercourse attempts that were successful, and the response to a global efficacy question at the end of treatment. Patients were well balanced for age and duration of ED (placebo = 149 and sildenafil = 151). Compared with placebo, sildenafil significantly improved self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction (P < 0.0001). The psychosocial measures of well-being assessed with the SEAR were positively correlated (range 0.60-0.86, P < 0.0001) with erectile function, the frequency of achieving erections that allowed satisfactory sexual intercourse, the percentage of successful sexual intercourse attempts, and global treatment efficacy. Significant improvements in self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction after treatment of ED with sildenafil were consistent among countries. These data suggest a substantial cross-cultural improvement in well-being after successful treatment of ED with sildenafil.

Therapist-aided exposure for women with lifelong vaginismus: a randomized waiting-list control trial of efficacy.

PubMed

Ter Kuile, Moniek M; Melles, Reinhilde; de Groot, H Ellen; Tuijnman-Raasveld, Charlotte C; van Lankveld, Jacques J D M

2013-12-01

Vaginismus is commonly described as a persistent difficulty in allowing vaginal entry of a penis or other "objects" (e.g., tampons, fingers, speculum). Lifelong vaginismus is diagnosed when a woman has never been able to have intercourse. The aim of this study was to investigate the efficacy of therapist-aided exposure for lifelong vaginismus. Seventy women and their partners were randomly allocated to exposure or a waiting-list control period of 3 months. The main outcome measure (intercourse ability) was assessed daily during 12 weeks. Secondary outcome measures were complaints about vaginismus, coital pain, coital fear, sexual distress, and sexual functioning. The exposure treatment consisted of a maximum of three 2-hr sessions during 1 week at a university hospital. Each participant performed vaginal penetration exercises herself, in the presence of her partner and a female therapist. Two follow-up sessions were scheduled over a 5-week period. Thirty-one out of 35 (89%; 95% CI [72%, 96%]) participants reported having had sexual intercourse at posttreatment compared with 4 out of 35 (11%; 95% CI [4%, 28%]) participants in the control condition. In most of the successfully treated women (90%), intercourse was possible within the first 2 weeks of treatment. Moreover, treatment resulted in clinical improvement regarding other symptoms related to vaginismus, coital fear, coital pain, and sexual distress. No treatment effects were found regarding other aspects of sexual functioning in women or their partners. This study provides evidence of the efficacy of therapist-aided exposure therapy for women with lifelong vaginismus.

A Streetcar Named "Derousal"? A Psychophysiological Examination of the Desire-Arousal Distinction in Sexually Functional and Dysfunctional Women.

PubMed

Sarin, Sabina; Amsel, Rhonda; Binik, Yitzchak M

2016-01-01

Research indicates that desire and arousal problems are highly interrelated in women. Therefore, hypoactive sexual desire disorder (HSDD) and female sexual arousal disorder (FSAD) were removed from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and a new diagnostic category, female sexual interest/arousal disorder (FSIAD), was created to include both arousal and desire difficulties. However, no research has tried to distinguish these problems based on psychosocial-physiological patterns to identify whether unique profiles exist. This study compared psychosocial-physiological patterns in a community sample of 84 women meeting DSM-IV (American Psychiatric Association, 2000 ) criteria for HSDD (n = 22), FSAD (n = 18), both disorders (FSAD/HSDD; n = 25), and healthy controls (n = 19). Women completed self-report measures and watched neutral and erotic films while genital arousal (GA) and subjective arousal (SA) were measured. Results indicated that GA increased equally for all groups during the erotic condition, whereas women with HSDD and FSAD/HSDD reported less SA than controls or FSAD women. Women in the clinical groups also showed lower concordance and greater impairment on psychosocial variables as compared to controls, with women with FSAD/HSDD showing lowest functioning. Results have important implications for the classification and treatment of these difficulties.

Effects of a Proprietary Freeze-Dried Water Extract of Eurycoma longifolia (Physta) and Polygonum minus on Sexual Performance and Well-Being in Men: A Randomized, Double-Blind, Placebo-Controlled Study

PubMed Central

Udani, Jay K.; George, Annie A.; Musthapa, Mufiza; Pakdaman, Michael N.; Abas, Azreena

2014-01-01

Background. Physta is a proprietary product containing a freeze-dried water extract of Eurycoma longifolia (tongkat ali), which is traditionally used as an energy enhancer and aphrodisiac. We aim to evaluate a 300 mg combination of Physta and Polygonum minus, an antioxidant, with regard to sexual performance and well-being in men. Methods. Men that aged 40–65 years were screened for this 12-week randomized, double-blind, placebo-controlled, parallel-group study. Outcome measures included validated questionnaires that aimed to evaluate erectile function, satisfaction with intervention, sexual intercourse performance, erectile hardness, mood, and overall quality of life. Results. 12 subjects in the active group and 14 in the placebo group completed the study. Significant improvements were noted in scores for the Sexual Intercourse Attempt diary, Erection Hardness Scale, Sexual Health Inventory of Men, and Aging Male Symptom scale (P < 0.05 for all). Three adverse events were reported in the active group and four in the placebo group, none of which were attributed to study product. Laboratory evaluations, including liver and kidney function testing, showed no clinically significant abnormality. Conclusion. Supplementation for twelve weeks with Polygonum minus and the proprietary Eurycoma longifolia extract, Physta, was well tolerated and more effective than placebo in enhancing sexual performance in healthy volunteers. PMID:24550993

Effects of a Proprietary Freeze-Dried Water Extract of Eurycoma longifolia (Physta) and Polygonum minus on Sexual Performance and Well-Being in Men: A Randomized, Double-Blind, Placebo-Controlled Study.

PubMed

Udani, Jay K; George, Annie A; Musthapa, Mufiza; Pakdaman, Michael N; Abas, Azreena

2014-01-01

Background. Physta is a proprietary product containing a freeze-dried water extract of Eurycoma longifolia (tongkat ali), which is traditionally used as an energy enhancer and aphrodisiac. We aim to evaluate a 300 mg combination of Physta and Polygonum minus, an antioxidant, with regard to sexual performance and well-being in men. Methods. Men that aged 40-65 years were screened for this 12-week randomized, double-blind, placebo-controlled, parallel-group study. Outcome measures included validated questionnaires that aimed to evaluate erectile function, satisfaction with intervention, sexual intercourse performance, erectile hardness, mood, and overall quality of life. Results. 12 subjects in the active group and 14 in the placebo group completed the study. Significant improvements were noted in scores for the Sexual Intercourse Attempt diary, Erection Hardness Scale, Sexual Health Inventory of Men, and Aging Male Symptom scale (P < 0.05 for all). Three adverse events were reported in the active group and four in the placebo group, none of which were attributed to study product. Laboratory evaluations, including liver and kidney function testing, showed no clinically significant abnormality. Conclusion. Supplementation for twelve weeks with Polygonum minus and the proprietary Eurycoma longifolia extract, Physta, was well tolerated and more effective than placebo in enhancing sexual performance in healthy volunteers.

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.

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.

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.

Emotional and sexual jealousy as a function of sex and sexual orientation in a Brazilian sample.

PubMed

de Souza, Altay Alves Lino; Verderane, Michele Pereira; Taira, Juliana Tieme; Otta, Emma

2006-04-01

The goal of the present study was to compare the relative distress of homosexual and heterosexual Brazilian men and women on scenarios in which they imagined their partners sexually or emotionally involved with another person, using a forced-choice paradigm and continuous measures. Participants were 68 heterosexual men, 72 heterosexual women, 42 homosexual men, and 35 homosexual women. On the forced-choice questions heterosexual men (39 on one question and 37 on the other) were more upset than their female counterparts (21 on one question and 15 on the other) by scenarios of sexual infidelity than those of emotional infidelity. On questions using continuous measures no significant difference was found between pleasurable sex and attachment scenarios for heterosexual women or heterosexual men. On the highly upsetting scenarios heterosexual men discriminated between flirting and both pleasurable sex and attachment scenarios, being less disturbed by the former. In contrast, heterosexual women were equally distressed by the three scenarios. Scores for the homosexual men and homosexual women fell in between those of the heterosexual men and heterosexual women and did not show a clear cut preference for the sexual infidelity or the emotional alternative on the forced-choice paradigm. However, on the continuous measures of jealousy homosexuals resembled heterosexuals of the opposite sex. There was no evidence that jealousy would be less intense among homosexuals although reproductive outcomes were not at risk.

Changes in the magnitude of the eyeblink startle response during habituation of sexual arousal.

PubMed

Koukounas, E; Over, R

2000-06-01

Modulation of the startle response was used to examine emotional processing of sexual stimulation across trials within a session. Eyeblink startle was elicited by a probe (burst of intense white noise) presented intermittently while men were viewing an erotic film segment. Repeated display of the film segment resulted in a progressive decrease in sexual arousal. Habituation of sexual arousal was accompanied by a reduction over trials in the extent the men felt absorbed when viewing the erotic stimulus and by an increase over trials in the magnitude of the eyeblink startle response. Replacing the familiar stimulus by a novel erotic stimulus increased in sexual arousal and absorption and reduced startle (novelty effect), while dishabituation was evident for all three response measures when the familiar stimulus was reintroduced. This pattern of results indicates that with repeated presentation an erotic stimulus is experienced not only as less sexually arousing but also as less appetitive and absorbing. The question of whether habituation of sexual arousal is mediated by changes in attentional and affective processing over trials is discussed, as are clinical contexts in which eyeblink startle can be used in studying aspects of sexual functioning.

Clinical correlates of verbal aggression, physical aggression and inappropriate sexual behaviour after brain injury.

PubMed

James, Andrew I W; Young, Andrew W

2013-01-01

To explore the relationships between verbal aggression, physical aggression and inappropriate sexual behaviour following acquired brain injury. Multivariate statistical modelling of observed verbal aggression, physical aggression and inappropriate sexual behaviour utilizing demographic, pre-morbid, injury-related and neurocognitive predictors. Clinical records of 152 participants with acquired brain injury were reviewed, providing an important data set as disordered behaviours had been recorded at the time of occurrence with the Brain Injury Rehabilitation Trust (BIRT) Aggression Rating Scale and complementary measures of inappropriate sexual behaviour. Three behavioural components (verbal aggression, physical aggression and inappropriate sexual behaviour) were identified and subjected to separate logistical regression modelling in a sub-set of 77 participants. Successful modelling was achieved for both verbal and physical aggression (correctly classifying 74% and 65% of participants, respectively), with use of psychotropic medication and poorer verbal function increasing the odds of aggression occurring. Pre-morbid history of aggression predicted verbal but not physical aggression. No variables predicted inappropriate sexual behaviour. Verbal aggression, physical aggression and inappropriate sexual behaviour following acquired brain injury appear to reflect separate clinical phenomena rather than general behavioural dysregulation. Clinical markers that indicate an increased risk of post-injury aggression were not related to inappropriate sexual behaviour.

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.