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

PubMed

Dekker, J; Dronkers, J; Staffeleu, J

1985-01-01

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

Sexual behaviour and risk of sexually transmitted infections in young female healthcare students in Spain

PubMed Central

Navarro-Cremades, Felipe; Marhuenda-Amorós, Dolores; Tomás-Rodríguez, María Isabel; Antón-Ruiz, Fina; Belda-Ibañez, Josefina; Montejo, Ángel Luis; Gil-Guillén, Vicente Francisco

2016-01-01

Background. Several authors have examined the risk for sexually transmitted infections (STI), but no study has yet analyzed it solely in relation with sexual behaviour in women. We analyzed the association of sexual behaviour with STI risk in female university students of healthcare sciences. Methods. We designed a cross-sectional study assessing over three months vaginal intercourse with a man. The study involved 175 female university students, without a stable partner, studying healthcare sciences in Spain. Main outcome variable: STI risk (not always using male condoms). Secondary variables: sexual behaviour, method of orgasm, desire to increase the frequency of sexual relations, desire to have more variety in sexual relations, frequency of sexual intercourse with the partner, and age. The information was collected with an original questionnaire. A logistic regression model was used to estimate the adjusted odds ratios (ORs) in order to analyze the association between the STI risk and the study variables. Results. Of the 175 women, 52 were positive for STI risk (29.7%, 95% CI [22.9–36.5%]). Factors significantly associated with STI risk (p < 0.05) included: orgasm (not having orgasms →OR = 7.01, 95% CI [1.49–33.00]; several methods →OR = 0.77, 95% CI [0.31–1.90]; one single method →OR = 1; p = 0.008) and desiring an increased frequency of sexual activities (OR = 0.27, 95% CI [0.13–0.59], p < 0.001). Conclusions. Women’s desire for sexual activities and their sexual function were significant predictors of their risk for STI. Information about sexual function is an intrinsic aspect of sexual behaviour and should be taken into consideration when seeking approaches to reduce risks for STI. PMID:26966654

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

Comparison effect of physiotherapy with surgery on sexual function in patients with pelvic floor disorder: A randomized clinical trial

PubMed Central

Eftekhar, Tahereh; Sohrabi, Maryam; Haghollahi, Fedyeh; Shariat, Mamak; Miri, Elahe

2014-01-01

Background: Female sexual dysfunction is a common problem among general population, especially in urogynecological patient, and can lead to a decrease in quality of life and affect martial relationship. Objective: This study was compared the effect of surgical methods versus physiotherapy on sexual function in pelvic floor disorder. Materials and Methods: This randomized controlled trial was performed in Urogynecology clinic since August 2007 to December 2009 on 90 patients aged from 25-55 years with previous delivery, positive history of sexual dysfunction with stage <3 of pelvic organ prolapsed and divided in two groups. Group A (n=45) received standard rectocele repair and prineorrhaphy, group B (n=45) received physiotherapy for eight weeks twice a week (electrical stimulation, Kegel exercises). The female sexual function index (FSFI) used to evaluate the sexual function in cases before and after intervention. Frequency of variable scores (libido, orgasm, dysparunia) included without disorder, frequently good, sometimes good, very much and extreme were compared between two groups. Results: Libido and arousal were improved in both groups (p=0.007, p=0.001 respectively). Orgasm and dyspareunia were improved in group B (p=0.001). Dysparunia was more painful in group A. There was significant difference between two groups (improvement of orgasm and dysparunia in group B) (p=0.001). Conclusion: It seems that physiotherapy is an appropriate method for treatment of sexual disorder in pelvic floor disorder. Registration ID in IRCT: IRCT2013031112790N1. PMID:24799856

Circulating Endocannabinoid Concentrations and Sexual Arousal in Women

PubMed Central

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

2013-01-01

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

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

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

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

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

Comparing the effects of treatment with sildenafil and cognitive-behavioral therapy on treatment of sexual dysfunction in women: a randomized controlled clinical trial

PubMed Central

Omidi, Abdollah; Ahmadvand, Afshin; Najarzadegan, Mohammad Reza; Mehrzad, Fateme

2016-01-01

Background Sexual dysfunction in women is prevalent and common in women after menopause. Many attempts to treat patients with sexual dysfunction by cognitive-behavioral therapy (CBT) methods. But to the best of our knowledge, there has been no study that compared these two methods. Objective The aim of this study was to assess and compare the effects of sildenafil and cognitive-behavioral therapy on treatment of sexual dysfunction in women. Methods In this randomized, controlled, clinical trial, 86 women with arousal and orgasm dysfunction were surveyed. The patients were divided into two groups, i.e., sildenafil and CBT groups. The patients in the sildenafil group were treated by 50 mg of oral sildenafil one hour before intercourse, and the other group had weekly sessions of CBT for eight weeks. Sexual dysfunctions were evaluated by the Female Sexual Function Index (FSFI), a sexual satisfaction questionnaire, and the Enrich marital satisfaction scale. Results The mean age of the participants was 33.14 ± 7.34 years. The mean scores for female sexual function index, sexual satisfaction, and the Enrich marital satisfaction scale were increased in both groups during treatment (p < 0.001). It was found that cognitive-behavioral therapy compared to treatment with sildenafil increased all subscales, except arousal, orgasm, and lubrication. Conclusion Cognitive-behavioral therapy is more effective than treatment with sildenafil for improving female sexual function. Clinical trial registration The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT2014070318338N1. Funding The authors received no financial support for the research, authorship, and/or publication of this article. PMID:27382439

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).

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

The Evaluation of Relationship between Sexual Self-concept and Sexual Dysfunction in Individuals Undergoing Methadone Maintenance Treatment.

PubMed

Rajabizadeh, Ghodratolah; Yazdanpanah, Fatemeh; Ramezani, Mohammad Arash

2017-04-01

The present study was conducted with the aim of designing a causal model for the evaluation of sexual dysfunctions based on the variables of methadone dosage and sexual self-concept among individuals undergoing methadone maintenance treatment (MMT). The study population of the present study consisted of married men of 20 to 45 years of age with sexual ýrelations and undergoing MMT for a minimum of 8 weeks referring to all MMT clinics of Kerman, Iran, in ýý2015-2016. ýThe subjects were selected through multi-stage cluster sampling (n = 250). Data were collected using the General Health Questionnaire (GHQ-28), Multi-Dimensional Sexual Self-concept Questionnaire (MSSQ), and Internal Index for Erectile Function (IIEF). Data were analyzed using path analysis method and Pearson correlation coefficient. The suggested model was evaluated using structural equation model (SEM), and indirect relationships were assessed using Bootstrap method. The suggested model showed acceptable fitness with the data, and all routes, except methadone use route, to sexual function were significant. The result of the multiple ýindirect route showed that sexual function had a significant relationship with methadone use through ýsexual self-concept. In total, 60% of variance in sexual dysfunction was explained using the variables of the suggested model. Further studies are suggested to be conducted regarding psychological factors effective on the sexual dysfunctions among individuals undergoing MMT, such as sexual self-concept. Moreover, more detailed evaluation of each subscale of positive and negative sexual self-concept is recommended to assess the psychological causes of sexual dysfunctions in these individuals and design psychological, behavioral, and cognitive-behavioral treatment interventions for them.

A cross-sectional survey of quality of life in colostomates: a report from Iran

PubMed Central

2012-01-01

Background Considering the complications that colostomies may cause, patient self-assessments of their social, emotional, physical, sexual and functional conditions may help their surgeons to evaluate the impact of their interventions or use supplementary methods to maintain patient functional status or decrease its loss to the minimum level. The aim of this study was to evaluate the Quality of Life in Iranian patients with colostomies and to compare the age and gender differences among them. Method This cross-sectional study was conducted from 2009 to 2010 to evaluate the quality of life of 96 patients who had undergone surgery for rectal cancer and had permanent colostomies. The European Organization for Research and Treatment of Cancers Quality of Life Questionnaire (EORTC QLQ)-C30 and the EORTC QLQ-CR38 were used to assess patient Quality of Life. Results The mean scores for the functional subscales were as follows: Physical Function, 70.9 (±2.2); Role Function, 68.4 (±2.6); Emotional Function, 56.9 (±2.7); Cognitive Function, 68.7 (± 2.6); and Social Function, 64.2 (±3.3). The EORTC questionnaires showed significant differences between males and females. Males had better body image scores. Sexual Function and Sexual Enjoyment were impaired in both males and females, but males had significantly higher scores and better roles in Physical and Sexual Functions. More sexual enjoyment problems in older ages were observed in both males and females. Conclusion Having a colostomy was associated with a high level of emotional and sexual function impairment. The differing challenges between males and females should encourage us to design sex-specific interventions that improve the quality of life in this group of patients. PMID:23170951

Comparison effect of physiotherapy with surgery on sexual function in patients with pelvic floor disorder: A randomized clinical trial.

PubMed

Eftekhar, Tahereh; Sohrabi, Maryam; Haghollahi, Fedyeh; Shariat, Mamak; Miri, Elahe

2014-01-01

Female sexual dysfunction is a common problem among general population, especially in urogynecological patient, and can lead to a decrease in quality of life and affect martial relationship. This study was compared the effect of surgical methods versus physiotherapy on sexual function in pelvic floor disorder. This randomized controlled trial was performed in Urogynecology clinic since August 2007 to December 2009 on 90 patients aged from 25-55 years with previous delivery, positive history of sexual dysfunction with stage <3 of pelvic organ prolapsed and divided in two groups. Group A (n=45) received standard rectocele repair and prineorrhaphy, group B (n=45) received physiotherapy for eight weeks twice a week (electrical stimulation, Kegel exercises). The female sexual function index (FSFI) used to evaluate the sexual function in cases before and after intervention. Frequency of variable scores (libido, orgasm, dysparunia) included without disorder, frequently good, sometimes good, very much and extreme were compared between two groups. Libido and arousal were improved in both groups (p=0.007, p=0.001 respectively). Orgasm and dyspareunia were improved in group B (p=0.001). Dysparunia was more painful in group A. There was significant difference between two groups (improvement of orgasm and dysparunia in group B) (p=0.001). It seems that physiotherapy is an appropriate method for treatment of sexual disorder in pelvic floor disorder. IRCT2013031112790N1.

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

Can you ask? We just did! Assessing sexual function and concerns in patients presenting for initial gynecologic oncology consultation

PubMed Central

Kennedy, Vanessa; Abramsohn, Emily; Makelarski, Jennifer; Barber, Rachel; Wroblewski, Kristen; Tenney, Meaghan; Lee, Nita Karnik; Yamada, S. Diane; Lindau, Stacy Tessler

2015-01-01

Objectives To describe patterns of response to, and assess sexual function and activity elicited by, a self-administered assessment incorporated into a new patient intake form for gynecologic oncology consultation. Methods A cross-sectional study of patients presenting to a single urban academic medical center between January 2010 and September 2012. New patients completed a self-administered intake form, including six brief sexual activity and function items. These items, along with abstracted medical record data, were descriptively analyzed. Logistic regression was used to assess the association between sexual activity and function and disease status, adjusting for age. Results Median age was 50 years (range 18–91, N = 499); more than half had a final diagnosis of cancer. Most patients completed all sex-related items on the intake form; 98% answered at least one. Among patients who were sexually active in the prior 12 months (57% with cancer, 64% with benign disease), 52% indicated on the intake form having, during that period, a sexual problem lasting several months or more. Of these, 15% had physician documentation of the sexual problem. Eighteen women were referred for care. Providers reported no patient complaints about the inclusion of sexual items on the intake form. Conclusions Nearly all new patients presenting for gynecologic oncology consultation answered self-administered items to assess sexual activity and function. Further study is needed to determine the role of pretreatment identification of sexual function concerns in improving sexual outcomes associated with cancer diagnosis and treatment. PMID:25582823

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

Who’s Asking the Important Questions? Sexual Topics Discussed among Young Pregnant Couples

PubMed Central

Albritton, Tashuna; Day, Kyla M.; Divney, Anna; Gordon, Derrick; Magriples, Urania; Kershaw, Trace S.

2013-01-01

Purpose The aim was to examine gender differences in sexual risk communication among young couples and factors influencing communication. Methods Sample consisted of 296 young pregnant couples. We assessed individual, interpersonal, and community factors on sexual risk communication. The Actor-Partner Independence Model was used to assess actor and partner effects on sexual risk communication. Results For actor effects, being female, older, not being Hispanic, and higher condom use self-efficacy was associated with sexual risk communication. The significant partner effect was avoidant romantic attachment. Gender interactions were significant for high risk behaviors and family functioning. High risk behaviors and family functioning were associated with sexual risk communication for females but not for males. Conclusion The study emphasizes the need to promote sexual risk communication among young high risk couples, particularly for males. Family support could serve as a catalyst for sexual risk communication and other sexual protective behaviors among young couples. PMID:24043405

Evaluation of sexuality in a Paraguayan mid-aged female urban population using the six-item Female Sexual Function Index.

PubMed

Sánchez, S C; Chedraui, P; Pérez-López, F R; Ortiz-Benegas, M E; Palacios-De Franco, Y

2016-06-01

Background There are scant data related to sexuality assessed among mid-aged women from Paraguay. Objective To assess sexual function in a sample of mid-aged Paraguayan women. Methods This was a cross-sectional study in which 265 urban-living women from Asunción (Paraguay) aged 40-65 years were surveyed with the six-item version of the Female Sexual Function Index (FSFI-6) and a questionnaire containing personal and partner data. Results The median age of the sample was 48 years, 48.2% were postmenopausal (median/interquartile range age at menopause 46/13 years), 11.3% used hormone therapy, 37.0% used psychotropic drugs, 44.5% had hypertension, 7.2% diabetes, 46.1% abdominal obesity and 89.4% had a partner (n = 237). Overall, 84.1% (223/265) of surveyed women were sexually active, presenting a median total FSFI-6 score of 23.0, and 25.6% obtained a total score of 19 or less, suggestive of sexual dysfunction (lower sexual function). Upon bivariate analysis, several factors were associated with lower total FSFI-6 scores; however, multiple linear regression analysis found that lower total FSFI-6 scores (worse sexual function) were significantly correlated to the postmenopausal status and having an older partner, whereas coital frequency was positively correlated to higher scores (better sexual function). Conclusion In this pilot sample of urban-living, mid-aged Paraguayan women, as determined with the FSFI-6, lower sexual function was related to menopausal status, coital frequency and partner age. There is a need for more research in this regard in this population.

Effects of Sex Education and Kegel Exercises on the Sexual Function of Postmenopausal Women: A Randomized Clinical Trial.

PubMed

Nazarpour, Soheila; Simbar, Masoumeh; Ramezani Tehrani, Fahimeh; Alavi Majd, Hamid

2017-07-01

The sex lives of women are strongly affected by menopause. Non-pharmacologic approaches to improving the sexual function of postmenopausal women might prove effective. To compare two methods of intervention (formal sex education and Kegel exercises) with routine postmenopausal care services in a randomized clinical trial. A randomized clinical trial was conducted of 145 postmenopausal women residing in Chalus and Noshahr, Iran. Their sexual function statuses were assessed using the Female Sexual Function Index (FSFI) questionnaire. After obtaining written informed consents, they were randomly assigned to one of three groups: (i) formal sex education, (ii) Kegel exercises, or (iii) routine postmenopausal care. After 12 weeks, all participants completed the FSFI again. Analysis of covariance was used to compare the participants' sexual function before and after the interventions, and multiple linear regression analysis was used to determine the predictive factors for variation in FSFI scores in the postintervention stage. Sexual function was assessed using the FSFI. There were no statistically significant differences in demographic and socioeconomic characteristics and FSFI total scores among the three study groups at the outset of the study. After 12 weeks, the scores of arousal in the formal sex education and Kegel groups were significantly higher compared with the control group (3.38 and 3.15 vs 2.77, respectively). The scores of orgasm and satisfaction in the Kegel group were significantly higher compared with the control group (4.43 and 4.88 vs 3.95 and 4.39, respectively). Formal sex education and Kegel exercises were used as two non-pharmacologic approaches to improve the sexual function of women after menopause. The main strength of this study was its design: a well-organized randomized trial using precise eligibility criteria with a small sample loss. The second strength was the methods of intervention used, namely non-pharmacologic approaches that are simple, easily accessible, and fairly inexpensive. The main limitation of the study was our inability to objectively assess the participants' commitment to exercise and the sexual function of their partners. Sex education programs and Kegel exercises could cause improvements in some domains of sexual function-specifically arousal, orgasm, and satisfaction-in postmenopausal women. Nazarpour S, Simbar M, Tehrani FR, Majd HA. Effects of Sex Education and Kegel Exercises on the Sexual Function of Postmenopausal Women: A Randomized Clinical Trial. J Sex Med 2017;14:959-967. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Sexual function after external-beam radiotherapy for prostate cancer: what do we know?

PubMed

Incrocci, Luca

2006-02-01

Quality of life in general and sexual functioning in particular have become very important in cancer patients. Due to modern surgical techniques, improved quality of drugs for chemotherapy and very modern radiation techniques, more patients can be successfully treated without largely compromising sexual functioning. One can assume that because of the life-threatening nature of cancer, sexual activity is not important to patients and their partners, but this is not true. Prostate cancer has become the most common non-skin malignant neoplasm in older men in Western countries. In this paper, we discuss the various methods used to evaluate erectile and sexual dysfunction and the definition of potency. Data on the etiology of erectile dysfunction after external-beam radiotherapy for prostate cancer is reviewed, and the literature is been summarized. Patients should be offered sexual counseling and informed about the availability of effective treatments for erectile dysfunction, such as sildenafil, intracavernosal injection, and vacuum devices. Cancer affects quality of life and sexual function. The challenge for oncologists is to address this with compassion.

Sexual (dys)function after radiotherapy for prostate cancer: a review.

PubMed

Incrocci, Luca; Slob, A Koos; Levendag, Peter C

2002-03-01

Prostate cancer has become the most common nonskin malignant neoplasm in older men in Western countries. As treatment efficacy has improved, issues related to posttherapy quality of life and sexual functioning have become more important. We discuss the various methods used to evaluate erectile and sexual dysfunction and the definition of potency. The etiologies of erectile dysfunction after external beam radiotherapy and brachytherapy for prostate cancer are also reviewed. The literature is summarized, and comparative studies of radiation and surgery are surveyed briefly. Rates of erectile dysfunction vary from 6 to 84% after external beam radiotherapy and from 0 to 51% after brachytherapy. In most of the studies, the analysis is retrospective, the definition of erectile dysfunction is not clear, only one question about sexual functioning is asked, and nonvalidated instruments are used. The etiology of erectile dysfunction after radiation for prostate cancer is not completely understood. Because erectile function is only one component of sexual function, it is necessary to assess sexual desire, satisfaction, frequency of intercourse, and other such factors when evaluating the effects of therapy. Patients should be offered sexual counseling and informed about the availability of effective treatments for erectile dysfunction, such as sildenafil, intracavernosal injection, and vacuum devices.

Body Image and Sexual Function in Women after Treatment for Anal and Rectal Cancer

PubMed Central

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

2016-01-01

Objective Treatment for anal and rectal cancer (ARCa) often results in side effects that directly impact sexual functioning; however, ARCa survivors are an understudied group and factors contributing to the sexual sequelae are not well understood. Body image problems are distressing and may further exacerbate sexual difficulties, particularly for women. This preliminary study sought to (1) describe body image problems, including sociodemographic and disease/treatment correlates; and (2) examine relations between body image and sexual function. Methods For the baseline assessment of a larger study, 70 women completed the EORTC QLQ-C30 and CR38, including the Body Image subscale, and Female Sexual Function Index (FSFI). Pearson’s correlation and multiple regression evaluated correlates of body image. Among sexually active women (n=41), hierarchical regression examined relations between body image and sexual function domains. Results Women were an average 55 years old (SD=11.6), Non-Hispanic White (79%), married (57%), and employed (47%). The majority (86%) reported at least one body image problem. Younger age, lower global health status, and greater severity of symptoms related to poorer body image (p’s<.05). Poor body image was inversely related to all aspects of sexual function (β range .50 to .70, p’s<.05), except pain. The strongest association was with FSFI Sexual/Relationship Satisfaction. Conclusion These preliminary findings suggest the importance of assessing body image as a potentially modifiable target to address sexual difficulties in this understudied group. Further longitudinal research is needed to inform the development and implementation of effective interventions to improve the sexual health and well-being of female ARCa survivors. PMID:25974874

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.

Sexuality: Desire, activity and intimacy in the elderly

PubMed Central

Kalra, Gurvinder; Subramanyam, Alka; Pinto, Charles

2011-01-01

Background: Sexual function and activity in old age have been inadequately studied world over. It is important to know that aging processes are not confined to persons beyond the age of 60 years; many changes in elderly have their antecedents in the middle age. Aims: This study sought to determine the patterns of sexual activity and function in individuals over 50 years of age. It also sought to discuss barriers such as chronic illness that may interfere with sexual function. Materials and Methods: We conducted a study of subjects above the age of 50 years in various outpatient departments (OPDs) of a teaching municipal hospital in Mumbai, by interviewing 60 individuals who attended the OPDs, after taking their informed consent. Socio-demographic and other information on their sexual function and activities were obtained. Data was analyzed using statistical package for social sciences v15. Results: 72% individuals below 60 were sexually active, while only 57% above 60 were active. Others had become completely abstinent at some time in their lives. Statistical analysis revealed significant gender, health and educational status based differences in the sample. Conclusion: Our study showed significant presence of sexual desire, activity and function even after the age of 50 years; a decline by the age of 60 and above was a finding that reflected more in women. Chronic illness did affect sexual function and desire. PMID:22303037

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

Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study

PubMed Central

Dongre, Swati

2015-01-01

Background. Many women experience sexual dysfunction where there are orgasm disorders and sexual difficulties. Ashwagandha (Withania somnifera) is a herb known to improve the body's physical and psychological condition. Objective. The purpose of the study was to determine the efficacy and safety of a high-concentration ashwagandha root extract (HCARE) supplementation for improving sexual function in healthy females. Methods. In this pilot study, 50 study subjects were randomized to either (i) HCARE-treated group or (ii) placebo- (starch-) treated group. The subjects consumed either HCARE or placebo capsules of 300mg twice daily for 8 weeks. Sexual function was assessed using two psychometric scales, the Female Sexual Function Index (FSFI) Questionnaire and the Female Sexual Distress Scale (FSDS), and by the number of total and successful sexual encounters. Results. The analysis indicates that treatment with HCARE leads to significantly higher improvement, relative to placebo, in the FSFI Total score (p < 0.001), FSFI domain score for “arousal” (p < 0.001), “lubrication” (p < 0.001), “orgasm” (p = 0.004), and “satisfaction” (p < 0.001), and also FSDS score (p < 0.001) and the number of successful sexual encounters (p < 0.001) at the end of the treatment. Conclusions. This study demonstrated that oral administration of HCARE may improve sexual function in healthy women. The present study is registered in the Clinical Trial Registry, Government of India, with a number CTRI/2015/07/006045. PMID:26504795

Sexual well being in parkinsonian patients after deep brain stimulation of the subthalamic nucleus

PubMed Central

Castelli, L; Perozzo, P; Genesia, M; Torre, E; Pesare, M; Cinquepalmi, A; Lanotte, M; Bergamasco, B; Lopiano, L

2004-01-01

Objectives: To evaluate changes in sexual well being in a group of patients with Parkinson's disease following deep brain stimulation (DBS) of the subthalamic nucleus (STN). Methods: 31 consecutive patients with Parkinson's disease (21 men and 10 women), bilaterally implanted for DBS of STN, were evaluated one month before and 9–12 months after surgery. Sexual functioning was assessed using a reduced form of the Gollombok Rust inventory of sexual satisfaction (GRISS). Depression (Beck depression inventory) and anxiety (STAI-X1/X2) were also evaluated. Relations between sexual functioning and modifications in the severity of disease (Hoehn and Yahr stage), reduction in levodopa equivalent daily dosage (LEDD), age, and duration of disease were analysed. Results: While no modifications were found in female patients, male patients reported slightly but significantly more satisfaction with their sexual life after DBS of STN. When only male patients under 60 years old were considered, a greater improvement in sexual functioning was found, though still small. Modifications in depressive symptoms and anxiety, as well as duration of the disease, reduction in LEDD, and improvement in the severity of disease, showed no relation with changes in sexual functioning after DBS of STN. Conclusions: DBS of STN appears to affect sexual functioning in a small but positive way. Male patients with Parkinson's disease, especially when under 60, appeared more satisfied with their sexual well being over a short term follow up period. PMID:15314111

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

Residential Treatment for Sexually Abusive Youth: An Assessment of Treatment Outcomes

ERIC Educational Resources Information Center

Jones, Christopher D.; Chancey, Roy; Lowe, Laura A.; Risler, Edwin A.

2010-01-01

Objective: This research study assesses the effectiveness of participation in a multimodal/holistic residential treatment program on changing deviant sexual interests and functional impairment among sexually abusive youth. Method: A one-group pretest posttest design was utilized to examine pretest (intake) and posttest (discharge) scores for 58…

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

PubMed

Krassioukov, Andrei; Elliott, Stacy

2017-01-01

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

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

PubMed Central

Elliott, Stacy

2017-01-01

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

Sexual dysfunction in married women with Systemic Sclerosis

PubMed Central

Frikha, Faten; Masmoudi, Jawaher; Saidi, Noura; Bahloul, Zouhir

2014-01-01

Introduction Sexuality is an often neglected area in patients with rheumatic disease. The aim of this study is to assess sexual functioning and quality of life in a group of married women with Systemic Sclerosis (SSc). Methods This is a horizontal study for descriptive and analytical purposes. Married women with SSc were interviewed about their sexual functioning and their quality of life. Results A total of ten patients who met the criteria have accepted to participate to the study. Their mean age was 52, 4± 8,2 years. Eight women thought that the disease had affected their sexual activity. All patients reported a decrease in the frequency of intercourse since the onset of their disease. Eight of the sample reported a diminished desire for a sexual relationship. The reasons were fatigue, altered body image and pain. The assessment of sexual functioning using the Female sexual function index (FSFI) showed a mean FSFI score at 14,2±7,8 with nine women scoring in the range associated with sexual dysfunction (SD) (<26). All the subscales were affected. Our patients reported a mean total score on WHOQOL-brief (World Health Quality of Life-Brief Version) of 60 out of 120 indicating a moderate altered quality of life. Depression has been identified as determinants of impaired sexual function. Conclusion The prevalence of SD in women with SSc is high when a specific questionnaire is used to assess it. These results indicate that in daily practice, inquiring about sexuality and screening for depressive symptoms is indicated for every patient with SSc. PMID:25452828

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

PubMed Central

Jamali, Safieh; Rahmanian, Afifeh; Javadpour, Shohreh

2016-01-01

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

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.

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

Pelvic floor muscle strength of women consulting at the gynecology outpatient clinics and its correlation with sexual dysfunction: A cross-sectional study.

PubMed

Ozdemir, Filiz Ciledag; Pehlivan, Erkan; Melekoglu, Rauf

2017-01-01

To investigate the pelvic floor muscle strength of the women andevaluateits possible correlation with sexual dysfunction. In this cross-sectional type study, stratified clusters were used for the sampling method. Index of Female Sexual Function (IFSF) worksheetwere used for questions on sexual function. The pelvic floor muscle strength of subjects was assessed byperineometer. The chi-squared test, logistic regression and Pearson's correlation analysis were used for the statistical analysis. Four hundred thirty primiparous women, mean age 38.5 participated in this study. The average pelvic floor muscle strength value was found 31.4±9.6 cm H 2 O and the average Index of Female Sexual Function (IFSF) score was found 26.5±6.9. Parity (odds ratio OR=5.546) and age 40 or higher (OR=3.484) were found correlated with pelvic floor muscle weakness (p<0.05). The factors directly correlated with sexual dysfunction were found being overweight (OR=2.105) and age 40 or higher (OR=2.451) (p<0.05). Pearson's correlation analysis showed that there was a statistically significantlinear correlation between the muscular strength of the pelvic floor and sexual function (p=0.001). The results suggested subjects with decreased pelvic floor muscle strength value had higher frequency of sexual dysfunction.

A strong pelvic floor is associated with higher rates of sexual activity in women with pelvic floor disorders

PubMed Central

Kanter, Gregg; Rogers, Rebecca G; Pauls, Rachel N; Kammerer-Doak, Dorothy; Thakar, Ranee

2015-01-01

Introduction and Hypothesis We evaluated the associations between pelvic floor muscle strength and tone with sexual activity and sexual function in women with pelvic floor disorders. Methods This was a secondary analysis of a multicenter study of women with pelvic floor disorders from the US and UK performed to validate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR). Participants were surveyed about whether they were sexually active and completed the PISQ-IR and Female Sexual Function Index (FSFI) questionnaires to assess sexual function. Physical exams included assessment of pelvic floor strength by the Oxford Grading Scale, and assessment of pelvic floor tone per ICS guidelines. Results The cohort of 585 women was middle aged (mean age 54.9 +/−12.1) with 395 (67.5%) reporting sexual activity. Women with a strong pelvic floor (n=275) were more likely to report sexual activity than women with weak strength (n=280) (75.3 vs. 61.8%, p<0.001), but normal or hypoactive pelvic floor tone was not associated with sexual activity (68.8 vs. 60.2%, normal vs. hypoactive, p=0.08). After multivariable analysis, a strong pelvic floor remained predictive of sexual activity (OR 1.89, CI 1.18–3.03, p<0.01). Among sexually active women (n=370), a strong pelvic floor was associated with higher scores on the PISQ-IR domain of condition impact (Parameter Estimate 0.20+/−0.09, P=0.04), and FSFI orgasm domain (PE 0.51+/−0.17, P=0.004). Conclusion A strong pelvic floor is associated with higher rates of sexual activity as well as higher sexual function scores on the condition impact domain of the PISQ-IR and orgasm domain of the FSFI. PMID:25994625

Evaluation of a Mobile Phone App for Providing Adolescents With Sexual and Reproductive Health Information, New York City, 2013-2016.

PubMed

Steinberg, Allyna; Griffin-Tomas, Marybec; Abu-Odeh, Desiree; Whitten, Alzen

The New York City (NYC) Department of Health and Mental Hygiene released the Teens in NYC mobile phone application (app) in 2013 as part of a program to promote sexual and reproductive health among adolescents aged 12-19 in NYC. The app featured a locator that allowed users to search for health service providers by sexual health services, contraceptive methods, and geographic locations. We analyzed data on searches from the Where to Go section of the app to understand the patterns of use of the app's search functionality. From January 7, 2013, through March 20, 2016, the app was downloaded more than 20 000 times, and more than 25 000 unique searches were conducted within the app. Results suggest that the app helped adolescents discover and access a wide range of sexual health services, including less commonly used contraceptives. Those designing similar apps should consider incorporating search functionality by sexual health service (including abortion), contraceptive method, and user location.

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.

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

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

The Sexual Acceptability of Contraception: Reviewing the Literature and Building a New Concept

PubMed Central

Higgins, Jenny A.; Smith, Nicole K.

2016-01-01

How contraceptives affect women’s sexual well-being is critically understudied. Fortunately, a growing literature focuses on sexual aspects of contraception, especially hormonal contraception’s associations with libido. However, a more holistic approach to contraceptive sexual acceptability is needed to capture the full range of women’s sexual experiences. We conducted a narrative literature review of this topic, working with an original sample of 3,001 citations published from 2005 to 2015. In Part 1, we draw from a subset of this literature (264 citations) to build a new conceptual model of sexual acceptability. Aspects include macro factors (gender, social inequality, culture, and structure), relationship factors (dyadic influences and partner preferences), and individual factors (sexual functioning, sexual preferences, such as dis/inhibition, spontaneity, pleasure, the sexual aspects of side effects, such as bleeding, mood changes, sexual identity and sexual minority status, and pregnancy intentions). In Part 2, we review the empirical literature on the sexual acceptability of individual methods (103 citations), applying the model as much as possible. Results suggest contraceptives can affect women’s sexuality in a wide variety of positive and negative ways that extend beyond sexual functioning alone. More attention to sexual acceptability could promote both women’s sexual well-being and more widespread, user-friendly contraceptive practices. PMID:26954608

Childhood Sexual Abuse, Attachment, and Trauma Symptoms in College Females: The Moderating Role of Attachment

ERIC Educational Resources Information Center

Aspelmeier, Jeffery E.; Elliott, Ann N.; Smith, Christopher H.

2007-01-01

Objective: The present study tests a model linking attachment, childhood sexual abuse (CSA), and adult psychological functioning. It expands on previous work by assessing the degree to which attachment security moderates the relationship between a history of child sexual abuse and trauma-related symptoms in college females. Method: Self-reports of…

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

Sexuality after a cancer diagnosis: A population‐based study

PubMed Central

Wardle, Jane; Steptoe, Andrew; Fisher, Abigail

2016-01-01

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

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

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

Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran

PubMed Central

DANESHKHAH, Farzaneh; ALLAHVERDIPOUR, Hamid; JAHANGIRI, Leila; ANDREEVA, Tatiana

2017-01-01

Background: Female genital mutilation is an intentional inhumane procedure that threatens girls and women’s health. It is especially widespread in developing countries due to cultural, traditional and religious preferences. The aim of the current study was to investigate how circumcision affects women’s sexual function. Methods: This cross-sectional study was conducted in the urban and rural area of Piranshahr County, Iran, in 2015 among convenience samples of 200 women, 15–49 yr old, who were applying to health care centers for receiving routine health care services. Data collection was conducted with the use of a self-administered written questionnaire to assess female sexual function, mental well-being, and quality of life. Results: Significant differences were found between circumcised and non-circumcised women in total score of female sexual function index (FSFI) in domains of desire, arousal, vaginal moisture, orgasm, satisfaction, and pain [(P<0.001), MD(95%CI)=5.64(3.64 to 7.64)] and based on Hotelling’s T-square, significant differences were found in dimensions of quality of life and FSFI. Conclusion: The revealed sexual dysfunction among mutilated women gives ground to require that public health systems take actions aimed at implementing special sexual education program to improve sexual functions of mutilated women and changing beliefs and social norms in the community level. PMID:29026793

Relationship between Gender Roles and Sexual Assertiveness in Married Women

PubMed Central

Azmoude, Elham; Firoozi, Mahbobe; Sadeghi Sahebzad, Elahe; Asgharipour, Neghar

2016-01-01

ABSTRACT Background: Evidence indicates that sexual assertiveness is one of the important factors affecting sexual satisfaction. According to some studies, traditional gender norms conflict with women’s capability in expressing sexual desires. This study examined the relationship between gender roles and sexual assertiveness in married women in Mashhad, Iran. Methods: This cross-sectional study was conducted on 120 women who referred to Mashhad health centers through convenient sampling in 2014-15. Data were collected using Bem Sex Role Inventory (BSRI) and Hulbert index of sexual assertiveness. Data were analyzed using SPSS 16 by Pearson and Spearman’s correlation tests and linear Regression Analysis. Results: The mean scores of sexual assertiveness was 54.93±13.20. According to the findings, there was non-significant correlation between Femininity and masculinity score with sexual assertiveness (P=0.069 and P=0.080 respectively). Linear regression analysis indicated that among the predictor variables, only Sexual function satisfaction was identified as the sexual assertiveness summary predictor variables (P=0.001). Conclusion: Based on the results, sexual assertiveness in married women does not comply with gender role, but it is related to Sexual function satisfaction. So, counseling psychologists need to consider this variable when designing intervention programs for modifying sexual assertiveness and find other variables that affect sexual assertiveness. PMID:27713899

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

PubMed

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

1995-05-01

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

Comparison of sexual dysfunction in women with infertility and without infertility referred to Al-Zahra Hospital in 2013-2014

PubMed Central

Mirblouk, Fariba; Asgharnia, Dr.Maryam; Solimani, Robabeh; Fakor, Fereshteh; Salamat, Fatemeh; Mansoori, Samaneh

2016-01-01

Background: One of the affected aspects in infertile women that have not been given sufficient attention is sexual function. Sexual function is a key factor in physical and marital health, and sexual dysfunction could significantly lower the quality of life. Aim of this study was to assess the comparison sexual dysfunction in women with infertility and without infertility, admitted to Al- Zahra Hospital. Objective: We decided to assess the prevalence of women sexual disorders in fertile and infertile subjects, admitted to Al-Zahra Hospital. Materials and Methods: 149 fertile and 147 infertile women who referred to infertility clinic of Al-Zahra Hospital during 2013-2014 were entered this cross-sectional study and Female Sexual Function Index questionnaire (FSFI) had been filled by all the cases. Most of women were married for 6-10 years (35.5%) and mean marriage time in participants was 9.55±6.07 years. Data were analyzed using SPSS software Ver. 18 and 2 test and logistic regression model has been used for analysis. Results: Results showed significant differences between desire (p=0.004), arousal (p=0.001), satisfaction (p=0.022) and total sexual dysfunction (p=0.011) in both groups but in lubrication (p=0.266), orgasm (p=0.61) and pain (p=0.793) difference were not significant. Conclusion: Some of sexual dysfunction indices are high in all infertile women. Our findings suggest that infertility impacts on women’s sexual function in desire, arousal, satisfaction and total sexual dysfunction. Health care professional should be sensitive to impact that diagnosis of infertility can have on women’s sexuality. PMID:27200426

HIV Infection and Women’s Sexual Functioning

PubMed Central

Wilson, Tracey E.; Jean-Louis, Girardin; Schwartz, Rebecca; Golub, Elizabeth T.; Cohen, Mardge H.; Maki, Pauline; Greenblatt, Ruth; Massad, L. Stewart; Robison, Esther; Goparaju, Lakshmi; Lindau, Stacy

2010-01-01

Objective To compare sexual problems among HIV-positive and HIV-negative women, and describe clinical and psychosocial factors associated with these problems. Design Data were collected during a study visit of the Women’s Interagency HIV Study (WIHS). The WIHS studies the natural and treated history of HIV among women in the United States. Methods Between 10/01/2006 and 3/30/2007, 1,805 women (1,279 HIV-positive and 526 HIV-negative) completed a study visit that included administration of the Female Sexual Function Index (FSFI). In addition, the visit included completion of standardized, interviewer-administered surveys, physical and gynecological examinations, and blood sample collection. Results Women with HIV reported greater sexual problems than did those without HIV. Women also reported lower sexual function if they were classified as menopausal, had symptoms indicative of depression, or if they reported not being in a relationship. CD4+ cell count was associated with FSFI scores, such that those with CD4 ≤199 cells/µL reported lower functioning as compared to those whose cell count was 200 or higher. Conclusions Given research documenting relationships between self-reported sexual problems and both clinical diagnoses of sexual dysfunction and women’s quality of life, greater attention to this issue as a potential component of women’s overall HIV care is warranted. PMID:20179602

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

Bremelanotide for Female Sexual Dysfunctions in Premenopausal Women: A Randomized, Placebo-Controlled Dose-Finding Trial

PubMed Central

Clayton, Anita H; Althof, Stanley E; Kingsberg, Sheryl; DeRogatis, Leonard R; Kroll, Robin; Goldstein, Irwin; Kaminetsky, Jed; Spana, Carl; Lucas, Johna; Jordan, Robert; Portman, David J

2016-01-01

Aim: Evaluate efficacy/safety of bremelanotide (BMT), a melanocortin-receptor-4 agonist, to treat female sexual dysfunctions in premenopausal women. Methods: Patients randomized to receive placebo or BMT 0.75, 1.25 or 1.75 mg self-administered subcutaneously, as desired, over 12 weeks. Primary end point was change in satisfying sexual events/month. Secondary end points included total score changes on female sexual function index and female sexual distress scale-desire/arousal/orgasm. Results: Efficacy data, n = 327. For 1.25/1.75-mg pooled versus placebo, mean changes from baseline to study end were +0.7 versus +0.2 satisfying sexual events/month (p = 0.0180), +3.6 versus +1.9 female sexual function index total score (p = 0.0017), −11.1 versus −6.8 female sexual distress scale-desire/arousal/orgasm total score (p = 0.0014). Adverse events: nausea, flushing, headache. Conclusion: In premenopausal women with female sexual dysfunctions, self-administered, as desired, subcutaneous BMT was safe, effective, and well tolerated (NCT01382719). PMID:27181790

Development of the NIH PROMIS® Sexual Function and Satisfaction Measures in Patients with Cancer

PubMed Central

Flynn, Kathryn E.; Lin, Li; Cyranowski, Jill M.; Reeve, Bryce B.; Reese, Jennifer Barsky; Jeffery, Diana D.; Smith, Ashley Wilder; Porter, Laura S.; Dombeck, Carrie B.; Bruner, Deborah Watkins; Keefe, Francis J.; Weinfurt, Kevin P.

2013-01-01

Introduction We describe the development and validation of the PROMIS Sexual Function and Satisfaction (PROMIS SexFS) measures version 1.0 for cancer populations. Aim To develop a customizable self-report measure of sexual function and satisfaction as part of the U.S. National Institutes of Health PROMIS® Network. Methods Our multidisciplinary working group followed a comprehensive protocol for developing psychometrically robust patient reported outcome (PRO) measures including qualitative (scale development) and quantitative (psychometric evaluation) development. We performed an extensive literature review, conducted 16 focus groups with cancer patients and multiple discussions with clinicians, and evaluated candidate items in cognitive testing with patients. We administered items to 819 cancer patients. Items were calibrated using item response theory and evaluated for reliability and validity. Main Outcome Measures The PROMIS Sexual Function and Satisfaction (PROMIS SexFS) measures version 1.0 include 79 items in 11 domains: interest in sexual activity, lubrication, vaginal discomfort, erectile function, global satisfaction with sex life, orgasm, anal discomfort, therapeutic aids, sexual activities, interfering factors, and screener questions. Results In addition to content validity (patients indicate that items cover important aspects of their experiences) and face validity (patients indicate that items measure sexual function and satisfaction), the measure shows evidence for discriminant validity (domains discriminate between groups expected to be different), convergent validity (strong correlations between scores on PROMIS and scores on conceptually-similar older measures of sexual function), as well as favorable test-retest reliability among people not expected to change (inter-class correlations from 2 administrations of the instrument, 1 month apart). Conclusions The PROMIS SexFS offers researchers a reliable and valid set of tools to measure self-reported sexual function and satisfaction among diverse men and women. The measures are customizable; researchers can select the relevant domains and items comprising those domains for their study. PMID:23387911

Free Association in Sex Education: Understanding Sexuality as the Flow of Thought in Conversation and Curriculum

ERIC Educational Resources Information Center

Casemore, Brian

2010-01-01

This paper draws on the theory and method of free association in psychoanalysis to frame an investigation of the content, structure, and function of the thinking expressed in conversations about sexuality and sexual health. The investigation emerges from an ongoing three-year study of the way adolescents, teachers, and peer sex educators negotiate…

Neuroimaging in pedophilia.

PubMed

Wiebking, Christine; Northoff, Georg

2013-04-01

Paraphilia is a set of disorders characterized by abnormal sexual desires. Perhaps most discussed amongst them, pedophilia is a complex interaction of disturbances of the emotional, cognitive and sexual experience. Using new imaging techniques such as functional magnetic resonance imaging, neural correlates of emotional, sexual and cognitive abnormalities and interactions have been investigated. As described on the basis of current research, altered patterns of brain activity, especially in the frontal areas of the brain, are seen in pedophilia. Building on these results, the analysis of neural correlates of impaired psychological functions opens the opportunity to further explore sexual deviances, which may contribute ultimately to the development of tools for risk assessment, classification methods and new therapeutic approaches.

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

Postpartum sexual health: a principle-based concept analysis.

PubMed

O'Malley, Deirdre; Higgins, Agnes; Smith, Valerie

2015-10-01

The aim of this study is to report an analysis of the concept of postpartum sexual health. Postpartum sexual health is a minimally understood concept, most often framed within physical/biological dimensions or as a 'checklist' task in postpartum information provision. This has the potential to leave women unprepared to manage transient or normative sexual health changes after childbirth. For meaningful discussions, clarity and understanding of postpartum sexual health is required. A principle-based method of concept analysis. The databases of PubMed, CINAHL, Maternity and Infant Care, PsychInfo, Web of Science, EMBASE, SCOPUS and Social Science Index were systematically searched, from their earliest dates, using a combination of key terms, including; 'sexual health', 'sexual function', 'dyspareunia', 'sexuality', 'sexual desire', 'sexual dysfunction', 'postnatal' and 'postpartum', resulting in a final included dataset of 91 studies. Using the principle-based approach, postpartum sexual health was analysed under the four philosophical principles of epistemological, pragmatic, linguistic and logical. Philosophically, postpartum sexual health is underdeveloped as a concept. A precise theoretical definition remains elusive and, presently, postpartum sexual health cannot be separated theoretically from sexuality and sexual function. Identified antecedents include an instrument free birth, an intact perineum and avoidance of episiotomy. Attributes include sexual arousal, desire, orgasm, sexual satisfaction and resumption of sexual intercourse. Outcomes are sexual satisfaction and a satisfying intimate relationship with one's partner. Postpartum sexual health is conceptually immature with limited applicability in current midwifery practice. © 2015 John Wiley & Sons Ltd.

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.

Sexuality and elderly with chronic diseases: A review of the existing literature

PubMed Central

Merghati-Khoei, Effat; Pirak, Arezoo; Yazdkhasti, Mansoureh; Rezasoltani, Parvaneh

2016-01-01

Background: Increased life expectancy and the growing phenomenon of aging can lead to increased burden of chronic diseases (CDs) which adversely affects the overall health of elderly, their sexuality in particular. Sexual life of an aged population is overlooked in many of the societies. In the present narrative review, we aim to assess the impact of CDs on sexual function of elderly people. Materials and Methods: We used internet databases including PubMed, EMBASE, ISI Web of Science, Google Scholar, SID, Iran Medex, Magiran, IPPF, and UNFPA without time limit. Ninety-eight out of 174 relevant articles were selected which met the inclusion criteria: those articles were research-based in English or Persian (original or review articles) and textbooks; specified one or more CDs and sexual function of the cases; elderly people over the age of sixty, men and women; and coordination between articles and research goals. We excluded qualitative and case studies. We reported the most related CDs with sexual function in literature review and used the biological and psychological impact of the CDs on sexual function of elderly population based on the conceptual model of Verschuren et al. (2010). Results: The results of the studies were classified into the themes including physical, psychological, and cultural and social. Diabetes, cardiovascular, cancerous, and chronic respiratory diseases and also some medications can reduce sexual capacity and desire in particular resulting in negative impact on the quality of elderly sexual life. CDs may influence sexual expressions and responses which adversely affect one's mood and energy so that can cause depression and grief, as well as loss of self-confidence, self-esteem, and self-concept in elderly adults. The factors affecting sexuality of an elderly with CDs include cultural and mythical beliefs about age and illnesses, fear, and embarrass of changed physical appearance. The research conducted among elderly population examining the adverse influence of CDs on aged people's sexual life in general, sexual function and performance, and intimate interaction. Conclusion: It is considered that programs on sexual health needs of aged population for the health-care workers can prove beneficial in improving sexual health. PMID:28331522

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

Differential effects of intranasal oxytocin on sexual experiences and partner interactions in couples.

PubMed

Behnia, Behnoush; Heinrichs, Markus; Bergmann, Wiebke; Jung, Stefanie; Germann, Janine; Schedlowski, Manfred; Hartmann, Uwe; Kruger, Tillmann H C

2014-03-01

Knowledge about the effects of the neuropeptide oxytocin (OXT) on human sexual behaviors and partner interactions remains limited. Based on our previous studies, we hypothesize that OXT should be able to positively influence parameters of sexual function and couple interactions. Employing a naturalistic setting involving 29 healthy heterosexual couples (n=58 participants), we analyzed the acute effects of intranasally administered OXT (24IU) on sexual drive, arousal, orgasm and refractory aspects of sexual behavior together with partner interactions. Data were assessed by psychometric instruments (Acute Sexual Experiences Scale, Arizona Sexual Experience Scale) as well as biomarkers, such as cortisol, α-amylase and heart rate. Intranasal OXT administration did not alter "classical" parameters of sexual function, such as sexual drive, arousal or penile erection and lubrication. However, analysis of variance and a hierarchical linear model (HLM) revealed specific effects related to the orgasmic/post-orgasmic interval as well as parameters of partner interactions. According to HLM analysis, OXT increased the intensity of orgasm, contentment after sexual intercourse and the effect of study participation. According to ANOVA analysis, these effects were more pronounced in men. Men additionally indicated higher levels of sexual satiety after sexual intercourse with OXT administration. Women felt more relaxed and subgroups indicated better abilities to share sexual desires or to empathize with their partners. The effect sizes were small to moderate. Biomarkers indicated moderate psychophysiological activation but were not affected by OXT, gender or method of contraception. Using a naturalistic setting, intranasal OXT administration in couples exerted differential effects on parameters of sexual function and partner interactions. These results warrant further investigations, including subjects with sexual and relationship problems. Copyright © 2014 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 and the use of Medical Devices or Drugs to Optimize Potency after Prostate Brachytherapy

PubMed Central

Whaley, J. Taylor; Levy, Lawrence B.; Swanson, David A.; Pugh, Thomas J.; Kudchadker, Rajat J.; Bruno, Teresa L.; Frank, Steven J.

2013-01-01

Purpose Prospective evaluation of sexual outcomes after prostate brachytherapy with iodine-125 seeds as monotherapy at a tertiary cancer care center. Methods and Materials Subjects were 129 men with prostate cancer with I-125 seed implants (prescribed dose, 145 Gy) without supplemental hormonal or external beam radiation therapy. Sexual function, potency, and bother were prospectively assessed at baseline and at 1, 4, 8, and 12 months using validated quality-of-life self-assessment surveys. Postimplant dosimetry values, including dose to 10% of the penile bulb (D10), D20, D33, D50, D75, D90, and penile-volume receiving 100% of the prescribed dose (V100) were calculated. Results At baseline, 56% of patients recorded having optimal erections; at 1 year, 62% of patients with baseline erectile function maintained optimal potency, 58% of whom with medically prescribed sexual aids or drugs. Variables associated with pretreatment-to-posttreatment decline in potency were time after implant (p=0.04) and age (p=0.01). Decline in urinary function may have been related to decline in potency. At 1 year, 69% of potent patients younger than 70 years maintained optimal potency, whereas 31% of patients over 70 maintained optimal potency (p=0.02). Diabetes was related to a decline in potency (p=0.05), but neither smoking nor hypertension were. For patients with optimal potency at baseline, mean sexual bother scores had declined significantly at 1 year (p<0.01). Sexual potency, sexual function, and sexual bother scores failed to correlate with any dosimetric variable tested. Conclusions Erections firm enough for intercourse can be achieved at 1 year after treatment, but most men will require medical aids to optimize potency. Although younger men were better able to maintain erections firm enough for intercourse than older men, there was no correlation between potency, sexual function, or sexual bother and penile bulb dosimetry. PMID:22300559

Sexual Function and the Use of Medical Devices or Drugs to Optimize Potency After Prostate Brachytherapy

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

Whaley, J. Taylor; Levy, Lawrence B.; Swanson, David A.

Purpose: Prospective evaluation of sexual outcomes after prostate brachytherapy with iodine-125 seeds as monotherapy at a tertiary cancer care center. Methods and Materials: Subjects were 129 men with prostate cancer with I-125 seed implants (prescribed dose, 145 Gy) without supplemental hormonal or external beam radiation therapy. Sexual function, potency, and bother were prospectively assessed at baseline and at 1, 4, 8, and 12 months using validated quality-of-life self-assessment surveys. Postimplant dosimetry values, including dose to 10% of the penile bulb (D10), D20, D33, D50, D75, D90, and penile volume receiving 100% of the prescribed dose (V100) were calculated. Results: Atmore » baseline, 56% of patients recorded having optimal erections; at 1 year, 62% of patients with baseline erectile function maintained optimal potency, 58% of whom with medically prescribed sexual aids or drugs. Variables associated with pretreatment-to-posttreatment decline in potency were time after implant (p = 0.04) and age (p = 0.01). Decline in urinary function may have been related to decline in potency. At 1 year, 69% of potent patients younger than 70 years maintained optimal potency, whereas 31% of patients older than 70 maintained optimal potency (p = 0.02). Diabetes was related to a decline in potency (p = 0.05), but neither smoking nor hypertension were. For patients with optimal potency at baseline, mean sexual bother scores had declined significantly at 1 year (p < 0.01). Sexual potency, sexual function, and sexual bother scores failed to correlate with any dosimetric variable tested. Conclusions: Erections firm enough for intercourse can be achieved at 1 year after treatment, but most men will require medical aids to optimize potency. Although younger men were better able to maintain erections firm enough for intercourse than older men, there was no correlation between potency, sexual function, or sexual bother and penile bulb dosimetry.« less

Executive function associated with sexual risk in young South African women: Findings from the HPTN 068 cohort

PubMed Central

Pettifor, Audrey; Duta, Mihaela; Demeyere, Nele; Wagner, Ryan G.; Selin, Amanda; MacPhail, Catherine; Laeyendecker, Oliver; Hughes, James P.; Stein, Alan; Tollman, Stephen; Kahn, Kathleen

2018-01-01

Purpose Heightened sexual risk in adolescence and young adulthood may be partially explained by deficits in executive functioning, the set of cognitive processes used to make reasoned decisions. However, the association between executive function and sexual risk is understudied among adolescent girls and young women, particularly in low- and middle-income countries. Methods In a cohort of 853 young women age 18–25 in rural Mpumalanga province, South Africa, we evaluated executive function with three non-verbal cognitive tests: I. a rule-finding test, II. a trail-making test, and III. a figure drawing test. Using log-binomial regression models, we estimated the association between lower executive function test scores and indicators of sexual risk (unprotected sex acts, concurrent partnerships, transactional sex, and recent HSV-2 infection). Results In general, young women with lower executive function scores reported higher frequencies of sexual risk outcomes, though associations tended to be small with wide confidence intervals. Testing in the lowest quintile of Test I was associated with more unprotected sex [aPR (95% CI): 1.4 (1.0, 1.8)]. Testing in the lowest quintile of Test II was associated with more concurrent relationships and transactional sex [aPR (95% CI): 1.6 (1.1, 2.5) and 1.7 (1.3, 2.4), respectively], and testing in the lowest four quintiles of Test III was associated with more concurrent relationships [aPR (95% CI): 1.7 (1.0, 2.7)]. Conclusions These results demonstrate an association between low executive function and sexual risk in South African young women. Future work should seek to understand the nature of this association and whether there is promise in developing interventions to enhance executive function to reduce sexual risk. PMID:29608615

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

PubMed

Stephenson, Kyle R; Meston, Cindy M

2015-03-01

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

Sexual function in adolescent and young adult cancer survivors-a population-based study.

PubMed

Olsson, Maria; Steineck, Gunnar; Enskär, Karin; Wilderäng, Ulrica; Jarfelt, Marianne

2018-03-05

Previous research has established that treatments for cancer can result in short- and long-term effects on sexual function in adult cancer patients. The purpose was to investigate patient-reported physical and psychosexual complications in adolescents and young adults after they have undergone treatment for cancer. In this population-based study, a study-specific questionnaire was developed by a method used in several previous investigations carried out by our research group, Clinical Cancer Epidemiology. The questionnaire was developed in collaboration with adolescent and young adult cancer survivors (15-29 years) and validated by professionals from oncology units, midwives, epidemiologists, and statisticians. The topics covered in the questionnaire were psychosocial health, body image, sexuality, fertility, education, work, and leisure. The web-based questionnaire was sent to adolescent and young adult cancer survivors and matched controls in Sweden. In this study, adolescent and young adult cancer survivors (15-29 years) showed low satisfaction regarding sexual function compared to controls (P < 0.01). Female adolescent and young adult cancer survivors had a statistically significant lower frequency of orgasm during sexual activity than the controls (P < 0.01). Male adolescent and young adult cancer survivors had statistically significant lower sexual desire than the controls (P = 0.04). We found that adolescent and young adult cancer survivors perceived themselves as being less satisfied with their sexual function than matched population-based controls. Adolescent and young adult cancer survivors need psychological rehabilitation support from the health care profession during and after cancer treatment to help them to reduce their reported poor sexual function to enhance a good sexual quality of life.

Erotic Issues in Cotherapy

ERIC Educational Resources Information Center

Dunn, Marian E.; Dickes, Robert

1977-01-01

This paper concentrates on the erotic aspects of the interaction between cotherapists. This includes the nonrational but healthy sexual attraction that can influence the functioning of the therapeutic team. Increased sexual tensions may adversely affect the therapeutic relationship. Methods of dealing with these matters are presented. (Author)

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

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.

A cross-sectional survey of quality of life in colostomates: a report from Iran.

PubMed

Mahjoubi, Bahar; Mirzaei, Rezvan; Azizi, Rasoul; Jafarinia, Mehdi; Zahedi-Shoolami, Leila

2012-11-21

Considering the complications that colostomies may cause, patient self-assessments of their social, emotional, physical, sexual and functional conditions may help their surgeons to evaluate the impact of their interventions or use supplementary methods to maintain patient functional status or decrease its loss to the minimum level. The aim of this study was to evaluate the Quality of Life in Iranian patients with colostomies and to compare the age and gender differences among them. This cross-sectional study was conducted from 2009 to 2010 to evaluate the quality of life of 96 patients who had undergone surgery for rectal cancer and had permanent colostomies. The European Organization for Research and Treatment of Cancers Quality of Life Questionnaire (EORTC QLQ)-C30 and the EORTC QLQ-CR38 were used to assess patient Quality of Life. The mean scores for the functional subscales were as follows: Physical Function, 70.9 (±2.2); Role Function, 68.4 (±2.6); Emotional Function, 56.9 (±2.7); Cognitive Function, 68.7 (± 2.6); and Social Function, 64.2 (±3.3). The EORTC questionnaires showed significant differences between males and females. Males had better body image scores. Sexual Function and Sexual Enjoyment were impaired in both males and females, but males had significantly higher scores and better roles in Physical and Sexual Functions. More sexual enjoyment problems in older ages were observed in both males and females. Having a colostomy was associated with a high level of emotional and sexual function impairment. The differing challenges between males and females should encourage us to design sex-specific interventions that improve the quality of life in this group of patients.

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.

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

An Exploration of the Psycho-Sexual Experiences of Women Who Have Undergone Female Genital Cutting: A Case of the Maasai in Kenya

PubMed Central

Esho, T.

2012-01-01

The research explored the link between type II Female Genital Cutting (FGC) and sexual functioning. This thesis summary thus draws from an exploratory ethnographic field study carried out among the Maasai people of Kenya where type II FGC is still being practiced. A purposely sample consisting of 28 women and 19 men, within the ages of 15-80 years took part in individual interviews and 5 focus group discussions. Participants responded to open-ended questions, a method deemed appropriate to elicit insider’s in-depth information. The study found out that one of the desired effects of FGC ritual among the Maasai was to reduce women’s sexual desire, embodied as tamed sexuality. This consequence was however not experienced as an impediment to sexual function. The research established that esteeming transformational processes linked with the FGC ‘rite of passage’ are crucial in shaping a woman’s femininity, identity, marriageable status and legitimating sexuality. In turn, these elements are imperative in inculcating and nurturing a positive body-self image and sex appeal and consequently, positive sexual self actualization. These finding brings to question the validity of conventional sexuality theory, particularly those that subscribe to bio-physical models as universal bases for understanding the subject of female sexual functioning among women with FGC. Socio-cultural-symbolic nexus and constructions of sexuality should also be considered when investigating psychosexual consequences of FGC. PMID:24753899

Production of functional sperm by subcutaneous auto-grafting of immature testes in rainbow trout.

PubMed

Hayashi, Makoto; Sakuma, Daika; Yoshizaki, Goro

2018-02-01

Sexually mature individuals are indispensable for breeding programs. Salmonids require a long period before reaching sexual maturity, so we aimed to shorten the period required to obtain functional sperm by grafting immature testicular fragments into mature recipients, which we predicted would allow the grafted testicular fragments to skip the long pre-pubertal period. First, we demonstrated successful subcutaneous auto-grafting of testicular fragments in rainbow trout. Unilateral testectomy was performed, and the isolated immature testicular fragment was auto-grafted into the subcutaneous space along the back of recipient fish. The grafted testicular fragments developed synchronously with the recipients' testis remaining in its body cavity, and both eventually produced functional sperm. Next, immature testicular fragments were auto-grafted into the subcutaneous space of sexually mature males. We achieved this, without immune rejection, by isolating and cryopreserving testes from immature fish, and rearing these unilaterally testectomized fish until sexual maturity. The cryopreserved testes were then auto-grafted into the original, now spermiating fish. The grated immature testicular fragments differentiated and produced functional sperm within 5 months after grafting. By combining this grafting method with a technique to avoid immune rejection, we expect to develop a practical method for producing sperm in a shorter period in salmonids. © 2017 Wiley Periodicals, Inc.

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

PubMed

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

2008-10-01

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

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.

Exploring infertile women's experiences about sexual life: A qualitative study

PubMed Central

Kohan, Shahnaz; Ghasemi, Zahra; Beigi, Marjan

2015-01-01

Background: Infertility is a serious problem in a couple's life that affects their marriage relationships. So, dissatisfaction with sexual function resulting from interpersonal problems is common among these couples. This qualitative study aimed to explore the experiences of infertile women in their sexual life. Materials and Methods: This is a qualitative study with a phenomenological approach. The participants were 20 infertile women referring to the health care centers and infertility clinics of Isfahan and were selected through purposive sampling. Data were collected by tape recording of deep interviews and analyzed by Colaizzi's method. Results: Analysis of the participants’ experiences led to five main concepts: “Disturbed in femininity-body image,” “discouragement of sexual relations,” “sacrifice of sexual pleasure for the sake of getting pregnant,” “confusion in sexual relation during infertility treatment,” and “striving to protect their marriage.” Conclusions: Findings revealed that infertility affects women's different aspects of sexual life, especially disturbance in femininity-body image and sexual reluctance. With regard to women's willingness to protect their matrimonial life and prevent sexual trauma as a destroying factor for their family's mental health, it seems sexual counseling is necessary for infertile couples. PMID:25709688

Counseling on vaginal delivery of contraceptive hormones: implications for women's body knowledge and sexual health.

PubMed

Nappi, Rossella E

2013-12-01

Healthcare providers (HCPs) have an important role in helping women select the contraceptive method that best matches their needs and lifestyle. Recent surveys outline the need of women to be informed about all available choices, including the newest methods (particularly those not requiring daily administration), such as vaginal contraception. The most relevant publications on combined contraceptive vaginal ring are revised in the context of counseling as an opportunity to empower women in term of vaginal health and sexual functioning. HCPs should explain the main characteristics of the combined contraceptive vaginal ring including the anatomical and physiological implications that make the vagina an ideal route of hormonal administration and the basic notions about functional modifications of the vagina during reproductive life. Clinical data on the vaginal ring should be summarized with regard to efficacy, tolerability, pharmacokinetics, cycle control and user acceptability, including recent findings on extra-contraceptive benefits (also compared to other hormonal contraceptives) on the vaginal flora and on sexual function. Vaginal contraception offers various benefits and should always be discussed during contraceptive counseling. An open dialogue about vaginal contraception will also help enhance body knowledge and sexual health.

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

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

Sexual concerns after Spinal Cord Injury: An update on management.

PubMed

Alexander, Marcalee Sipski; Aisen, Carrie Mlynarczyk; Alexander, Sterling Morrison; Aisen, Mindy Lipson

2017-01-01

Spinal Cord Injury (SCI) causes neurological impairment with resultant neurogenic sexual dysfunction which can compound preexisting psychological and medical sexual concerns. Understanding these concerns is important in managing the lifelong needs of persons with SCIs. To provide an overview of the impact of SCI on sexuality along with a framework for treatment of sexual concerns. To briefly review male infertility and its treatments and pregnancy in females after SCI. Interdisciplinary literature review and synthesis of information. The average age at SCI is increased, thus persons with SCIs may have preexisting sexual concerns. Sexual activity and satisfaction are decreased after SCI. Psychogenic sexual arousal is related to remaining sensation in the T11-L2 dermatomes. Orgasm occurs in approximately 50% of persons with SCIs with all injuries except subjects with complete lower motor neuron (LMN) injuries affecting the lowest sacral segments A structured approach to treatment including assessing preinjury function, determining the impact of injury, education, assessing and treating iatrogenic sexual dysfunction and treatment of concomitant problems is recommended. Basic and advanced methods to improve sexual arousal and orgasm are discussed and treatment of anejaculation and issues associated with pregnancy and SCI are reviewed. Sexual satisfaction is impaired after SCI; however, education and new therapies can improve responsiveness. Future research is warranted to improve sexual function and fertility potential in persons with SCIs.

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.

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

PubMed

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

2016-05-01

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

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

PubMed

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

2013-11-01

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

Sexual 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.

Psychosexual Functioning Among Adult Female Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

PubMed Central

Ford, Jennifer S.; Kawashima, Toana; Whitton, John; Leisenring, Wendy; Laverdière, Caroline; Stovall, Marilyn; Zeltzer, Lonnie; Robison, Leslie L.; Sklar, Charles A.

2014-01-01

Purpose Childhood cancer survivors may be at risk for impaired psychosexual functioning as a direct result of their cancer or its treatments, psychosocial difficulties, and/or diminished quality of life. Patients and Methods Two thousand one hundred seventy-eight female adult survivors of childhood cancer and 408 female siblings from the Childhood Cancer Survivor Study (CCSS) completed a self-report questionnaire about their psychosexual functioning and quality of life. On average, participants were age 29 years (range, 18 to 51 years) at the time of the survey, had been diagnosed with cancer at a median age of 8.5 years (range, 0 to 20) and were most commonly diagnosed with leukemia (33.2%) and Hodgkin lymphoma (15.4%). Results Multivariable analyses suggested that after controlling for sociodemographic differences, survivors reported significantly lower sexual functioning (mean difference [MnD], −0.2; P = .01), lower sexual interest (MnD, −0.2; P < .01), lower sexual desire (MnD, −0.3; P < .01), lower sexual arousal (MnD, −0.3; P < .01), lower sexual satisfaction (MnD, −0.2; P = .01), and lower sexual activity (MnD, −0.1; P = .02) compared with siblings. Risk factors for poorer psychosexual functioning among survivors included older age at assessment, ovarian failure at a younger age, treatment with cranial radiation, and cancer diagnosis during adolescence. Conclusion Decreased sexual functioning among female survivors of childhood cancers seems to be unrelated to emotional factors and is likely to be an underaddressed issue. Several risk factors among survivors have been identified that assist in defining high-risk subgroups who may benefit from targeted screening and interventions. PMID:25113763

Child Peer Sexual Abuse: Preliminary Data on Outcomes and Disclosure Experiences

ERIC Educational Resources Information Center

Sperry, Debbie M.; Gilbert, Brenda O.

2005-01-01

Objective: This study compared experiences of children sexually abused by peers to those of children abused by adolescents/adults. Variables examined included perceived negativity of the abuse, self-reported outcomes, overall psychological functioning, and disclosure. Method: An archival data set containing retrospective reports of childhood…

Changes in sexual function of women with refractory interstitial cystitis/bladder pain syndrome after intravesical therapy with a hyaluronic acid solution.

PubMed

Hung, Man-Jung; Su, Tsung-Hsien; Lin, Yi-Hao; Huang, Wen-Chu; Lin, Tzu-Yin; Hsu, Chun-Shuo; Chuang, Fei-Chi; Tsai, Ching-Pei; Shen, Pao-Sheng; Chen, Gin-Den

2014-09-01

Intravesical instillation with a hyaluronic acid (HA) solution is an effective treatment for interstitial cystitis/bladder pain syndrome (IC/BPS), but its impact on sexual functioning of patients is not known. The aim of this study was to evaluate the changes in sexual function of women with refractory IC/BPS who underwent a second-line intravesical HA therapy. A total of 103 women diagnosed with refractory IC/BPS were enrolled in this prospective, multicenter study. Sexual function was evaluated using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-9). Bladder-related symptoms and bother were assessed by the Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI), and a pain visual analog scale (VAS), respectively. Data were analyzed with univariate methods or multivariate logistic regression analysis accordingly. Changes in PISQ-9, ICSI, ICPI, and pain VAS scores after treatment were assessed. Mean age and duration of symptoms was 43.6 ± 11.8 and 5.1 ± 5.0 years, respectively. ICSI, ICPI, and pain VAS scores were significantly (P < 0.001) improved after 1 month and 6 months of treatment. Of the 87 (84.5%) sexually active women evaluated, PISQ-9 total scores improved significantly (P < 0.001) from the baseline (mean 18.9 ± 6.4), after 1 month (20.4 ± 5.8), and 6-months (21.5 ± 5.6) of treatment. Significantly improved PISQ-9 items included "dyspareunia" (P < 0.001) and "negative reactions" (P = 0.015) during sexual intercourse, and "intensity" (P < 0.001) of sexual orgasms. After a logistic regression analysis, we found that a baseline PISQ-9 score was negatively correlated with the duration of IC/BPS symptoms (P = 0.022). Meanwhile, the changes in PISQ-9 scores were positively correlated with the reduction in ICSI scores after treatment (P = 0.045). Intravesical HA is an effective treatment for refractory IC/BPS. A longer duration of IC/BPS symptoms may be a predictor of poor sexual function. However, intravesical HA may improve sexual function along with the reduction of IC/BPS symptoms. © 2014 International Society for Sexual Medicine.

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

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

Sexual Behavior Pattern and Related Factors in Women with Breast Cancer in Iran.

PubMed

Rashidi, Sanaz; Dashti, Forouzandeh

2015-12-18

Despite the most of treatment team efforts focused on the maintaining patient's life, attention to sexual issues don't be considered. This stud is designed to determine the sexual behavior pattern and related factors in women with breast cancer. This descriptive- correlation study was performed on 90 women that diagnosed with breast Cancer that was admitted to sayed-al- shohada hospital of Isfahan in 2010. Sampling method was available (non- random sampling) and Sexual Behavior Pattern determined with 3 domains: sexual identity, sexual role and sexual function. Data collection tools, was a questionnaire that made by the researcher and was used after determining the validity and reliability. For data analysis, was used of Descriptive- analytic statistics, frequency and ANOVA and Pearson correlation analytical tests in the SPSS statistical software (version 16). Cases had 60% of Desirable sexual identity, 50% of Desirable sexual role, 40% Desirable sexual function and were be able to play 47.61% Desirable sexual behavior. Participants that their husbands had Elementary education had more desirable sexual behavior (p<0.031). Cases that were homemaker had more desirable Sexual behavior than of were working and retired (p<0.023). Non-surgical treatment with chemotherapy, radiotherapy and hormone therapy had a negative impact on sexual behavior (p<0.014). Study of sexual behavior pattern that is one of the important aspects of health, Provide valuable information to nurses and medical team and will be enhance the quality of provided services. Adopt appropriate strategies and interventions to promote sexual health, breast cancer is recommended.

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

PubMed

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

2011-10-01

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

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.

Acceptability of a combination testosterone gel and depomedroxyprogesterone acetate male contraceptive regimen.

PubMed

Amory, John K; Page, Stephanie T; Anawalt, Bradley D; Matsumoto, Alvin M; Bremner, William J

2007-03-01

Testosterone (T) gel, administered transdermally in combination with injections of depomedroxyprogesterone acetate (DMPA) every 3 months, results in effective suppression of spermatogenesis in 90% of men. Men's attitudes regarding the daily self-administration of T-gel and the impact of such a regimen on sexual function, however, are unknown. Therefore, we questioned subjects enrolled in a combination T-gel plus DMPA male contraceptive trial regarding the acceptability of T-gel for male contraception and the impact of the T-gel/DMPA regimen on sexual function and satisfaction during treatment. Thirty-eight healthy men, ages 18-55, were treated with T-gel (100 mg daily) + DMPA (300 mg every 3 months) for 24 weeks. Sexual function was assessed using a validated questionnaire at baseline, after 12 and 24 weeks of treatment and 12 weeks into recovery. The overall acceptability of the method and attitudes regarding the daily self-administration of T-gel were assessed by a questionnaire 12 weeks into recovery. Fifty percent of subjects were either satisfied or very satisfied with the T-gel-based contraceptive regimen, and 45% indicated they would use the regimen if it were commercially available. The T-gel was found to be easy to use by 76% of men, but a third of subjects felt that T-gel administration interfered with their daily routine. Sexual function was largely preserved during treatment; however, slight decreases in sexual function were noted during recovery. The experimental male hormonal contraceptive regimen of T-gel + DMPA is acceptable to approximately one half of study volunteers, most of whom would use the method if it were commercially available. Given its appeal to a significant proportion of men, additional studies using T-gel and DMPA for male contraception are warranted.

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

The Impact of an Ostomy on the Sexual Lives of Persons With Stomas: A Phenomenological Study.

PubMed

Vural, Fatma; Harputlu, Deniz; Karayurt, Ozgul; Suler, Gulseren; Edeer, Aylin Durmaz; Ucer, Ceylanim; Onay, Deniz Cenan

2016-01-01

The purpose of this study was to describe the lived experiences of persons with stomas related to sexual function and perceptions and their expectations of the ostomy nurses who care for them. Qualitative, phenomenological study. Fourteen persons living with an ostomy for least 2 months participated in the study. Data collection occurred at the ostomy and wound care unit at Dokuz Eylul University Hospital in Izmir, Turkey. Data were collected using an in-depth interview method. Interviews lasted from 20 to 60 minutes and were audiotaped. These recordings were transcribed and subjected to content analysis. Five themes emerged from the unstructured interviews: (1) changes in sexual life; (2) changes in body image; (3) fear and anxiety experienced during sexual intercourse; (4) psychological impact of sexual problems; and (5) expectations concerning sexual counseling from ostomy nurses. Study findings suggest that persons with ostomies experience changes in their body image, along with a decrease in sexual desire. Respondents described avoiding sexual intercourse, and abstained from sleeping with their partners. Male respondents described erectile dysfunction, and female respondents reported pain during sexual intercourse (dyspareunia). Participants stated that they did not feel adequately informed about these problems and desired to receive more information and support from ostomy nurses regarding sexual issues. Based on these findings, we recommend that ostomy nurses provide more counseling concerning sexual function and challenges following ostomy surgery.

Asexuality: a mixed-methods approach.

PubMed

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

2010-06-01

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

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.

Sexual Abuse and Sexual Functioning in a Chronic Pelvic Pain Sample

ERIC Educational Resources Information Center

Randolph, Mary E.; Reddy, Diane M.

2006-01-01

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

Sexual function outcomes following fracture of the penis

PubMed Central

Nason, Gregory J.; McGuire, Barry B.; Liddy, Stephen; Looney, Aisling; Lennon, Gerald M.; Mulvin, David W.; Galvin, David J.; Quinlan, David M.

2013-01-01

Introduction: Fracture of the penis is a rare urological emergency which occurs as a result of abrupt trauma to an erect penis. There is paucity of data regarding long-term sexual function or erectile potency following fracture of the penis. The aim of this study is to objectively assess the overall sexual function following fracture of the penis. Methods: A retrospective analysis of 21 penile fractures was performed. A voluntary telephone questionnaire was performed to assess long term outcomes using three validated questionnaires-the Erection Hardness Grading Scale, the International Index of Erectile Function (IIEF-5) and the Brief Male Sexual Function inventory (BMSFI). Results: The mean age was 33.1 years (range: 19–63). The median follow up was 46 months (range: 3–144). All fractures were a result of sexual misadventure and all were surgically repaired. There were two concomitant urethral injuries. Seventeen patients were contactable. Fourteen patients demonstrated no evidence of erectile dysfunction (ED) (IIEF-5>22), 1 patient reported symptoms of mild ED (IIEF-5, 17–21) and one patient reported mild to moderate ED (IIEF-5, 12–16). No patients reported insufficient erection for penetration (EHGS: 1 or 2). Regarding the overall BMSFI, 13 (83%) patients were mostly satisfied or very satisfied with their sex life within the previous month. Conclusion: In a small surgical series of men with penile fracture managed within a short time frame from presentation, we demonstrate erectile potency is maintained. Long-term overall sexual satisfaction is promising. PMID:24032060

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

"A plea for the prostate": doctors, prostate dysfunction, and male sexuality in late 19th- and early 20th-century Canada.

PubMed

O'Shea, Christopher D

2012-01-01

Historical examinations of medical discourse concerning male sexuality have focused on the perceived linkage between masturbation and sexual neurasthenia. However, more tangible conditions such as prostatic hypertrophy were also linked to the sexual misconduct of young and old men. This paper examines both the medical discourse concerning prostatic hypertrophy and how the development of treatment was influenced by contemporary concerns with both sexuality and masculinity. It argues that mainstream doctors moved away from the Victorian preoccupation with the dangers of illicit sexuality and increasingly regarded the restoration of sexual function as being in the best interests of their patients. This view was particularly evident in their quest for an operative method that would cure prostatic hypertrophy while preserving potency.

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

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.

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.

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

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

PubMed

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

2017-10-03

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

Neural pathways in processing of sexual arousal: a dynamic causal modeling study.

PubMed

Seok, J-W; Park, M-S; Sohn, J-H

2016-09-01

Three decades of research have investigated brain processing of visual sexual stimuli with neuroimaging methods. These researchers have found that sexual arousal stimuli elicit activity in a broad neural network of cortical and subcortical brain areas that are known to be associated with cognitive, emotional, motivational and physiological components. However, it is not completely understood how these neural systems integrate and modulated incoming information. Therefore, we identify cerebral areas whose activations were correlated with sexual arousal using event-related functional magnetic resonance imaging and used the dynamic causal modeling method for searching the effective connectivity about the sexual arousal processing network. Thirteen heterosexual males were scanned while they passively viewed alternating short trials of erotic and neutral pictures on a monitor. We created a subset of seven models based on our results and previous studies and selected a dominant connectivity model. Consequently, we suggest a dynamic causal model of the brain processes mediating the cognitive, emotional, motivational and physiological factors of human male sexual arousal. These findings are significant implications for the neuropsychology of male sexuality.

Sexual and functional results after creation of a neovagina in women with Mayer-Rokitansky-Küster-Hauser syndrome: a comparison of nonsurgical and surgical procedures.

PubMed

Morcel, Karine; Lavoué, Vincent; Jaffre, Frédérique; Paniel, Bernard-Jean; Rouzier, Roman

2013-07-01

To compare nonsurgical and surgical procedures for creation of a neovagina in women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome in terms of sexual satisfaction. We report a cross-sectional study of 91 women with MRKH syndrome undergoing a neovagina creation procedure. They were members of the French National Association of Women with MRKH syndrome. We analyzed all answers to a questionnaire mailed to each woman. The questionnaire solicited short answers concerning the diagnosis and the neovagina procedure, and included the standardized FSFI (Female Sexual Function Index) questionnaire. All analyses were performed using the chi-squared test and Student's t-test. A p-value of <0.05 was considered statistically significant. Forty women answered the questionnaire. Twenty had been treated by Frank's method (non-surgical group) and 20 had undergone a surgical procedure, sigmoid vaginoplasty (12 cases) or Davidov's technique (8 cases) (surgical group). The mean time after neovagina creation was 7 years (range 1-44 years). The population characteristics did not differ significantly between the nonsurgical and surgical groups. The total FSFI score indicated good and similar functional results in the two groups (25.3±7.5 versus 25.3±8.0). Functional sexual outcomes after nonsurgical and surgical methods were similar. Therefore, the Frank's method should be proposed as first line therapy because it is less invasive than surgical procedures. In the case of failure of this technique or of refusal by the patient, surgical reconstruction may then be offered. Copyright © 2013. Published by Elsevier Ireland Ltd.

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

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

Loss of sexual recombination and segregation is associated with increased diversification in evening primroses.

PubMed

Johnson, Marc T J; Fitzjohn, Richard G; Smith, Stacey D; Rausher, Mark D; Otto, Sarah P

2011-11-01

The loss of sexual recombination and segregation in asexual organisms has been portrayed as an irreversible process that commits asexually reproducing lineages to reduced diversification. We test this hypothesis by estimating rates of speciation, extinction, and transition between sexuality and functional asexuality in the evening primroses. Specifically, we estimate these rates using the recently developed BiSSE (Binary State Speciation and Extinction) phylogenetic comparative method, which employs maximum likelihood and Bayesian techniques. We infer that net diversification rates (speciation minus extinction) in functionally asexual evening primrose lineages are roughly eight times faster than diversification rates in sexual lineages, largely due to higher speciation rates in asexual lineages. We further reject the hypothesis that a loss of recombination and segregation is irreversible because the transition rate from functional asexuality to sexuality is significantly greater than zero and in fact exceeded the reverse rate. These results provide the first empirical evidence in support of the alternative theoretical prediction that asexual populations should instead diversify more rapidly than sexual populations because they are free from the homogenizing effects of sexual recombination and segregation. Although asexual reproduction may often constrain adaptive evolution, our results show that the loss of recombination and segregation need not be an evolutionary dead end in terms of diversification of lineages. © 2011 The Author(s). Evolution© 2011 The Society for the Study of Evolution.

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.

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

Online-based interventions for sexual health among individuals with cancer: a systematic review.

PubMed

Kang, Hee Sun; Kim, Hyun-Kyung; Park, Seong Man; Kim, Jung-Hee

2018-03-07

Online interventions have the advantages of being widely available, accessible, comfortable, cost effective, and they can provide tailored information and support. Despite these benefits, the effects of specifically devised online intervention programs for cancer patients' sexual problems are somewhat unclear. The aim of this review is to describe online-based interventions and to assess their effects on sexual health among cancer survivors and/or their partners. We investigated the effects of online sexual interventions among individuals with cancer or their partners. Among these, we considered 4 eligible articles. Despite the diversity of contents of the interventions, the identified modes of delivery among most of the interventions were as follows: education, interactive methods, cognitive behavior therapy, tailored information, and self-monitoring. Methods of monitoring the interventions, including the utilization of the web site and post-treatment program rating, were reported. All the online intervention programs incorporated a focus on physical, psychological, cognitive, and social aspects of sexual health. Significant effects on patient sexual function and interest and the psychological aspect of sexual problems were reported. This study provides evidence that online-based interventions would be effective in improving the psycho-sexual problems of cancer survivors and their partners.

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.

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

PubMed

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

2015-08-01

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

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.

Designing a national plan for improving sexual health in Iran: An experience of an Islamic country

PubMed Central

Damari, Behzad; Tabrizchi, Narges; Riazi-Isfahani, Sahand

2016-01-01

Background: Prevalence of sexual dysfunction varies from 20% to 40% in men and women in different studies in Iran. Despite its high prevalence, it seems that this issue has been neglected, particularly in Islamic countries. The aim of this study was to assess sexual health in Iran. This was a mixed method study. Methods: Data were collected through evaluating country’s sexual health programs and literature review. Sexual health status was drafted and formed following a sound analysis by stakeholders. After conducting interviews and focus group discussions, the main points of the meetings, influencing factors of the present status and oncoming strategies were obtained upon experts’ opinions. Results: Review of general policies and the literature showed that although there is adequate support for improving sexual health status in the country, sexual health status has been decreased in the last decade. Based on Iranian sexual health indicators and experts’ opinions, the focus points could be divided into the following groups: Structural and functional –political, legal-behavior, and cultural. Conclusion: Breaking the taboo of sexual health issues would require attention from the policy makers especially in Islamic nations to facilitate the steps on the road to sexual health. In this regard, clarified vision, strategic goals and interventional policies are proposed. An inter-sectional cooperation is needed to implement interventions to promote sexual health status. PMID:27683648

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

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.

[Biopsychosocial understanding of human sexuality. Prerequisite for diagnostics and treatment in sexual medicine].

PubMed

Beier, K M

2006-08-01

Sexual medicine is a subdiscipline of clinical medicine that deals with human sexuality and disorders. Sexuality eludes a unilateral definition. As a biologically, psychologically, and socially determined experience dimension of the human being, its individual form depends on biological factors and developments in the person's life. Moreover, sexuality exhibits different dimensions--lust, reproduction, and relationship--that are indeed closely interrelated. For this reason, directing therapy at only one of these dimensions is not adequate. All human beings are programmed toward fulfillment of elementary biopsychosocial needs such as acceptance, closeness, warmth, and security. If these basic needs are shortchanged in terms of fulfillment, all sorts of restrictions in the quality of life ensue, even to the point of resultant disorders of sexual function. Treatment then approaches the roots when it does not center on the sexual dysfunction but rather on the underlying frustrated relationship of the partners. Syndyastic sexual therapy is an important treatment method in sexual medicine.

Frontal alpha asymmetry and sexually motivated states.

PubMed

Prause, Nicole; Staley, Cameron; Roberts, Verena

2014-03-01

Anterior alpha asymmetry of electroencephalographic (EEG) signals has been suggested to index state approach (or avoidance) motivation. This model has not yet been extended to high approach-motivation sexual stimuli, which may represent an important model of reward system function. Sixty-five participants viewed a neutral and a sexually motivating film while their EEG was recorded, and reported their sexual feelings after each film. Greater alpha power in the left hemisphere during sexually motivated states was evident. A positive relationship between self-reported mental sexual arousal and alpha asymmetry was identified, where coherence between these indicators was higher in women. Notably, coherence was stronger when mental versus physical sexual arousal was rated. Alpha asymmetry appears to offer a new method for further examining this novel coherence pattern across men and women. Copyright © 2014 Society for Psychophysiological Research.

Sexual Intimacy Constructions of Heterosexual Couples Living in a Low-Income, "Colored," Farmworker Community in South Africa.

PubMed

Lesch, Elmien; Adams, Arlene R

2016-01-01

This study has been motivated by the scarcity of research that adopts an unproblematic focus on sexuality in South African Black and Colored low-income communities. We explored the sexual intimacy constructions of 15 Colored married/cohabiting couples who live in a low-income, historical South African farmworker community. Using a social constructionist thematic analysis method, we identified four themes: (a) metaphoric and indirect sexual language; (b) the use of a romantic discourse to talk about sexual experiences; (c) male-centered sexual relationships; and (d) lack of privacy brings both restriction and pleasure. We consider how these themes may be linked to the participants' community context and colonial and apartheid history. Finally, we emphasize the need for research that also explores positive sex functions and experiences rather than focuses narrowly on problematic sexual behavior.

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

PubMed

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

2015-01-01

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

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

PubMed

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

2015-12-01

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

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

PubMed

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

2011-01-01

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

Medical Student Sexuality: How Sexual Experience and Sexuality Training Impact U.S. and Canadian Medical Students’ Comfort in Dealing with Patients’ Sexuality in Clinical Practice

PubMed Central

Shindel, Alan W.; Ando, Kathryn A.; Nelson, Christian J.; Breyer, Benjamin N.; Lue, Tom F.; Smith, James F.

2013-01-01

Purpose To determine factors associated with students’ comfort in addressing patients’ sexuality in the clinical context. Method The authors invited students enrolled in MD-degree-granting and osteopathic medical schools in the United States and Canada to participate in an anonymous Internet survey between February and July 2008. The survey assessed ethnodemographic factors and sexual history. Respondents also completed the Center for Epidemiologic Studies Depression Scale. Male respondents completed the International Index of Erectile Function and the Premature Ejaculation Diagnostic Tool. Female respondents completed the Female Sexual Function Index and the Index of Sex Life. The authors used descriptive statistics, ANOVA, and multivariable logistic regression to analyze responses. Results The authors’ analyses included 2,261 completed survey responses: 910 from men, 1,343 from women, and 8 from individuals who self-identified as “other” gendered. Over 53% of respondents (n = 1,206) stated that they felt they had not received sufficient training in medical school to address sexual concerns clinically. Despite this, 81% of students (n = 1,827) reported feeling comfortable dealing with their patients’ sexuality issues. Students with limited sexual experience, students at risk for sexual problems, and students who felt that they had not been trained adequately were less likely to report being comfortable talking to patients about sexual health issues. Conclusions Perception of inadequate sexuality training in medical school and personal issues pertaining to sex may be associated with students’ difficulty in addressing patients’ sexuality. Adequate training is preeminently associated with feeling comfortable addressing patients’ sexuality and should be a priority for medical education. PMID:20671459

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

Ejaculatory Function After Permanent {sup 125}I Prostate Brachytherapy for Localized Prostate Cancer

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

Huyghe, Eric; Department of Urology and Andrology, Paul Sabatier University, CHU Paule de Viguier, Toulouse; Delannes, Martine

Purpose: Ejaculatory function is an underreported aspect of male sexuality in men treated for prostate cancer. We conducted the first detailed analysis of ejaculatory function in patients treated with permanent {sup 125}I prostate brachytherapy for localized prostate cancer. Patients and Methods: Of 270 sexually active men with localized prostate cancer treated with permanent {sup 125}I prostate brachytherapy, 241 (89%), with a mean age of 65 years (range, 43-80), responded to a mailed questionnaire derived from the Male Sexual Health Questionnaire regarding ejaculatory function. Five aspects of ejaculatory function were examined: frequency, volume, dry ejaculation, pleasure, and pain. Results: Of themore » 241 sexually active men, 81.3% had conserved ejaculatory function after prostate brachytherapy; however, the number of patients with rare/absent ejaculatory function was double the pretreatment number (p < .0001). The latter finding was correlated with age (p < .001) and the preimplant International Index of Erectile Function score (p < .001). However, 84.9% of patients with maintained ejaculatory function after implantation reported a reduced volume of ejaculate compared with 26.9% before (p < .001), with dry ejaculation accounting for 18.7% of these cases. After treatment, 30.3% of the patients experienced painful ejaculation compared with 12.9% before (p = .0001), and this was associated with a greater number of implanted needles (p = .021) and the existence of painful ejaculation before implantation (p < .0001). After implantation, 10% of patients who continued to be sexually active experienced no orgasm compared with only 1% before treatment. in addition, more patients experienced late/difficult or weak orgasms (p = .001). Conclusion: Most men treated with brachytherapy have conserved ejaculatory function after prostate brachytherapy. However, most of these men experience a reduction in volume and a deterioration in orgasm.« less

Anabolic Steroid Misuse Among US Adolescent Boys: Disparities by Sexual Orientation and Race/Ethnicity

PubMed Central

Calzo, Jerel P.; Griffiths, Scott; Murray, Stuart B.

2017-01-01

Objectives. To examine the prevalence of anabolic steroid misuse among US adolescent boys as a function of sexual orientation and race/ethnicity. Methods. We analyzed boys from the 2015 Youth Risk Behavior Survey (n = 6248; mean age = 16), a representative sample of US high school students. Lifetime prevalence of anabolic steroid misuse was dichotomized as never versus 1 or more times. Results. Sexual minority boys reported elevated misuse compared with heterosexual boys, within each level of race/ethnicity. Black, Hispanic, and White sexual minority boys reported misuse at approximately 25%, 20%, and 9%, respectively. Conclusions. Sexual orientation health disparities in anabolic steroid misuse disproportionally affect Black and Hispanic sexual minority adolescent boys, but more research is needed to understand the mechanisms driving these disparities. PMID:27997246

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

PubMed

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

2015-02-01

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

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

PubMed

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

2015-03-01

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

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

PubMed

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

2017-10-01

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

The association between sexual satisfaction and body image in women.

PubMed

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

2010-02-01

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

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

PubMed

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

2015-07-01

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

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

PubMed

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

1999-09-01

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

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

PubMed

Fatemi, Seyedeh Seddigeh; Taghavi, Seyed Morteza

2009-01-01

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

Testosterone supplementation and sexual function: a meta-analysis study.

PubMed

Corona, Giovanni; Isidori, Andrea M; Buvat, Jaques; Aversa, Antonio; Rastrelli, Giulia; Hackett, Geoff; Rochira, Vincenzo; Sforza, Alessandra; Lenzi, Andrea; Mannucci, Edoardo; Maggi, Mario

2014-06-01

The role of testosterone supplementation (TS) as a treatment for male sexual dysfunction remains questionable. The aim of this study was to attempt a meta-analysis on the effect of TS on male sexual function and its synergism with the use of phosphodiesterase type 5 inhibitor (PDE5i). An extensive Medline, Embase, and Cochrane search was performed. All randomized controlled trials (RCTs) comparing the effect of TS vs. placebo or the effect of TS as add on to PDE5is on sexual function were included. Data extraction was performed independently by two of the authors (A. M. Isidori and G. Corona), and conflicts resolved by the third investigator (M. Maggi). Out of 1,702 retrieved articles, 41 were included in the study. In particular, 29 compared TS vs. placebo, whereas 12 trials evaluated the effect of TS as add on to PDE5is. TS is able to significantly ameliorate erectile function and to improve other aspects of male sexual response in hypogonadal patients. However, the presence of possible publication bias was detected. After applying "trim and fill" method, the positive effect of TS on erectile function and libido components retained significance only in RCTs partially or completely supported by pharmaceutical companies (confidence interval [0.04-0.53] and [0.12; 0.52], respectively). In addition, we also report that TS could be associated with an improvement in PDE5i outcome. These results were not confirmed in placebo-controlled studies. The majority of studies, however, included mixed eugonadal/hypogonadal subjects, thus imparting uncertainty to the statistical analyses. TS plays positive effects on male sexual function in hypogonadal subjects. The role of TS is uncertain in men who are not clearly hypogonadal. The apparent difference between industry-supported and independent studies could depend on trial design more than on publication bias. New RCTs exploring the effect of TS in selected cases of PDE5i failure that persistently retain low testosterone levels are advisable. © 2014 International Society for Sexual Medicine.

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

PubMed Central

Meston, Cindy M.

2010-01-01

This study examined the effects of state self-focused attention on sexual arousal and trait self-consciousness on sexual arousal and function in sexually functional (n = 16) and dysfunctional (n = 16) women. Self-focused attention was induced using a 50% reflectant television screen in one of two counterbalanced sessions during which self-report and physiological sexual responses to erotic films were measured. Self-focused attention significantly decreased vaginal pulse amplitude (VPA) responses among sexually functional but not dysfunctional women, and substantially decreased correlations between self-report and VPA measures of sexual arousal. Self-focused attention did not significantly impact subjective sexual arousal in sexually functional or dysfunctional women. Trait private self-consciousness was positively related to sexual desire, orgasm, compatibility, contentment and sexual satisfaction. Public self-consciousness was correlated with sexual pain. The findings are discussed in terms of Masters and Johnson’s [Masters, W. H. & Johnson, V. E. (1970). Human sexual inadequacy. Boston: Little, Brown) concepts of “spectatoring” and “sensate focus.” PMID:15927143

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 health and quality of life among male veterans with intestinal ostomies.

PubMed

Symms, Michelle R; Rawl, Susan M; Grant, Marcia; Wendel, Christopher S; Coons, Stephen Joel; Hickey, Sara; Baldwin, Carol M; Krouse, Robert S

2008-01-01

This secondary analysis was conducted to expand our understanding of the challenges men with ostomies face regarding intimate relationships and sexual functioning. We examined quantitative and qualitative data to examine sexual functioning, intimate relationships, and health-related quality of life (HR-QOL) among military veterans who are living with an intestinal stoma. Three Veterans Health Administration sites. Four hundred eighty-one male veterans. Case-control, mixed-methods design; cases were those who had ostomies for at least 2 months, and controls had a similar major intestinal surgical procedure that did not result in an ostomy. Quantitative and qualitative data on sexual functioning, relationships, and other dimensions of HR-QOL were collected using the modified City of Hope Quality of Life-Ostomy questionnaire. The overall response rate was 49%. Prevalence of erectile dysfunction was significantly higher among ostomates compared with controls (P < .001). Although a greater proportion of veterans with ostomies reported being sexually active before surgery compared with controls (P < .001), the proportion of men who had resumed sexual activity after surgery is significantly lower among the ostomy group (P = .015). Compared with veterans with ostomies who did not resume sexual activity after surgery, those who were sexually active reported a higher total HR-QOL score and higher scores on all 4 modified City of Hope Quality of Life-Ostomy dimensions (psychological, social, physical, and spiritual well-being). Veterans with ostomies who had resumed sexual activity after their ostomy also reported that their ostomy had caused significantly less interference with social activities, less isolation, less interference with their personal relationships, and less interference with their ability to be intimate. These men also reported less difficulty adjusting to the ostomy. Results of qualitative analyses showed that problems with intimacy and sexual function are among the greatest challenges faced by ostomates. Presence of an ostomy was associated with lower rates of sexual activity and higher erectile dysfunction. The lower rates of sexual activity and sexual satisfaction were related to the social and psychological dimensions of HR-QOL among men with ostomies. Interventions to address sexual concerns of male ostomates and their partners may prevent decrements to HR-QOL for these patients. Results of the study have implications for the clinical nurse specialist role in supporting and educating patients with ostomies to minimize the negative impact of an intestinal ostomy on sexual health and HR-QOL. Implications also relate to the need to educate current and future nurses about the importance of assessing sexual health.

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.

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.

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

PubMed

Turchik, Jessica A; Hassija, Christina M

2014-09-01

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

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

PubMed

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

2018-02-20

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

Sexual self-schema and depressive symptoms after prostate cancer.

PubMed

Hoyt, Michael A; Carpenter, Kristen M

2015-04-01

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

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.

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.

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.

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.

Sexual health of male cardiac patients – present status and expectations of patients with coronary heart disease

PubMed Central

Karpiński, Łukasz; Gebala, Jana; Rusiecki, Lesław; Biełous-Wilk, Anna; Krauz, Ewa S.; Piłot, Magdalena; Womperski, Krzysztof; Rusiecka, Małgorzata; Pilecki, Witold

2017-01-01

Introduction Due to the pathogenetic association between erectile disorders and cardiovascular diseases, cardiologists consult many patients with erectile dysfunction (ED). The aim of the study was to evaluate sexual function in patients with coronary heart disease (CHD) and the use of sexual knowledge in cardiology practice, both current use and that expected by patients. Material and methods One thousand one hundred and thirty-six patients (average age: 60.73 ±9.20) underwent a dedicated survey which encompassed demographic data and the presence of modifiable ED risk factors. The presence of ED was assessed using the International Index of Erectile Function (IIEF-5) Questionnaire. Results Sexual problems were discussed by cardiologists with 45 (3.96%) patients. The frequency of initiating the topic was significantly associated with the respondents’ education level (p = 0.0031); however, it was not associated with the patients’ age, duration of CHD, presence of ED, or modifiable risk factors. Four hundred and sixteen (36.62%) respondents indicated that they expect their cardiologist to take an interest in their ED. Nine hundred and twenty-six (81.51%) patients claimed good sexual function to be important or very important to them. Attitude to sexual function was significantly associated with age (p < 0.0001), duration of CHD (p = 0.0018), education (p = 0.0011), presence of ED (p = 0.0041), diabetes (p = 0.0283) and hyperlipidaemia (p = 0.0014). Conclusions The low frequency with which cardiologists initiate the topic of ED is in contrast to the expectations of patients with CHD. The majority of these patients regard good sexual maintenance as an important part of their life. PMID:28261282

Childhood Sexual Abuse as a Predictor of Birth-Related Posttraumatic Stress and Postpartum Posttraumatic Stress

ERIC Educational Resources Information Center

Lev-Wiesel, Rachel; Daphna-Tekoah, Shir; Hallak, Mordechai

2009-01-01

Objective: To investigate the extent to which childbirth may function as a retraumatization of childhood sexual abuse, and may exacerbate postpartum posttraumatic stress reactions. Methods: Data was obtained from a convenience sample of 837 women in mid-pregnancy, at 2 and 6 months following childbirth. Three groups were drawn from this sample:…

Child Maltreatment and Perceived Family Environment as Risk Factors for Adult Rape: Is Child Sexual Abuse the Most Salient Experience?

ERIC Educational Resources Information Center

Messman-Moore, T.L.; Brown, A.L.

2004-01-01

Objective:: Child maltreatment and family functioning were examined as predictors of adult rape in a sample of 925 college women. Method:: Information was obtained from retrospective self-report questionnaires. Child sexual abuse (CSA) was assessed with the Life Experiences Questionnaire, child emotional abuse (CEA) and physical abuse (CPA) were…

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.

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 Study of Sexuality and Health among Older Adults in the United States

PubMed Central

Lindau, Stacy Tessler; Schumm, L. Philip; Laumann, Edward O.; Levinson, Wendy; O’Muircheartaigh, Colm A.; Waite, Linda J.

2008-01-01

BACKGROUND Despite the aging of the population, little is known about the sexual behaviors and sexual function of older people. METHODS We report the prevalence of sexual activity, behaviors, and problems in a national probability sample of 3005 U.S. adults (1550 women and 1455 men) 57 to 85 years of age, and we describe the association of these variables with age and health status. RESULTS The unweighted survey response rate for this probability sample was 74.8%, and the weighted response rate was 75.5%. The prevalence of sexual activity declined with age (73% among respondents who were 57 to 64 years of age, 53% among respondents who were 65 to 74 years of age, and 26% among respondents who were 75 to 85 years of age); women were significantly less likely than men at all ages to report sexual activity. Among respondents who were sexually active, about half of both men and women reported at least one bothersome sexual problem. The most prevalent sexual problems among women were low desire (43%), difficulty with vaginal lubrication (39%), and inability to climax (34%). Among men, the most prevalent sexual problems were erectile difficulties (37%). Fourteen percent of all men reported using medication or supplements to improve sexual function. Men and women who rated their health as being poor were less likely to be sexually active and, among respondents who were sexually active, were more likely to report sexual problems. A total of 38% of men and 22% of women reported having discussed sex with a physician since the age of 50 years. CONCLUSIONS Many older adults are sexually active. Women are less likely than men to have a spousal or other intimate relationship and to be sexually active. Sexual problems are frequent among older adults, but these problems are infrequently discussed with physicians. PMID:17715410

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.

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

PubMed

Kelley, Erika L; Gidycz, Christine A

2015-01-01

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

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

PubMed

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

2016-10-01

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

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

PubMed

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

2013-01-01

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

Impact of a Stress Management Intervention Program on Sexual Functioning and Stress Reduction in Women with Breast Cancer

PubMed Central

Shayan, Arezoo; Jamshidi, Farkhondeh; Tahmasebiboldaji, Vahid; Khani, Somayeh; Babaei, Maryam; Havasian, Mohamad Reza; Masoumi, Seyedeh Zahra

2017-01-01

Breast cancer as the most common cancer among women endangers various aspects of their sexual lives and is a major culprit regarding health impairment and low life quality. The aim of this study was to examine the effect of a stress management intervention program on sexual functioning and stress reduction in women with breast cancer. This study employed a quasi-experimental pre-test, post-test design which included follow-up checks and a control group. To this end, 104 women with breast cancer referring to Hamadan’s Mahdiyeh MRI Center at the time of data collection were conventionally selected in 2015. Using permuted blocks, they were randomly divided into experimental and control groups (n= 52), only the former receiving stress management counseling for 18 hours. Data were collected through a demographic questionnaire, the Female Sexual Function Index (FSFI) questionnaire, and Harry’s stress questionnaire, filled out by patients before and after the intervention. To analyze the data, descriptive statistics and two-way ANOVA were used. The results showed that cognitive - behavioral stress management group therapy improved total sexual functioning and its subscales. After the treatment, there was a significant difference in mean scores between the groups (p=0.01). Moreover, significant differences were observed in the mean scores for stress with improvement in the experimental group in post-test results. Cognitive - behavioral group therapy for stress management was thuis found to improve total sexual functioning and its subscales and reduce the level of stress in the experimental group after the intervention and follow-up period with an interval of two weeks. Therefore, this method can be used as a complementary therapy along with medical treatment in oncology centers. PMID:29072415

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.

Exploring infertile women's experiences about sexual life: A qualitative study.

PubMed

Kohan, Shahnaz; Ghasemi, Zahra; Beigi, Marjan

2015-01-01

Infertility is a serious problem in a couple's life that affects their marriage relationships. So, dissatisfaction with sexual function resulting from interpersonal problems is common among these couples. This qualitative study aimed to explore the experiences of infertile women in their sexual life. This is a qualitative study with a phenomenological approach. The participants were 20 infertile women referring to the health care centers and infertility clinics of Isfahan and were selected through purposive sampling. Data were collected by tape recording of deep interviews and analyzed by Colaizzi's method. Analysis of the participants' experiences led to five main concepts: "Disturbed in femininity-body image," "discouragement of sexual relations," "sacrifice of sexual pleasure for the sake of getting pregnant," "confusion in sexual relation during infertility treatment," and "striving to protect their marriage." Findings revealed that infertility affects women's different aspects of sexual life, especially disturbance in femininity-body image and sexual reluctance. With regard to women's willingness to protect their matrimonial life and prevent sexual trauma as a destroying factor for their family's mental health, it seems sexual counseling is necessary for infertile couples.

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

PubMed

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

2011-03-01

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

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

PubMed

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

2015-04-01

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

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

PubMed

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

2015-08-01

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

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.

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.

Vaginal and Sexual Health Treatment Strategies within a Female Sexual Medicine Program for Cancer Patients and Survivors

PubMed Central

Carter, Jeanne; Stabile, Cara; Seidel, Barbara; Baser, Raymond E.; Goldfarb, Shari; Goldfrank, Deborah J.

2016-01-01

Purpose We sought to evaluate patient adherence and response to simple vaginal and sexual health treatment strategies in female cancer patients receiving treatment at a female sexual medicine and health program, and identify improvements of physical symptoms, per patient and clinical evaluation. Methods Evalubility criteria included gynecologic exam at initial visit; at least one follow-up with gynecologic exam within 8 months of initial visit; and all consecutive follow-ups <6 months apart. Demographics, medical information, and clinical assessments from 175 evaluable patients with at least 1 follow-up from 09/12–10/14 were analyzed. The majority of patients were being treated for or had a history of breast (n=90, 53%), gynecologic (n=54, 32%), or colorectal/anal (n=15, 9%) cancers. An assessment form included a clinician evaluation, Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), and patient-reported outcomes. Compliance with treatment recommendations were summarized, and changes over time were compared for clinical outcomes. Results Mean number of visits was 3.43. Mean age was 55.4 years; 92% (n=155/169) were in menopause. Treatment strategies included rationale and instruction for use of vaginal moisturizers, lubricants, pelvic floor exercises and dilator therapy, in addition to psychosexual education regarding sexual changes (response, anatomy and function) associated with cancer treatment and support. At last assessment, 89% had complied with the clinical recommendation (moisturize 2–5+ times/week). Vaginal pH scores >6.5 declined over time (p=0.03). VAS scores improved by last assessment (p<0.001), as did VuAS scores (p=0.001). Sexual function scores significantly improved (p<0.001), confidence about future sexual activity increased (p=0.004), and sexual/vaginal health concerns decreased (p=0.00003). Conclusion Significant changes were observed in women using treatment strategies, with improvement in vulvovaginal symptoms, a decrease in elevated vaginal pH and pain with exams, enhanced sexual function, and intimacy confidence. Implications for Cancer Survivors These findings have high clinical relevance for symptom management with improvement of sexual function using simple strategies and clinical tools in the oncology setting. PMID:27868156

Effects of functionally asexual reproduction on quantitative genetic variation in the evening primroses (Oenothera, Onagraceae).

PubMed

Godfrey, Ryan M; Johnson, Marc T J

2014-11-01

It has long been predicted that a loss of sexual reproduction leads to decreased heritable variation within populations and increased differentiation between populations. Despite an abundance of theory, there are few empirical tests of how sex affects genetic variation in phenotypic traits, especially for plants. Here we test whether repeated losses of two critical components of sex (recombination and segregation) in the evening primroses (Oenothera L., Onagraceae) affect quantitative genetic variation within and between populations. We sampled multiple genetic families from 3-5 populations from each of eight Oenothera species, which represented four independent transitions between sexual reproduction and a functionally asexual genetic system called "permanent translocation heterozygosity." We used quantitative genetics methods to partition genetic variation within and between populations for eight plant traits related to growth, leaf physiology, flowering, and resistance to herbivores. Heritability was, on average, 74% higher in sexual Oenothera populations than in functionally asexual populations, with plant growth rate, specific leaf area, and the percentage of leaf water content showing the strongest differences. By contrast, genetic differentiation among populations was 2.8× higher in functionally asexual vs. sexual Oenothera species. This difference was particularly strong for specific leaf area. Sexual populations tended to exhibit higher genetic correlations among traits, but this difference was weakly supported. These results support the prediction that sexual reproduction maintains higher genetic variation within populations, which may facilitate adaptive evolution. We also found partial support for the prediction that a loss of sex leads to greater population differentiation, which may elevate speciation rates. © 2014 Botanical Society of America, Inc.

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

PubMed

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

2013-08-01

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

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

PubMed

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

2013-12-05

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

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

PubMed Central

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

2013-01-01

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

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.

Effects of low-dose paroxetine 7.5 mg on weight and sexual function during treatment of vasomotor symptoms associated with menopause

PubMed Central

Portman, David J.; Kaunitz, Andrew M.; Kazempour, Kazem; Mekonnen, Hana; Bhaskar, Sailaja; Lippman, Joel

2014-01-01

Abstract Objective Two phase 3, randomized, placebo-controlled trials demonstrated that low-dose paroxetine 7.5 mg reduced the frequency and severity of vasomotor symptoms (VMS) associated with menopause and had a favorable tolerability profile. The impact of paroxetine 7.5 mg on body weight and sexual function was evaluated in a pooled analysis. Methods Postmenopausal women aged 40 years or older who had moderate to severe VMS were randomly assigned to receive paroxetine 7.5 mg or placebo once daily for 12 or 24 weeks. Assessments included changes in body mass index (BMI) and weight, Arizona Sexual Experiences Scale score, Hot Flash–Related Daily Interference Scale sexuality subscore, and adverse events related to weight or sexual dysfunction. Results Pooled efficacy and safety populations comprised 1,174 and 1,175 participants, respectively. Baseline values were similar for median weight (∼75 kg), median BMI (∼28 kg/m2), and the proportion of women with sexual dysfunction (∼58%). No clinically meaningful or statistically significant changes from baseline in weight or sexual function assessments occurred in the paroxetine 7.5 mg group. Small but statistically significant increases in weight and BMI were observed in the placebo group only on week 4. No significant difference between treatment groups was observed in the proportion of participants who had 7% or higher gain in body weight on week 4, 12, or 24. Rates of adverse events suggestive of sexual dysfunction were low and similar in both treatment groups. Conclusions Paroxetine 7.5 mg does not cause weight gain or negative changes in libido when used to treat menopause-associated VMS in postmenopausal women. PMID:24552977

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

PubMed

Stoeber, Joachim; Harvey, Laura N

2016-11-01

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

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

PubMed

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

2016-05-01

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

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.

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

PubMed

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

2016-08-01

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

Impact of fibromyalgia on sexual function in women.

PubMed

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

2018-03-09

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

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

PubMed

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

2014-02-01

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

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

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

PubMed

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

2015-07-01

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

A Qualitative Study on Experiences After Vulvar Surgery in Women With Lichen Sclerosus and Sexual Pain.

PubMed

Brauer, Marieke; van Lunsen, Rik H W; Laan, Ellen T M; Burger, Matthé P M

2016-07-01

Lichen sclerosus (LS) of the vulva can profoundly affect sexual interaction because of painful fissures and narrowing of the vaginal introitus. Successful surgical treatment is usually defined as restoration of (pain-free) penetrative sexual activity. To evaluate the impact of surgery on (dyadic) sexual functioning and pleasure and psychological well-being. Nineteen women with anogenital LS participated in audiotaped, qualitative, individual interviews after surgery to re-enable sexual intercourse. Physical, sexual, and psychological experiences were analyzed using the constant comparative method. Vulvar surgery resulted in a decrease of sexual pain in 13 of 19 patients (68%). Of these 13 patients, 4 were completely free of pain and the other 9 patients expressed a shift from preoperative sexual pain to postoperative sexual discomfort. These women reported improved sexual functioning, increased sexual activity and intimacy with the partner, and reinstated feelings of being an adequate woman and sexual partner. In 1 of the 19 patients (5%), surgery did not result in decreased sexual pain, yet she continued to have intercourse. Five of the 19 patients (26%) stopped having intercourse because of pain; one woman had secondary vaginismus and another woman, in retrospect, had premorbid generalized unprovoked vulvodynia. Four of these women were unable to communicate with their partner about sexual matters and to change their sexual repertoire (satisfactorily) once they had ceased intercourse (attempts). Eighteen women (95%) reported a decrease of LS symptoms in daily life. Vulvar surgery seems an effective treatment for most women with LS who experience sexual pain owing to anatomic or epithelial changes and who wish to resume intercourse. To assess whether women might benefit from such surgery and/or whether (additional) sexual counseling is indicated, preoperative sexological couple-based consultation is needed. This consultation should exclude comorbid vaginismus and generalized unprovoked vulvodynia and index the couple's pre-existing sex life, including sexual communication skills, and the ability to incorporate non-coital pain-free sexual activities. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

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

Maca (L. meyenii) for improving sexual function: a systematic review

PubMed Central

2010-01-01

Background Maca (Lepidium meyenii) is an Andean plant of the brassica (mustard) family. Preparations from maca root have been reported to improve sexual function. The aim of this review was to assess the clinical evidence for or against the effectiveness of the maca plant as a treatment for sexual dysfunction. Methods We searched 17 databases from their inception to April 2010 and included all randomised clinical trials (RCTs) of any type of maca compared to a placebo for the treatment of healthy people or human patients with sexual dysfunction. The risk of bias for each study was assessed using Cochrane criteria, and statistical pooling of data was performed where possible. The selection of studies, data extraction, and validations were performed independently by two authors. Discrepancies were resolved through discussion by the two authors. Results Four RCTs met all the inclusion criteria. Two RCTs suggested a significant positive effect of maca on sexual dysfunction or sexual desire in healthy menopausal women or healthy adult men, respectively, while the other RCT failed to show any effects in healthy cyclists. The further RCT assessed the effects of maca in patients with erectile dysfunction using the International Index of Erectile Dysfunction-5 and showed significant effects. Conclusion The results of our systematic review provide limited evidence for the effectiveness of maca in improving sexual function. However, the total number of trials, the total sample size, and the average methodological quality of the primary studies were too limited to draw firm conclusions. More rigorous studies are warranted. PMID:20691074

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.

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

PubMed

Vallejo-Medina, Pablo; Sierra, Juan Carlos

2013-02-01

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

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

PubMed

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

2008-12-01

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

Sexual harassment against nurses in Turkey.

PubMed

Celik, Yusuf; Celik, Sevilay Senol

2007-01-01

To identify the prevalence and sources of sexual harassment against nurses in Turkey, its consequences, and factors affecting harassment experiences. Descriptive survey. Participants (N=622) were selected from nurses working in eight Ministry of Health hospitals in Turkey. Participants were surveyed with a Sexual Harassment Questionnaire, consisting of the sociodemographic characteristics of participants, types of sexual harassment, sources, feelings, ramifications, and ways to cope with sexual harassment behaviors. Frequency and percentage distributions, chi-square, and logistic regression were used for data analysis. The results showed 37.1% of participants had been harassed sexually. Physicians were identified as the primary instigators of sexual harassment. The most common reactions against harassers were anger and fear; frequently reported negative effects of sexual harassment were disturbed mental health function, decline in job performance, and headache. "Did nothing" was the coping method used most commonly by the nurses. About 80% of sexually harassed nurses did not report the incident of sexual harassment to hospital administration. The lower working status and power of nurses in the workplace, poor working conditions in healthcare settings, and insufficient administrative mechanisms, including the present law and regulations against sexual harassers, were identified as important factors in the work environment in Turkey.

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.

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.

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

PubMed

Perz, Janette; Ussher, Jane M

2015-09-09

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

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…

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.

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

PubMed

Burri, Andrea

2017-01-01

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

Disgust and Sexual Arousal in Young Adult Men and Women.

PubMed

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

2015-08-01

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

Education Based on Theory of Planned Behavior over Sexual Function of Women with Breast Cancer in Iran.

PubMed

Jalambadani, Zeinab; Garmaroudi, Gholamreza; Tavousi, Mahmood

2018-01-01

Sexual function in patients with breast cancer, especially in younger patients, is an important issue from clinical and psychosocial perspectives. Theory of planned behavior (TPB) is one of the important theories that explain the main process of adopting healthy behaviors. This study investigated the effect of education based on TPB on sexual function of women with breast cancer in Mashhad, Iran. In this quasi-experimental study, 120 women (60 women in education group, 60 women in control group) visiting Razavi Hospital of Mashhad city were studied, selected by using the random method in 2016. The data collection tool was a questionnaire which was completed during the interview. The validity and reliability of this questionnaire were determined through the face and content validity and through Cronbach's alpha and test-retest, respectively. Data were analyzed using statistical SPSS 22 software. Using linear regression analysis, it was determined that attitudes, subjective norm, and perceived behavioral control (PBC) predict 0.85 overall of the total variance of sexual function intention, which among these variables, the effect of the subjective norm was more than the other ones ( P < 0.05). After educational intervention, the average rates of knowledge, attitude, PBC, and intention of sexual function in sex education group were significantly increased ( P < 0.05); these changes were not meaningful in the control group. There was no statistically significant difference in subjective norm between the two groups after intervention. The results of this research suggest that TPB can be used in sex education interventions and have relevant results.

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

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.

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

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

PubMed

Nobre, Pedro J; Pinto-Gouveia, José

2006-08-01

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

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

PubMed

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

2017-07-01

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

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.

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

PubMed

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

2010-12-15

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

Sexual Functioning Among Endometrial Cancer Patients Treated With Adjuvant High-Dose-Rate Intra-Vaginal Radiation Therapy

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

Damast, Shari, E-mail: shari.damast@yale.edu; Alektiar, Kaled M.; Goldfarb, Shari

Purpose: We used the Female Sexual Function Index (FSFI) to investigate the prevalence of sexual dysfunction (SD) and factors associated with diminished sexual functioning in early stage endometrial cancer (EC) patients treated with simple hysterectomy and adjuvant brachytherapy. Methods and Materials: A cohort of 104 patients followed in a radiation oncology clinic completed questionnaires to quantify current levels of sexual functioning. The time interval between hysterectomy and questionnaire completion ranged from <6 months to >5 years. Multivariate regression was performed using the FSFI as a continuous variable (score range, 1.2-35.4). SD was defined as an FSFI score of <26, basedmore » on the published validation study. Results: SD was reported by 81% of respondents. The mean ({+-} standard deviation) domain scores in order of highest-to-lowest functioning were: satisfaction, 2.9 ({+-}2.0); orgasm, 2.5 ({+-}2.4); desire, 2.4 ({+-}1.3); arousal, 2.2 ({+-}2.0); dryness, 2.1 ({+-}2.1); and pain, 1.9 ({+-}2.3). Compared to the index population in which the FSFI cut-score was validated (healthy women ages 18-74), all scores were low. Compared to published scores of a postmenopausal population, scores were not statistically different. Multivariate analysis isolated factors associated with lower FSFI scores, including having laparotomy as opposed to minimally invasive surgery (effect size, -7.1 points; 95% CI, -11.2 to -3.1; P<.001), lack of vaginal lubricant use (effect size, -4.4 points; 95% CI, -8.7 to -0.2, P=.040), and short time interval (<6 months) from hysterectomy to questionnaire completion (effect size, -4.6 points; 95% CI, -9.3-0.2; P=.059). Conclusions: The rate of SD, as defined by an FSFI score <26, was prevalent. The postmenopausal status of EC patients alone is a known risk factor for SD. Additional factors associated with poor sexual functioning following treatment for EC included receipt of laparotomy and lack of vaginal lubricant use.« less

Safe Sex Messages Within Dating and Entertainment Smartphone Apps: A Review

PubMed Central

Williams, Henrietta; Hocking, Jane S; Lim, Megan SC

2016-01-01

Background Smartphone apps provide a new platform for entertainment, information distribution, and health promotion activities, as well as for dating and casual sexual encounters. Previous research has shown high acceptability of sexual health interventions via smartphone apps; however, sexual health promotion apps were infrequently downloaded and underused. Integrating sexual health promotion into established apps might be a more effective method. Objective The objective of our study was to critically review popular sex-related apps and dating apps, in order to ascertain whether they contain any sexual health content. Methods Part 1: In January 2015, we used the term “sexual” to search for free apps in the Apple iTunes store and Android Google Play store, and categorized the sexual health content of the 137 apps identified. Part 2: We used the term “dating” to search for free geosocial-networking apps in the Apple iTunes and Android Google Play stores. The apps were downloaded to test functionality and to determine whether they included sexual health content. Results Part 1: Of the 137 apps identified, 15 (11.0%) had sexual health content and 15 (11.0%) contained messages about sexual assault or violence. The majority of the apps did not contain any sexual health content. Part 2: We reviewed 60 dating apps: 44 (73%) targeting heterosexual users, 9 (15%) targeting men who have sex with men (MSM), 3 (5%) targeting lesbian women, and 4 (7%) for group dating. Only 9 dating apps contained sexual health content, of which 7 targeted MSM. Conclusions The majority of sex-related apps and dating apps contained no sexual health content that could educate users about and remind them of their sexual risks. Sexual health practitioners and public health departments will need to work with app developers to promote sexual health within existing popular apps. For those apps that already contain sexual health messages, further study to investigate the effectiveness of the content is needed. PMID:27826133

Living with genital pain: Sexual function, satisfaction, and help-seeking among women living in Sweden.

PubMed

Thomtén, Johanna

2017-12-29

Background and aims Female genital pain is a debilitating problem that negatively affects several aspects of the life of women. Several studies present figures of prevalence indicating that the problem affects nearly 20% of young women. However, many women fail to consult health care and the estimated prevalence therefore remains insecure. Historically, genital pain was commonly viewed as either physiological or psychosexual. Although the current field of research and clinical expertise in general agree upon a biopsychosocial conceptualization, less is known about the manifestation of the problem in everyday life and the experience of seeking health care among afflicted women. The objectives of the present study was to examine genital pain in a general female population living in Sweden cross-sectionally in terms of prevalence, sexual function, sexual satisfaction and help seeking, and to identify possible predictors of genital pain among women. Methods The study was a population-based study using a postal questionnaire administered to 4052 women (age 18--35). Of these 944 (response rate: 23%) took part in the study. Results Genital pain of six months duration was reported by 16.1% of the women. Women with pain more commonly reported fungal infections, other pain problems, sexual dysfunctions and symptoms of anxiety than pain-free women and in addition lower sexual satisfaction. There were no differences in sexual frequency. Pain was most commonly reported during sexual intercourse, but many women also experienced pain during non-sexual activities, with pain durations of several hours after the pain eliciting activity was interrupted. Of those reporting pain, 50% had sought care for their pain. The most common was to counsel a doctor and to receive topical treatment. However, the experienced effects of the treatments were on average low. In the explanatory model, fungal infections, and sexual dysfunctions were associated with genital pain. Conclusions The study had a low response rate, but still indicates that genital pain is common and negatively affects several aspects of women' life, not just sexual activities. Although many women report pro-longed pain experiences, many fail to consult health care and among those who seek care the effects of treatment are on average poor. There are strong associations between sexual dysfunctions (lack of sexual arousal, vaginal muscle tension hindering intercourse) and genital pain that, based on previous findings in this field of research, might be viewed in terms of circular maintaining processes. Implications Female genital pain is not just limited to the sexual context, but often negatively affects several situations in women' life. The size of the problem calls for immediate development of preventive interventions and treatment programs that focus on sexual education and to encourage a healthy sexuality among women and their partners. There is a need to identify methods in order to assemble evidence based interventions of female genital pain. Such methods are currently lacking, resulting in poor treatment options for women with pain.

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.

A multi-method study of health behaviours and perceived concerns of sexual minority females in Mumbai, India.

PubMed

Bowling, Jessamyn; Dodge, Brian; Banik, Swagata; Bartelt, Elizabeth; Rawat, Shruta; Guerra-Reyes, Lucia; Hensel, Devon; Herbenick, Debby; Anand, Vivek

2018-02-01

This multi-method study explores the perceived health status and health behaviours of sexual minority (i.e. self-identifying with a sexual identity label other than heterosexual) females (i.e. those assigned female at birth who may or may not identify as women) in Mumbai, India, a population whose health has been generally absent in scientific literature. Using community-based participatory research approaches, this study is a partnership with The Humsafar Trust (HST). HST is India's oldest and largest LGBT-advocacy organisation. An online survey targeted towards sexual minority females was conducted (n=49), with questions about sexual identity, perceived health and wellbeing, physical and mental healthcare access and experiences, and health behaviours (including substance use). Additionally, photo-elicitation interviews in which participants' photos prompt interview discussion were conducted with 18 sexual minority females. Sexual minority females face obstacles in health care, mostly related to acceptability and quality of care. Their use of preventative health screenings is low. Perceived mental health and experiences with care were less positive than that for physical health. Participants in photo-elicitation interviews described bodyweight issues and caretaking of family members in relation to physical health. Substance use functioned as both a protective and a risk factor for their health. Our findings point to a need for more resources for sexual minority females. Education on screening guidelines and screening access for sexual minority females would also assist these individuals in increasing their rates of preventative health.

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

PubMed

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

2017-01-02

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

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

PubMed

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

2016-07-01

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

Implementing international sexual counselling guidelines in hospital cardiac rehabilitation: development of the CHARMS intervention using the Behaviour Change Wheel.

PubMed

Mc Sharry, J; Murphy, P J; Byrne, M

2016-10-10

Decreased sexual activity and sexual problems are common among people with cardiovascular disease, negatively impacting relationship satisfaction and quality of life. International guidelines recommend routine delivery of sexual counselling to cardiac patients. The Cardiac Health and Relationship Management and Sexuality (CHARMS) baseline study in Ireland found, similar to international findings, limited implementation of sexual counselling guidelines in practice. The aim of the current study was to develop the CHARMS multi-level intervention to increase delivery of sexual counselling by healthcare professionals. We describe the methods used to develop the CHARMS intervention following the three phases of the Behaviour Change Wheel approach: understand the behaviour, identify intervention options, and identify content and implementation options. Survey (n = 60) and focus group (n = 14) data from two previous studies exploring why sexual counselling is not currently being delivered were coded by two members of the research team to understand staff's capability, opportunity, and motivation to engage in the behaviour. All potentially relevant intervention functions to change behaviour were identified and the APEASE (affordability, practicability, effectiveness, acceptability, side effects and equity) criteria were used to select the most appropriate. The APEASE criteria were then used to choose between all behaviour change techniques (BCTs) potentially relevant to the identified functions, and these BCTs were translated into intervention content. The Template for Intervention Description and Replication (TIDieR) checklist was used to specify details of the intervention including the who, what, how and where of proposed intervention delivery. Providing sexual counselling group sessions by cardiac rehabilitation staff to patients during phase III cardiac rehabilitation was identified as the target behaviour. Education, enablement, modelling, persuasion and training were selected as appropriate intervention functions. Twelve BCTs, linked to intervention functions, were identified for inclusion and translated into CHARMS intervention content. This paper details the use of Behaviour Change Wheel approach to develop an implementation intervention in an under-researched area of healthcare provision. The systematic and transparent development of the CHARMS intervention will facilitate the evaluation of intervention effectiveness and future replication and contribute to the advancement of a cumulative science of implementation intervention design.

Sexual Function Across Aging.

PubMed

Clayton, Anita H; Harsh, Veronica

2016-03-01

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

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

PubMed

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

2015-02-01

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

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

PubMed

Jiannine, Lia M

2018-01-01

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

A double-blind placebo-controlled trial of maca root as treatment for antidepressant-induced sexual dysfunction in women.

PubMed

Dording, Christina M; Schettler, Pamela J; Dalton, Elizabeth D; Parkin, Susannah R; Walker, Rosemary S W; Fehling, Kara B; Fava, Maurizio; Mischoulon, David

2015-01-01

Objective. We sought to demonstrate that maca root may be an effective treatment for antidepressant-induced sexual dysfunction (AISD) in women. Method. We conducted a 12-week, double-blind, placebo-controlled trial of maca root (3.0 g/day) in 45 female outpatients (mean age of 41.5 ± 12.5 years) with SSRI/SNRI-induced sexual dysfunction whose depression remitted. Endpoints were improvement in sexual functioning as per the Arizona Sexual Experience Scale (ASEX) and the Massachusetts General Hospital Sexual Function Questionnaire (MGH-SFQ). Results. 45 of 57 consented females were randomized, and 42 (30 premenopausal and 12 postmenopausal women) were eligible for a modified intent-to-treat analysis based on having had at least one postmedication visit. Remission rates by the end of treatment were higher for the maca than the placebo group, based on attainment of an ASEX total score ≤ 10 (9.5% for maca versus 4.8% for placebo), attaining an MGH-SFQ score ≤ 12 (30.0% for maca versus 20.0% for placebo) and reaching an MGH-SFQ score ≤ 8 (9.5% for maca versus 5.0% for placebo). Higher remission rates for the maca versus placebo group were associated with postmenopausal status. Maca was well tolerated. Conclusion. Maca root may alleviate SSRI-induced sexual dysfunction in postmenopausal women. This trial is registered with NCT00568126.

A Double-Blind Placebo-Controlled Trial of Maca Root as Treatment for Antidepressant-Induced Sexual Dysfunction in Women

PubMed Central

Dording, Christina M.; Schettler, Pamela J.; Dalton, Elizabeth D.; Parkin, Susannah R.; Walker, Rosemary S. W.; Fehling, Kara B.; Fava, Maurizio

2015-01-01

Objective. We sought to demonstrate that maca root may be an effective treatment for antidepressant-induced sexual dysfunction (AISD) in women. Method. We conducted a 12-week, double-blind, placebo-controlled trial of maca root (3.0 g/day) in 45 female outpatients (mean age of 41.5 ± 12.5 years) with SSRI/SNRI-induced sexual dysfunction whose depression remitted. Endpoints were improvement in sexual functioning as per the Arizona Sexual Experience Scale (ASEX) and the Massachusetts General Hospital Sexual Function Questionnaire (MGH-SFQ). Results. 45 of 57 consented females were randomized, and 42 (30 premenopausal and 12 postmenopausal women) were eligible for a modified intent-to-treat analysis based on having had at least one postmedication visit. Remission rates by the end of treatment were higher for the maca than the placebo group, based on attainment of an ASEX total score ≤ 10 (9.5% for maca versus 4.8% for placebo), attaining an MGH-SFQ score ≤ 12 (30.0% for maca versus 20.0% for placebo) and reaching an MGH-SFQ score ≤ 8 (9.5% for maca versus 5.0% for placebo). Higher remission rates for the maca versus placebo group were associated with postmenopausal status. Maca was well tolerated. Conclusion. Maca root may alleviate SSRI-induced sexual dysfunction in postmenopausal women. This trial is registered with NCT00568126. PMID:25954318

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

Sexual Minority Health and Health Risk Factors

PubMed Central

Hsieh, Ning; Ruther, Matt

2016-01-01

Introduction Although population studies have documented the poorer health outcomes of sexual minorities, few have taken an intersectionality approach to examine how sexual orientation, gender, and race jointly affect these outcomes. Moreover, little is known about how behavioral risks and healthcare access contribute to health disparities by sexual, gender, and racial identities. Methods Using ordered and binary logistic regression models in 2015, data from the 2013 and 2014 National Health Interview Surveys (N=62,302) were analyzed to study disparities in self-rated health and functional limitation. This study examined how gender and race interact with sexual identity to create health disparities, and how these disparities are attributable to differential exposure to behavioral risks and access to care. Results Conditional on sociodemographic factors, all sexual–gender–racial minority groups except straight white women, gay white men, and bisexual non-white men reported worse self-rated health than straight white men (p<0.05). Some of these gaps were attributable to differences in behaviors and healthcare access. All female groups, as well as gay non-white men, were more likely to report a functional limitation than straight white men (p<0.05), and these gaps largely remained when behavioral risks and access to care were accounted for. The study also discusses health disparities within sexual–gender–racial minority groups. Conclusions Sexual, gender, and racial identities interact with one another in a complex way to affect health experiences. Efforts to improve sexual minority health should consider heterogeneity in health risks and health outcomes among sexual minorities. PMID:26803358

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.

Examining Sexual Dysfunction in Non-Muscle-Invasive Bladder Cancer: Results of Cross-Sectional Mixed-Methods Research

PubMed Central

Kowalkowski, Marc A; Chandrashekar, Aravind; Amiel, Gilad E; Lerner, Seth P; Wittmann, Daniela A; Latini, David M; Goltz, Heather Honoré

2014-01-01

Introduction More than 70,000 new cases of bladder cancer are diagnosed in the United States annually; with 75% being non-muscle-invasive (NMIBC). Research examining sexual dysfunction in bladder cancer survivors is limited, and previous studies have focused on cystectomy patients. Aims To evaluate the impact of sexual dysfunction on NMIBC survivors. Methods Mixed-methods data collection integrated a quantitative survey (Study 1; n = 117) and semi-structured qualitative interviews (Study 2; n = 26) from a non-overlapping sample of NMIBC survivors. We performed descriptive and classification and regression tree (CART) analyses of survey data and qualitative analysis of interviews. Main Outcome Measures Self-reported sexual activity, interest in sex, and physiologic symptoms (e.g., male erectile/ejaculatory difficulties, female vaginal dryness) over the previous 4 weeks; partner communication about sexuality; contamination concerns; illness intrusiveness. Results Participants in these studies averaged 65 years of age (mean and median) and were male (77%), white (91%), and married (75%). Survey (Study 1) results linked NMIBC treatment to sexual symptoms and relationship issues. Many participants reported sexual inactivity (38.8%). Sexually active participants reported erectile difficulties (60.0%), vaginal dryness (62.5%), and worry about contaminating partner with treatment agents (23.2%). While almost one-half reported the usefulness of talking with partners about sexual function, only one-fifth of participants reported sharing all concerns with their partners. CART analysis supported the importance of communication. One-half of interviewees (Study 2) reported sexual dysfunction. Two-thirds reported negative impacts on their relationships, including perceived loss of intimacy and divorce; over one-third were sexually inactive for fear of contaminating their partner or spreading NMIBC. Conclusions Survivors' sexual symptoms may result from NMIBC, comorbidities, or both. These results inform literature and practice by raising awareness about the frequency of symptoms and the impact on NMIBC survivors' intimate relationships. Further work is needed to design symptom management education programs to dispel misinformation about contamination post-treatment and improve quality of life. Kowalkowski MA, Chandrashekar A, Amiel GE, Lerner SP, Wittmann DA, Latini DM, and Goltz HH. Examining sexual dysfunction in non-muscle-invasive bladder cancer: Results of cross-sectional mixed-methods research. Sex Med 2014;2:141–151. PMID:25356311

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

PubMed

Marshall, Barbara L

2010-02-01

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

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

PubMed

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

2017-09-01

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

Sexual Function After Stereotactic Body Radiotherapy for Prostate Cancer: Results of a Prospective Clinical Trial

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

Wiegner, Ellen A.; King, Christopher R., E-mail: crking@stanford.ed

Purpose: To study the sexual quality of life for prostate cancer patients after stereotactic body radiotherapy (SBRT). Methods and Materials: Using the Expanded Prostate Cancer Index Composite (EPIC)-validated quality-of-life questionnaire, the sexual function of 32 consecutive patients who received prostate SBRT in a prospective Phase II clinical trial were analyzed at baseline, and at median times of 4, 12, 20, and 50 months after treatment. SBRT consisted of 36.25 Gy in five fractions of 7.25 Gy using the Cyberknife. No androgen deprivation therapy was given. The use of erectile dysfunction (ED) medications was monitored. A comprehensive literature review for radiotherapy-alonemore » modalities based on patient self-reported questionnaires served as historical comparison. Results: Median age at treatment was 67.5 years, and median follow-up was 35.5 months (minimum 12 months). The mean EPIC sexual domain summary score, sexual function score, and sexual bother score decreased by 45%, 49%, and 25% respectively at 50 months follow-up. These differences reached clinical relevance by 20 months after treatment. Baseline ED rate was 38% and increased to 71% after treatment (p = 0.024). Use of ED medications was 3% at baseline and progressed to 25%. For patients aged <70 years at follow-up, 60% maintained satisfactory erectile function after treatment compared with only 12% aged {>=}70 years (p = 0.008). Penile bulb dose was not associated with ED. Conclusions: The rates of ED after treatment appear comparable to those reported for other modalities of radiotherapy. Given the modest size of this study and the uncertainties in the physiology of radiotherapy-related ED, these results merit further investigations.« less

Are hormonal components of oral contraceptives associated with impaired female sexual function? A questionnaire-based online survey of medical students in Germany, Austria, and Switzerland.

PubMed

Wallwiener, Christian W; Wallwiener, Lisa-Maria; Seeger, Harald; Schönfisch, Birgitt; Mueck, Alfred O; Bitzer, Johannes; Zipfel, Stephan; Brucker, Sara Y; Taran, Florin-Andrei; Wallwiener, Markus

2015-10-01

To investigate in a large cohort of young university women whether different progestins and different ethinyl estradiol (EE) dosages in oral hormonal contraceptives (OHCs) adversely affect sexual function. Female medical students from German, Austrian, and Swiss universities (14/1/1) completed an anonymous online questionnaire comprising the 19 Female Sexual Function Index (FSFI) questions and 17 additional questions concerning demographics, lifestyle, sexual activity, and contraceptive use. OHCs were categorized by EE dose (≤20, <20 to ≤30, and >30 µg) and partially androgenic or antiandrogenic progestins. FSFI scores were analyzed by contraceptive method using descriptive statistics and standard nonparametric tests. We analyzed 2612 questionnaires submitted by respondents aged ≤30 years [mean age (SD) 23.5 (2.5) years]. Of 2126 contraceptive users, 1535 (72.2 %) used OHCs. Median FSFI total scores (ranges) were 28.2 (2.0-36.0) for all respondents. Median FSFI was significantly lower in non-users (24.4) versus users (28.7) of contraception (p < 0.001). Stratified analysis showed that 279/486 (57.4 %) respondents using no contraceptives, 563/1535 (36.7 %) using OHCs, 71/227 (31.3 %) using non-oral hormonal contraceptives, and 96/351 (27.4 %) using non-hormonal contraceptives were at risk for female sexual dysfunction (FSFI total score <26.55). FSFI scores for the three EE dosage categories and progestin components did not differ significantly. For OHCs, the FSFI score was lower than for other contraceptives but there was no significant association with EE dose or progestins, possibly due to small sample sizes. Further research needs to clarify the role of OHCs in female sexual function.

[Historical Transition of Sexuality Education in Japan and Outline of Reproductive Health/Rights].

PubMed

Nishioka, Emiko

2018-01-01

In this paper, we describe the historical transition of sexuality education in Japan and the direction of sexuality education taken by the Ministry of Education, Culture, Sports, Science and Technology (MEXT). Reproductive health/rights, a key concept in sex education, is also discussed. In Japanese society, discussion on sexuality has long been considered taboo. After the Second World War, sexuality education in Japan began as "purity education." From 1960 until the early 1970s, physical aspects such as genital organs, function, secondary sexual characteristics, and gender differences were emphasized. Comprehensive education as a human being, including physiological, psychological, and social aspects, began to be adopted in the late 1970s. In 2002, it was criticized that teaching genital terms at primary schools and teaching about sexual intercourse and contraceptive methods at junior high schools were "overdue guidance" and "extreme contents." Sexuality education in schools has become a problem and has stagnated for about 10 years. Currently, schools teach sexuality education that does not deviate from the MEXT course guidelines. The direction of MEXT regarding sexuality education should be examined from the basic position that sexual activity by children is inappropriate. Reproductive health/rights apply the concept of human rights to sexuality and reproduction. Reproductive health/rights are key concepts that support sex education and women's health.

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

PubMed

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

2018-02-01

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

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

PubMed

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

2008-08-01

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

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

PubMed

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

2014-03-01

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

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

PubMed

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

2015-11-14

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

Self-Reported Sexual Functioning Concerns among Undergraduate Students

ERIC Educational Resources Information Center

Tambling, Rachel B.; Reckert, Ashley

2014-01-01

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

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

PubMed

Yıldız, Hatice

2015-01-01

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

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

PubMed

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

2004-09-01

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

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

PubMed

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

2016-11-16

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

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

PubMed

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

2016-11-01

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

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

PubMed

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

2015-04-01

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

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

PubMed

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

2013-12-01

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

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

PubMed

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

2016-03-01

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

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

PubMed

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

2016-01-01

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

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

PubMed

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

2013-01-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-01-01

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

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

ERIC Educational Resources Information Center

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

2006-01-01

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

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.

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

PubMed

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

2010-11-01

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

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

PubMed Central

Stoléru, Serge

2014-01-01

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

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

PubMed

Sacomori, Cinara; Cardoso, Fernando Luiz

2015-03-01

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

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

PubMed

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

2004-01-01

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

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

PubMed

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

2016-10-01

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

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.

[Quality of life and sexual function of cervical cancer patients following radical hysterectomy and vaginal extension].

PubMed

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

2014-08-01

To investigate the quality of life and sexual function of cervical cancer patients following radical hysterectomy (RH) and vaginal extension. Case-control and questionnaire- based method was employed in this study. Thirty-one patients of early-stage (I b1-I b2) cervical cancer who had undergone vaginal extension following classic RH in Peking Union Medical College Hospital from December 2008 to September 2012 were included in study group, while 28 patients with matching factors and RH only during the same period were allocated to control group. There was no significant difference between two groups in terms of clinical and demographic variables including age at diagnosis, tumor stage and follow-up time (P > 0.05). Patients were assessed retrospectively by validated self-reported questionnaires the European Organization for Research and Treatment of Cancer Cervix Cancer Module Questionnaire (EORTC QLQ-CX24) mainly for quality of life and sexual function for cervical cancer patients; the Sexual Function and Vaginal Changes Questionnaire (SVQ) further investigates sexual function and vaginal changes of patients with gynecologic malignancy at least 6 months after treatment. Vaginal length acquired by pelvic examination by gynecologic oncologists during follow-up visits was (10.0 ± 1.3) cm and (5.9 ± 1.0)cm in study group and control group respectively (P = 0.000). Sixty-eight percent (21/31) of cases in study group and 64% (18/28) of cases in control group had resumed sexual activity at the time of interview, and the time interval between treatment and regular sexual activity was mean 6 months (range 3-20 months) and mean 5 months (range 1-12 months) in study and control group respectively, in which there was not statistical significance (P > 0.05). No difference was observed regarding pelvic floor symptoms (P > 0.05) while difficulty emptying bladder, incomplete emptying and constipation were most commonly reported. Both group presented with hypoactive sexual desire disorder [88% (52/59)], orgasm dysfunction [72% (28/39)] and low enjoyment or relaxation after sex [51% (20/39)], which was not statistically significant (P > 0.05). Reduced vagina size and shorter vagina was more prominent in control group (12/18) than that in study group [19% (4/21)] with statistical significance (P < 0.05), while no difference in sexual desire, vaginal lubrication, dyspareunia and sexual enjoyment (P > 0.05). Patients with peritoneovaginoplasty following RH had much longer vagina and less self-perceived short vagina. Vaginal extension following RH does not worsen the pelvic floor symptoms.

Sexual functioning among women with physical disabilities.

PubMed

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

1996-02-01

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

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

PubMed

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

2009-07-01

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

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

PubMed

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

2015-01-01

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

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

ERIC Educational Resources Information Center

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

2013-01-01

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

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.

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

PubMed

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

2014-09-01

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

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.

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

PubMed

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

2015-09-01

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

Sexual function of young women with myelomeningocele.

PubMed

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

2014-06-01

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

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

PubMed

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

2011-01-01

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

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

PubMed Central

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

2010-01-01

Despite the documented association between trauma exposure and sexual problems (sexual dissatisfaction and sexual functioning), only a paucity of studies have investigated possible mechanisms underlying this association. The present study tested the role of emotion dysregulation in regard to levels of sexual dissatisfaction and functioning among a sample of 43 trauma-exposed cigarette smokers (17 women; Mage = 20.20, SD = 10.87). When controlling for negative affectivity, type of trauma (sexual vs. non-sexual), daily smoking rate, posttraumatic stress symptoms, and anxiety sensitivity, emotion dysregulation provided an independent and unique contribution to sexual dissatisfaction, but not sexual function. These preliminary findings suggest that emotion dysregulation may be more important to understanding certain sexual problems (dissatisfaction) among cigarette smoking trauma survivors than previously recognized, and is therefore, a topic worthy of further investigation. PMID:20169494

Childhood Sexual Abuse: Long-Term Effects on Psychological and Sexual Functioning in a Nonclinical and Nonstudent Sample of Adult Women.

ERIC Educational Resources Information Center

Greenwald, Evan; And Others

1990-01-01

Comparison of psychological and sexual functioning of 54 women sexually abused as children and 54 nonabused women found no differences in self-esteem, but abused women reported more symptoms of distress and psychological symptoms previously associated with sexual abuse. No differences in self-reported sexual satisfaction or dysfunction were found.…

How has early testicular cancer affected your life? A study of sexual function in men attending active surveillance for stage one testicular cancer.

PubMed

Brand, Sue; Williams, Hilary; Braybrooke, Jeremy

2015-06-01

Testicular cancer is the most common cancer in young men, it is frequently diagnosed at key times in relationship formation. In early stage disease the vast majority of tumours will be cured by surgery alone with patients being offered active surveillance rather than adjuvant therapies. To date, research has not evaluated how surveillance alone impacts on sexual function. The aim of this quantitative longitudinal study was to ascertain the sexual function of men with stage one disease at 3 and 12 months post diagnosis and to compare with normative data. Additional data was collected on the information men sought regarding sexual function and media they used to access this. This study shows that men's sexual function is altered at diagnosis and improves by 3 months. At 12 months, whilst not statistically significant, sexual function improves but not to the same level as normative data comparison. Men appear to find verbal information useful at 3 months, however men appear to be seeking written and online information at 12 months. The intricacies of sexual function together with the low number of participants may have been best met with a qualitative approach. However, the information data indicates the importance of further research into the effects of early stage testicular cancer on sexual function. Therefore, further qualitative research is recommended to explore the effects of early stage testicular cancer in relation to sexual function. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sexual Functioning in Men Living with a Spinal Cord Injury-A Narrative Literature Review.

PubMed

Sunilkumar, M M; Boston, Patricia; Rajagopal, M R

2015-01-01

Sexual dysfunction is a major concern for Indian men living with a spinal cord injury. To examine the literature related to sexuality traumatic cord injury and its impact on sexual functioning. Databases using Cumulative Index to Nursing and Allied Health Literature (CINAHL) 2000-2012, Medline 1989-2012, Applied Social Sciences Index and Abstracts (ASSIA) 1989-2012 and Google Scholar were the search engines used used for literature review. The search yielded a total of 457 articles and only 75 of them were found relevant. The minimum number of articles required to meet the inclusion criteria for this review was 25-30 articles. Out of the 75 articles, 33 were considered relevant or related to the topic of sexual functioning, spinal cord injury, and paraplegia. Six areas were identified: Sexual stigmatization, physiological barriers to sexual satisfaction, clinical aspects of sexual functioning, biomedical approaches to sexual dysfunction, partner satisfaction, and lack of accessibility to sexual education. Spinal cord injury and sexual functioning affects a large segment of the male Indian population, yet most current research focuses on quantitative measurement with the emphasis on ejaculatory dysfunction, orgasm impairment, incontinence, and other physiological dysfunction. Further research is needed to address the subjective accounts of patients themselves with respect to the emotional and social impact of sexual disability. This would help to identify the best possible outcomes for both treatment and rehabilitation.

Longitudinal Changes in Sexual Functioning as Women Transition Through Menopause: Results from the Study of Women’s Health Across the Nation (SWAN)

PubMed Central

Avis, Nancy E.; Brockwell, Sarah; Randolph, John F.; Shen, Shunhua; Cain, Virginia S.; Ory, Marcia; Greendale, Gail A.

2009-01-01

Objective Sexual functioning is an important component of women’s lives. The extent to which the menopause transition is associated with decreased sexual functioning remains inconclusive. This study seeks to determine if advancing through the menopause transition is associated with changes in sexual functioning. Design A prospective, longitudinal cohort study of women aged 42–52 at baseline recruited at 7 US sites (N=3302) in the Study of Women’s Health Across the Nation (SWAN). Cohort eligible women had an intact uterus, at least one ovary, were not currently using exogenous hormones, were either pre- or early perimenopausal, and self-identified as one of the study’s designated racial/ethnic groups. Data from the baseline interview and six annual follow-up visits are reported. Outcomes are self-reported ratings of importance of sex; frequency of sexual desire, arousal, masturbation, sexual intercourse, and pain during intercourse; degree of emotional satisfaction and physical pleasure. Results Adjusting for baseline age, chronological aging, and relevant social, health, and psychological parameters, the odds of reporting vaginal or pelvic pain increased and desire decreased by late perimenopause. Masturbation increased at early perimenopause, but declined during postmenopause. Menopausal transition was unrelated to other outcomes. Health, psychological functioning, and importance of sex were related to all sexual function outcomes. Age, race/ethnicity, marital status, change in relationship, and vaginal dryness were also associated with sexual functioning. Conclusions Pain during sexual intercourse increases and sexual desire decreases over the menopausal transition. Masturbation increases during the early transition, but then declines in postmenopause. Adjusting for other factors, the menopausal transition was not independently associated with reports of the importance of sex, sexual arousal, frequency of sexual intercourse, emotional satisfaction with partner, or physical pleasure. PMID:19212271

Longitudinal changes in sexual functioning as women transition through menopause: results from the Study of Women's Health Across the Nation.

PubMed

Avis, Nancy E; Brockwell, Sarah; Randolph, John F; Shen, Shunhua; Cain, Virginia S; Ory, Marcia; Greendale, Gail A

2009-01-01

Sexual functioning is an important component of women's lives. The extent to which the menopausal transition is associated with decreased sexual functioning remains inconclusive. This study seeks to determine if advancing through the menopausal transition is associated with changes in sexual functioning. This was a prospective, longitudinal cohort study of women aged 42 to 52 years at baseline recruited at seven US sites (N = 3,302) in the Study of Women's Health Across the Nation (SWAN). Cohort-eligible women had an intact uterus, had at least one ovary, were not currently using exogenous hormones, were either premenopausal or early perimenopausal, and self-identified as one of the study's designated racial/ethnic groups. Data from the baseline interview and six annual follow-up visits are reported. Outcomes are self-reported ratings of importance of sex; frequency of sexual desire, arousal, masturbation, sexual intercourse, and pain during intercourse; and degree of emotional satisfaction and physical pleasure. With adjustment for baseline age, chronological aging, and relevant social, health, and psychological parameters, the odds of reporting vaginal or pelvic pain increased and desire decreased by late perimenopause. Masturbation increased at early perimenopause but declined during postmenopause. The menopausal transition was unrelated to other outcomes. Health, psychological functioning, and importance of sex were related to all sexual function outcomes. Age, race/ethnicity, marital status, change in relationship, and vaginal dryness were also associated with sexual functioning. Pain during sexual intercourse increases and sexual desire decreases over the menopausal transition. Masturbation increases during the early transition, but then declines in postmenopause. With adjustment for other factors, the menopausal transition was not independently associated with reports of the importance of sex, sexual arousal, frequency of sexual intercourse, emotional satisfaction with partner, or physical pleasure.

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

Quality of life, binge eating and sexual function in participants treated for obesity with sustained release naltrexone/bupropion

PubMed Central

Shan, K.; Gilder, K.; Malone, M.; Acevedo, L.; Fujioka, K.

2018-01-01

Summary Objective This multicenter, randomized, controlled, open‐label trial examined weight‐related quality of life, control over eating behaviour and sexual function after 26 weeks of treatment with either 32 mg naltrexone sustained release (SR)/360 mg bupropion SR plus a comprehensive lifestyle intervention program (NB + CLI, N = 153) or usual care (UC, N = 89), which included minimal lifestyle intervention. Methods Impact of Weight on Quality of Life‐Lite, Binge Eating Scale and Arizona Sexual Experiences Scale were assessed at baseline (BL) and weeks 16 and 26. Results NB + CLI and UC participants lost 9.46 and 0.94% respectively of initial body weight at week 26 (P < 0.0001). NB + CLI participants had greater improvements in Impact of Weight on Quality of Life‐Lite total score than UC participants (P < 0.0001). In participants with moderate/severe Binge Eating Scale scores at BL, 91% of NB + CLI and 18% of UC participants experienced categorical improvements. In participants with Arizona Sexual Experiences Scale‐defined sexual dysfunction at BL, 58% of NB + CLI and 19% of UC participants no longer met dysfunction criteria at week 26. The most frequent adverse events leading to discontinuation before week 26 in NB + CLI included nausea (10.5%); anxiety (3.3%); and headache, hypertension, insomnia and palpitations (1.3% each). Conclusion Compared with UC, participants treated with NB + CLI experienced greater improvements in weight‐related quality of life, control over eating behaviour, and sexual function. PMID:29670752

Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction.

PubMed

Vannier, Sarah A; Rosen, Natalie O

2017-03-01

Sexual problems are common during pregnancy, but the proportion of pregnant women who experience sexual distress is unknown. In non-pregnant samples, sexual distress is associated with lower sexual and relationship satisfaction. To identify the proportion of women experiencing sexual distress during pregnancy and to compare the sexual and relationship satisfaction of women who report sexual distress during pregnancy with that of women without distress. Two-hundred sixty-one pregnant women completed a cross-sectional online survey. Women completed validated measurements of sexual functioning (Female Sexual Function Index; score < 26.55 indicates a sexual problem), sexual distress (Female Sexual Distress Scale; score ≥ 15 indicates clinically significant distress), sexual satisfaction (Global Measure of Sexual Satisfaction), and relationship satisfaction (Couples Satisfaction Index). Overall, 42% of women met the clinical cutoff for sexual distress. Of sexually active women (n = 230), 26% reported concurrent sexual problems and distress and 14% reported sexual distress in the absence of sexual problems. Sexual distress and/or problems in sexual functioning were linked to lower sexual and relationship satisfaction compared with pregnant women with lower sexual distress and fewer sexual problems. Sexual distress is common during pregnancy and associated with lower sexual and relationship satisfaction. Health care providers should ask pregnant women about feelings of sexual distress. Identifying pregnant women who experience sexual distress and referring them to appropriate resources could help minimize sexual and relationship problems during pregnancy. Vannier SA, Rosen NO. Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction. J Sex Med 2017;14:387-395. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

A Single Session of Autogenic Training Increases Acute Subjective and Physiological Sexual Arousal in Sexually Functional Women.

PubMed

Stanton, Amelia; Meston, Cindy

2017-10-03

Heart rate variability (HRV) has recently been associated with female sexual function (Stanton, Lorenz, Pulverman, & Meston, 2015). Below-average HRV was identified as a possible risk factor for sexual arousal dysfunction and overall sexual dysfunction in women. Based on this newly established relationship between HRV and female sexual function, the present study examined the effect of autogenic training to increase HRV on acute physiological and subjective sexual arousal in women. Specifically, vaginal pulse amplitude (VPA), an index of genital sexual arousal, and subjective sexual arousal were assessed in 33 sexually functional women, aged 18 to 27, before and after a short session of autogenic training. Autogenic training, a relaxation technique that restores the balance between the activity of the sympathetic and the parasympathetic branches of the autonomic nervous system, has been shown to significantly increase HRV (Miu, Heilman, & Miclea, 2009). After autogenic training, significant increases in both VPA (p <.05) and subjective sexual arousal (p <.005) were observed. Moreover, change in HRV from pre- to postmanipulation significantly moderated changes in subjective sexual arousal (p <.05) when it was measured continuously during the presentation of the erotic stimulus. This cost-effective, easy-to-administer behavioral intervention may have important implications for increasing sexual arousal in women.

The Impact of Illicit Use of Amphetamine on Male Sexual Functions.

PubMed

Chou, Nan-Hua; Huang, Yung-Jui; Jiann, Bang-Ping

2015-08-01

Data concerning the impact of amphetamine on male sexual functions are limited, although amphetamine has been used as an aphrodisiac. This cross-sectional study was to assess the impact of illicit use of amphetamine on male sexual functions. Male illicit drug users in a Drug Abstention and Treatment Center were recruited to complete a self-administered questionnaire, and data were compared with age-matched controls. The International Index of Erectile Function (IIEF) and global assessment questions were used to assess sexual functions. Of 1,159 amphetamine mono-illicit drug users, the mean age was 31.9 ± 7.5 (18-57) years, and mean duration of drug use was 30.7 ± 52.2 (median 9, range 0.1-252) months. Half of them reported that drug use had no impact on their sexual functions. The other half reported drug impacts as reduced erectile rigidity and sexual life satisfaction, enhanced orgasmic intensity, and prolonged ejaculation latency time more often than the opposite effects, while they reported enhanced or reduced effect equally on sexual desire. Dosing frequency of amphetamine was associated with its impact on sexual functions, but duration of its use had little association with that. Compared with 211 age-matched controls, the amphetamine mono-illicit drug users had lower IIEF scores in the domains of erectile function, orgasmic function, and overall satisfaction, but there are no significant differences in intercourse satisfaction and sexual desire scores. The prevalence of erectile dysfunction (ED) was significantly higher in the drug users than in the controls (29.3% vs. 11.9%). The odds ratio of ED for amphetamine use was 2.1 (95% confidence interval 1.2-3.6) after adjustment for other risk factors. The impact of illicit use of amphetamine on male sexual functions varied among users, and their ED prevalence was higher than the controls. © 2015 International Society for Sexual Medicine.

Use of an Ecological Model to Study Sexual Satisfaction in a Heterosexual Spanish Sample.

PubMed

Del Mar Sánchez-Fuentes, María; Salinas, José María; Sierra, Juan Carlos

2016-11-01

Sexual satisfaction is a key factor in sexual health and has been associated with quality of life. However, few studies have focused on the factors related to sexual satisfaction in the population in Spain. The main goal of this research was to analyze the predictive capacity of an ecological model for the study of sexual satisfaction in a Spanish sample of 723 men and 851 women, with mean age equal to 36.28 (SD = 12.59) and who were in a heterosexual relationship. We analyzed, using structural equation modeling, the degree to which sexual satisfaction was related to different variables. These variables were the following: personal variables (depression and sexual attitudes); interpersonal variables (relationship satisfaction, sexual function, and sexual assertiveness); social variables (social support, parenthood, and annual income); and cultural variables (political ideology, religion, and religious practice). In men, sexual satisfaction was directly predicted by relationship satisfaction and sexual function. Furthermore, political ideology, religious practice, social support, annual income, initiation sexual assertiveness, and sexual attitudes were indirectly associated with sexual satisfaction. In women, sexual satisfaction was directly predicted by relationship satisfaction, sexual function, sexual assertiveness, and sexual attitudes. In addition, political ideology, religious practice, and social support were indirectly associated with sexual satisfaction. Implications for research and therapy are also discussed.

Sexual dysfunction in women with ESRD requiring hemodialysis.

PubMed

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

2012-06-01

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

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.

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.

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

Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: a prospective controlled study.

PubMed

Aerts, L; Christiaens, M R; Enzlin, P; Neven, P; Amant, F

2014-10-01

Breast cancer (BC) and/or its treatments may affect sexual functioning based on physiological and psychosocial mechanisms. The aim of this study was to prospectively investigate sexual adjustment of BC patients during a follow-up period of one year after mastectomy (ME) or breast conserving therapy (BCT). In this prospective controlled study, women with BC and an age-matched control group of healthy women completed the Beck Depression Inventory Scale, World Health Organization 5 Well-being scale, Body Image Scale, EORTC QLQ questionnaire, Dyadic Adjustment Scale, Short Sexual Functioning Scale and Specific Sexual Problems Questionnaire to assess various aspects of sexual and psychosocial functioning before surgery, six months and one year after surgical treatment. In total, 149 women with BC and 149 age-matched healthy controls completed the survey. Compared to the situation before surgery, significantly more BCT women reported problems with sexual arousal six months after surgery and significantly more women of the ME group reported problems with sexual desire, arousal and the ability to achieve an orgasm six months and one year after surgery. While in comparison with healthy controls, no significant differences in sexual functioning were found after BCT surgery, significantly more women who underwent ME reported problems with sexual desire, arousal, the ability to achieve an orgasm and intensity of the orgasm. Although little differences were seen in sexual functioning in the BCT group during prospective analyses and in comparison with healthy controls, analyses revealed that women who underwent a ME were at risk for post-operative sexual dysfunctions. Copyright © 2014. Published by Elsevier Ltd.

Non-erotic thoughts and sexual functioning.

PubMed

Purdon, Christine; Watson, Chris

2011-10-01

This study sought to replicate and extend investigations of current models of sexual dysfunction (Barlow, 2002; Janssen, Everaerd, Spiering, & Janssen, 2000) which implicate factors such as spectatoring, failure to use ameliorative strategies, and information processing biases in the development and persistence of sexual difficulties. A sample of 165 (n = 71 men) undergraduates completed measures of sexual dysfunction and relationship satisfaction, and reported on the content and frequency of non-erotic thoughts during sex with a partner (i.e., spectatoring), the emotional impact of non-erotic thoughts, and the strategies used to manage them. They also reported on their main sexual functioning difficulties and the strategies they used to manage those difficulties. Finally, participants were presented with a series of hypothetical sexual scenarios and were asked to report their immediate interpretation of events in the scenario. The content of non-erotic thoughts was similar to previous work (Purdon & Holdaway, 2006), although gender differences in thought content were less pronounced. As in previous research, greater frequency of, and anxiety evoked by, non-erotic thoughts was associated with poorer sexual functioning, but we found that this was over and above relationship satisfaction. Participants both high and low in sexual functioning reported using a variety of strategies to manage their non-erotic thoughts, thought suppression being the least effective, and also used a variety of strategies to manage sexual difficulties. Poorer sexual functioning was associated with more negative interpretations of ambiguous sexual scenarios, but this was mediated by relationship satisfaction. However, positive interpretations were predicted by sexual functioning. Results were discussed in terms of their theoretical and clinical implications.

The Sexual Thoughts Questionnaire: Psychometric Evaluation of a Measure to Assess Self-Reported Thoughts During Exposure to Erotica Using Sexually Functional Individuals.

PubMed

Sigre-Leirós, Vera; Carvalho, Joana; Nobre, Pedro J

2016-05-01

Validated instruments for assessing specific thought content during exposure to sexually explicit material are lacking. To investigate the psychometric properties of a measure that assesses self-reported thoughts during exposure to sexual stimuli in laboratory settings, namely the Sexual Thoughts Questionnaire. The factorial structure of the questionnaire and its reliability and validity were examined. One hundred sixty-seven sexually functional individuals (97 women and 70 men) were exposed to sexually explicit material while their genital arousal was being assessed. Subjective sexual arousal and thoughts during exposure to sexually explicit material also were assessed. Women's genital arousal was measured with a vaginal photoplethysmograph and men's genital arousal was measured with an indium-gallium strain gauge. Subjective sexual arousal and thoughts during exposure to erotica were assessed with self-report scales. Principal component analysis with varimax rotation identified five factors: sexual arousal thoughts, distractive and disengaging thoughts, body image and performance thoughts, actress's physical attractiveness thoughts, and sinful and lack of affection thoughts. Moreover, the scale showed satisfactory levels of internal consistency. Studies on convergent validity showed an association between self-reported thoughts and subjective sexual arousal levels in the women and men. The Sexual Thoughts Questionnaire showed adequate psychometric properties in a sexually functional sample. It could be useful in further experimental research on the role of cognitions in sexual response and allow further comparison between sexually functional and dysfunctional individuals, with possible significant implications for the assessment and treatment of sexual problems. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Sexual satisfaction and distress in sexual functioning in a sample of the BDSM community: a comparison study between BDSM and non-BDSM contexts.

PubMed

Pascoal, Patrícia Monteiro; Cardoso, Daniel; Henriques, Rui

2015-04-01

Little attention has been paid to distress in sexual functioning or the sexual satisfaction of people who practice BDSM (Bondage and Discipline, Domination and Submission, Sadism and Masochism). The purpose of this study was to describe sociodemographic characteristics and BDSM practices and compare BDSM practitioners' sexual outcomes (in BDSM and non-BDSM contexts). A convenience sample of 68 respondents completed an online survey that used a participatory research framework. Cronbach's alpha and average inter-item correlations assessed scale reliability, and the Wilcoxon paired samples test compared the total scores between BDSM and non-BDSM contexts separately for men and women. Open-ended questions about BDSM sexual practices were coded using a preexisting thematic tree. We used self-reported demographic factors, including age at the onset of BDSM interest, age at first BDSM experience, and favorite and most frequent BDSM practices. The Global Measure of Sexual Satisfaction measured the amount of sexual distress, including low desire, arousal, maintaining arousal, premature orgasm, and anorgasmia. The participants had an average age of 33.15 years old and were highly educated and waited 6 years after becoming interested in BDSM to act on their interests. The practices in which the participants most frequently engaged did not coincide with the practices in which they were most interested and were overwhelmingly conducted at home. Comparisons between genders in terms of distress in sexual functioning in BDSM and non-BDSM contexts demonstrate that, with the exception of maintaining arousal, we found distress in sexual functioning to be statistically the same in BDSM and non-BDSM contexts for women. For men, we found that distress in sexual functioning, with the exception of premature orgasm and anorgasmia, was statistically significantly lower in the BDSM context. There were no differences in sexual satisfaction between BDSM and non-BDSM contexts for men or women. Our findings suggest that BDSM sexual activity should be addressed in clinical settings that account for BDSM identities, practices, relationships, preferences, sexual satisfaction, and distress in sexual function for men and women. Additional research needs are identified, such as the need to define distressful sexual functioning experiences and expand our understanding of the development of BDSM sexual identities. © 2015 International Society for Sexual Medicine.

[The role of physical therapy in the treatment of female sexual dysfunction].

PubMed

Rosenbaum, Talli Y; Ben-Dror, Inbal

2009-09-01

Healthy sexual function requires physical, mental, and emotional well-being. Physical presentations that may limit sexual activity include decreased mobility, alterations in sensation, decreased genital circulation and pain. Physical therapists play an important role in facilitating optimal sexual function by providing treatment to restore function, improve mobility and relieve pain. This article illustrates, through four case reports, the importance of physiotherapy in the multidisciplinary approach to the treatment of female sexual dysfunction.

Female sexual function mediates the effects of medication adherence on quality of life in people with epilepsy.

PubMed

Lin, Chung-Ying; Burri, Andrea; Fridlund, Bengt; Pakpour, Amir H

2017-02-01

The purpose of this study was to understand the mediating effects of female sexual functioning in the association between medication adherence and quality of life (QoL) in Iranian women with epilepsy (WWE). Women's sexual functioning was measured using Female Sexual Function Index; QoL using Quality of Life in Epilepsy; epilepsy severity using Liverpool Seizure Severity Scale; subjective medication adherence using Medication Adherence Report Scale; and objective medication adherence using serum level for antiepileptic drugs in 567 WWE. Medication adherence was measured at baseline, while women's sexual functioning, QoL, and epilepsy severity were measured at the 6-month follow-up. Structural equation modeling and regression models were conducted to examine the mediating role of women's sexual functioning. The mediating effects of sexual functioning in the relationship between medication adherence (including subjective and objective measures) and QoL were supported in the total score of Female Sexual Function Index (coefficient=0.415, SE=0.117, p<0.001 for subjective medication adherence; coefficient=1.980, SE=0.446, p<0.001 for objective medication adherence). Seizure severity was significantly associated with QoL but only when objective medication adherence was measured (coefficient=-0.094, SE=0.036, p=0.009). Our results extended the importance of medication adherence from symptom reduction to the beneficial effects of women's sexual functioning and QoL. Health care providers should be aware of these additional benefits of medication adherence and use these arguments to encourage female patients to take their medication, which can eventually increase their sexual satisfaction and overall QoL. Copyright © 2016 Elsevier Inc. All rights reserved.

Risk factors for negative impacts on sexual activity and function in younger breast cancer survivors.

PubMed

Lee, Maria; Kim, Yun Hwan; Jeon, Myung Jae

2015-09-01

We aim to examine changes in sexual activity and function among younger breast cancer survivors who were sexually active before diagnosis and to investigate risk factors for negative impacts on them. An observational cohort study enrolled 304 premenopausal and sexually active women diagnosed with early stage breast cancer. Questionnaires were completed, and sexual activity was measured at two time points: after surgery, to assess sexual activity and function before diagnosis, and then at least 12 months after the completion of chemotherapy or endocrine therapy. For each domain of the Female Sexual Function Index, a score below 3 was classified as indicative of a sexual problem. Each sexual problem was considered to be dysfunctional if it was associated with distress. The median age at the last survey was 46.0 years (range: 23-57). Of the participants, 35 (11.5%) became sexually inactive after treatment. Among the 269 women who remained sexually active, 31.6% were currently experiencing sexual dysfunction, which was significantly higher compared with the frequency before diagnosis. In the multivariate logistic regression model, chemo-related menopause, thyroid dysfunction, and depression were independent risk factors for sexual inactivity. Chemo-related menopause was a significant risk factor for sexual dysfunction. Chemo-related menopause was significantly associated with both sexual inactivity and dysfunction after treatment. Thyroid dysfunction and depression were risk factors for sexual inactivity in younger breast cancer survivors. Copyright © 2015 John Wiley & Sons, Ltd.

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

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

Sexual behavior and intention to engage in sexual behavior in junior secondary school students in Hong Kong.

PubMed

Shek, D T L

2013-06-01

The present study examined the prevalence, changes, and demographic as well as psychosocial correlates of sexual behavior and intention to engage in sexual behavior in early adolescents in Hong Kong, with sexual behavior indexed by sexual intercourse. Three waves of longitudinal data on sexual intercourse, intention to engage in sexual intercourse, family functioning, and positive youth development were collected from 28 secondary schools in Hong Kong. There were significant influences of grade and gender on adolescent sexual behavior or intention to engage in sexual behavior. Significant main effects of immigration status on sexual behavior were also found. While no effect of family economic background was found, effect of family intactness existed for sexual behavior. Family functioning and positive youth development at Grade 7 were negatively associated with students' sexual behavior and intention to engage in sexual behavior at Grade 9. Grade, gender, immigration status, and family intactness were related to sexual behavior and/or intention to engage in sexual behavior in junior secondary school students. Promoting positive youth development and family functioning could serve as protective factors to reduce sexual behavior and intention to engage in sexual behavior in Chinese early adolescents in Hong Kong. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Sexual Function in 16- to 21-Year-Olds in Britain.

PubMed

Mitchell, Kirstin R; Geary, Rebecca; Graham, Cynthia; Clifton, Soazig; Mercer, Catherine H; Lewis, Ruth; Macdowall, Wendy; Datta, Jessica; Johnson, Anne M; Wellings, Kaye

2016-10-01

Concern about young people's sexuality is focused on the need to prevent harmful outcomes such as sexually transmitted infections and unplanned pregnancy. Although the benefit of a broader perspective is recognized, data on other aspects of sexuality, particularly sexual function, are scant. We sought to address this gap by measuring the population prevalence of sexual function problems, help seeking, and avoidance of sex in young people. A cross-sectional stratified probability sample survey (Natsal-3) of 15,162 women and men in Britain (response rate: 57.7%), using computer-assisted self-interviews. Data come from 1875 (71.9%) sexually active, and 517 sexually inactive (18.7%), participants aged 16-21 years. Measures were single items from a validated measure of sexual function (the Natsal-SF). Among sexually active 16- to 21-year-old participants, 9.1% of men and 13.4% of women reported a distressing sexual problem lasting 3 months or more in the last year. Most common among men was reaching a climax too quickly (4.5%), and among women was difficulty in reaching climax (6.3%). Just over a third (35.5%) of men and 42.3% of women reporting a problem had sought help, but rarely from professional sources. Among those who had not had sex in the last year, just >10% of young men and women said they had avoided sex because of sexual difficulties. Distressing sexual function problems are reported by a sizeable minority of sexually active young people. Education is required, and counseling should be available, to prevent lack of knowledge, anxiety, and shame progressing into lifelong sexual difficulties. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

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.

Critical analysis of the literature investigating urogenital function preservation following robotic rectal cancer surgery

PubMed Central

Panteleimonitis, Sofoklis; Ahmed, Jamil; Harper, Mick; Parvaiz, Amjad

2016-01-01

AIM To analyses the current literature regarding the urogenital functional outcomes of patients receiving robotic rectal cancer surgery. METHODS A comprehensive literature search of electronic databases was performed in October 2015. The following search terms were applied: “rectal cancer” or “colorectal cancer” and robot* or “da Vinci” and sexual or urolog* or urinary or erect* or ejaculat* or impot* or incontinence. All original studies examining the urological and/or sexual outcomes of male and/or female patients receiving robotic rectal cancer surgery were included. Reference lists of all retrieved articles were manually searched for further relevant articles. Abstracts were independently searched by two authors. RESULTS Fifteen original studies fulfilled the inclusion criteria. A total of 1338 patients were included; 818 received robotic, 498 laparoscopic and 22 open rectal cancer surgery. Only 726 (54%) patients had their urogenital function assessed via means of validated functional questionnaires. From the included studies, three found that robotic rectal cancer surgery leads to quicker recovery of male urological function and five of male sexual function as compared to laparoscopic surgery. It is unclear whether robotic surgery offers favourable urogenital outcomes in the long run for males. In female patients only two studies assessed urological and three sexual function independently to that of males. In these studies there was no difference identified between patients receiving robotic and laparoscopic rectal cancer surgery. However, in females the presented evidence was very limited making it impossible to draw any substantial conclusions. CONCLUSION There seems to be a trend towards earlier recovery of male urogenital function following robotic surgery. To evaluate this further, larger well designed studies are required. PMID:27933136

Emerging roles for neurosteroids in sexual behavior and function.

PubMed

King, Steven R

2008-01-01

Although gonadal and adrenal steroids heavily impact sexual function at the level of the brain, the nervous system also produces its own steroids de novo that may regulate sexual behavior and reproduction. Current evidence points to important roles for neurosteroids in sexual and gender-typical behaviors, control of ovulation, and behaviors that strongly influence sexual interest and motivation like aggression, anxiety and depression. At the cellular level, neurosteroids act through stimulating rapid changes in excitability and direct activation of membrane receptors in neurons. Thus, unlike peripheral steroids, neurosteroids can have immediate and specific effects on select neuronal pathways to regulate sexual function.

Attachment and sexual functioning in women and men seeking fertility treatment.

PubMed

Purcell-Lévesque, Coralie; Brassard, Audrey; Carranza-Mamane, Belina; Péloquin, Katherine

2018-05-11

The purpose of the study was to examine the frequency of sexual difficulties and the associations among attachment insecurities (anxiety, avoidance) and sexual functioning (problems with sexual function, sexual dissatisfaction) in women and couples seeking fertility treatment. In a cross-sectional study, 88 Canadian women and 45 couples receiving fertility treatments completed self-reported measures of adult attachment and sexual functioning. The frequency of problems in sexual function varied from 14.8% (pain) to 58.0% (desire) in women and from 6.7% (satisfaction with orgasm) to 28.9% (desire) in men. Among women, attachment-related avoidance predicted their low levels of sexual satisfaction (β = -0.30, p = .007) and sexual pain (β = 0.22, p = .044). Dyadic analyses revealed associations between men's attachment-related anxiety and their difficulties in reaching erection (β = 0.30, p = .042) and orgasm (β = 0.33, p = .009). Anxiety in women was related to their lubrication difficulties (β = 0.44, p = .006). One partner effect was found: men's avoidance was related to their partners' difficulty in achieving orgasms (β = 0.39, p = .045). Results support the pertinence of attachment theory and the relevance of using dyadic designs to understand sexuality in couples seeking fertility treatment.

The relationship between function and sexual satisfaction with sexual violence among women in Ahvaz, Iran.

PubMed

Tadayon, Mitra; Hatami-Manesh, Zahra; Sharifi, Nasibeh; Najar, Shahnaz; Saki, Azadeh; Pajohideh, Zahra

2018-04-01

One of the forms of violence that receives less attention due to cultural and social issues is sexual violence against women, which is a hidden and a constant epidemic and impact on their health. This study aimed to determine the relationship between function and sexual satisfaction in women who have experienced sexual violence in Ahvaz-Iran. This study was a case-control study which was conducted on 105 women (cases=35 and control=70) referred to one forensic center and seventeen Shahrivar health centers during 2013-2014 in Ahwaz-Iran. The data collection tools included questionnaires for evaluating demographic characteristics and sexual satisfaction, sexual female function index and sexual violence. The data were analyzed using descriptive and inferential statistics (Chi-square, Fisher's exact, and independent-samples t-test) in SPSS, version 19. P-value < 0.05 was considered significant. Two groups of women were matched according to age and education. Mean ± SD sexual satisfaction was (71.4±15.84) in the case group and (99.44±15.68) in the control group (p<0.001). The mean ± SD of sexual function was (17.1±4.94) in the case group and (26.37±5.27) in the control group. The groups had a statistically significant difference in terms of sexual arousal, sexual orgasm, sexual lubrication, pain and sexual satisfaction (p<0.001). Sexual dysfunction and dissatisfaction have a relation with sexual violence, and a major concern is that the sexual violence in most cases is hidden and can seriously affect the general health condition of women.

Provoked Vestibulodynia: Does Pain Intensity Correlate With Sexual Dysfunction and Dissatisfaction?

PubMed

Aerts, Leen; Bergeron, Sophie; Pukall, Caroline F; Khalifé, Samir

2016-06-01

Provoked vestibulodynia (PVD) is suspected to be the most frequent cause of vulvodynia in premenopausal women. Previous research has been inconclusive as to whether higher vulvovaginal pain ratings are associated with lower sexual function and satisfaction in women with PVD. Whether pain intensity correlates with sexual impairment is an important question given its implications for treatment recommendations. To examine the associations among self-reported and objective pain measurements, sexual function, and sexual satisfaction in a large combined clinical and community sample of premenopausal women diagnosed with PVD. Ninety-eight women with PVD underwent a cotton-swab test, a vestibular friction pain measurement, and a vestibular pressure-pain threshold measurement. In addition to sociodemographics, participants completed measurements of pain, sexual function, and sexual satisfaction. Self-report measurements were the pain numerical rating scale (0-10), the McGill-Melzack Pain Questionnaire, the Female Sexual Function Index, and the Global Measure of Sexual Satisfaction. Objective measurements were pain during a cotton-swab test, pain during a vestibular friction procedure, and the vestibular pressure-pain threshold measurement. Age and relationship duration were significantly correlated with the Female Sexual Function Index total score (r = -0.31, P < .01; and r = -0.22, P < .05, respectively). When controlling for age, intercourse-related pain intensity, pain during the cotton-swab test, pain during vestibular friction, the vestibular pressure-pain threshold, and the McGill-Melzack Pain Questionnaire sensory and affective subscale scores were not significantly associated with sexual function and satisfaction in women with PVD. The findings show that in women with PVD, self-report and objective pain ratings are not associated with sexual function and satisfaction. The results support the biopsychosocial nature of PVD and underscore the importance of a patient-focused multidisciplinary treatment approach for PVD. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Etiological correlates of vaginismus: sexual and physical abuse, sexual knowledge, sexual self-schema, and relationship adjustment.

PubMed

Reissing, Elke D; Binik, Yitzchak M; Khalifé, Samir; Cohen, Deborah; Amsel, Rhonda

2003-01-01

This study investigated the role of sexual and physical abuse, sexual self-schema, sexual functioning, sexual knowledge, relationship adjustment, and psychological distress in 87 women matched on age, relationship status, and parity and assigned to 3 groups--vaginismus, dyspareunia/vulvar vestibulitis syndrome (VVS), and no pain. More women with vaginismus reported a history of childhood sexual interference, and women in both the vaginismus and VVS groups reported lower levels of sexual functioning and a less positive sexual self-schema. Lack of support for traditionally held hypotheses concerning etiological correlates of vaginismus and the relationship between vaginismus and dyspareunia are discussed.

Hormonal profile impact on female sexual function in young women

NASA Astrophysics Data System (ADS)

Stoian, Dana; Craciunescu, Mihalea; Craina, Marius; Pater, Liana; Pater, Flavius

2014-12-01

Female sexual function is dependent, in physiological milieu upon hormonal impulses: estradiol, testosterone, cortisol, progesterone, prolactin and TSH. Out study tries to appreciate the impact of testosterone, estradiol and prolactin, the major hormones involved in the sexual response, on the normal sexual function. This parameter is approximated by the value of the total FSFI score, a validated international structured interview.

Improvement in quality of life and sexual functioning in a comorbid sample after the unified protocol transdiagnostic group treatment.

PubMed

de Ornelas Maia, Ana Claudia Corrêa; Sanford, Jenny; Boettcher, Hannah; Nardi, Antonio E; Barlow, David

2017-10-01

Patients with multiple mental disorders often experience sexual dysfunction and reduced quality of life. The unified protocol (UP) is a transdiagnostic treatment for emotional disorders that has the potential to improve quality of life and sexual functioning via improved emotion management. The present study evaluates changes in quality of life and sexual functioning in a highly comorbid sample treated with the UP in a group format. Forty-eight patients were randomly assigned to either a UP active-treatment group or a medication-only control group. Treatment was delivered in 14 sessions over the course of 4 months. Symptoms of anxiety and depression were assessed using the Beck Anxiety Inventory and Beck Depression Inventory. Sexual functioning was assessed by the Arizona Sexual Experience Scale (ASEX), and quality of life was assessed by the World Health Organization Quality of Life-BREF scale (WHOQOL-BREF). Quality of life, anxiety and depression all significantly improved among participants treated with the UP. Some improvement in sexual functioning was also noted. The results support the efficacy of the UP in improving quality of life and sexual functioning in comorbid patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sexual Activity and Satisfaction in Healthy Community-dwelling Older Women

PubMed Central

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

2011-01-01

BACKGROUND Female sexual dysfunction is a focus of medical research but few studies describe the prevalence and covariates of recent sexual activity and satisfaction in older community-dwelling women. METHODS 1303 older women from the Rancho Bernardo Study were mailed a questionnaire on general health, recent sexual activity, sexual satisfaction, and the Female Sexual Function Index (FSFI). RESULTS 806 of 921 respondents (87.5%) age ≥40 years answered questions about recent sexual activity. Their median age was 67; mean years since menopause, 25; most were upper-middle class; 57% had attended at least one year of college; 90% reported good to excellent health. Half (49.8%) reported sexual activity within the past month with or without a partner, the majority of whom reported arousal (64.5%), lubrication (69%), and orgasm (67.1%) at least most of the time, although one-third reported low, very low, or no sexual desire. Although frequency of arousal, lubrication, and orgasm decrease with age, the youngest (<55 yrs) and oldest (>80 yrs) women reported a higher frequency of orgasm satisfaction. Emotional closeness during sex was associated with more frequent arousal, lubrication, and orgasm; estrogen therapy was not. Overall, two-thirds of sexually active women were moderately or very satisfied with their sex life, as were almost half of sexually inactive women. CONCLUSION Half these women were sexually active, with arousal, lubrication, and orgasm maintained into old age, despite low libido in one-third. Sexual satisfaction increased with age and did not require sexual activity. PMID:22195529

The reliability and validity of a sexual functioning questionnaire.

PubMed

Corty, E W; Althof, S E; Kurit, D M

1996-01-01

The present study assessed the reliability and validity of a measure of sexual functioning, the CMSH-SFQ, for male patients and their partners. The CMSH-SFQ measures erectile and orgasmic functioning, sexual drive, frequency of sexual behavior, and sexual satisfaction. Test-retest reliability was assessed with 19 males and 19 females for the baseline CMSH-SFQ. Criterion validity was measured by comparing the answers of 25 male patients to those of their partners at baseline and follow-up. The majority of items had acceptable levels of reliability and validity. The CMSH-SFQ provides a reliable and valid device that can be used to measure global sexual functioning in men and their partners and may be used to evaluate the efficacy of treatments for sexual dysfunctions. Limitations and suggestions for use of the CMSH-SFQ are addressed.

Influence of androgen receptor CAG polymorphism on sexual function recovery after testosterone therapy in late-onset hypogonadism.

PubMed

Tirabassi, Giacomo; Corona, Giovanni; Biagioli, Andrea; Buldreghini, Eddi; delli Muti, Nicola; Maggi, Mario; Balercia, Giancarlo

2015-02-01

Androgen receptor (AR) CAG polymorphism has been found to influence sexual function. However, no study has evaluated its potential to condition sexual function recovery after testosterone replacement therapy (TRT) in a large cohort of hypogonadic subjects. To evaluate the role of this polymorphism in sexual function improvement after TRT in late-onset hypogonadism (LOH). Seventy-three men affected by LOH were retrospectively considered. Evaluations were performed before TRT started (time 0) and before the sixth undecanoate testosterone injection. International Index of Erectile Function (IIEF) questionnaire (erectile function [EF], orgasmic function [OF], sexual desire [SD], intercourse satisfaction [IS], overall satisfaction [OS], and total IIEF-15 score); total and free testosterone and estradiol; AR gene CAG repeat number. TRT induced a significant increase in total and free testosterone and estradiol. All IIEF domains significantly improved after TRT. AR CAG repeats negatively and significantly correlated with all the variations (Δ-) of sexual function domains, except for Δ-OS. Conversely, Δ-total testosterone was found to be positively and significantly correlated with sexual function domain variations, except for Δ-IS and Δ-OS. Δ-estradiol did not correlate significantly with any of the variations of sexual function domains. After inclusion in generalized linear models, the number of AR gene CAG triplets was found to be independently and negatively associated with Δ-EF, Δ-SD, Δ-IS, and Δ-Total IIEF-15 score, whereas Δ-total testosterone was independently and positively associated with Δ-EF, Δ-OF, Δ-SD, and Δ-Total IIEF-15 score. However, after including time 0 total testosterone in the model, AR gene CAG triplets remained independently and negatively associated only with Δ-EF and Δ-Total IIEF-15 score, whereas Δ-total testosterone was independently and positively associated only with Δ-EF. Longer length of AR gene CAG repeat tract seems to lower TRT-induced improvement of sexual function in LOH. © 2014 International Society for Sexual Medicine.

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.

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.

The effects of self-focused attention, performance demand, and dispositional sexual self-consciousness on sexual arousal of sexually functional and dysfunctional men.

PubMed

van Lankveld, Jacques J D M; van den Hout, Marcel A; Schouten, Erik G W

2004-08-01

Sexually functional (N=26) and sexually dysfunctional heterosexual men with psychogenic erectile disorder (N=23) viewed two sexually explicit videos. Performance demand was manipulated through verbal instruction that a substantial genital response was to be expected from the videos. Self-focused attention was manipulated by introducing a camera pointed at the participant. Dispositional self-consciousness was assessed by questionnaire. Performance demand was found to independently inhibit the genital response. No main effect of self-focus was found. Self-focus inhibited genital response in men scoring high on general and sexual self-consciousness traits, whereas it enhanced penile tumescence in low self-conscious men. Inhibition effects were found in both volunteers and patients. No interaction effects of performance demand and self-focus were found. Subjective sexual arousal in sexually functional men was highest in the self-focus condition. In sexually dysfunctional men, subjective sexual response proved dependent on locus of attention as well as presentation order.

Sexual Behavior in High-Functioning Male Adolescents and Young Adults with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Hellemans, Hans; Colson, Kathy; Verbraeken, Christine; Vermeiren, Robert; Deboutte, Dirk

2007-01-01

Group home caregivers of 24 institutionalized, male, high-functioning adolescents and young adults with Autism Spectrum Disorder, were interviewed with the Interview Sexuality Autism. Most subjects were reported to express sexual interest and to display some kind of sexual behavior. Knowledge of socio-sexual skills existed, but practical use was…

Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse? A randomized controlled trial.

PubMed

Braekken, Ingeborg H; Majida, Memona; Ellström Engh, Marie; Bø, Kari

2015-02-01

Pelvic floor muscle training (PFMT) has level 1 evidence of reducing the size and symptoms associated with pelvic organ prolapse (POP). There is scant knowledge, however, regarding whether PFMT has an effect on sexual function. The aim of the trial was to evaluate the effect of PFMT on sexual function in women with POP. In this randomized controlled trial, 50 women were randomized to an intervention group (6 months of PFMT and lifestyle advice) and 59 women were randomized to a control group (lifestyle advice only). Participants completed a validated POP-specific questionnaire to describe frequency and bother of prolapse, bladder, bowel, and sexual symptoms and answered a semi-structured interview. No significant change in number of women being sexually active was reported. There were no significant differences between groups regarding change in satisfaction with frequency of intercourse. Interview data revealed that 19 (39%) of women in the PFMT group experienced improved sexual function vs. two (5%) in the control group (P<0.01). Specific improvements reported by some of the women were increased control, strength and awareness of the pelvic floor, improved self-confidence, sensation of a "tighter" vagina, improved libido and orgasms, resolution of pain with intercourse, and heightened sexual gratification for partners. Women who described improved sexual function demonstrated the greatest increases in pelvic floor muscle (PFM) strength (mean 16 ± 10 cmH2 0) and endurance (mean 150 ± 140 cmH2 0s) (P<0.01). PFMT can improve sexual function in some women. Women reporting improvement in sexual function demonstrated the greatest increase in PFM strength and endurance. © 2014 International Society for Sexual Medicine.

Sexual function in infertile women with polycystic ovary syndrome and unexplained infertility.

PubMed

Diamond, Michael P; Legro, Richard S; Coutifaris, Christos; Alvero, Ruben; Robinson, Randal D; Casson, Peter A; Christman, Gregory M; Huang, Hao; Hansen, Karl R; Baker, Valerie; Usadi, Rebecca; Seungdamrong, Aimee; Bates, G Wright; Rosen, R Mitchell; Schlaff, William; Haisenleder, Daniel; Krawetz, Stephen A; Barnhart, Kurt; Trussell, J C; Santoro, Nanette; Eisenberg, Esther; Zhang, Heping

2017-08-01

While female sexual dysfunction is a frequent occurrence, characteristics in infertile women are not well delineated. Furthermore, the impact of infertility etiology on the characteristics in women with differing androgen levels observed in women with polycystic ovary syndrome and unexplained infertility has not been assessed. The objective of the study was to determine the characteristics of sexual dysfunction in women with polycystic ovary syndrome and unexplained infertility. A secondary data analysis was performed on 2 of Eunice Kennedy Shriver National Institute of Child Health and Human Development Cooperative Reproductive Medicine Networks clinical trials: Pregnancy in Polycystic Ovary Syndrome Study II and Assessment of Multiple Intrauterine Gestations From Ovarian Stimulation. Both protocols assessed female sexual function using the Female Sexual Function Inventory and the Female Sexual Distress Scale. Women with polycystic ovary syndrome had higher weight and body mass index than women with unexplained infertility (each P < .001), greater phenotypic (Ferriman-Gallwey hirsutism score, sebum score, and acne score; each P < .001), and hormonal (testosterone, free testosterone, and dehydroepiandrosterone; each P < .001) evidence of androgen excess. Sexual function scores, as assessed by the Female Sexual Function Inventory, were nearly identical. The Female Sexual Distress Scale total score was higher in women with polycystic ovary syndrome. The mean Female Sexual Function Inventory total score increased slightly as the free androgen index increased, mainly as a result of the desire subscore. This association was more pronounced in the women with unexplained infertility. Reproductive-age women with infertility associated with polycystic ovary syndrome and unexplained infertility, despite phenotypic and biochemical differences in androgenic manifestations, do not manifest clinically significant differences in sexual function. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of female genital mutilation/cutting on the sexual function of Sudanese women: a cross-sectional study.

PubMed

Rouzi, Abdulrahim A; Berg, Rigmor C; Sahly, Nora; Alkafy, Susan; Alzaban, Faten; Abduljabbar, Hassan

2017-07-01

Female genital mutilation/cutting (FGM/C) is a cultural practice that involves several types of removal or other injury to the external female genitalia for nonmedical reasons. Although much international research has focused on the health consequences of the practice, little is known about sexual functioning among women with various types of FGM/C. To assess the impact of FGM/C on the sexual functioning of Sudanese women. This is a cross-sectional study conducted at Doctor Erfan and Bagedo Hospital, Jeddah, Saudi Arabia. Eligible women completed a survey and a clinical examination, which documented and verified women's type of FGM/C. The main outcome measure was female sexual function, as assessed by the Arabic Female Sexual Function Index. A total of 107 eligible women completed the survey and the gynecological examination, which revealed that 39% of the women had FGM/C Type I, 25% had Type II, and 36% had Type III. Reliability of self-report of the type of FGM/C was low, with underreporting of the extent of the procedure. The results showed that 92.5% of the women scored lower than the Arabic Female Sexual Function Index cut-off point for sexual dysfunction. The multivariable regression analyses showed that sexual dysfunction was significantly greater with more extensive type of FGM/C, across all sexual function domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) and overall. The study documents that a substantial proportion of women subjected to FGM/C experience sexual dysfunction. It shows that the anatomical extent of FGM/C is related to the severity of sexual dysfunction. Copyright © 2017 Elsevier Inc. All rights reserved.

Sexual learning, sexual experience, and healthy adolescent sex.

PubMed

Fortenberry, J Dennis

2014-01-01

This chapter is organized around the question "How do adolescents learn to have healthy sex?" The chapter assumes that sexual learning derives from a broad range of both informal and formal sources that contribute to learning within the context of neurocognitive brain systems that modulate sexual motivations and self-regulation. The overall objective is to consider how adolescents become sexually functional and healthy and to provide a conceptual basis for expansion of sexual learning to better support healthy sexual functioning. © 2014 Wiley Periodicals, Inc.

Changes in Sexual Activity in Male Patients Surgically Treated for Kyphosis due to Ankylosing Spondylitis.

PubMed

Yao, Ziming; Du, Jianwei; Wang, Zheng; Zheng, Guoquan; Zhang, Xuesong; Cui, Geng; Wang, Yan

2016-09-01

A retrospective study. The aim of this study was to assess the changes in sexual activities in male patients surgically treated for ankylosing spondylitis (AS)-induced kyphosis and the correlation between these changes and spinal sagittal realignment. Sexual function may be affected by AS. However, little is known about the effect of spinal surgery on the sexual activity of patients with AS-induced kyphosis. Data of 45 male patients who had been surgically treated for AS-induced kyphosis were retrospectively reviewed. Changes in sexual activity were evaluated by the international index of erectile function (IIEF), frequency of sexual activity, and time point at which sexual activity began postoperatively. We compared the above-mentioned parameters before and 24 months postoperatively and analyzed the correlation of the changes in the IIEF with the changes in radiological characteristics. Each domain of the IIEF and the total IIEF were increased postoperatively. Improved sexual function was correlated with changes in spinal sagittal characteristics, among which lumbar lordosis (LL) and the chin-brow vertical angle (CBVA) were the most significant causes (P < 0.05). Most patients (71.1%) resumed their sexual activity 5 to 12 weeks after surgery. At the 24-month follow-up, the frequency of patients' sexual activity was higher than that before surgery (P < 0.05). Surgical correction of spinal deformity may improve sexual function and increase the frequency of sexual activity in men with AS. Spinal sagittal realignment and pelvic rotation may be correlated with improvement of sexual function. 4.

Construct validity of the PROMIS® sexual function and satisfaction measures in patients with cancer

PubMed Central

2013-01-01

Background With data from a diverse sample of patients either in treatment for cancer or post-treatment for cancer, we examine inter-domain and cross-domain correlations among the core domains of the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction measures (PROMIS® SexFS) and the corresponding domains from conceptually-similar measures of sexual function, the International Index of Erectile Function and the Female Sexual Function Index. Findings Men (N=389) and women (N=430) were recruited from a tumor registry, oncology clinics, and an internet panel. The PROMIS SexFS, International Index of Erectile Function, and Female Sexual Function Index were used to collect participants’ self-reported sexual function. The domains shared among the measures include desire/interest in sexual activity, lubrication and vaginal discomfort/pain (women), erectile function (men), orgasm, and satisfaction. We examined correlations among different domains within the same instrument (discriminant validity) and correlations among similar domains measured by different instruments (convergent validity). Correlations demonstrating discriminant validity ranged from 0.38 to 0.73 for men and 0.48 to 0.74 for women, while correlations demonstrating convergent validity ranged from 0.62 to 0.83 for men and 0.71 to 0.92 for women. As expected, correlations demonstrating convergent validity were higher than correlations demonstrating discriminant validity, with one exception (orgasm for men). Conclusions Construct validity was supported by convergent and discriminant validity in a diverse sample of patients with cancer. For patients with cancer who may or may not have sexual dysfunction, the PROMIS SexFS measures provide a comprehensive assessment of key domains of sexual function and satisfaction. PMID:23497200

Confirmatory factor analysis of the female sexual function index.

PubMed

Opperman, Emily A; Benson, Lindsay E; Milhausen, Robin R

2013-01-01

The Female Sexual Functioning Index (Rosen et al., 2000 ) was designed to assess the key dimensions of female sexual functioning using six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. A full-scale score was proposed to represent women's overall sexual function. The fifth revision to the Diagnostic and Statistical Manual (DSM) is currently underway and includes a proposal to combine desire and arousal problems. The objective of this article was to evaluate and compare four models of the Female Sexual Functioning Index: (a) single-factor model, (b) six-factor model, (c) second-order factor model, and (4) five-factor model combining the desire and arousal subscales. Cross-sectional and observational data from 85 women were used to conduct a confirmatory factor analysis on the Female Sexual Functioning Index. Local and global goodness-of-fit measures, the chi-square test of differences, squared multiple correlations, and regression weights were used. The single-factor model fit was not acceptable. The original six-factor model was confirmed, and good model fit was found for the second-order and five-factor models. Delta chi-square tests of differences supported best fit for the six-factor model validating usage of the six domains. However, when revisions are made to the DSM-5, the Female Sexual Functioning Index can adapt to reflect these changes and remain a valid assessment tool for women's sexual functioning, as the five-factor structure was also supported.

Correlation Between Transperineal 3-Dimensional Ultrasound Measurements of Levator Hiatus and Female Sexual Function.

PubMed

Aydin, Serdar; Bakar, Rabia Zehra; Arioğlu Aydin, Çağri; Ateş, Seda

The aim of this study is to investigate the association of sexual functions with levator hiatus biometry measurements and levator ani muscle defect. In 62 heterosexual, sexually active premenopausal women without pelvic floor disorders or urinary incontinence, 3-dimensional transperineal ultrasound imaging was used. Two 3-dimensional volumes were recorded, one at rest and one on Valsalva maneuver. Levator biometry measurements and levator defect were evaluated in an axial plane. Sexual function was assessed by a validated questionnaire, Female Sexual Function Index (FSFI). The primary outcome measure was correlation of sexual functions with the levator hiatus area, transverse and anteroposterior diameters, levator ani muscle thickness, vaginal length, and changes in measurements with Valsalva and levator defect. Forty-two women (67.7%) had low total FSFI scores (<26.55). Levator defect rates were similar in female sexual dysfunction (7/42, 16.7%) and women without female sexual dysfunction (5/20, 25%). The FSFI was negatively and weakly correlated with Δhiatal anteroposterior diameter (r = -0.33, P < 0.009) in the study population. There was a weak and inverse correlation between Δhiatal anteroposterior diameter and arousal (r = -0.35, P < 0.002), desire (r = -0.38, P < 0.001), and orgasm (r = -0.33, P < 0.007). Pain and lubrication did not correlate with any measurement. Hiatal area and diameters at rest are not related to sexual functions. Changes in anteroposterior diameter of the levator hiatus during Valsalva, which may be a sign of pelvic floor laxity or levator muscle weakness, are weakly associated with sexual functions, particularly desire, arousal, and orgasm domains.

Conceptualization of the Sexual Response Models in Men: Are there Differences Between Sexually Functional and Dysfunctional Men?

PubMed

Connaughton, Catherine; McCabe, Marita; Karantzas, Gery

2016-03-01

Research to validate models of sexual response empirically in men with and without sexual dysfunction (MSD), as currently defined, is limited. To explore the extent to which the traditional linear or the Basson circular model best represents male sexual response for men with MSD and sexually functional men. In total, 573 men completed an online questionnaire to assess sexual function and aspects of the models of sexual response. In total, 42.2% of men (242) were sexually functional, and 57.8% (331) had at least one MSD. Models were built and tested using bootstrapping and structural equation modeling. Fit of models for men with and without MSD. The linear model and the initial circular model were a poor fit for men with and without MSD. A modified version of the circular model demonstrated adequate fit for the two groups and showed important interactions between psychological factors and sexual response for men with and without MSD. Male sexual response was not represented by the linear model for men with or without MSD, excluding possible healthy responsive desire. The circular model provided a better fit for the two groups of men but demonstrated that the relations between psychological factors and phases of sexual response were different for men with and without MSD as currently defined. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

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

Sexual Anxiety and Eroticism Predict the Development of Sexual Problems in Youth With a History of Sexual Abuse

PubMed Central

Simon, Valerie A.; Feiring, Candice

2017-01-01

Youth with confirmed histories of sexual abuse (N = 118) were followed longitudinally to examine associations between their initial sexual reactions to abuse and subsequent sexual functioning. Participants were interviewed at abuse discovery (ages 8 through 15) and again 1 and 6 years later. Eroticism and sexual anxiety emerged as distinct indices of abuse-specific sexual reactions and predicted subsequent sexual functioning. Eroticism was associated with indicators of heightened sexuality, including more sexual risk behavior and views of sexual intimacy focused on partners’ needs. Sexual anxiety was associated with indicators of diminished sexuality, including few sexual partners and avoidant views of sexual intimacy. Age at abuse discovery moderated some associations, suggesting that the timing of abuse-specific reactions affects trajectories of sexual development. Findings point to the need for a developmental approach to understanding how abuse-specific sexual reactions disrupt sexual development and the need for early interventions promoting healthy sexual development. PMID:18408212

Mating Strategies and Sexual Functioning in Personality Disorders: A Comprehensive Review of Literature.

PubMed

Collazzoni, Alberto; Ciocca, Giacomo; Limoncin, Erika; Marucci, Carmela; Mollaioli, Daniele; Di Sante, Stefania; Di Lorenzo, Giorgio; Niolu, Cinzia; Siracusano, Alberto; Maggi, Mario; Castellini, Giovanni; Rossi, Alessandro; Jannini, Emmanuele A

2017-10-01

Personality disorders impair several aspects of intrapsychic and interpersonal life. In particular, mating strategies and sexual functioning could manifest in different and/or dysfunctional ways in people with personality disorders. To describe, through a comprehensive review of the literature, the mating strategies and sexual functioning in patients with personality disorders. We listed and discussed the principal studies on the relation between mating strategies and sexual functioning in personality disorders. The search strategy used search terms in PubMed for the main studies published from January 2000 to December 2016. We considered two main sections for our selection according to the aim of the present review: mating and sexuality. Interesting evidence on mating strategies in personality disorders was found. In particular, the major items were found in the dramatic-unpredictable cluster, with borderline personality disorder being the most studied. In contrast, the bizarre-eccentric cluster had fewer items, with the schizoid personality disorder being the least studied. For sexual behavior, borderline personality seems to be the unique disorder sufficiently studied, with evidence of major histories of child sexual abuse, the presence of sexual dysfunctions, and paraphilic interests. A large spectrum of mating strategies characterizes different personality disorders, although an inconsistent knowledge about the relation between sexual function and personality disorders emerged from our analysis of the literature. Hence, we invite clinicians and researchers to integrate psychodiagnostic and sexual assessments in psychiatric disciplines for people with personality disorders. Collazzoni A, Ciocca G, Limoncin E, et al. Mating Strategies and Sexual Functioning in Personality Disorders: A Comprehensive Review of Literature. Sex Med Rev 2017;5:414-428. Copyright © 2017 International Society for Sexual Medicine. All rights reserved.

Can you ask? We just did! Assessing sexual function and concerns in patients presenting for initial gynecologic oncology consultation.

PubMed

Kennedy, Vanessa; Abramsohn, Emily; Makelarski, Jennifer; Barber, Rachel; Wroblewski, Kristen; Tenney, Meaghan; Lee, Nita Karnik; Yamada, S Diane; Lindau, Stacy Tessler

2015-04-01

To describe patterns of response to, and assess sexual function and activity elicited by, a self-administered assessment incorporated into a new patient intake form for gynecologic oncology consultation. A cross-sectional study of patients presenting to a single urban academic medical center between January 2010 and September 2012. New patients completed a self-administered intake form, including six brief sexual activity and function items. These items, along with abstracted medical record data, were descriptively analyzed. Logistic regression was used to assess the association between sexual activity and function and disease status, adjusting for age. Median age was 50 years (range 18-91, N=499); more than half had a final diagnosis of cancer. Most patients completed all sex-related items on the intake form; 98% answered at least one. Among patients who were sexually active in the prior 12 months (57% with cancer, 64% with benign disease), 52% indicated on the intake form having, during that period, a sexual problem lasting several months or more. Of these, 15% had physician documentation of the sexual problem. Eighteen women were referred for care. Providers reported no patient complaints about the inclusion of sexual items on the intake form. Nearly all new patients presenting for gynecologic oncology consultation answered self-administered items to assess sexual activity and function. Further study is needed to determine the role of pre-treatment identification of sexual function concerns in improving sexual outcomes associated with cancer diagnosis and treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

Long-Term Effects of a Randomised Controlled Trial Comparing High Protein or High Carbohydrate Weight Loss Diets on Testosterone, SHBG, Erectile and Urinary Function in Overweight and Obese Men

PubMed Central

Moran, Lisa J.; Brinkworth, Grant D.; Martin, Sean; Wycherley, Thomas P.; Stuckey, Bronwyn; Lutze, Janna; Clifton, Peter M.; Wittert, Gary A.; Noakes, Manny

2016-01-01

Introduction Obesity is associated with reduced testosterone and worsened erectile and sexual function in men. Weight loss improves these outcomes. High protein diets potentially offer anthropometric and metabolic benefits, but their effects on reproductive and sexual outcomes is not known. Aim To examine the long-term effects of weight loss with a higher protein or carbohydrate diet on testosterone, sex hormone binding globulin, erectile dysfunction, lower urinary tract symptoms and sexual desire in overweight and obese men. Methods One-hundred and eighteen overweight or obese men (body mass index 27–40 kg/m2, age 20–65 years) were randomly assigned to an energy restricted higher protein low fat (35% protein, 40% carbohydrate, 25% fat; n = 57) or higher carbohydrate low fat diet (17% protein, 58% carbohydrate, 25% fat, n = 61) diet for 52 weeks (12 weeks weight loss, 40 weeks weight maintenance). Primary outcomes were serum total testosterone, sex hormone binding globulin and calculated free testosterone. Secondary outcomes were erectile function as assessed by the International Index of Erectile Function (IIEF) (total score and erectile function domain), lower urinary tract symptoms and sexual desire. Results Total testosterone, sex hormone binding globulin and free testosterone increased (P<0.001) and the total IIEF increased (P = 0.017) with no differences between diets (P≥0.244). Increases in testosterone (P = 0.037) and sex hormone binding globulin (P<0.001) and improvements in the total IIEF (P = 0.041) occurred from weeks 0–12 with a further increase in testosterone from week 12–52 (P = 0.002). Increases in free testosterone occurred from week 12–52 (p = 0.002). The IIEF erectile functon domain, lower urinary tract symptoms and sexual desire did not change in either group (P≥0.126). Conclusions In overweight and obese men, weight loss with both high protein and carbohydrate diets improve testosterone, sex hormone binding globulin and overall sexual function. Trial Registration Anzctr.org.au ACTRN12606000002583 PMID:27584019

Adherence to Vaginal Dilation Following High Dose Rate Brachytherapy for Endometrial Cancer

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

Friedman, Lois C., E-mail: Lois.Friedman@UHhospitals.org; Abdallah, Rita; Schluchter, Mark

Purpose: We report demographic, clinical, and psychosocial factors associated with adherence to vaginal dilation and describe the sexual and marital or nonmarital dyadic functioning of women following high dose rate (HDR) brachytherapy for endometrial cancer. Methods and Materials: We retrospectively evaluated women aged 18 years or older in whom early-stage endometrial (IAgr3-IIB) cancers were treated by HDR intravaginal brachytherapy within the past 3.5 years. Women with or without a sexual partner were eligible. Patients completed questionnaires by mail or by telephone assessing demographic and clinical variables, adherence to vaginal dilation, dyadic satisfaction, sexual functioning, and health beliefs. Results: Seventy-eight ofmore » 89 (88%) eligible women with early-stage endometrial cancer treated with HDR brachytherapy completed questionnaires. Only 33% of patients were adherers, based on reporting having used a dilator more than two times per week in the first month following radiation. Nonadherers who reported a perceived change in vaginal dimension following radiation reported that their vaginas were subjectively smaller after brachytherapy (p = 0.013). Adherers reported more worry about their sex lives or lack thereof than nonadherers (p = 0.047). Patients reported considerable sexual dysfunction following completion of HDR brachytherapy. Conclusions: Adherence to recommendations for vaginal dilator use following HDR brachytherapy for endometrial cancer is poor. Interventions designed to educate women about dilator use benefit may increase adherence. Although sexual functioning was compromised, it is likely that this existed before having cancer for many women in our study.« less

Aromatherapy for Sexual Problems in Menopausal Women: A Systematic Review and Meta-analysis

PubMed Central

Khadivzadeh, Talat; Najafi, Mona Najaf; Irani, Morvarid; Dizavandi, Fatemeh Rajab; Shariati, Khatereh

2018-01-01

Objectives The aim of the present systematic review and meta-analysis is the exploration of the potential evidence of the effectiveness of aromatherapy products on the sexual function of menopausal women. Methods From inception to December 2017, the search process was performed using the MEDLINE and Scopus databases and the Cochrane Library regarding the trials on the effectiveness of herbal-medicine aromatherapy on the sexual function of menopausal women. Results Three of the trials comprise suitable data for inclusion in the meta-analysis. According to the meta-analysis, it is possible to improve the standardized mean difference (SMD) of the sexual desire up to 0.56 in the aromatherapy group compared with the control group (SMD = 0.56; P < 0.001; heterogeneity; I2 = 42%; P = 0.141). According to one of the trials, the serum-estrogen level of two different doses did not change in the neroli oil inhalation group compared with the almond-oil group. Conclusions Both aromatherapy with neroli oil or lavender (monopreparation) and combined-oil aromatherapy with lavender, fennel, geranium, and rose significantly improved human sexual function; however, a significant change of the serum-estrogen level was not detected. The findings of the present review should be presented cautiously because of the corresponding limitations such as the lack of a standardized tool, the lack of intention-to-treat reporting, the low study amount, and the short-term follow-up. PMID:29765928

Sexual Health Care, Sexual Behaviors and Functioning, and Female Genital Cutting: Perspectives From Somali Women Living in the United States.

PubMed

Connor, Jennifer Jo; Hunt, Shanda; Finsaas, Megan; Ciesinski, Amanda; Ahmed, Amira; Robinson, Beatrice Bean E

2016-01-01

We investigated the sexual values, attitudes, and behaviors of 30 Somali female refugees living in a large metropolitan area of Minnesota by collecting exploratory sexual health information based on the components of the sexual health model-components posited to be essential aspects of healthy human sexuality. A Somali-born bilingual interviewer conducted the semistructured interviews in English or Somali; 22 participants chose to be interviewed in Somali. Interviews were translated, transcribed, and analyzed using descriptive statistics and thematic analyses. Our study findings highlighted a sexually conservative culture that values sexual intimacy, female and male sexual pleasure, and privacy in marriage; vaginal sexual intercourse as the only sanctioned sexual behavior; and the importance of Islamic religion in guiding sexual practices. Findings related to human immunodeficiency virus (HIV) revealed HIV testing at immigration, mixed attitudes toward condom use, and moderate knowledge about HIV transmission modes. Female genital cutting (FGC) was a pervasive factor affecting sexual functioning in Somali women, with attitudes about the controversial practice in transition. We recommend that health professionals take the initiative to discuss sexual health care and safer sex, sexual behaviors/functioning, and likely challenges to sexual health with Somali women--as they may be unlikely to broach these subjects without permission and considerable encouragement.

International spinal cord injury male sexual function and female sexual and reproductive function basic data sets-version 2.0.

PubMed

Alexander, Marcalee S; New, Peter W; Biering-Sørensen, Fin; Courtois, Frederique; Popolo, Giulio Del; Elliott, Stacy; Kiekens, Carlotte; Vogel, Lawrence; Previnaire, Jean G

2017-01-01

Data set review and modification. To describe modifications in the International Spinal Cord Injury (SCI) Male Sexual Function Basic Data Set Version 2.0 and the International SCI Female Sexual and Reproductive Function Basic Data Set Version 2.0. International expert work group using on line communication. An international team of experts was compiled to review and revise the International SCI Male Sexual Function and Female Sexual and Reproductive Function Basic Data Sets Version 1.0. The group adapted Version 1.0 based upon review of published research, suggestions from concerned individuals and on line work group consensus. The revised data sets were then posted on the International Spinal Cord Society (ISCoS) and American Spinal Injury Association (ASIA) websites for 2 months for review. Subsequently, the data sets were approved by the ISCoS Scientific and Executive Committees and ASIA board of directors. The data sets were modified to a self-report format. They were reviewed for appropriateness for the pediatric age group and adapted to include a new variable to address the issue of sexual orientation. A clarification of the difference between the data sets and the autonomic standards was also developed. Sexuality is a continuously evolving topic. Modifications were needed to address this topic in a comprehensive fashion. It is recommended that Version 2.0 of these data sets are used for ongoing documentation of sexual status in the medical record and for documentation of sexual concerns during on-going research.

Combined Oral Contraceptives and Sexual Function in Women-a Double-Blind, Randomized, Placebo-Controlled Trial.

PubMed

Zethraeus, Niklas; Dreber, Anna; Ranehill, Eva; Blomberg, Liselott; Labrie, Fernand; von Schoultz, Bo; Johannesson, Magnus; Hirschberg, Angelica Lindén

2016-11-01

There is a lack of knowledge about how oral contraceptives may affect sexual function. To determine whether there is a causal effect of oral contraceptives on sexuality. We hypothesized that a widely used pill impairs sexuality. A double-blind, randomized, placebo-controlled trial. Enrollment began in February 2012 and was completed in August 2015. Karolinska University Hospital, Stockholm, Sweden. A total of 340 healthy women, aged 18-35 years, were randomized to treatment, and 332 completed the study. A combined oral contraceptive (150 μg levonorgestrel and 30 μg ethinylestradiol) or placebo for 3 months of treatment. The primary outcome was the aggregate score on the Profile of Female Sexual Function (PFSF). Secondary outcomes were the seven domains of the PFSF, the Sexual Activity Log, and the Personal Distress Scale. Overall sexual function was similar in women in the oral contraceptive and placebo groups. The PFSF domains desire (-4.4; 95% confidence interval [CI], -8.49 to -0.38; P = .032), arousal (-5.1; 95% CI, -9.63 to -0.48; P = .030), and pleasure (-5.1; 95% CI, -9.97 to -0.32; P = .036) were significantly reduced in comparison to placebo, whereas orgasm, concern, responsiveness, and self-image were similar between groups. The mean frequency of satisfying sexual episodes and personal distress were also similar between groups. This study shows no negative impact of a levonorgestrel-containing oral contraceptive on overall sexual function, although three of seven sexual function domains were adversely affected.

Functional brain correlates of heterosexual paedophilia.

PubMed

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

2008-05-15

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

Women's Sexual Health and Reproductive Function After SCI.

PubMed

Courtois, Frédérique; Alexander, Marcalee; McLain, Amie B Jackson

2017-01-01

Sexual function and to a lesser extent reproduction are often disrupted in women with spinal cord injuries (SCI), who must be educated to better understand their sexual and reproductive health. Women with SCI are sexually active; they can use psychogenic or reflexogenic stimulation to obtain sexual pleasure and orgasm. Treatment should consider a holistic approach using autonomic standards to describe remaining sexual function and to assess both genital function and psychosocial factors. Assessment of genital function should include thoracolumbar dermatomes, vulvar sensitivity (touch, pressure, vibration), and sacral reflexes. Self-exploration should include not only clitoral stimulation, but also stimulation of the vagina (G spot), cervix, and nipples conveyed by different innervation sources. Treatments may consider PDE5 inhibitors and flibanserin on an individual basis, and secondary consequences of SCI should address concerns with spasticity, pain, incontinence, and side effects of medications. Psychosocial issues must be addressed as possible contributors to sexual dysfunctions (eg, lower self-esteem, past sexual history, depression, dating habits). Pregnancy is possible for women with SCI; younger age at the time of injury and at the time of pregnancy being significant predictors of successful pregnancy, along with marital status, motor score, mobility, and occupational scores. Pregnancy may decrease the level of functioning (eg, self-care, ambulation, upper-extremity tasks), may involve complications (eg, decubitus ulcers, weight gain, urological complications), and must be monitored for postural hypotension and autonomic dysreflexia. Taking into consideration the physical and psychosocial determinants of sexuality and childbearing allows women with SCI to achieve positive sexual and reproductive health.

Sexuality in Perimenopausal and Postmenopausal Women.

ERIC Educational Resources Information Center

Morokoff, Patricia J.

1988-01-01

Reviews psychological and biological aspects of effects of menopause on sexuality. Discusses population studies revealing that postmenopausal status is associated with decline in some components of sexual functioning. Notes that little research has examined psychological response to menopause and its effect on sexual functioning. Research on…

Characteristics of self-identified sexual addicts in a behavioral addiction outpatient clinic

PubMed Central

Wéry, Aline; Vogelaere, Kim; Challet-Bouju, Gaëlle; Poudat, François-Xavier; Caillon, Julie; Lever, Delphine; Billieux, Joël; Grall-Bronnec, Marie

2016-01-01

Background and aims Research on sexual addiction flourished during the last decade, promoted by the development of an increased number of online sexual activities. Despite the accumulation of studies, however, evidence collected in clinical samples of treatment-seeking people remains scarce. The aim of this study was to describe the characteristics (socio-demographics, sexual habits, and comorbidities) of self-identified “sexual addicts.” Methods The sample was composed of 72 patients who consulted an outpatient treatment center regarding their sexual behaviors. Data were collected through a combination of structured interviewing and self-report measures. Results Most patients were males (94.4%) aged 20–76 years (mean 40.3 ± 10.9). Endorsement of sexual addiction diagnosis varied from 56.9% to 95.8% depending on the criteria used. The sexual behaviors reported to have the highest degree of functional impairment were having multiple sexual partners (56%), having unprotected sexual intercourse (51.9%), and using cybersex (43.6%). Ninety percent of patients endorsed a comorbid psychiatric diagnosis, and 60.6% presented at least one paraphilia. Conclusions Results showed highly different profiles in terms of sexual preferences and behaviors, as well as comorbidities involved. These findings highlight the need to develop tailored psychotherapeutic interventions by taking into account the complexity and heterogeneity of the disorder. PMID:27774812

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.

Sexual Problems of Patients With Breast Cancer After Treatment: A Systematic Review.

PubMed

Chang, Yun-Chen; Chang, Shiow-Ru; Chiu, Shih-Che

2018-04-04

Sexual health is a crucial part of quality of life in breast cancer survivors, regardless of their relationship status. However, previous studies have rarely used qualitative methods to explore the postoperative experiences and feelings of patients with breast cancer. The aim of this study was to explore the reasons underlying postoperative sexual relationship changes, sexual inactivity, and adaptation to sexual life in patients with breast cancer, as well as interventions provided by medical staff. A survey was performed by using electronic databases and electronic journals accessed through the Internet. The following keywords were used: "breast cancer," "sexual problem," "sexual dysfunction," and "qualitative." Seven articles were included in the literature review. Three main domains were explored, namely, reasons for sexual relationship changes, including age and treatment; the way patients used to adapt to sexual life after the diagnosis of breast cancer, including support systems, communication with partner, and religious beliefs; and intervention by healthcare workers, including intimacy enhancement measures and patient-provider communication. The results of this study can facilitate and encourage health professionals to identify, examine, and solve most of the patient's sexual problems by using the functional and medical framework of the healthcare system. One practical recommendation of this study is the incorporation of sexual counseling units into the national healthcare system. Counselors in these units can aid patients with breast cancer in resolving their sexual issues and promoting sexual satisfaction in the husbands (or partners) of the patients.

A Multidisciplinary Approach to Sexual and Fertility Rehabilitation: The Sexual Rehabilitation Framework

PubMed Central

Hocaloski, Shea; Carlson, Marie

2017-01-01

Many studies have identified improvement in sexual function as a priority for persons with spinal cord injury (SCI). Due to the various secondary sensory, motor, and autonomic consequences following SCI and due to the complexity of sexuality per se, this area can be overwhelming to many health care professionals. The literature indicate that sexual and fertility rehabilitation must be addressed in a biopsychosocial manner and include various disciplines. The multidisciplinary utilization of a Sexual Rehabilitation Framework (SRF) allows the medical and/or psychosocial factors that impede or improve sexual and reproductive function to be examined. The SRF is a user-friendly and simplified way to proactively address the major biopsychosocial areas of sexuality and to create a plan of action for the person with SCI. It is an adjunct tool to the full sexual history, and it encourages all disciplines involved in SCI rehabilitation to address the issue of sexual function in the same manner as they would other activities of daily living. Eight areas are included in the SRF: sexual drive/interest, sexual functioning, fertility and contraception, factors associated with the condition, motor and sensory influences, bladder and bowel influences, sexual self-view and self-esteem, and partnership issues. The use of the SRF is encouraged in both inpatient and outpatient settings. Multidisciplinary or interdisciplinary team work is encouraged in sexual and fertility rehabilitation to move clinicians toward providing proactive and comprehensive care for individuals with SCI or other chronic disabilities. PMID:29339877

Childhood Abuse and Neglect and Adult Intimate Relationships: A Prospective Study

ERIC Educational Resources Information Center

Colman, R.A.; Widom, C.S.

2004-01-01

Objective:: The present study extends prior research on childhood maltreatment and social functioning by examining the impact of early childhood physical abuse, sexual abuse, and neglect on rates of involvement in adult intimate relationships and relationship functioning. Method:: Substantiated cases of child abuse and neglect from 1967 to 1971…

Sexual Function and Testosterone Level in Men With Conservatively Treated Chronic Kidney Disease.

PubMed

Fugl-Meyer, Kerstin S; Nilsson, Marie; Hylander, Britta; Lehtihet, Mikael

2017-07-01

Sexual dysfunctions are common, but underrecognized, in patients with chronic kidney disease (CKD) and are inversely associated with the glomerular filtration rate (GFR). Sexual dysfunctions may affect quality of life in males with CKD. The aim of this study was to analyze the relationship among sex hormones, sexual function, and sexual satisfaction in a group of men between 18 and 50 years of age with CKD Stages 1 to 5 not treated with hemodialysis or peritoneal dialysis. Fasting blood samples for hemoglobin, testosterone, prolactin, and luteinizing hormone and questionnaire surveys (Sexual Complaints Screener for Men, International Index of Erectile Function, and Aging Male Symptom scale) were evaluated in 100consecutive men. Higher CKD stage (i.e., lower renal function) had a statistically significant ( p < .01) correlation with lower total testosterone, free testosterone, and hemoglobin levels, and higher luteinizing hormone and prolactin levels. Sexual function/dysfunctions were not significantly associated with CKD stage, even after adjustment for age and serum testosterone. The results indicate that CKD stage is a factor affecting testosterone levels in combination with age in men between 18 and 50 years of age at different stages of CKD but not treated with hemodialysis or peritoneal dialysis. Sexual dysfunctions are common but not strongly correlated to testosterone levels, prolactin levels, and survey (Sexual Complaints Screener for Men, International Index of Erectile Function, and Aging Male Symptom scale) responses in patients with CKD.

Associations Between Penetration Cognitions, Genital Pain, and Sexual Well-being in Women with Provoked Vestibulodynia.

PubMed

Anderson, Alexandra B; Rosen, Natalie O; Price, Lisa; Bergeron, Sophie

2016-03-01

Provoked vestibulodynia (PVD) is a common vulvovaginal pain condition that negatively impacts women's psychological and sexual well-being. Controlled studies have found that women with PVD report greater negative and less positive cognitions about penetration; however, associations between these types of cognitions and women's pain and sexual well-being remain unknown. Further, researchers have yet to examine how interpersonal variables such as sexual communication may impact the association between women's penetration cognitions and PVD outcomes. We examined associations between vaginal penetration cognitions and sexual satisfaction, sexual function, and pain in women with PVD, as well as the moderating role of sexual communication. Seventy-seven women (M age = 28.32, SD = 6.19) diagnosed with PVD completed the catastrophic and pain cognitions and positive cognitions subscales of the Vaginal Penetration Cognition Questionnaire, as well as the Dyadic Sexual Communication Scale. Participants also completed measures of sexual satisfaction, sexual function, and pain. Dependent measures were the (i) Global Measure of Sexual Satisfaction Scale; (ii) Female Sexual Function Index; and (iii) Present Pain Intensity scale of the McGill Pain Questionnaire, with reference to pain during vaginal intercourse. Women's lower catastrophic and pain cognitions, higher positive cognitions, and higher sexual communication were each uniquely associated with higher sexual satisfaction and sexual function. Lower catastrophic and pain cognitions also were associated with women's lower pain. For women who reported higher sexual communication, as positive cognitions increased, there was a significantly greater decrease in pain intensity during intercourse compared to women who reported lower levels of sexual communication. Findings may inform cognitive-behavioral interventions aimed at improving the pain and sexual well-being of women with PVD. Targeting the couple's sexual communication and women's penetration cognitions may improve women's sexual adjustment and reduce pain. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Changes in sexual functioning in women after neuromodulation for voiding dysfunction.

PubMed

Yih, Jessica M; Killinger, Kim A; Boura, Judith A; Peters, Kenneth M

2013-10-01

Sacral neuromodulation is a well-established treatment for urinary and bowel disorders with potential use for other disorders such as sexual dysfunction. To evaluate changes in sexual functioning in women undergoing neuromodulation for voiding symptoms. Patients enrolled in our prospective, observational neuromodulation database study were evaluated. Data were collected from medical records, and patient-completed Female Sexual Function Index (FSFI) and Interstitial Cystitis Symptom-Problem Indices (ICSI-PI) at baseline, 3, 6, and 12 months post-implant. Patients rated overall change in sexual functioning on scaled global response assessments (GRA) at 3, 6, and 12 months post-implant. We grouped women by baseline FSFI scores: less (score<26) and more sexually functional (score≥26). Data were analyzed with Pearson's Chi-square or Fisher's Exact test and repeated measures. Changes in FSFI and ICSI-PI scores in women grouped by baseline FSFI score<26 and ≥26. Of 167 women evaluated, FSFI scores improved overall from preimplant (mean 13.5±8.5) to 12 months (N=72; mean 15.9±8.9, P=0.004). At baseline and each follow-up point, ICSI-PI scores were similar between groups and improved through time. For patients in the FSFI<26 group there was improvement from baseline to 12-month scores (N=63; 11.9±6.9 to 14.8±8.7; P=0.0006). Improved FSFI domains included desire, orgasm, satisfaction, and pain. Furthermore, of the 74 subjects in this group not sexually active at baseline, 10 became sexually active during follow-up. In the FSFI≥26 group there was slight but statistically significant decline in mean scores between baseline and 12 months (N=9; 27.4±1.1 to 24.5±3.4; P=0.0302); however one had become sexually inactive. A significant decrease was seen in the satisfaction domain. Many factors affect sexual functioning in women; however sexual function may improve along with urinary symptoms after neuromodulation. © 2013 International Society for Sexual Medicine.

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

PubMed

Kolenc, Matej; Kobal, Jan; Podnar, Simon

2017-01-01

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

Biomechanical Diversity of Mating Structures among Harvestmen Species Is Consistent with a Spectrum of Precopulatory Strategies

PubMed Central

Burns, Mercedes; Shultz, Jeffrey W.

2015-01-01

Diversity in reproductive structures is frequently explained by selection acting at individual to generational timescales, but interspecific differences predicted by such models (e.g., female choice or sexual conflict) are often untestable in a phylogenetic framework. An alternative approach focuses on clade- or function-specific hypotheses that predict evolutionary patterns in terms neutral to specific modes of sexual selection. Here we test a hypothesis that diversity of reproductive structures in leiobunine harvestmen (daddy longlegs) of eastern North America reflects two sexually coevolved but non-overlapping precopulatory strategies, a primitive solicitous strategy (females enticed by penis-associated nuptial gifts), and a multiply derived antagonistic strategy (penis exerts mechanical force against armature of the female pregenital opening). Predictions of sexual coevolution and fidelity to precopulatory categories were tested using 10 continuously varying functional traits from 28 species. Multivariate analyses corroborated sexual coevolution but failed to partition species by precopulatory strategy, with multiple methods placing species along a spectrum of mechanical antagonistic potential. These findings suggest that precopulatory features within species reflect different co-occurring levels of solicitation and antagonism, and that gradualistic evolutionary pathways exist between extreme strategies. The ability to quantify antagonistic potential of precopulatory structures invites comparison with ecological variables that may promote evolutionary shifts in precopulatory strategies. PMID:26352413

Biomechanical Diversity of Mating Structures among Harvestmen Species Is Consistent with a Spectrum of Precopulatory Strategies.

PubMed

Burns, Mercedes; Shultz, Jeffrey W

2015-01-01

Diversity in reproductive structures is frequently explained by selection acting at individual to generational timescales, but interspecific differences predicted by such models (e.g., female choice or sexual conflict) are often untestable in a phylogenetic framework. An alternative approach focuses on clade- or function-specific hypotheses that predict evolutionary patterns in terms neutral to specific modes of sexual selection. Here we test a hypothesis that diversity of reproductive structures in leiobunine harvestmen (daddy longlegs) of eastern North America reflects two sexually coevolved but non-overlapping precopulatory strategies, a primitive solicitous strategy (females enticed by penis-associated nuptial gifts), and a multiply derived antagonistic strategy (penis exerts mechanical force against armature of the female pregenital opening). Predictions of sexual coevolution and fidelity to precopulatory categories were tested using 10 continuously varying functional traits from 28 species. Multivariate analyses corroborated sexual coevolution but failed to partition species by precopulatory strategy, with multiple methods placing species along a spectrum of mechanical antagonistic potential. These findings suggest that precopulatory features within species reflect different co-occurring levels of solicitation and antagonism, and that gradualistic evolutionary pathways exist between extreme strategies. The ability to quantify antagonistic potential of precopulatory structures invites comparison with ecological variables that may promote evolutionary shifts in precopulatory strategies.

Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study.

PubMed

Dongre, Swati; Langade, Deepak; Bhattacharyya, Sauvik

2015-01-01

Many women experience sexual dysfunction where there are orgasm disorders and sexual difficulties. Ashwagandha (Withania somnifera) is a herb known to improve the body's physical and psychological condition. The purpose of the study was to determine the efficacy and safety of a high-concentration ashwagandha root extract (HCARE) supplementation for improving sexual function in healthy females. In this pilot study, 50 study subjects were randomized to either (i) HCARE-treated group or (ii) placebo- (starch-) treated group. The subjects consumed either HCARE or placebo capsules of 300mg twice daily for 8 weeks. Sexual function was assessed using two psychometric scales, the Female Sexual Function Index (FSFI) Questionnaire and the Female Sexual Distress Scale (FSDS), and by the number of total and successful sexual encounters. The analysis indicates that treatment with HCARE leads to significantly higher improvement, relative to placebo, in the FSFI Total score (p < 0.001), FSFI domain score for "arousal" (p < 0.001), "lubrication" (p < 0.001), "orgasm" (p = 0.004), and "satisfaction" (p < 0.001), and also FSDS score (p < 0.001) and the number of successful sexual encounters (p < 0.001) at the end of the treatment. This study demonstrated that oral administration of HCARE may improve sexual function in healthy women. The present study is registered in the Clinical Trial Registry, Government of India, with a number CTRI/2015/07/006045.

Why Are Men Satisfied or Dissatisfied with Penile Implants? A Mixed Method Study on Satisfaction with Penile Prosthesis Implantation.

PubMed

Carvalheira, Ana; Santana, Rita; Pereira, Nuno M

2015-12-01

Studies have demonstrated high levels of satisfaction with penile prosthesis implantation (PPI). However, qualitative research exploring the experience of PPI through men's narratives is scarce. The main goals were to analyze (i) the level of sexual satisfaction (quantitatively), and (ii) the reasons for satisfaction and/or dissatisfaction with PPI (qualitatively). Participants were 47 men with erectile dysfunction who underwent surgery between 2003 and 2012, placed by a single surgeon. Structured telephone interviews were carried out. Satisfaction with PPI was a qualitative and quantitative measure assessed through the following four items: (i) "Would you repeat the PPI surgery?"; (ii) "Would you recommend the PPI surgery?"; (iii) "How satisfied are you with the PP?"; and (iv) "Could you explain the motives of your satisfaction/dissatisfaction?". The majority of men (79%) reported to be satisfied with PPI. Content analysis revealed four main themes for men's satisfaction with the PPI: (i) psychological factors were reported 54 times (n = 54) and included positive emotions, self-esteem, confidence, enhancement of male identity, major live change, and self-image; (ii) improvement of sexual function was reported 54 times (n = 54) and referred to achievement of vaginal penetration, increase of sexual desire, sexual satisfaction, penis size, and improvement of erectile function; (iii) relationship factors were reported 11 times (n = 11) and referred to relationship improvement and the possibility of giving pleasure to the partner; and (iv) improvement in urinary function (n = 3). The level of satisfaction with the implementation of penile prostheses is very high, therefore constituting a treatment for erectile dysfunction with a positive impact on the experience of men at sexual, psychological and relational level. © 2015 International Society for Sexual Medicine.

A review of affecting factors on sexual satisfaction in women.

PubMed

Shahhosseini, Zohreh; Gardeshi, Zeinab Hamzeh; Pourasghar, Mehdi; Salehi, Fariba

2014-12-01

Sex is a complex, important and sensitive issue in human being and interwoven with the whole of human existence. Given the serious changes in attitude, function and behavior in sex, the need to address sexual function, especially sexual satisfaction, is felt completely. Sexual satisfaction has a very important role in creating marital satisfaction and any defect in sexual satisfaction is significantly associated with risky sexual behaviors, serious mental illness, social crimes and ultimately divorce. The aim of this study was to explore affecting factors on sexual satisfaction in women based on an overview in scientific database. In this narrative review the researchers searched MEDLINE database, Google Scholar and Science Direct as well as Persian database like Scientific Information Database with search terms of sexual satisfaction and sexual function, restricted to English/ Persian language, during the 20 years ago. Then those articles written by renowned experts were selected. In this regard, 57 articles have been reviewed, which 30 articles related to this research have been extracted. The findings were divided in to four categories including: Demographic factors, Pathophysiological factors, Psychological factors and Sociocultural factors. Sexuality, especially sexual intimacy is sophisticated and yet elegant affair that the other persons has different definitions and different functions. Discrepancies in the results of the studies show that analysis of factors affecting sexual satisfaction regardless of the women's' sociocultural context, religious beliefs, and personal attitudes is undoubtedly inefficient, unscientific and irrational.

Association between higher levels of sexual function, activity, and satisfaction and self-rated successful aging in older postmenopausal women.

PubMed

Thompson, Wesley K; Charo, Lindsey; Vahia, Ipsit V; Depp, Colin; Allison, Matthew; Jeste, Dilip V

2011-08-01

To determine whether measures of successful aging are associated with sexual activity, satisfaction, and function in older postmenopausal women. Cross-sectional study using self-report surveys; analyses included chi-square and t-tests and multiple linear regression analyses. Community-dwelling older postmenopausal women in the greater San Diego region. One thousand two hundred thirty-five community-dwelling women aged 60 to 89 participating at the San Diego site of the Women's Health Initiative. Demographic information and self-reported measures of sexual activity, function, and satisfaction and successful aging. Sexual activity and functioning (desire, arousal, vaginal tightness, use of lubricants, and ability to climax) were negatively associated with age, as were physical and mental health. In contrast, sexual satisfaction and self-rated successful aging and quality of life remained unchanged across age groups. Successful aging measures were positively associated with sexual measures, especially self-rated quality of life and sexual satisfaction. Self-rated successful aging, quality of life, and sexual satisfaction appear to be stable in the face of declines in physical health, some cognitive abilities, and sexual activity and function and positively associated with each other from age 60 to 89. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

Association between higher levels of sexual function, activity, and satisfaction and self-rated successful aging in older postmenopausal women

PubMed Central

Thompson, Wesley K.; Charo, Lindsey; Vahia, Ipsit V.; Depp, Colin; Allison, Matthew; Jeste, Dilip V.

2014-01-01

Objectives To determine if measures of successful-aging are associated with sexual activity, satisfaction, and function in older post-menopausal women. Design Cross-sectional study using self-report surveys; analyses include chi-square and t-tests and multiple linear regression analyses. Setting Community-dwelling older post-menopausal women in the greater San Diego Region. Participants 1,235 community-dwelling women aged 60-89 years participating at the San Diego site of the Women's Health Initiative. Measurements Demographics and self-report measures of sexual activity, function, and satisfaction and successful aging. Results Sexual activity and functioning (desire, arousal, vaginal tightness, use of lubricants, and ability to climax) were negatively associated with age, as were physical and mental health. In contrast, sexual satisfaction and self-rated successful aging and quality of life remained unchanged across age groups. Successful aging measures were positively associated with sexual measures, especially self-rated quality of life and sexual satisfaction. Conclusions Self-rated successful aging, quality of life, and sexual satisfaction appear to be stable in the face of declines in physical health, some cognitive abilities, and sexual activity and function and are positively associated with each other across ages 60-89 years. PMID:21797827

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

PubMed Central

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

2015-01-01

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

Sexual functioning 1 year after traumatic brain injury: findings from a prospective traumatic brain injury model systems collaborative study.

PubMed

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

2012-08-01

To investigate the incidence and types of sexual difficulties in men and women with traumatic brain injury (TBI) 1 year after injury, as well as their comfort level in discussing problems with health care professionals. Prospective cohort study. Community. Persons with TBI (N=223; 165 men and 58 women) who had been treated at 1 of 6 participating TBI Model Systems inpatient rehabilitation units and were living in the community. None. Derogatis Interview for Sexual Functioning-self-report (DISF-SR); Global Sexual Satisfaction Index (GSSI); structured interview regarding changes in sexual functioning; and comfort level discussing sexuality with health care professionals. Women with TBI scored significantly below the normative sample for all subscales of the DISF-SR, including sexual cognition/fantasy, arousal, sexual behavior/experience, and orgasm. Men scored significantly below the normative sample on all scales except arousal. Women reported greater dysfunction than men for sexual cognition/fantasy and arousal. Twenty-nine percent of participants reported dissatisfaction with sexual functioning on the GSSI, with a greater percentage of men reporting dissatisfaction. Sixty-eight percent of participants indicated that they would spontaneously raise issues of sexual difficulties with health care professionals, while the remainder would either bring it up only if directly asked or would not discuss it at all. Sexual difficulties were present in a substantial portion of community-dwelling people with TBI at 1 year after injury. Educational interventions to increase awareness among people with TBI and rehabilitation professionals are warranted, as well as interventions to improve sexual functioning. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A Preliminary Examination of Negative Life Events and Sexual Assault Victimization as Predictors of Psychological Functioning in Female College Students: Does One Matter More Than the Other?

PubMed

Chang, Edward C; Lee, Jerin; Morris, Lily E; Lucas, Abigael G; Chang, Olivia D; Hirsch, Jameson K

2017-07-01

The present study examined negative life events (NLEs) and sexual assault victimization as predictors of positive and negative psychological functioning in a sample of 151 female college students. Results obtained from conducting regression analyses indicated several notable patterns. NLEs, compared with sexual assault victimization, were a stronger negative predictor of positive functioning based on indices related to subjective well-being (e.g., life satisfaction, positive affect). Alternatively, sexual assault victimization, compared with NLEs, was a stronger positive predictor of negative functioning based on indices related to posttraumatic stress disorder symptoms (e.g., anxiety) and related conditions (e.g., alcohol use). Furthermore, both NLEs and sexual assault victimization were found to be positive predictors of negative functioning based on indices related to suicide risk (e.g., depressive symptoms, suicidal behaviors). Overall, our findings indicate that both NLEs and sexual assault victimization represent important and distinct predictors of psychological functioning in female college students.

How does health-promoting lifestyle relate to sexual function among women of reproductive age in Iran?

PubMed

Abedi, Parvin; Jorfi, Maryam; Afshari, Poorandokht; Fakhri, Ahmad

2017-08-01

This study aimed to evaluate the relation between health-promoting lifestyle and sexual function among women of reproductive age. In this cross-sectional study, 1200 women were recruited randomly from 10 public health centers in Ahvaz, Iran. A demographic questionnaire, Health Promoting Lifestyle Profile 2 (HPLP2), and Female Sexual Function Index (FSFI) were used for data collection. The inclusion criteria were as follows: women aged 15-45 years, married, monogamous, and having basic literacy. Data were analyzed using Kruskal-Wallis test, chi-square test, Spearman correlation coefficient, and logistic regression. All aspects of sexual function showed a significant relationship with different dimensions of HPLP2, except for pain and physical activity ( p < 0.001). Women who had better self-actualization were more likely to have better sexual function than other women (OR = 1.10, 95% CI: 1.06-1.14, p < 0.001). Other variables like responsibility, interpersonal relations and stress management also showed a significant correlation with sexual function. Results of this study showed that health-promoting lifestyle dimensions are significantly related to all aspects of sexual function in women of reproductive age. Health policy makers should take lifestyle-related factors of reproductive-aged women into account when seeking to improve the sexual wellbeing of this population. Further attention should also be given to assessing the direction of causality.

Sexual Response Models: Toward a More Flexible Pattern of Women's Sexuality.

PubMed

Ferenidou, Fotini; Kirana, Paraskevi-Sofia; Fokas, Konstantinos; Hatzichristou, Dimitrios; Athanasiadis, Loukas

2016-09-01

Recent research suggests that none of the current theoretical models can sufficiently describe women's sexual response, because several factors and situations can influence this. To explore individual variations of a sexual model that describes women's sexual responses and to assess the association of endorsement of that model with sexual dysfunctions and reasons to engage in sexual activity. A sample of 157 randomly selected hospital employees completed self-administered questionnaires. Two models were developed: one merged the Master and Johnson model with the Kaplan model (linear) and the other was the Basson model (circular). Sexual function was evaluated by the Female Sexual Function Index and the Brief Sexual Symptom Checklist for Women. The Reasons for Having Sex Questionnaire was administered to investigate the reasons for which women have sex. Women reported that their current sexual experiences were at times consistent with the linear and circular models (66.9%), only the linear model (27%), only the circular model (5.4%), and neither model (0.7%). When the groups were reconfigured to the group that endorsed more than 5 of 10 sexual experiences, 64.3% of women endorsed the linear model, 20.4% chose the linear and circular models, 14.6% chose the circular model, and 0.7% selected neither. The Female Sexual Function Index, demographic factors, having sex for insecurity reasons, and sexual satisfaction correlated with the endorsement of a sexual response model. When these factors were entered in a stepwise logistic regression analysis, only the Female Sexual Function Index and having sex for insecurity reasons maintained a significant association with the sexual response model. The present study emphasizes the heterogeneity of female sexuality, with most of the sample reporting alternating between the linear and circular models. Sexual dysfunctions and having sex for insecurity reasons were associated with the Basson model. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Talking About Sex When Sex Is Painful: Dyadic Sexual Communication Is Associated With Women's Pain, and Couples' Sexual and Psychological Outcomes in Provoked Vestibulodynia.

PubMed

Rancourt, Kate M; Rosen, Natalie O; Bergeron, Sophie; Nealis, Logan J

2016-11-01

Provoked vestibulodynia (PVD) is a recurrent vulvovaginal pain condition associated with psychological and sexual consequences for affected women and their partners, including lower quality of dyadic sexual communication compared to pain-free couples. Although greater sexual communication is associated with positive sexual and relational outcomes for both pain-free couples and couples experiencing painful sex, little is known about its role in women's pain and psychological outcomes, especially in a relational context. The present study examined associations between dyadic sexual communication and pain, sexual satisfaction, sexual functioning, and depressive symptoms in a sample of 107 couples in which the woman was diagnosed with PVD via a standardized gynecological assessment. Women completed a measure of pain intensity, and both members of the couple completed measures of their dyadic sexual communication, sexual satisfaction, sexual functioning, and depressive symptoms. Analyses were guided by the actor-partner interdependence model. Women and partners' own perceptions of greater dyadic sexual communication were associated with their own greater sexual satisfaction and sexual functioning, and lower depressive symptoms. Partners' perceptions of greater dyadic sexual communication were also associated with women's lower pain and greater sexual satisfaction. Results point to the importance of dyadic coping conceptualizations for both individual and interpersonal outcomes in PVD. Dyadic sexual communication may be a key treatment target for interventions aimed at improving the pain and psychological and sexual impairments of women with PVD and their partners.

Women with deep infiltrating endometriosis: sexual satisfaction, desire, orgasm, and pelvic problem interference with sex.

PubMed

Montanari, Giulia; Di Donato, Nadine; Benfenati, Arianna; Giovanardi, Giulia; Zannoni, Letizia; Vicenzi, Claudia; Solfrini, Serena; Mignemi, Giuseppe; Villa, Gioia; Mabrouk, Mohamed; Schioppa, Claudio; Venturoli, Stefano; Seracchioli, Renato

2013-06-01

Endometriosis is a chronic and progressive condition of women of reproductive age. It is strongly associated with a significant reduction of quality of life (QOL) and sexual function. This study aims to objectively evaluate sexual function in women with deep infiltrating endometriosis (DIE) and to study the impact of endometriosis symptoms and type of lesion on patient's sexual function. This is a cross-sectional study in a tertiary care university hospital. It included 182 patients with preoperative clinical and ultrasound diagnosis of DIE who were referred to our center from 2008 to 2011. A sexual activity questionnaire, the Sexual Health Outcomes in Women Questionnaire (SHOW-Q) was used to collect data pertaining to satisfaction, orgasm, desire, and pelvic problem interference with sex. Short Form 36 (SF-36) was used to evaluate QOL. Demographic and clinical characteristics were assessed: age, body mass index, parity, ethnicity, postsecondary education, employment, smoking, history of surgical treatment, and hormonal contraception. Patients were asked about pain symptoms (dysmenorrhea, dyspareunia, dyschezia, chronic pelvic pain, and dysuria) using a visual analog scale. The mean values obtained on the different scales of the SHOW-Q showed poor sexual function (mean SHOW-Q total score 56.38 ± 22.74). Satisfaction was the dimension most affected (mean satisfaction score 55.66 ± 34.55), followed by orgasm (mean orgasm score 56.90 ± 33.77). We found a significant correlation between the SF-36 scores and the SHOW-Q scores (P < 0.0001). Sexual dysfunction and deterioration of QOL seem to be correlated. Analyzing the impact of symptoms and lesions on sexual function, we found that dyspareunia and vaginal DIE nodules significantly affect sexual activity (P < 0.05). The results of this study demonstrated that women with DIE have a sexual function impairment, correlated with the overall well-being decrease. Moreover, the presence of dyspareunia and vaginal endometriotic lesions seems to be involved in sexual dysfunction. © 2013 International Society for Sexual Medicine.

The impact of primary Sjögren's syndrome on female sexual function.

PubMed

van Nimwegen, Jolien F; Arends, Suzanne; van Zuiden, Greetje S; Vissink, Arjan; Kroese, Frans G M; Bootsma, Hendrika

2015-07-01

Prevalence of vaginal dryness and dyspareunia is high in women with primary SS (pSS). Our aim was to compare sexual function and sexual distress in women with pSS with healthy controls, as well as to assess parameters that are associated with sexual dysfunction and distress in pSS. Forty-six women fulfilling the American-European Consensus Group criteria for pSS [mean age 46.3 years (s.d. 10.5)] and 43 age-matched healthy controls were included. Participants completed self-administered questionnaires, namely the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), Multidimensional Fatigue Inventory (MFI), Hospital Anxiety and Depression Scale (HADS), Maudsley Marital Questionnaire (MMQ) and RAND 36-item Health Survey (RAND-36). In addition, the European League Against Rheumatism Sjögren's Syndrome Disease Activity Index (ESSDAI) and Patient Reported Index (ESSPRI) were recorded in patients. Women with pSS had impaired sexual function compared with healthy controls (median FSFI 20.6 vs 30.3, P < 0.001), as reflected by significantly lower scores in the domains of desire, arousal, orgasm, lubrication and pain. Furthermore, pSS patients experienced more sexual distress (median FSDS 7 vs 4, P < 0.05) and were sexually active less frequently than controls (76% vs 93%, P < 0.05). Sexual dysfunction correlated significantly with patient-reported symptoms of pSS (ESSPRI), symptoms of fatigue (MFI), depressive symptoms (HADS), relationship dissatisfaction (MMQ) and lower mental quality of life (RAND-36), but not with systemic disease activity (ESSDAI). Women with pSS have impaired sexual function and more sexual distress compared with healthy controls. Sexual function and distress are influenced by vaginal dryness and patient-reported symptoms of pSS as well as psychosocial factors. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Functional cortical and subcortical abnormalities in pedophilia: a combined study using a choice reaction time task and fMRI.

PubMed

Poeppl, Timm B; Nitschke, Joachim; Dombert, Beate; Santtila, Pekka; Greenlee, Mark W; Osterheider, Michael; Mokros, Andreas

2011-06-01

Pedophiles show sexual interest in prepubescent children but not in adults. Research into the neurofunctional mechanisms of paraphilias has gathered momentum over the last years. To elucidate the underlying neural processing of sexual interest among pedophiles and to highlight the differences in comparison with nonparaphilic sexual interest in adults. Nine pedophilic patients and 11 nonpedophilic control subjects underwent functional magnetic resonance imaging (fMRI) while viewing pictures of nude (prepubescents, pubescents, and adults) and neutral content, as well as performing a concomitant choice reaction time task (CRTT). Brain blood oxygen level-dependent (BOLD) signals and response latencies in the CRTT during exposure to each picture category. Analysis of behavioral data showed group differences in reaction times regarding prepubescent and adult but not pubescent stimuli. During stimulation with pictures displaying nude prepubescents, pedophiles showed increased BOLD response in brain areas known to be involved in processing of visual sexual stimuli. Comparison of pedophilic patients with the control group discovered differences in BOLD responses with respect to prepubescent and adult but not to pubescent stimuli. Differential effects in particular occurred in the cingulate gyrus and insular region. The brain response of pedophiles to visual sexual stimulation by images of nude prepubescents is comparable with previously described neural patterns of sexual processing in nonpedophilic human males evoked by visual stimuli depicting nude adults. Nevertheless, group differences found in the cingulate gyrus and the insular region suggest an important role of these brain areas in pedophilic sexual interest. Furthermore, combining attention-based methods like CRTT with fMRI may be a viable option for future diagnostic procedures regarding pedophilia. © 2011 International Society for Sexual Medicine.

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.

Sexuality and intimacy among people living with serious mental illnesses: Factors contributing to sexual activity

PubMed Central

Bonfils, Kelsey A.; Firmin, Ruth L.; Salyers, Michelle P.; Wright, Eric R.

2015-01-01

Objective Limited research has focused on sexuality for those diagnosed with a severe mental illness. We aimed to extend existing work by exploring relationships between mastery (perception of control of one's life and future), sexual self-esteem (perceptions of one's capacity to engage in healthy sexual behavior), sexual attitudes (permissive ideas about sexuality), and perceived importance of relationships/sexuality and number of sexual partners. Methods A secondary analysis of survey data from adult participants living with a severe mental illness (N=401) in the Indiana Mental Health Services and HIV-Risk Study (Perry & Wright, 2006) was conducted. Analysis of covariance (controlling for marital status) compared those with zero partners, one partner, or multiple partners over the past three months on the dependent variables of mastery, sexual self-esteem, sexual attitudes, and perceived importance. Results Participants with more permissive attitudes, greater perceived importance, and higher mastery were more likely to be sexually active with multiple partners. Self-esteem did not differentiate groups. Conclusions and Implications for Practice Given the key role of sexual satisfaction in quality of life and the high rates of sexual risk behavior in this population, it is important that clinicians systematically assess mastery, perceived importance, and attitudes about sexuality when working with consumers diagnosed with a severe mental illness. Individually tailoring existing interventions based on consumers' levels of mastery, related to self-efficacy for implementing changes in life, could improve long-term outcomes for these programs. Future research should examine other constructs that may account for more variance in sexual activity, such as perceptions of risk, intentions for sexual safety, or romantic relationship functioning. PMID:25664756

Development and validation of the Female Sexual Function Index adaptation for breast cancer patients (FSFI-BC).

PubMed

Bartula, Iris; Sherman, Kerry A

2015-08-01

Sexual dysfunction following breast cancer treatment is common and screening for this is recommended. This study determined the reliability, validity, and acceptability of a breast cancer-specific adaptation of the Female Sexual Function Index, the FSFI-BC. This new measure addresses limitations in the FSFI when assessing sexual dysfunction of women with breast cancer regarding applicability to non-sexually active women, measuring distress and changes after cancer. Female breast cancer survivors (n = 596; 429 sexually active, 166 non-sexually active) completed an online survey including demographic/medical information, the FSFI-BC, and scales measuring sexual functioning, fatigue, body image, physical and mental health, and relationship adjustment (Time 1). Three weeks later, 326 women (245 sexually active; 81 non-sexually active) completed the Time 2 survey including the FSFI-BC, and questions regarding its acceptability and perceived change in sexual functioning. Reliability, construct validity, and acceptability were examined using standard scale validation techniques. Exploratory factor analysis delineated seven factors: Changes after cancer, desire/arousal, lubrication, orgasm, pain, satisfaction, and distress, accounting for 79.98 % (sexually active) and 77.19 % (non-active) variance in responses. Acceptable internal consistencies (non-active: α = 0.71-0.96; sexually active: α = 0.89-0.96) and test-retest reliabilities (non-active: r = 0.63-0.86; sexually active: r = 0.71-0.88) were evident. Inter-scale correlations provided evidence for convergent and divergent validities of the FSFI-BC. Both sexually active and non-active women provided positive feedback about the FSFI-BC. The optional partner questions demonstrated clinical utility. With desirable psychometric properties and acceptability to participants, the FSFI-BC is suitable for screening for sexual dysfunction in women with breast cancer.

Latent structures of female sexual functioning.

PubMed

Carvalho, Joana; Vieira, Armando Luís; Nobre, Pedro

2012-08-01

For the last three decades, male and female sexual responses have been conceptualized as similar, based on separated and sequential phases as proposed by the models of Masters and Johnson (1966) and Kaplan (1979) model. However, there is a growing debate around the need to conceptualize female sexual response and the classification of sexual dysfunction in women, in view of the upcoming editions of the DSM and ICD. The aim of this study was to test, using structural equation modeling, five conceptual, alternative models of female sexual function, using a sample of women with sexual difficulties and a sample of women without sexual problems. A total of 1993 Portuguese women participated in the study and completed a modified version of the Female Sexual Function Index. Findings suggested a four-factor solution as the model that best fit the data regarding women presenting sexual difficulties: (1) desire/arousal; (2) lubrication; (3) orgasm; (4) pain/vaginismus. In relation to sexually healthy women, the best model was a five-factor solution comprising of (1) desire; (2) arousal; (3) lubrication; (4) orgasm; and (5) pain/vaginismus. Discriminant validity between factors was supported, suggesting that these dimensions measure distinct phenomena. Model fit to the data significantly decreased in both samples, as models began to successively consider greater levels of overlap among phases of sexual function, towards a single-factor solution. By suggesting the overlap between pain and vaginismus, results partially support the new classification that is currently being discussed regarding DSM-5. Additionally, results on the relationship between sexual desire and arousal were inconclusive as sexually healthy women were better characterized by a five-factor model that considered the structural independence among these factors, whereas women with sexual difficulties better fit with a four-factor model merging sexual desire and subjective sexual arousal.

Trade-offs between sexual advertisement and immune function in the pied flycatcher (Ficedula hypoleuca).

PubMed

Kilpimaa, Janne; Alatalo, Rauno V; Siitari, Heli

2004-02-07

Good genes models of sexual selection assume that sexual advertisement is costly and thus the level of advertisement honestly reveals heritable viability. Recently it has been suggested that an important cost of sexual advertisement might be impairment of the functioning of the immune system. In this field experiment we investigated the possible trade-offs between immune function and sexual advertisement by manipulating both mating effort and activity of immune defence in male pied flycatchers. Mating effort was increased in a non-arbitrary manner by removing females from mated males during nest building. Widowed males sustained higher haematocrit levels than control males and showed higher expression of forehead patch height, suggesting that manipulation succeeded in increasing mating effort. Males that were experimentally forced to increase mating effort had reduced humoral immune responsiveness compared with control males. In addition, experimental activation of immune defence by vaccination with novel antigens reduced the expression of male ornament dimensions. To conclude, our results indicate that causality behind the trade-off between immune function and sexual advertisement may work in both directions: sexual activity suppresses immune function but immune challenge also reduces sexual advertisement.

Trade-offs between sexual advertisement and immune function in the pied flycatcher (Ficedula hypoleuca).

PubMed Central

Kilpimaa, Janne; Alatalo, Rauno V.; Siitari, Heli

2004-01-01

Good genes models of sexual selection assume that sexual advertisement is costly and thus the level of advertisement honestly reveals heritable viability. Recently it has been suggested that an important cost of sexual advertisement might be impairment of the functioning of the immune system. In this field experiment we investigated the possible trade-offs between immune function and sexual advertisement by manipulating both mating effort and activity of immune defence in male pied flycatchers. Mating effort was increased in a non-arbitrary manner by removing females from mated males during nest building. Widowed males sustained higher haematocrit levels than control males and showed higher expression of forehead patch height, suggesting that manipulation succeeded in increasing mating effort. Males that were experimentally forced to increase mating effort had reduced humoral immune responsiveness compared with control males. In addition, experimental activation of immune defence by vaccination with novel antigens reduced the expression of male ornament dimensions. To conclude, our results indicate that causality behind the trade-off between immune function and sexual advertisement may work in both directions: sexual activity suppresses immune function but immune challenge also reduces sexual advertisement. PMID:15058434

Factors associated with sexual functioning in women following spinal cord injury.

PubMed

Harrison, J; Glass, C A; Owens, R G; Soni, B M

1995-12-01

Research into sexuality following spinal cord injury (SCI) has tended to concentrate on male experiences and the physical capabilities for sexual intercourse. The sexuality of women following SCI has only recently been addressed and studies are limited to small numbers and the use of non-standardised measures. The present investigation utilised standard measures of affective state and body satisfaction together with pre and post-injury questionnaire information of sexual dysfunction, feelings about sex and importance of sexual activity in a group of 85 women with SCI. Sexual dysfunction increased significantly post-injury, whilst feelings about sex and it's importance were unaffected. Sexual dysfunction and the importance of sex were inversely correlated. General and Head satisfaction estimates were not significantly different to control samples, whilst Body Satisfaction was increased for women with disabilities. None of the body satisfaction measures were related to the sexual functioning measure. General dissatisfaction was associated depression. Both anxiety and depression were experienced by the same individuals, and anxiety related to current sexual dysfunction. Qualitative data supported previous findings concerning the effects of social and attitudinal barriers on sexual functioning.

Affective disorders and sexual function: from neuroscience to clinic.

PubMed

Barata, Bernardo C

2017-11-01

Sexual dysfunction is a frequent issue in patients with affective disorders, affecting its quality of life and posing challenges to the approach of these patients. In recent years, human sexuality has attracted interest from the scientific community, and today we have a much deeper knowledge of the mechanisms involved in the sexual response. Paraphilias or sexual dysfunctions like low sexual desire, premature ejaculation, and erectile dysfunction, are frequent in affective disorders, and the frequency of each sexual problem varies according to the affective disorder. Comparing what is currently known about the sexual response with the main neurobiological findings of depressive, anxiety, obsessive-compulsive and posttraumatic stress disorders, it is possible to better understand specific sexual complaints of patients with these disorders. A better understanding of sexual function in affective disorders may help clinicians to choose treatments more suited to specific needs of these patients. Although the current state of science already allows us to have some understanding about sexual function in affective disorders, this critical area of research is still in its infancy, waiting for more investment.

Sexual health and function in later life: a population-based study of 606 older adults with a partner.

PubMed

Wang, Vicki; Depp, Colin A; Ceglowski, Jennifer; Thompson, Wesley K; Rock, David; Jeste, Dilip V

2015-03-01

Sexual health and function is an important yet understudied aspect of overall health and well-being in older adults. There are limited data on the relative strength of associations between various aspects of sexual health with the physical, emotional, and cognitive function in older adults. Additionally, there is little information on how these associations differ by age and sex. In this Successful Aging Evaluation (SAGE) study, 606 community-dwelling adults in San Diego County, aged 50-99 years and who had a partner, were included in the analysis. Evaluations included a phone-based cognitive screening followed by a comprehensive mail-in survey including rating scales of sexual health, depression, anxiety, and physical function. The mean age of the sample was 75.2 years. Over 80% of respondents had engaged in sexual activity in the past year, over 70% engaged in sexual activity weekly or more than once a week, and over 60% were somewhat or very satisfied with their sex lives. No sex differences were evident on dimensions of sexual health except for a higher rate of rejection of sexual overtures by women. Depressive symptoms were negatively associated with all assessed aspects of sexual health, even after adjusting for age, physical functioning, anxiety, cognitive ability, or perceived stress in both men and women. In this population-based study older men and women who had a partner reported frequent engagement in and satisfaction with sexual activity. Depressive symptoms were broadly associated with worse sexual health, more so than physical function, anxiety or stress, or age itself. Copyright © 2015. Published by Elsevier Inc.

Effects of visual erotic stimulation on vibrotactile detection thresholds in men.

PubMed

Jiao, Chuanshu; Knight, Peter K; Weerakoon, Patricia; Turman, A Bulent

2007-12-01

This study examined the effects of sexual arousal on vibration detection thresholds in the right index finger of 30 healthy, heterosexual males who reported no sexual dysfunction. Vibrotactile detection thresholds at frequencies of 30, 60, and 100 Hz were assessed before and after watching erotic and control videos using a forced-choice, staircase method. A mechanical stimulator was used to produce the vibratory stimulus. Results were analyzed using repeated measures analysis of variance. After watching the erotic video, the vibrotactile detection thresholds at 30, 60, and 100 Hz were significantly reduced (p < .01). No changes in thresholds were detected at any frequency following exposure to the non-erotic stimulus. The results show that sexual arousal resulted in an increase in vibrotactile sensitivity to low frequency stimuli in the index finger of sexually functional men.

Dyadic Aspects of Sexual Well-Being in Men with Laser-Treated Penile Carcinoma.

PubMed

Skeppner, Elisabet; Fugl-Meyer, Kerstin

2015-06-01

Coping with cancer, its treatment and recovery are dyadic processes within a relationship. Sexual dysfunctions and problems of penile cancer may add to the demands of coping. The prospective study aimed to describe the dyadic aspects of sexual well-being and life satisfaction before and 1 year after organ-sparing laser treatment of penile carcinoma. A consecutive series of 29 patients with penile carcinoma suitable for laser treatment were included together with their partners, median age 60 (37-73) years and 57 (30-72) years, respectively. Median length of relationship was 29 years (1-54 years). The participants completed structured interviews before treatment, at 6 months' and 12 months' follow-up. The interview addressed sexual activities, sexual functions, verbal (sexual) communication, and life satisfaction. Three well-validated instruments were included: Hospital Anxiety and Depression Scale, International Index of Erectile Function-5, and Life Satisfaction checklist, LiSat-11. The interviews contained the same questions for patients and partners at all three measuring points. There was a high level of within-couple agreement on sexual activities, sexual function, and life satisfaction before and after organ-sparring treatment. No significant differences between interview data at 6 and 12 months' follow-up occurred. Before treatment, sexual dysfunctions were common among men, especially decreased sexual interest and dyspareunia. At follow-up, increased sexual function was found, with the exception of erectile function and women's orgasm. A rather high proportion was being unsatisfactory sexually inactive. Few had an ongoing verbal (sexual) mutual communication. Couples with an active sexual life at follow-up showed coherence in high satisfaction with life as a whole. A high level of within-couple agreement concerning sexuality and life satisfaction points to the necessity of including an adequate sexological case history, counseling, and treatment for this group of patients and their partners.

Mediators of sexual functioning and marital quality in chronically depressed adults with and without a history of childhood sexual abuse.

PubMed

Dunlop, Boadie W; Hill, Eric; Johnson, Benjamin N; Klein, Daniel N; Gelenberg, Alan J; Rothbaum, Barbara O; Thase, Michael E; Kocsis, James H

2015-03-01

Sexual dysfunction is common among depressed adults. Childhood sexual abuse (CSA) and depressive symptomology are among the risk factors for sexual dysfunction, and these factors may interact to predict adult relationship functioning. Several models have been developed postulating interactions between these variables. We tested models of the effects of CSA and elucidate the associations between CSA, sexual dysfunction, depression severity, anxiety, and relationship quality in chronically depressed adults. Baseline data from 808 chronically depressed outpatients enrolled in the Research Evaluating the Value of Augmenting Medication with Psychotherapy study were evaluated using structural equation modeling. The Inventory of Depressive Symptomology, self-report version (IDS-SR) assessed depression severity, and the Mood and Anxiety Symptom Questionnaire Anxious Arousal subscale assessed anxiety. Sexual function was assessed with the Arizona Sexual Experiences Scale (ASEX), and the Quality of Marriage Index (QMI) assessed relationship quality for patients in stable relationships. CSA scores predicted depression severity on the IDS-SR, as well as lower relationship quality and sexual satisfaction. ASEX scores were significantly associated with depression severity but were not correlated with the QMI. Two models were evaluated to elucidate these associations, revealing that (i) depression severity and anxious arousal mediated the relationship between CSA and adult sexual function, (ii) anxious arousal and sexual functioning mediated the association between CSA and depression symptoms, and (iii) when these models were combined, anxious arousal emerged as the most important mediator of CSA on depression which, in turn, mediated associations with adult sexual satisfaction and relationship quality. Although CSA predicts lower relationship and sexual satisfaction among depressed adults, the long-term effects of CSA appear to be mediated by depressive and anxious symptoms. It is important to address depression and anxiety symptoms when treating patients with CSA who present with sexual dysfunction or marital concerns. © 2014 International Society for Sexual Medicine.

Exploring the Sexuality of African American Older Women

PubMed Central

Laganá, Luciana; White, Theresa; Bruzzone, Daniel E.; Bruzzone, Cristine E.

2014-01-01

Aims To identify sexually-related themes of the sexuality of older African American women. Study Design Mixed method. Place and Duration of Study Department of Psychology, California State University Northridge, between July 2009 and June 2011. Methodology We included 13 African American older women (57 to 82 years of age), 11 of whom self-identified as heterosexual, one as bisexual, and one as lesbian. We used a semi-structured interview protocol through which we explored some aspects of the respondents’ sexuality (assessed at a superficial level, to be as tactful as possible). Moreover, we collected information on demographics and self-rated physical health. Two co-authors served as coders, and used content analysis to identify the most salient sexuality themes. Results Emerging themes were (in order from most to least endorsed): having sexual desire (often unfulfilled); engaging in less sexual activity in older age; experiencing changes in one’s sexual life as a function of absence of a spouse; and exercising control over how one’s sexual life is conducted. Motivated by the paucity of our sexuality data, we have also provided suggestions to scholars interested in conducting more in-depth further research on this topic with older African American women. Conclusion Our findings indicate that the common notion that older women are asexual is a myth, while lack of a suitable sexual partner is a problem reported by many African American older women who would otherwise enjoy sexual interaction. PMID:25632380

[Interactions between human sexual arousal and sexual desire: a challenge for social neuroscience].

PubMed

Ortigue, Stephanie; Bianchi-Demicheli, Francesco

2007-03-28

The frequent interaction and synergy between sexual arousal and sexual desire occuring during a sexual experience explains the difficulty in disentagling these two phenomena in the human sexual response. Sexual desire is defined as a goal-directed motivational state integrating the other in one's personal sphere on the basis of intentionality, rather than by instinct only. Sexual arousal includes physical manifestations and subjective perception of excitement. Interest in sexual arousal has engendered a growing body of research concerning its nature and function as well as the biological basis of the mechanisms sustaining it. Recent functional imaging has played a key role in seeking to isolate brain regions specific to sexual arousal. This field may represent a new challenge for social neuroscience.

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

PubMed Central

Ramdurg, Santosh; Ambekar, Atul; Lal, Rakesh

2015-01-01

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

Mindfulness-Based Sex Therapy Improves Genital-Subjective Arousal Concordance in Women With Sexual Desire/Arousal Difficulties.

PubMed

Brotto, Lori A; Chivers, Meredith L; Millman, Roanne D; Albert, Arianne

2016-11-01

There is emerging evidence for the efficacy of mindfulness-based interventions for improving women's sexual functioning. To date, this literature has been limited to self-reports of sexual response and distress. Sexual arousal concordance-the degree of agreement between self-reported sexual arousal and psychophysiological sexual response-has been of interest due to the speculation that it may be a key component to healthy sexual functioning in women. We examined the effects of mindfulness-based sex therapy on sexual arousal concordance in a sample of women with sexual desire/arousal difficulties (n = 79, M age 40.8 years) who participated in an in-laboratory assessment of sexual arousal using a vaginal photoplethysmograph before and after four sessions of group mindfulness-based sex therapy. Genital-subjective sexual arousal concordance significantly increased from pre-treatment levels, with changes in subjective sexual arousal predicting contemporaneous genital sexual arousal (but not the reverse). These findings have implications for our understanding of the mechanisms by which mindfulness-based sex therapy improves sexual functioning in women, and suggest that such treatment may lead to an integration of physical and subjective arousal processes. Moreover, our findings suggest that future research might consider the adoption of sexual arousal concordance as a relevant endpoint in treatment outcome research of women with sexual desire/arousal concerns.

Women's Sexual Health and Reproductive Function After SCI

PubMed Central

Alexander, Marcalee; McLain, Amie B. (Jackson)

2017-01-01

Sexual function and to a lesser extent reproduction are often disrupted in women with spinal cord injuries (SCI), who must be educated to better understand their sexual and reproductive health. Women with SCI are sexually active; they can use psychogenic or reflexogenic stimulation to obtain sexual pleasure and orgasm. Treatment should consider a holistic approach using autonomic standards to describe remaining sexual function and to assess both genital function and psychosocial factors. Assessment of genital function should include thoracolumbar dermatomes, vulvar sensitivity (touch, pressure, vibration), and sacral reflexes. Self-exploration should include not only clitoral stimulation, but also stimulation of the vagina (G spot), cervix, and nipples conveyed by different innervation sources. Treatments may consider PDE5 inhibitors and flibanserin on an individual basis, and secondary consequences of SCI should address concerns with spasticity, pain, incontinence, and side effects of medications. Psychosocial issues must be addressed as possible contributors to sexual dysfunctions (eg, lower self-esteem, past sexual history, depression, dating habits). Pregnancy is possible for women with SCI; younger age at the time of injury and at the time of pregnancy being significant predictors of successful pregnancy, along with marital status, motor score, mobility, and occupational scores. Pregnancy may decrease the level of functioning (eg, self-care, ambulation, upper-extremity tasks), may involve complications (eg, decubitus ulcers, weight gain, urological complications), and must be monitored for postural hypotension and autonomic dysreflexia. Taking into consideration the physical and psychosocial determinants of sexuality and childbearing allows women with SCI to achieve positive sexual and reproductive health. PMID:29339874

It Takes Two: Sexual Communication Patterns and the Sexual and Relational Adjustment of Couples Coping With Provoked Vestibulodynia.

PubMed

Rancourt, Kate M; Flynn, Michelle; Bergeron, Sophie; Rosen, Natalie O

2017-03-01

Provoked vestibulodynia (PVD) is a prevalent vulvovaginal pain condition that is associated with sexual and relational consequences for women and their partners. Greater perceived quality of sexual communication has been associated with women's lower pain during intercourse and with couples' better sexual and relational well-being. Whether couples' collaborative (eg, expressing feelings or problem solving) and negative (eg, withdrawing or criticizing) sexual communication patterns (SCPs) are differentially associated with couples' adjustment to PVD is unknown. To examine associations between collaborative and negative SCPs and women's pain and the sexual and relationship adjustment of women with PVD and their partners. Women diagnosed with PVD (N = 87) and their partners completed the Sexual Communication Patterns Questionnaire and measurements of pain (women only), sexual functioning, sexual satisfaction, sexual distress, and relationship satisfaction. (i) Numerical rating scale of pain during intercourse, (ii) Female Sexual Function Index and International Index of Erectile Function, (iii) Global Measure of Sexual Satisfaction, (iv) Female Sexual Distress Scale-Revised, and (v) Couple Satisfaction Index. When women reported greater collaborative SCP, they also reported higher sexual and relationship satisfaction. When women reported greater negative SCP, they reported less relationship satisfaction and had partners who reported greater sexual distress. When partners reported greater collaborative SCP, they also reported higher relationship satisfaction and had female partners who were less sexually distressed. When partners reported higher negative SCP, they also reported less relationship satisfaction. There were no associations between SCP and women's or partners' sexual functioning or women's pain. Collaborative SCP may benefit couples' sexual and relational well-being, whereas negative SCP may impede sexual and relational adjustment to PVD. Findings provide preliminary support for the need to assess and target collaborative and negative SCPs in psychological interventions for couples affected by PVD. Rancourt KM, Flynn M, Bergeron S, Rosen NO. It Takes Two: Sexual Communication Patterns and the Sexual and Relational Adjustment of Couples Coping With Provoked Vestibulodynia. J Sex Med 2017;14:434-443. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Incontinence and sexuality in later life.

PubMed

Garrett, Dawne; Tomlin, Karen

2015-07-01

This article explores the interrelated aspects of incontinence and sexuality in older age. It describes the physiological changes that may have an effect on sexual function and the genitourinary system as people age. The enduring importance of sexual intimacy is discussed. Treatments for incontinence and to improve sexual function are explored. The authors conclude that nurses, particularly those involved in continence management, have a role in ensuring sensitive assessment and access to treatment, which can support many older people to maintain fulfilling sexual activity.

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

PubMed

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

2016-11-01

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

Hypnotic Relaxation Therapy and Sexual Function in PostmenopausalWomen: Results of a Randomized Clinical Trial.

PubMed

Johnson, Aimee K; Johnson, Alisa J; Barton, Debra; Elkins, Gary

2016-01-01

Sexual dysfunction is a common problem for postmenopausal women. This study, as part of a larger randomized controlled trial, examined the effect of hypnotic relaxation therapy on sexual dysfunction, a secondary study outcome, in postmenopausal women. Sexual function was assessed using the Sexual Activity Questionnaire (SAQ). Significant improvement in sexual pleasure and discomfort were reported following 5 weekly sessions of hypnotic relaxation therapy, compared with those receiving an attention control. Total SAQ scores showed significant improvement in the hypnotic relaxation therapy treatment group while holding baseline SAQ scores constant. Improvements showed a slight increase at the Week 12 follow-up. The results of this analysis provide initial support for the use of hypnotic relaxation therapy to improve sexual function in postmenopausal women.

Scaling sexual behavior or "sexual risk propensity" among men at risk for HIV in Kisumu, Kenya.

PubMed

Mattson, C L; Campbell, Richard T; Karabatsos, George; Agot, Kawango; Ndinya-Achola, J O; Moses, Stephen; Bailey, Robert C

2010-02-01

We present a scale to measure sexual risk behavior or "sexual risk propensity" to evaluate risk compensation among men engaged in a randomized clinical trial of male circumcision. This statistical approach can be used to represent each respondent's level of sexual risk behavior as the sum of his responses on multiple dichotomous and rating scale (i.e. ordinal) items. This summary "score" can be used to summarize information on many sexual behaviors or to evaluate changes in sexual behavior with respect to an intervention. Our 18 item scale demonstrated very good reliability (Cronbach's alpha of 0.87) and produced a logical, unidimensional continuum to represent sexual risk behavior. We found no evidence of differential item function at different time points (except for reporting a concurrent partners when comparing 6 and 12 month follow-up visits) or with respect to the language with which the instrument was administered. Further, we established criterion validity by demonstrating a statistically significant association between the risk scale and the acquisition of incident sexually transmitted infections (STIs) at the 6 month follow-up and HIV at the 12 month follow-up visits. This method has broad applicability to evaluate sexual risk behavior in the context of other HIV and STI prevention interventions (e.g. microbicide or vaccine trials), or in response to treatment provision (e.g., anti-retroviral therapy).

Effect of sildenafil citrate on the male sexual experience assessed with the Sexual Experience Questionnaire: a multicenter, double-blind, placebo-controlled trial with open-label extension.

PubMed

Jones, LeRoy A; Klimberg, Ira W; McMurray, James G; Padula, Rebecca; Tseng, Li-Jung; Stecher, Vera J

2008-08-01

The Sexual Experience Questionnaire (SEX-Q) enables quick and easy assessment of functional, emotional, and satisfaction-related aspects of the sexual experience in men with erectile dysfunction (ED). To assess correlations between improvement on the SEX-Q and outcomes on other validated questionnaires. METHODS. Men with ED (score < or =25 on the Erectile Function domain of the International Index of Erectile Function [IIEF]) who had used less than or equal to six doses of any phosphodiesterase 5 inhibitor (none within 6 months) were randomized to 10 weeks of double-blind, placebo-controlled (DBPC) flexible-dose sildenafil citrate (50 or 100 mg, as needed), followed by 6 weeks of open-label (OL) sildenafil. SEX-Q, IIEF, Quality of Erection Questionnaire (QEQ), Self-Esteem and Relationship (SEAR) Questionnaire, Erection Hardness Score (EHS), successful intercourse attempts (SIAs), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), and global efficacy questions (GEQs). Compared with the placebo group (N = 105), the sildenafil group (N = 104) at DBPC end of treatment (EOT) had significantly more improvement (P < 0.05) on all SEX-Q, IIEF (except the Sexual Desire domain), QEQ, and SEAR outcomes, more frequent SIAs and EHS 3 (hard enough for penetration but not completely hard) or EHS 4 (completely hard) erections (odds ratio [OR], 2.52 and 3.46, respectively), EHS 4 erections four times as often (OR, 6.41), more men satisfied with treatment (EDITS; OR, 2.6), approximately twice as many men with improved erections (GEQ1; OR, 5.8) and ability to have sexual intercourse (GEQ2; OR, 5.4), and GEQ3 scores that indicated better sex (P < 0.0001). SEX-Q score improvements correlated positively with all other outcomes. At OL EOT, most outcomes were >60% (and approximately half were > or =80%) of the maximum positive result. SEX-Q change scores correlate with several other functional, emotional, and satisfaction-related outcomes in men treated with sildenafil for ED, allowing a simple and focused evaluation of the sexual experience.

Satisfaction guaranteed? How individual, partner, and relationship factors impact sexual satisfaction within partnerships

PubMed Central

Margraf, Jürgen

2017-01-01

Within committed relationships, a wide range of factors may challenge or facilitate sexual satisfaction. The aim of this study was to clarify which individual, partner-, and partnership-related aspects of a sexual relationship are crucial for the prediction of sexual satisfaction. The study included data of a representative sample of 964 couples from the general population. The actor-partner interdependence model was used to estimate actor and partner effects. Overall, predictors explained 57% of outcome variance. Actor effects were found for sexual function, sexual distress, frequency of sexual activity, desire discrepancy, sexual initiative, sexual communication, sociosexual orientation, masturbation, and life satisfaction. Gender-specific partner effects were found for sexual function and sexual distress. Neither age, nor relationship duration were significant predictors. To deepen our understanding of sexual satisfaction, it is necessary to take quantitative and qualitative aspects of sexual relationships into account and to consider actor-, partner-, and relationship-related predictors. PMID:28231314

Sexuality in High-Functioning Autism: A Systematic Review and Meta-Analysis

ERIC Educational Resources Information Center

Pecora, Laura A.; Mesibov, Gary B.; Stokes, Mark A.

2016-01-01

Preliminary research examining sexuality within High-Functioning Autism (HFA) has been yet to consider the impact sex may have on the sexual/romantic functioning of this population. A systematic database search was carried out to identify 27 observational and cross-sectional publications meeting predetermined inclusion criteria. Using standardised…

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.

Women's Voices on Recovery: A Multi-Method Study of the Complexity of Recovery from Child Sexual Abuse

ERIC Educational Resources Information Center

Banyard, Victoria L.; Williams, Linda M.

2007-01-01

Objective: The current study was exploratory and used multiple methods to examine patterns of stability and change in resilient functioning across 7 years of early adulthood. Second, qualitative data were used to examine in greater detail survivors' own narratives about correlates of healing. Method: This study was longitudinal and used both…

Psychosocial Correlates of Attitudes Toward Male Sexual Violence in a Sample of Financial Crime, Property Crime, General Violent, and Homicide Offenders.

PubMed

Debowska, Agata; Boduszek, Daniel; Willmott, Dominic

2017-02-01

Although those currently serving prison sentences for sexual violence can be identified and receive treatment, the number of prisoners with a history of sexual violence against female partners is unknown. Methods to identify prisoners with a proclivity for such violence and accurately assess the risk they pose before and after incarceration are therefore required. Here, we aimed to assess the level of sexually violent attitudes within dating relationships and to examine their associations with experiences of child abuse and neglect (CAN), psychopathic personality traits, prisonization, number of incarcerations, age, years of schooling, relationship status, and parenting among different types of offenders (financial crime, property crime, general violent, and homicide offenders). Data were collected among a large systematically selected sample of adult male inmates ( N = 1,123). We demonstrated that sexual violence-supportive attitudes appear to be a function of child sexual abuse and psychopathic personality traits, and may be developed through early socialization experiences as well as incarceration. Practical implications of current findings are discussed.

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)

Randomised Trial of CPAP and Vardenafil on Erectile and Arterial Function in Men with Obstructive Sleep Apnea and Erectile Dysfunction.

PubMed

Melehan, Kerri L; Hoyos, Camilla M; Hamilton, Garun S; Wong, Keith K; Yee, Brendon J; McLachlan, Rob I; O'Meagher, Shamus; Celermajer, David; Ng, Martin K; Grunstein, Ronald R; Liu, Peter Y

2018-02-01

Erectile function is important for life satisfaction and is often impaired in men with obstructive sleep apnea (OSA). Uncontrolled studies show that treating OSA with continuous positive airway pressure (CPAP) improves erectile function. Phosphodiesterase type 5 inhibitors (e.g. vardenafil) are the first-line therapy for erectile dysfunction (ED), but may worsen OSA. To assess the effects of CPAP and vardenafil on ED. Sixty one men with moderate-to-severe OSA and ED were randomised to 12 weeks of CPAP or sham CPAP, and 10mg daily vardenafil or placebo, in a 2x2 factorial design. International Index of Erectile Function (primary endpoint), treatment and relationship satisfaction, sleep related erections, sexual function, endothelial function, arterial stiffness, quality of life, and sleep-disordered breathing. CPAP increased the frequency of sleep-related-erections, overall sexual satisfaction, and arterial stiffness but did not change erectile function or treatment satisfaction or relationship satisfaction. Vardenafil did not alter erectile function, endothelial function, arterial stiffness or sleep disordered breathing, but did improve overall self-esteem and relationship satisfaction, other aspects of sexual function and treatment satisfaction. Adherent CPAP improved erectile function, sexual desire, overall sexual, self-esteem and relationship, and treatment satisfaction, as well as sleepiness, and quality of life. Adherent vardenafil use did not consistently change nocturnal erection quality. CPAP improves overall sexual satisfaction, sleep related erections, and arterial stiffness. Low dose daily vardenafil improves certain aspects of sexual function, and did not worsen OSA. Adherent CPAP or vardenafil use further improves ED and quality of life. Copyright © 2018 Endocrine Society

Potency preservation following stereotactic body radiation therapy for prostate cancer

PubMed Central

2013-01-01

Background Erectile dysfunction after prostate radiation therapy remains an ongoing challenge and critical quality of life issue. Given the higher dose of radiation per fraction using stereotactic body radiation therapy (SBRT) there is concern that post-SBRT impotency would be higher than conventional radiation therapy approaches. This study sought to evaluate potency preservation and sexual function following SBRT for prostate cancer. Methods Between February 2008 and March 2011, 216 men with clinically localized prostate cancer were treated definitively with SBRT monotherapy at Georgetown University Hospital. Potency was defined as the ability to have an erection firm enough for intercourse with or without sexual aids while sexual activity was defined as the ability to have an erection firm enough for masturbation and foreplay. Patients who received androgen deprivation therapy (ADT) were excluded from this study. Ninety-seven hormone-naïve men were identified as being potent at the initiation of therapy and were included in this review. All patients were treated to 35–36.25 Gy in 5 fractions delivered with the CyberKnife Radiosurgical System (Accuray). Prostate specific antigen (PSA) and total testosterone levels were obtained pre-treatment, every 3 months for the first year and every 6 months for the subsequent year. Sexual function was assessed with the Sexual Health Inventory for Men (SHIM), the Expanded Prostate Index Composite (EPIC)-26 and Utilization of Sexual Medication/Device questionnaires at baseline and all follow-up visits. Results Ninety-seven men (43 low-, 50 intermediate- and 4 high-risk) at a median age of 68 years (range, 48–82 years) received SBRT. The median pre-treatment PSA was 5.9 ng/ml and the minimum follow-up was 24 months. The median pre-treatment total serum testosterone level was 11.4 nmol/L (range, 4.4-27.9 nmol/L). The median baseline SHIM was 22 and 36% of patients utilized sexual aids prior to treatment. Although potency rates declined following treatment: 100% (baseline); 68% (6 months); 62% (12 months); 57% (18 months) and 54.4% (24 months), 78% of previously potent patients had erections sufficient for sexual activity at 24 months post-treatment. Overall sexual aid utilization increased from 36% at baseline to 49% at 24 months. Average EPIC sexual scores showed a slow decline over the first two years following treatment: 77.6 (baseline); 68.7 (6 months); 63.2 (12 months); 61.9 (18 months); 59.3 (24 months). All sexual functions including orgasm declined with time. Prior to treatment, 13.4% of men felt their sexual function was a moderate to big problem which increased to 26.7% two years post treatment. Post-treatment testosterone levels gradually decreased with a median value at two year follow-up of 10.7 nmol/L. However, the average EPIC hormonal scores did not illustrate a statistically significant difference two years post-treatment. Review of the radiation doses to the penile bulb in this study, a potential marker of post-treatment sexual function, revealed that the dose was relatively low and at these low doses the percentage of the penile bulb receiving 29.5 Gy did not correlate with the development of ED. Conclusions Men undergoing SBRT monotherapy for prostate cancer report sexual outcomes comparable to those reported for conventional radiation modalities within the first 24 months after treatment. Longer follow-up is required to confirm the durability of these findings. PMID:24180317

Sexual function and quality of life in women with cervical cancer before radiotherapy: a pilot study.

PubMed

Grion, Regina Celia; Baccaro, Luiz Francisco; Vaz, Ana Francisca; Costa-Paiva, Lúcia; Conde, Délio Marques; Pinto-Neto, Aarão Mendes

2016-04-01

To achieve a better understanding of issues related to sexual function and quality of life (QOL) of women with cervical cancer before radiotherapy treatment. A pilot study with 80 women with cervical cancer from Jan/2013 to Mar/2014. The outcome variables were sexual function assessed using the Female Sexual Function Index (FSFI) and QOL, assessed using the World Health Organization questionnaire. Independent variables were clinical and sociodemographic data. Statistical analysis was carried out using Student's t test, Mann-Whitney test, ANOVA and multiple linear regression. The mean age was 48.1 years, 57.5 % were premenopausal and 55 % had clinical stage IIIB. Thirty percent had been sexually active in the 3 months prior to their interviews. The main adverse events during sexual intercourse were bleeding (41.7 %), lack of pleasure (33.3 %), dyspareunia (25 %), and vaginal dryness (16.7 %). The 18 women who had been sexually active in the previous month showed significant sexual dysfunction (total mean FSFI score = 25.6). Advanced clinical stage, using any chronic medication and not having undergone surgery for cancer were negatively correlated with QOL. Higher family income, a longer duration of schooling and no smoking were positive correlated with QOL. One-third of women with cervical cancer were sexually active 3 months prior to their interviews, but have concomitant significant sexual dysfunction. Factors related to the disease are primarily responsible for the deterioration of sexual function. QOL is influenced not only by factors related to the cancer itself, but also by lifestyle habits, comorbidities, and sociodemographic characteristics.

Sexual 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.

When love hurts. A systematic review on the effects of surgical and pharmacological treatments for endometriosis on female sexual functioning.

PubMed

Barbara, Giussy; Facchin, Federica; Meschia, Michele; Berlanda, Nicola; Frattaruolo, Maria P; VercellinI, Paolo

2017-06-01

Endometriosis is associated with an increased risk of dyspareunia, therefore this chronic gynecologic disease should be considered as a major cause of sexual dysfunctions. The aims of this study were to review the literature on the effects of surgical and pharmacological treatments for endometriosis on female sexual functioning, and to provide suggestions for future treatment strategies. We followed the PRISMA guidelines to conduct this systematic review, which involved an electronic database search of studies on the association between endometriosis and sexuality published between 2000 and 2016. As a result of the screening process, 22 studies were included in this systematic review. The 22 studies included were divided into two categories: (a) surgical intervention studies (n = 17), examining postoperative sexual outcomes of surgery for endometriosis; (b) pharmacological intervention studies (n = 5), evaluating the effects of pharmacological endometriosis treatments on sexual functioning. The studies considered showed that overall surgical and pharmacological interventions for endometriosis can lead to medium-/long-term improvement, but not necessarily to a definitive resolution of female sexual dysfunctions due to endometriosis. Sexual functioning is a multidimensional phenomenon and the ideal treatment for endometriosis-related sexual dysfunctions should be conducted by a multidisciplinary team that involves not only gynecologists, but also sexologists and psychologists/psychotherapists. Improving global sexual functioning, and not just reducing pain at intercourse, should be considered as a major clinical goal of endometriosis treatment. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases

PubMed Central

Healy, David; Le Noury, Joanna; Mangin, Derelie

2018-01-01

OBJECTIVE: To investigate clinical reports of post-SSRI sexual dysfunction (PSSD), post-finasteride syndrome (PFS) and enduring sexual dysfunction following isotretinoin. METHODS: Data from RxISK.org, a global adverse event reporting website, have been used to establish the clinical features, demographic details and clinical trajectories of syndromes of persistent sexual difficulties following three superficially different treatment modalities. RESULTS We report on 300 cases of enduring sexual dysfunction from 37 countries following 14 different drugs comprised of serotonin reuptake inhibiting antidepressants, 5α-reductase inhibitors and isotretinoin. While reports of certain issues were unique to the antidepressants, such as the onset of premature ejaculation and persistent genital arousal disorder (PGAD), there was also a significant overlap in symptom profile between the drug groups, with common features including genital anaesthesia, pleasureless or weak orgasm, loss of libido and impotence. Secondary consequences included relationship breakdown and impaired quality of life. CONCLUSIONS These data point to a legacy syndrome or syndromes comprising a range of disturbances to sexual function. More detailed studies will require developments in coding systems that recognise the condition(s). Further exploration of these tardive sexual syndromes may yield greater understanding of tardive syndromes in general. PMID:29733030

Questionnaires for assessment of female sexual dysfunction: a review and proposal for a standardized screener.

PubMed

Giraldi, Annamaria; Rellini, Alessandra; Pfaus, James G; Bitzer, Johannes; Laan, Ellen; Jannini, Emmanuele A; Fugl-Meyer, Axel R

2011-10-01

There are many methods to evaluate female sexual function and dysfunction (FSD) in clinical and research settings, including questionnaires, structured interviews, and detailed case histories. Of these, questionnaires have become an easy first choice to screen individuals into different categories of FSD. The aim of this study was to review the strengths and weaknesses of different questionnaires currently available to assess different dimensions of women's sexual function and dysfunction, and to suggest a simple screener for FSD. A literature search of relevant databases, books, and articles in journals was used to identify questionnaires that have been used in basic or epidemiological research, clinical trials, or in clinical settings. Measures were grouped in four levels based on their purposes and degree of development, and were reviewed for their psychometric properties and utility in clinical or research settings. A Sexual Complaints Screener for Women (SCS-W) was then proposed based on epidemiological methods. Although many questionnaires are adequate for their own purposes, our review revealed a serious lack of standardized, internationally (culturally) acceptable questionnaires that are truly epidemiologically validated in general populations and that can be used to assess FSD in women with or without a partner and independent of the partner's gender. The SCS-W is proposed as a 10-item screener to aid clinicians in making a preliminary assessment of FSD. The definition of FSD continues to change and basic screening tools are essential to help advance clinical diagnosis and treatment, or to slate patients adequately into the right diagnostic categories for basic and epidemiological research or clinical trials. © 2011 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.

Androgen receptor gene CAG repeat polymorphism independently influences recovery of male sexual function after testosterone replacement therapy in postsurgical hypogonadotropic hypogonadism.

PubMed

Tirabassi, Giacomo; Delli Muti, Nicola; Corona, Giovanni; Maggi, Mario; Balercia, Giancarlo

2014-05-01

Few and contradictory studies have evaluated the possible influence of androgen receptor (AR) gene CAG repeat polymorphism on male sexual function. In this study we evaluated the role of AR gene CAG repeat polymorphism in the recovery of sexual function after testosterone replacement therapy (TRT) in men affected by postsurgical hypogonadotropic hypogonadism, a condition which is often associated with hypopituitarism and in which the sexual benefits of TRT must be distinguished from those of pituitary-function replacement therapies. Fifteen men affected by postsurgical hypogonadotropic hypogonadism were retrospectively assessed before and after TRT. Main outcome measures included sexual parameters as assessed by the International Index of Erectile Function questionnaire, levels of pituitary dependent hormones (total testosterone, free T3, free T4, cortisol, insulin-like growth factor-1 [IGF-1], prolactin), and results of genetic analysis (AR gene CAG repeat number). Plasma concentrations of free T3, free T4, cortisol, and prolactin did not vary significantly between the two phases, while testosterone and IGF-1 increased significantly after TRT. A significant improvement in all sexual parameters studied was found. The number of CAG triplets was negatively and significantly correlated with changes in all the sexual parameters, while opposite correlations were found between changes in sexual parameters and changes in testosterone levels; no correlation of change in IGF1 with change in sexual parameters was reported. On multiple linear regression analysis, after correction for changes in testosterone, nearly all the associations between the number of CAG triplets and changes in sexual parameters were confirmed. Shorter length AR gene CAG repeat number is associated with the recovery of sexual function after TRT in postsurgical male hypogonadotropic hypogonadism, independently of the effects of concomitant pituitary-replacement therapies. © 2014 International Society for Sexual Medicine.

Iatrogenic sexual dysfunction and the protective withholding of information: in whose best interest?

PubMed

Higgins, A; Barker, P; Begley, C M

2006-08-01

In recent years a growing body of evidence has highlighted the impact of neuroleptics and antidepressants on sexual function. Research from a service user's perspective suggested that service users are dissatisfied with the information that they received on drugs, and would like more education, in particular, on the side effects of medication that impact on sexual function. This paper reports some of the findings of a grounded theory study that explored how psychiatric nurses responded to issues of sexuality in practice. Emphasis within the paper is given to how nursing staff addressed the side effects of drugs that impact on sexual function. Findings suggested that nurse addressed the issue of prescribed medication and sexual function in practice, using a 'Veiling Sexualities Cycle', which had three subcategories: 'Hanging the Veil', 'Lifting the Veil' and 'Re-veiling'. In the light of contemporary mental health policy, findings from the study are discussed and recommendations for practice and education made.

Medical Male Circumcision Is Associated With Improvements in Pain During Intercourse and Sexual Satisfaction in Kenya.

PubMed

Nordstrom, Monica P C; Westercamp, Nelli; Jaoko, Walter; Okeyo, Timothy; Bailey, Robert C

2017-04-01

Two cohort studies using data from randomized controlled trials in Africa offer the best evidence to date on the effects of voluntary medical male circumcision (VMMC) on male sexual function and satisfaction, suggesting no significant impairments in sexual function or satisfaction and some improvements in sexual function after male circumcision. To assess the effects of VMMC on sexual function and satisfaction in a large population-based cohort of men circumcised as adults and uncircumcised controls in Kenya. Sexual function and satisfaction of young (median age = 20 years) sexually active men (1,509 newly circumcised men and 1,524 age-matched uncircumcised controls after 5% loss to follow-up) were assessed at baseline and 6, 12, 18, and 24 months, with data collected in 2008 to 2012. Self-reported data on lack of sexual interest or pleasure, difficulty getting or maintaining erections, orgasm difficulties, premature ejaculation, pain during intercourse, and satisfaction with sexual intercourse were analyzed with mixed-effect models to detect differences between circumcised and uncircumcised men and changes over time. Changes over time in sexual interest, desire and pleasure, erectile and ejaculatory function, and pain during intercourse (dyspareunia) in circumcised and uncircumcised men; group differences in time trends; satisfaction with sexual performance; and enjoyment of sex before and after circumcision. Sexual dysfunctions decreased in the two study groups from 17% to 54% at baseline to 11% to 44% at 24 months (P < .001), except dyspareunia, which decreased only in circumcised men (P < .001). Sexual satisfaction outcomes increased in the two study groups from 34% to 82% at baseline to 66% to 93% at 24 months (P < .001), with greater improvements in circumcised men (P < .001). On average, 97% of circumcised men were satisfied with sexual intercourse and 92% rated sex as more enjoyable or no different after circumcision compared with before circumcision. Results are applicable to VMMC programs seeking to increase the acceptability of male circumcision as part of comprehensive HIV prevention. Large-scale population-based longitudinal data restricted to sexually active individuals and adjusted for differences in baseline levels of outcomes and potential confounders are used. The questionnaire used, although not a standardized survey instrument, includes all major domains of male sexual function and satisfaction used in the most common standardized tools. Results are consistent with large cohort studies of VMMC using data from randomized controlled trials and indicate that VMMC has no significant detrimental effect or might have beneficial effects on male sexual function and satisfaction for the great majority of men circumcised as adults. Nordstrom MPC, Westercamp N, Jaoko W, et al. Medical Male Circumcision Is Associated With Improvements in Pain During Intercourse and Sexual Satisfaction in Kenya. J Sex Med 2017;14:601-612. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Turner's syndrome and other forms of congenital hypogonadism impair quality of life and sexual function.

PubMed

Ros, Cristina; Alobid, Isam; Balasch, Juan; Mullol, Joaquim; Castelo-Branco, Camil

2013-06-01

We sought to assess the burden of Turner's syndrome (TS) and other congenital hypogonadisms (OCH) on quality of life (QOL) and sexual function. An observational study was undertaken in a gynecological endocrinology unit of a teaching hospital. Three cohorts of women aged 20-50 years were compared: 26 TS patients, 21 women with OCH and wild-type karyotype, and 41 healthy age-matched women who were included as controls. All subjects filled out the Medical Outcome Study Short Form (SF-36) and the Female Sexual Function Index. TS subjects had significantly worse QOL scores in physical functioning (P = .026) and role physical functioning (P = .032) whereas OCH showed significantly worse scores in physical functioning (P = .027) and bodily pain (P = .025) compared to controls. In all, 80% of OCH and 50% of TS patients declared sexual activity. Sexually active TS patients had poorer arousal outcomes (P = .009) and OCH women showed significantly worse scores in arousal (P = .002), orgasm (P = .007), pain (P = .001), and Female Sexual Function Index total score (P = .004) compared with healthy controls. No differences between sexually active and inactive TS women were found in SF-36 scores, clinical characteristics, or anthropomorphic characteristics. TS and OCH subjects presented impaired physical domains in QOL. Women with TS are less likely to be involved in sexual activity, arousal dysfunctions being their main symptom. Conversely, arousal, orgasm, pain, and total score were significantly affected in OCH subjects. Copyright © 2013 Mosby, Inc. All rights reserved.

Comparison of Quality of Life and Sexuality between Cervical Cancer Survivors and Healthy Women.

PubMed

Lee, Yumi; Lim, Myong Cheol; Kim, Se Ik; Joo, Jungnam; Lee, Dong Ock; Park, Sang-Yoon

2016-10-01

The purpose of this study is to compare quality of life (QoL) and sexual functioning between sexually active cervical cancer survivors and healthy women. In this cross-sectional study, propensity-score-matched cervical cancer survivors (n=104) and healthy women (n=104) were compared. All women had engaged in sexual activity within the previous 3 months, and cervical cancer survivors showed no evidence of disease after primary treatment. QoL and sexual functioning were assessed using three questionnaires; the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), Cervical Cancer Module (EORTC QLQ-CX24), and the Female Sexual Function Index (FSFI). Significantly higher scores for lymphedema were observed in the cervical cancer survivors group compared with the healthy women group (mean, 20.2 vs. 12.2; p < 0.05). Sexuality, both in terms of sexual activity, sexual enjoyment, and sexual worry (EORTC QLQ-CX24), and in terms of desire, arousal, lubrication, orgasm, satisfaction, and pain (FSFI) were similar between the groups. When the scale of sexual/vaginal functioning in EORTC QLQ-CX24 was divided into individual questions, cervical cancer survivors reported shorter vaginal length than the control group, but without statistical significance (mean, 80.6 vs. 85.4; p=0.077). Compared with healthy women, sexuality was not impaired in cervical cancer survivors who showed no evidence of disease after primary treatment and engaging in sexual activity. Further prospective cohort studies are warranted to confirm this finding.

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.

Fecal incontinence decreases sexual quality of life, but does not prevent sexual activity in women.

PubMed

Imhoff, Laurel R; Brown, Jeanette S; Creasman, Jennifer M; Subak, Leslee L; Van den Eeden, Stephen K; Thom, David H; Varma, Madhulika G; Huang, Alison J

2012-10-01

The impact of anal incontinence on women's sexual function is poorly understood. The aim of this study was to investigate the relationship between anal incontinence and sexual activity and functioning in women. This is a cross-sectional study. This investigation was conducted in a community-based integrated health care delivery system. Included were 2269 ethnically diverse women aged 40 to 80 years. Self-administered questionnaires assessed accidental leakage of gas (flatal incontinence) and fluid/mucus/stool (fecal incontinence) in the past 3 months. Additional questionnaires assessed sexual activity, desire and satisfaction, as well as specific sexual problems (difficulty with arousal, lubrication, orgasm, or pain). Multivariable logistic regression models compared sexual function in women with 1) isolated flatal incontinence, 2) fecal incontinence (with or without flatal incontinence), and 3) no fecal/flatal incontinence, controlling for potential confounders. Twenty-four percent of women reported fecal incontinence and 43% reported isolated flatal incontinence in the previous 3 months. The majority were sexually active (62% of women without fecal/flatal incontinence, 66% with isolated flatal incontinence, and 60% with fecal incontinence; p = 0.06). In comparison with women without fecal/flatal incontinence, women with fecal incontinence were more likely to report low sexual desire (OR: 1.41 (CI: 1.10-1.82)), low sexual satisfaction (OR: 1.56 (CI: 1.14-2.12)), and limitation of sexual activity by physical health (OR: 1.65 (CI: 1.19-2.28)) after adjustment for confounders. Among sexually active women, women with fecal incontinence were more likely than women without fecal/flatal incontinence to report difficulties with lubrication (OR: 2.66 (CI: 1.76-4.00)), pain (OR: 2.44 (CI: 1.52-3.91)), and orgasm (OR: 1.68 (CI: 1.12-2.51)). Women with isolated flatal incontinence reported sexual functioning similar to women without fecal/flatal incontinence. The cross-sectional design prevented evaluation of causality. Although most women with fecal incontinence are at high risk for several aspects of sexual dysfunction, the presence of fecal incontinence does not prevent women from engaging in sexual activity. This indicates that sexual function is important to women with anal incontinence and should be prioritized during therapeutic management.

Sexual dysfunctions in non-heterosexual men - literature review.

PubMed

Grabski, Bartosz; Kasparek, Krzysztof

2017-02-26

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

Evaluation of the aphrodisiac activity of Tribulus terrestris Linn. in sexually sluggish male albino rats

PubMed Central

Singh, Surender; Nair, Vinod; Gupta, Yogendra K.

2012-01-01

Objectives: To study the effect of acute and repeated dose administration of lyophilized aqueous extract of the dried fruits of Tribulus terrestris (LAET) on sexual function in sexually sluggish male albino rats. Materials and Methods: Aphrodisiac activity of the test drug was evaluated in terms of exhibited sexual behavior. In order to assess the effect of chronic T. terrestris exposure on the hypothalamus--pituitary--gonadal axis, testosterone level estimation and sperm count were carried out. Twenty-eight-day oral toxicity studies were carried out to evaluate the long-term effects of the LAET administration on different body systems. Results: A dose-dependent improvement in sexual behavior was observed with the LAET treatment as characterized by an increase in mount frequency, intromission frequency, and penile erection index, as well as a decrease in mount latency, intromission latency, and ejaculatory latency. The enhancement of sexual behavior was more prominent on chronic administration of LAET. Chronic administration of LAET produced a significant increase in serum testosterone levels with no significant effect on the sperm count. No overt body system dysfunctions were observed in 28-day oral toxicity study. Conclusions: Findings of the present study validate the traditional use of T. terrestris as a sexual enhancer in the management of sexual dysfunction in males. PMID:22368416

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.

HIV infection and women's sexual functioning.

PubMed

Wilson, Tracey E; Jean-Louis, Girardin; Schwartz, Rebecca; Golub, Elizabeth T; Cohen, Mardge H; Maki, Pauline; Greenblatt, Ruth; Massad, L Stewart; Robison, Esther; Goparaju, Lakshmi; Lindau, Stacy

2010-08-01

To compare sexual problems among HIV-positive and HIV-negative women and describe clinical and psychosocial factors associated with these problems. Data were collected during a study visit of the Women's Interagency HIV Study (WIHS). The WIHS studies the natural and treated history of HIV among women in the United States. Between October 01, 2006, and March 30, 2007, 1805 women (1279 HIV positive and 526 HIV negative) completed a study visit that included administration of the Female Sexual Function Index. In addition, the visit included completion of standardized interviewer-administered surveys, physical and gynecological examinations, and blood sample collection. Women with HIV reported greater sexual problems than did those without HIV. Women also reported lower sexual function if they were classified as menopausal, had symptoms indicative of depression, or if they reported not being in a relationship. CD4 cell count was associated with Female Sexual Function Index scores, such that those with CD4

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.

Psychological Factors Involved in Sexual Desire, Sexual Activity, and Sexual Satisfaction: A Multi-factorial Perspective.

PubMed

Dosch, Alessandra; Rochat, Lucien; Ghisletta, Paolo; Favez, Nicolas; Van der Linden, Martial

2016-11-01

This study explored the role of psychological trait factors in sexual desire and sexual activity. In particular, it investigated how these factors may contribute to maintaining a balance between motivational aspects and self-control abilities, as both have been considered important in relation to adaptive sexuality. Moreover, the study explored the relationship between sexual desire, activity, and satisfaction. Participants completed questionnaires assessing sexual desire (dyadic, solitary), sexual activity (with a partner, alone), sexual satisfaction, approach and avoidance motivation, attachment, self-control, sensation seeking, and mindfulness. Cluster analyses, based on participants' level of sexual desire and sexual activity, highlighted three distinct profiles for each gender related to different types of psychological functioning: (a) participants with high dyadic sexual desire and activity were the most sexually satisfied, showed optimal psychological functioning, and were characterized by a balance between motivational tendencies to seek positive rewards and self-control abilities (high approach motivation, secure attachment, high self-control, high mindfulness); (b) participants with high dyadic and solitary sexual desire and activity were moderately satisfied and showed a type of psychological functioning predominantly characterized by impulsivity (an overly high motivation to obtain rewards in women, and low self-control in men); (c) participants with low dyadic sexual desire and activity were the least sexually satisfied and were characterized by high motivation to avoid negative consequences and low self-control (high avoidance motivation, insecure attachment, and poor mindfulness). These results shed further light on how fundamental psychological factors contribute to explain the individual variability in sexual desire, activity, and satisfaction.

Pelvic floor muscle problems mediate sexual problems in young adult rape victims.

PubMed

Postma, Riemke; Bicanic, Iva; van der Vaart, Huub; Laan, Ellen

2013-08-01

Prior studies have addressed sexual abuse and sexual function in adult women. No studies have focused on the effect of adolescence rape on sexual functioning. To investigate the effect of rape on sexual problems and on pelvic floor problems, as well as the mediating role of pelvic floor problems on sexual problems, in a homogenous group of victims of adolescence rape without a history of childhood sexual, physical, and/or emotional abuse. Sexual functioning and pelvic floor functioning were assessed using self-report questionnaires. In this cross-sectional study, a group of 89 young women aged 18-25 years who were victimized by rape in adolescence was compared with a group of 114 nonvictimized controls. The rape victims were treated for posttraumatic stress disorder (PTSD) 3 years prior to participation in the study. Three years posttreatment, rape victims were 2.4 times more likely to have a sexual dysfunction (lubrication problems and pain) and 2.7 times more likely to have pelvic floor dysfunction (symptoms of provoked vulvodynia, general stress, lower urinary tract, and irritable bowel syndrome) than nonvictimized controls. The relationship between rape and sexual problems was partially mediated by the presence of pelvic floor problems. Rape victims and controls did not differ with regard to sexual activities. Rape victims suffer significantly more from sexual dysfunction and pelvic floor dysfunction when compared with nontraumatized controls, despite the provision of treatment for PTSD. Possibly, physical manifestations of PTSD have been left unaddressed in treatment. Future treatment protocols should consider incorporating (physical or psychological) treatment strategies for sexual dysfunction and/or pelvic floor dysfunction into trauma exposure treatments. © 2013 International Society for Sexual Medicine.

On orgasm, sexual techniques, and erotic perceptions in 18- to 74-year-old Swedish women.

PubMed

Fugl-Meyer, Kerstin S; Oberg, Katarina; Lundberg, Per Olov; Lewin, Bo; Fugl-Meyer, Axel

2006-01-01

To explore, in an age perspective, women's lifetime sexual techniques and the extent to which they had led to orgasm. To relate these techniques and current erotic perceptions to orgasmic function in women sexually active during the last 12 months and to describe the relative impact of orgasmic function/dysfunction on their sexual well-being. A nationally representative sample of 18- to 74-year-old women (N = 1,335) participated. Nearly all were heterosexual. Current orgasmic capacity was broadly and subjectively classified into: no, mild, or manifest dysfunction. Sexual techniques and erotic perceptions were recorded together with level of sexual satisfaction. Generational differences characterized age at first orgasm and intercourse, types and width of sexual repertoire, and also current erotic perceptions, while orgasmic dysfunction and distress caused by it were less age dependent. Likely protectors of good orgasmic function, mainly against manifest dysfunction, were: a relatively early age at first orgasm, a relatively greater repertoire of techniques used--in particular having been caressed manually or orally by partner(s), achievement of orgasm by penile intravaginal movements, attaching importance to sexuality and being relatively easily sexually aroused. In turn, among other aspects of female sexual function women who did not have orgasmic dysfunction or distress were particularly likely to be satisfied with their sexual life. Besides providing data on matters frequently said to be sensitive this investigation shows that women's generation and with it several long-ranging aspects of women's sexual history and their feelings of being sexual are important indicators of their orgasmic and thereby their overall sexual well-being. When (in clinical practice) establishing treatment strategy for women with orgasmic dysfunction due respect should be given to these factors.

Sexual function in Italian women with systemic sclerosis is affected by disease-related and psychological concerns.

PubMed

Maddali Bongi, Susanna; Del Rosso, Angela; Mikhaylova, Svetlana; Baccini, Marco; Matucci Cerinic, Marco

2013-10-01

In patients with systemic sclerosis (SSc), sexual function is somewhat impaired. Our aim was to evaluate sexual function in women with SSc in comparison to controls, and to investigate the association with sociodemographic and disease characteristics, and physical and psychological variables. Forty-six women with SSc and 46 healthy women were assessed for sociodemographic characteristics and gynecological development and administered the Female Sexual Function Index (FSFI), Medical Outcomes Study Short Form-36 (SF-36), Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), Rosenberg Self-Esteem Scale, Coping Orientation to Problems Experienced-New Italian Version, and Functional Assessment of Chronic Illness Therapy-Fatigue Scale. Patients were also assessed for disease duration and subset, Female Sexual Function in SSc, Hand Mobility in Scleroderma test (HAMIS), Cochin Hand Functional Disability Scale, Mouth Handicap in Systemic Sclerosis Scale (MHISS), Disability Sexual and Body Esteem Scale (PDSBE); and fist closure, hand opening, and mouth opening. In patients with SSc, only FSFI desire subscale score was significantly lower (p = 0.035) versus controls. Total FSFI score, similar to controls, was related with Medical Outcomes Study Short Form-36 mental component, HAQ (p = 0.022), MHISS (p = 0.038), and HAMIS (p = 0.037). In SSc, the main factors independently associated with sexual functioning were vaginal dryness [regression coefficient (B) = -0.72; p < 0.001], PDSBE (B = 0.42; p = 0.001), and HADS depression scale (B = -0.23; p = 0.035). Together, these variables explained 70% of the variance in the FSFI total score. In SSc, sexual function, although not different from controls, is influenced by specific disease-related and psychological concerns. Thus it should be included in patient evaluations and assessed in daily clinical practice.

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

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.

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

Sexual and Overall Quality of Life Improvements After Surgical Correction of "Buried Penis".

PubMed

Hughes, Duncan B; Perez, Edgar; Garcia, Ryan M; Aragón, Oriana R; Erdmann, Detlev

2016-05-01

"Buried penis" is an increasing burden in our population with many possible etiologies. Although surgical correction of buried penis can be rewarding and successful for the surgeon, the psychological and functional impact of buried penis on the patient is less understood. The study's aim was to evaluate the sexual satisfaction and overall quality of life before and after buried penis surgery in a single-surgeon's patient population using a validated questionnaire (Changes in Sexual Functioning Questionnaire short-form). Using Likert scales generated from the questionnaire and 1-tailed paired t test analysis, we found that there was significantly improved sexual function after correction of a buried penis. Variables individually showed that there was significant improvement with sexual pleasure, urinating, and with genital hygiene postoperatively. There were no significant differences concerning frequency of pain with orgasms. Surgical correction of buried penis significantly improves the functional, sexual, and psychological aspects of patient's lives.

Female genital cosmetic and plastic surgery: a review.

PubMed

Goodman, Michael P

2011-06-01

This review studies rationale and outcome of vulvovaginal aesthetic surgery. Discuss procedures designed to alter genital appearance and function; investigate sexual, philosophical, and ethical issues; examine outcomes. (i) Medline search of the existing literature utilizing terms labiaplasty, clitoral hood reduction, hymenoplasty (HP), vaginoplasty (VP), perineoplasty (PP), female genital surgery, sexual satisfaction/body image, and anterior/posterior colporrhaphy; (ii) references from bibliographies of papers found through the literature search and in the author's reading of available literature. (i) Demographics and psychosexual dynamics of women requesting female genital plastic/cosmetic surgery; (ii) overall and sexual satisfaction of subjects undergoing these procedures. The majority of studies regarding patient satisfaction and sexual function after vaginal aesthetic and functional plastic procedures report beneficial results, with overall patient satisfaction in the 90-95% range, sexual satisfaction over 80-85%. These data are supported by outcome data from nonelective vaginal support procedures. Complications appear minor and acceptable to patients. There are little data available regarding outcomes and satisfaction of HP, or function during the rigors of subsequent vaginal childbirth, although the literature contains no case reports of labiaplasty disruption during parturition. Women requesting labiaplasty and reduction of their clitoral hoods do so for both cosmetic and functional (chafing, interference with coitus, interference with athletic activities, etc.) reasons, while patients requesting VP and/or PP do so in order to increase friction and sexual satisfaction, occasionally for aesthetic reasons. Patients appear generally happy with outcomes. The majority of patients undergoing genital plastic surgery report overall satisfaction and subjective enhancement of sexual function and body image, but the literature is retrospective. Female genital plastic surgery procedures appear to fulfill the majority of patient's desires for cosmetic and functional improvement, as well as enhancement of the sexual experience. Little information is available regarding HP outcomes. © 2011 International Society for Sexual Medicine.

Mixed methods evaluation of an interdisciplinary sexuality education programme for staff working with people who have an acquired physical disability.

PubMed

Higgins, Agnes; Sharek, Danika; Nolan, Maeve; Sheerin, Barbara; Flanagan, Paul; Slaicuinaite, Sniguole; Mc Donnell, Sinead; Walsh, Heather

2012-11-01

.  To report a study evaluating the effectiveness of a 1-day interdisciplinary sexuality education programme for staff working with people with acquired physical disability.   Changes associated with an acquired physical disability can diminish a person's self-esteem, sense of attractiveness, relationships, and sexual functioning. Research suggests that people are dissatisfied with the quality of information and support around sexuality during their rehabilitation.   A mixed methods design was used, involving pretest and posttest questionnaires and interviews. Questionnaire data were analysed using descriptive statistics and paired samples t-tests to evaluate the effects of the programme on knowledge, skills, and comfort. Interview data were analyzed thematically, with particular emphasis on participants' opinions about the application of the course within practice. Participants were working in the area of acquired disability and rehabilitation, and were drawn from a number of disciplines. Data were collected between 2008-2009.   Comparison of the pre- and postmeasures, based on paired samples t-tests, showed that the programme statistically significantly increased participants' knowledge, skills, and comfort. Participants felt positive and enthusiastic about the programme and reported numerous incidents where they were more willing to raise issues for discussion and create a supportive listening space for patients to talk about their concerns around sexuality.   Providing healthcare practitioners with a 1-day programme leads to positive changes in knowledge, skills, and comfort towards sexuality. Sexuality education may be an ideal topic for bringing practitioners together within an interdisciplinary education context. © 2012 Blackwell Publishing Ltd.

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 function and quality of life in gynecological cancer pre- and post-short-term brachytherapy: a prospective study.

PubMed

Zomkowski, Kamilla; Toryi, Ariana Machado; Sacomori, Cinara; Dias, Mirella; Sperandio, Fabiana Flores

2016-10-01

To evaluate the sexual function and quality of life pre- and post-gynecological cancer treatment with high-dose rate brachytherapy in the short term. This is a descriptive and prospective study involving 20 women diagnosed with gynecological cancer aged between 18 and 70 years, resident in Florianopolis and the surrounding region. We used the Quality of Life Questionnaire Core-30 (QLQ-C30) 3.0 to assess quality of life pre- and post-brachytherapy treatment and the Female Sexual Function Index (FSFI) to assess sexual function. Regarding quality of life, significant worsening was observed for the items loss of appetite (p = 0.002) and diarrhea (p = 0.045) from pre- to post-brachytherapy treatment, whereas constipation (p = 0.013) improved. For sexual function, the statistical difference was found exclusively in the domain of lubrication reduction (p = 0.046). Only nine women were sexually active before and after brachytherapy treatment. There was a worsening of quality of life in comparing pre- and post-evaluations related to gastrointestinal symptoms over a period equivalent to 40 days. Regarding sexual function, lack of lubrication was identified in short-term post-gynecological cancer brachytherapy.

Pilates for Better Sex: Changes in Sexual Functioning in Healthy Turkish Women After Pilates Exercise.

PubMed

Halis, Fikret; Yildirim, Pelin; Kocaaslan, Ramazan; Cecen, Kursat; Gokce, Ahmet

2016-05-18

Although a large number of studies report the impact of daily exercise on many aspects of women's health, none of them address the relationship between Pilates exercise and sexual function prospectively. The aim of this study was to assess the effect of Pilates exercise on sexual function in healthy young women using a validated questionnaire. In total, 34 premenopausal healthy Turkish women aged between 20 and 50 years who had regular menstrual cycles and sexual relationships were included in the study. Women were asked to complete Beck Depression Inventory (BDI) and Female Sexual Function Index (FSFI) questionnaires. Questionnaires were completed before and after 12 weeks of Pilates exercise. Primary endpoints were changes in total and individual domain scores on the FSFI and BDI. After the 12-week Pilates intervention, BDI scores were decreased and all domains of the FSFI were significantly improved with mean ± SD total FSFI scores increasing from 25.9 ± 7.4 to 32.2 ± 3.6 (p <.0001). This is the first prospective study that quantifies the improvement in sexual function of healthy women after a 12-week Pilates program. Our findings suggest that Pilates may improve sexual function in healthy women. However, further studies with a larger sample size are needed in this field.

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.

Heightened Activity in Social Reward Networks is Associated with Adolescents’ Risky Sexual Behaviors

PubMed Central

Eckstrand, Kristen L.; Choukas-Bradley, Sophia; Mohanty, Arpita; Cross, Marissa; Allen, Nicholas B.; Silk, Jennifer S.; Jones, Neil P.; Forbes, Erika E.

2018-01-01

Adolescent sexual risk behavior can lead to serious health consequences, yet few investigations have addressed its neurodevelopmental mechanisms. Social neurocircuitry is postulated to underlie the development of risky sexual behavior, and response to social reward may be especially relevant. Typically developing adolescents (N=47; 18M, 29F; 16.3±1.4 years; 42.5% sexual intercourse experience) completed a social reward fMRI task and reported their sexual risk behaviors (e.g., lifetime sexual partners) on the Youth Risk Behavior Survey (YRBS). Neural response and functional connectivity to social reward were compared for adolescents with higher- and lower-risk sexual behavior. Adolescents with higher-risk sexual behaviors demonstrated increased activation in the right precuneus and the right temporoparietal junction during receipt of social reward. Adolescents with higher-risk sexual behaviors also demonstrated greater functional connectivity between the precuneus and the temporoparietal junction bilaterally, dorsal medial prefrontal cortex, and left anterior insula/ventrolateral prefrontal cortex. The greater activation and functional connectivity in self-referential, social reward, and affective processing regions among higher sexual risk adolescents underscores the importance of social influence underlying sexual risk behaviors. Furthermore, results suggest an orientation towards and sensitivity to social rewards among youth engaging in higher-risk sexual behavior, perhaps as a consequence of or vulnerability to such behavior. PMID:28755632

Evaluation of sexual functions of the pregnant women.

PubMed

Tosun Güleroğlu, Funda; Gördeles Beşer, Nalan

2014-01-01

Pregnant women may avoid sexual intercourse or may unavoidably undergo problems in their sexual lives because of various complaints they suffer from. The study aims to evaluate sexual functions of the pregnant women and to determine the factors that negatively affect their sexual health. This is a descriptive research study conducted to evaluate sexual functions of pregnant women. Three hundred six pregnant women admitted to the Women Birth Polyclinics within the Women Birth and Children's Hospital between October 1, 2010 and March 31, 2011 were included in the study. The data were gathered using a personal information form and the Female Sexual Function Index (FSFI). Kruskall-Wallis variance analysis and Mann-Whitney U-tests were used for the statistical analysis. The main outcome is an assessment of the FSFI domains in pregnancy and relationships between pregnancy complaints and sexual functions. The results indicated that the mean age of the pregnant women was 25.6 ± 5.4 and their length of marriage was 5.93 ± 5.4 years. The study revealed that 88.9% of the pregnant women had sexual desire disorders, 86.9% had sexual arousal disorder, 42.8% had lubrication disorders, 69.6% had orgasm disorders, and 48% had sexual satisfaction disorders. Statistically significant differences were found in correlations between FSFI medians and the characteristics of the pregnant women in terms of age, educational level, length and type of marriage, and gestational week. There were also statistically significant differences in correlations between the pregnancy characteristics in terms of backache, constipation, respiratory difficulty, leg ache, and cramp problems (P < 0.05). It was determined that the sexual lives of the pregnant women were negatively affected not only by factors such as old age, low educational status, arranged marriages lasting for more than 10 years, undesired pregnancy, and gestational week but also by health problems such as backache, constipation, respiratory difficulty, leg ache, and cramp problems. © 2013 International Society for Sexual Medicine.

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

PubMed

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

2016-12-15

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

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.

[Evaluation of sexuality and erectile function of candidates for radical prostatectomy].

PubMed

Long, Jean-Alexandre; Lebret, Thierry; Saporta, François; Hervé, Jean-Marie; Lugagne, Pierre-Marie; Poulain, Jean-Eudes; Yonneau, Laurent; Loison, Guillaume; Orsoni, Jean-Luc; Botto, Henry

2006-09-01

To evaluate sexuality and erectile function of candidates for radical prostatectomy in order to assess the place of nerve-sparing surgery in the preoperative discussion. From June 2004 to January 2005, 75 consecutive patients, candidates for radical prostatectomy, were prospectively evaluated. Their erectile function and sexuality were evaluated after announcing the diagnosis. Patients completed the IIEF (International Index of Erectile Function), EQS (Erection Quality Scale) and the sexual satisfaction score (SSS). The mean age of the patients was 65 years and 50% were younger than 65. Erectile dysfunction according to the IIEF-5 scale was observed in 64% of cases (43% of patients younger than 65 and 84% of patients over 65). Erectile dysfunction was considered to be severe in 5% of young patients versus 34% of patients over 65. The majority of patients (69%) had a sexual activity more than twice a month. Only 31% of patients under 65 and 8% of older patients considered their erections to be very satisfactory according to the EQS. Despite this high frequency of erectile dysfunction in men over the age of 65, sexual satisfaction was not influenced by erectile dysfunction. In contrast, patients younger than 65, erectile dysfunction clearly altered the SST sexual satisfaction score. Erectile dysfunction was present in a large proportion of candidates for radical prostatectomy. The presence of erectile dysfunction in patients over the age of 65 did not modify their sexual satisfaction score. A detailed clinical interview concerning sexuality should be conducted to select patients likely to benefit from nerve-sparing surgery. Nerve-sparing surgery would be beneficial in young patients in whom sexual satisfaction is dependent on erectile function. In the older men, erectile dysfunction can be present without affecting sexual satisfaction.

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.

Sexually Explicit Cell Phone Messaging Associated With Sexual Risk Among Adolescents

PubMed Central

Rhoades, Harmony; Winetrobe, Hailey; Sanchez, Monica; Montoya, Jorge; Plant, Aaron; Kordic, Timothy

2012-01-01

OBJECTIVES: Sexting (sending/receiving sexually explicit texts and images via cell phone) may be associated with sexual health consequences among adolescents. However, to date, no published data from a probability-based sample has examined associations between sexting and sexual activity. METHODS: A probability sample of 1839 students was collected alongside the 2011 Youth Risk Behavior Survey in Los Angeles high schools. Logistic regressions were used to assess the correlates of sexting behavior and associations between sexting and sexual risk-taking. RESULTS: Fifteen percent of adolescents with cell phone access reported sexting, and 54% reported knowing someone who had sent a sext. Adolescents whose peers sexted were more likely to sext themselves (odds ratio [OR] = 16.87, 95% confidence interval [CI]: 9.62–29.59). Adolescents who themselves sexted were more likely to report being sexually active (OR = 7.17, 95% CI: 5.01–10.25). Nonheterosexual students were more likely to report sexting (OR = 2.74, 95% CI: 1.86–4.04), sexual activity (OR = 1.52, 95% CI: 1.07–2.15), and unprotected sex at last sexual encounter (OR = 1.84, 95% CI: 1.17–2.89). CONCLUSIONS: Sexting, rather than functioning as an alternative to “real world” sexual risk behavior, appears to be part of a cluster of risky sexual behaviors among adolescents. We recommend that clinicians discuss sexting as an adolescent-friendly way of engaging patients in conversations about sexual activity, prevention of sexually transmitted infections, and unwanted pregnancy. We further recommend that discussion about sexting and its associated risk behavior be included in school-based sexual health curricula. PMID:22987882

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

PubMed Central

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

2015-01-01

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

Sexuality and elderly with chronic diseases: A review of the existing literature.

PubMed

Merghati-Khoei, Effat; Pirak, Arezoo; Yazdkhasti, Mansoureh; Rezasoltani, Parvaneh

2016-01-01

Increased life expectancy and the growing phenomenon of aging can lead to increased burden of chronic diseases (CDs) which adversely affects the overall health of elderly, their sexuality in particular. Sexual life of an aged population is overlooked in many of the societies. In the present narrative review, we aim to assess the impact of CDs on sexual function of elderly people. We used internet databases including PubMed, EMBASE, ISI Web of Science, Google Scholar, SID, Iran Medex, Magiran, IPPF, and UNFPA without time limit. Ninety-eight out of 174 relevant articles were selected which met the inclusion criteria: those articles were research-based in English or Persian (original or review articles) and textbooks; specified one or more CDs and sexual function of the cases; elderly people over the age of sixty, men and women; and coordination between articles and research goals. We excluded qualitative and case studies. We reported the most related CDs with sexual function in literature review and used the biological and psychological impact of the CDs on sexual function of elderly population based on the conceptual model of Verschuren et al . (2010). The results of the studies were classified into the themes including physical, psychological, and cultural and social. Diabetes, cardiovascular, cancerous, and chronic respiratory diseases and also some medications can reduce sexual capacity and desire in particular resulting in negative impact on the quality of elderly sexual life. CDs may influence sexual expressions and responses which adversely affect one's mood and energy so that can cause depression and grief, as well as loss of self-confidence, self-esteem, and self-concept in elderly adults. The factors affecting sexuality of an elderly with CDs include cultural and mythical beliefs about age and illnesses, fear, and embarrass of changed physical appearance. The research conducted among elderly population examining the adverse influence of CDs on aged people's sexual life in general, sexual function and performance, and intimate interaction. It is considered that programs on sexual health needs of aged population for the health-care workers can prove beneficial in improving sexual health.

How changes in depression and anxiety symptoms correspond to variations in female sexual response in a nonclinical sample of young women: a daily diary study.

PubMed

Kalmbach, David A; Kingsberg, Sheryl A; Ciesla, Jeffrey A

2014-12-01

A large body of literature supports the co-occurrence of depression, anxiety, and sexual dysfunction. However, the manner in which affective symptoms map onto specific female sexual response indices is not well understood. The present study aimed to examine changes in depression and anxiety symptoms and their correspondence to fluctuations in desire, subjective arousal, genital response, orgasmic function, and vaginal pain. The study used a 2-week daily diary approach to examine same-day and temporal relations between affective symptoms and sexual function. The unique relations between shared and disorder-specific symptoms of depression and anxiety (i.e., general distress, anhedonia, and anxious arousal) and female sexual response (i.e., desire, subjective arousal, vaginal lubrication, orgasmic function, and sexual pain) were examined, controlling for baseline levels of sexual distress, depression, and anxiety, as well as age effects and menstruation. Analyses revealed that changes in depression and anxiety severity corresponded to same-day variations in sexual response. Specifically, anhedonia (depression-specific symptom) was related to poorer same-day sexual desire, whereas greater anxious arousal (anxiety-specific symptom) was independently related to simultaneous increases in subjective sexual arousal, vaginal lubrication, and sexual pain. Increases in general distress (i.e., shared symptoms) were associated with greater same-day difficulties achieving orgasm. Notably, only one temporal relation was found; it indicated that higher levels of anhedonia predicted a next-day decrease in sexual desire. It is proposed that the simultaneous changes in affective symptoms and sexual function may indicate that they are products of shared underlying mechanisms. That is, in response to stress, the processes manifesting as feelings of weak positive affect and amotivation are the very same processes responsible for diminished capacity for sexual desire. In contrast, the physiological hyperarousal associated with anxiety also gives rise to sexual arousal difficulties and vaginal pain. © 2014 International Society for Sexual Medicine.

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.

Apomixis in hawkweed: Mendel's experimental nemesis.

PubMed

Koltunow, Anna M G; Johnson, Susan D; Okada, Takashi

2011-03-01

Mendel used hawkweeds and other plants to verify the laws of inheritance he discovered using Pisum. Trait segregation was not evident in hawkweeds because many form seeds asexually by apomixis. Meiosis does not occur during female gametophyte formation and the mitotically formed embryo sacs do not require fertilization for seed development. The resulting progeny retain a maternal genotype. Hawkweeds in Hieracium subgenus Pilosella form mitotic embryo sacs by apospory. The initiation of sexual reproduction is required to stimulate apospory in ovules and to promote the function of the dominant locus, LOSS OF APOMEIOSIS, which stimulates the differentiation of somatic aposporous initial (AI) cells near sexually programmed cells. As AI cells undergo nuclear mitosis the sexual pathway terminates. The function of the dominant locus LOSS OF PARTHENOGENESIS in aposporous embryo sacs enables fertilization-independent embryo and endosperm development. Deletion of either locus results in partial reversion to sexual reproduction, and loss of function in both loci results in reversion to sexual development. In these apomicts, sexual reproduction is therefore the default reproductive mode upon which apomixis is superimposed. These loci are unlikely to encode factors critical for sexual reproduction but might recruit the sexual pathway to enable apomixis. Incomplete functional penetrance of these dominant loci is likely to lead to the generation of rare sexual progeny also derived from these facultative apomicts.

A comparative study of sexual function, behavior, and cognitions of women with lifelong vaginismus.

PubMed

Cherner, Rebecca A; Reissing, Elke D

2013-11-01

Vaginismus is classified as a sexual dysfunction, yet limited research is available on the sexual function and behavior of women with this condition. Comparing women with lifelong vaginismus to women with lifelong dyspareunia and women with no pain during intercourse, this study explored sexual function, anxiety, and behavior along with cognitions related to vaginal penetration. A total of 152 women completed an online survey that included a series of validated questionnaires. Main findings indicated that, relative to both comparison groups, women in the vaginismus group reported a more limited range of sexual behavior across the lifespan and more maladaptive cognitions related to fear of losing control of one's body and the situation during penetration. Compared to the no-pain group, both symptomatic groups reported more difficulties across several indicators of sexual function, more limited sexual behavior in the past year and past month, and more maladaptive cognitions related to vaginal penetration. However, women with vaginismus reported more sexual desire and less difficulty with lubrication compared to women with dyspareunia. Numerous sexual problems extending beyond vaginal penetration difficulties were confirmed, suggesting a need for broader treatment approaches not limited to the experience of vaginal penetration. Results were discussed as they relate to the fear-avoidance model of vaginismus.

Effects of low sleep quality on sexual function, in women with fibromyalgia.

PubMed

Amasyali, A S; Taştaban, E; Amasyali, S Y; Turan, Y; Kazan, E; Sari, E; Erol, B; Cengiz, M; Erol, H

2016-01-01

Sexual dysfunction is a common experience in women with fibromyalgia. However, the physiopathology of this association is unclear. We aimed to evaluate whether sleep disturbance has an influence on sexual function in women with fibromyalgia. Fifty-four sexually active premenopausal women with fibromyalgia were enrolled in the study. The following questionnaires were used: the Female Sexual Function Index (FSFI), the Pittsburgh Sleep Quality Index (PSQI), the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Depression Inventory (BDI). Appropriate statistical analyses were used by using SPSS 18. The mean FSFI score was 25.344 ± 6.52 and showed no correlation with age, body mass index, BDI or duration of fibromyalgia. However, a positive correlation between sexual dysfunction and low sleep quality was found (r=0.43; P=0.001). In addition, the median FSFI score was 29.2 (27.2-32.4) in patients with higher sleep quality (PSQI⩽5), whereas it was 21.4 (18.9-25.3) in patients with lower sleep quality (PSQI>5) (P<0.001). There was a positive correlation between sexual dysfunction and symptoms of fibromyalgia as indicated by a higher FIQ score (r=0.37; P=0.006). Sexual dysfunction in female patients with fibromyalgia may be due to low sleep quality. Treatment of the sleep disorder may improve female sexual function.

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

Brain response to visual sexual stimuli in homosexual pedophiles

PubMed Central

Schiffer, Boris; Krueger, Tillmann; Paul, Thomas; de Greiff, Armin; Forsting, Michael; Leygraf, Norbert; Schedlowski, Manfred; Gizewski, Elke

2008-01-01

Objective The neurobiological mechanisms of deviant sexual preferences such as pedophilia are largely unknown. The objective of this study was to analyze whether brain activation patterns of homosexual pedophiles differed from those of a nonpedophile homosexual control group during visual sexual stimulation. Method A consecutive sample of 11 pedophile forensic inpatients exclusively attracted to boys and 12 age-matched homosexual control participants from a comparable socioeconomic stratum underwent functional magnetic resonance imaging during a visual sexual stimulation procedure that used sexually stimulating and emotionally neutral photographs. Sexual arousal was assessed according to a subjective rating scale. Results In contrast to sexually neutral pictures, in both groups sexually arousing pictures having both homosexual and pedophile content activated brain areas known to be involved in processing visual stimuli containing emotional content, including the occipitotemporal and prefrontal cortices. However, during presentation of the respective sexual stimuli, the thalamus, globus pallidus and striatum, which correspond to the key areas of the brain involved in sexual arousal and behaviour, showed significant activation in pedophiles, but not in control subjects. Conclusions Central processing of visual sexual stimuli in homosexual pedophiles seems to be comparable to that in nonpedophile control subjects. However, compared with homosexual control subjects, activation patterns in pedophiles refer more strongly to subcortical regions, which have previously been discussed in the context of processing reward signals and also play an important role in addictive and stimulus-controlled behaviour. Thus future studies should further elucidate the specificity of these brain regions for the processing of sexual stimuli in pedophilia and should address the generally weaker activation pattern in homosexual men. PMID:18197269

Expanding the Analysis of Psychosocial Factors of Sexual Desire in Men.

PubMed

Nimbi, Filippo Maria; Tripodi, Francesca; Rossi, Roberta; Simonelli, Chiara

2018-02-01

The literature lacks studies of the male sex drive. Most existing studies have focused on hypoactive sexual desire disorder in coupled heterosexual men, highlighting some of the main related biological, psychological, and social factors. To evaluate the role of selected psychological and social variables affecting male sexual desire such as quality of life, sexual function, distress, satisfaction, psychological symptoms, emotions, alexithymia, couple adjustment, sexism, cognitive schemas activated in a sexual context, sexual dysfunctional beliefs, and different classes of cognitions triggered during sexual activity about failure anticipation, erection concerns, age- and body-related thoughts, erotic fantasies, and negative attitudes toward sexuality. A wide self-administered survey used snowball sampling to reach 298 heterosexual Italian men (age = 32.66 ± 11.52 years) from the general population. 13 questionnaires exploring psychological and social elements involved in sexual response were administrated: International Index of Erectile Function, Short Form 36 for Quality of Life, Beck Depression Inventory-II, Symptom Check List-90-Revised, Toronto Alexithymia Scale, Premature Ejaculation Severity Index, Sexual Distress Scale, Sexual Satisfaction Scale, Dyadic Adjustment Scale, Ambivalent Sexism Inventory, Sexual Modes Questionnaire, Sexual Dysfunctional Belief Questionnaire, and Questionnaire of Cognitive Schema Activation in Sexual Context. Results showed lack of erotic thoughts (β = -0.328), fear (β = -0.259) and desire to have a baby (β = -0.259) as the main predictors of the level of sexual desire in this group. Energy-fatigue, depression, premature ejaculation severity, sexual distress, compatibility, subjective sexual response, and sexual conservatism had a weaker effect on sexual desire. Sexual functioning (13.80%), emotional response (12.70%), dysfunctional sexual beliefs (12.10%), and negative automatic thoughts (12.00%) had more variable effects on sexual drive. Analyzed variables could represent important factors that should be considered in the assessment of desire concerns and discussed in therapy. The strength of this study is the analysis of novel psychological and social factors on male sexual desire. Recruitment and sample size do not allow generalization of the results, but some crucial points for future research and clinical practice are discussed. Our findings showed that male sexual desire could be affected by many psychological and social elements. Other factors remain to be explored, in their direct and interactive effects, aiming to better explain male sexual desire functioning. Nimbi FM, Tripodi F, Rossi R, Simonelli C. Expanding the Analysis of Psychosocial Factors of Sexual Desire in Men. J Sex Med 2018;15:230-244. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Sexual Function After Three-Dimensional Conformal Radiotherapy for Prostate Cancer: Results From a Dose-Escalation Trial

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

Wielen, Gerard J. van der; Putten, Wim van; Incrocci, Luca

Purpose: The purpose of this study is to provide information about sexual function (SF) after three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer while taking important factors into account that influence SF. Methods and Materials: Between June 1997 and February 2003, a total of 268 patients from a randomized dose-escalation trial comparing 68 Gy and 78 Gy agreed to participate in an additional part of the trial that evaluated SF. Results: At baseline 28% of patients had erectile dysfunction (ED). After 1 year, 27% of the pretreatment potent patients had developed ED. After 2 years this percentage had increased to 36%.more » After 3 years it almost stabilized at 38%. Satisfaction with sexual life was significantly correlated with ED. After 2 years one third of the pre-treatment potent patients still had considerable to very much sexual desire and found sex (very) important. No significant differences were found between the two dose-arms. Potency aids were used on a regular base by 14% of the patients. Conclusion: By taking adjuvant hormonal therapy (HT), HT during follow-up and potency aids into account, we found a lower percentage of ED after 3D-CRT than reported in previous prospective studies. A large group of patients still had sexual desire, considered sex important and 14% used potency aids after 3D-CRT.« less

Condom use as a function of number of coital events in new relationships

PubMed Central

He, Fei; Hensel, Devon J.; Harezlak, Jaroslaw; Fortenberry, J. Dennis

2015-01-01

Study Objective Assess condom use as a function of number of coital events in newly formed sexual relationships. Methods Participants who reported at least one new partner during the 12-week study interval (N=115; ages 18–29 years; 48% women; 90% African American) completed weekly sexually transmitted infections testing and three-times daily electronic diary collection assessing individual and partner-specific affect, daily activities, sexual behavior and condom use. We analyzed event-level condom use percentage and subject-level behavior response effects. Generalized Additive Mixed Models (GAMMs) were used to estimate condom use probability accounting for within-partner and within-subject correlations via random effects. Results The average condom use probability at the first coital event in new relationships was 55% for men and 36% for women. Analyses showed that smooth shapes of estimated condom use probabilities were similar for both sexes and were fitted using GAMMs. Relatively higher condom use percentage was followed by a sharp decline during the first 9 coital events decreasing to 16% for men and 8% for women. More rapid decline in condom use among women was highly associated with higher levels of relationship and sexual satisfaction. Conclusions The likelihood of condom use declines sharply for both men and women after the early accrual experience with a partner. Relationship and sexual satisfaction also influence declines in condom use, especially among women. PMID:26766522

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.

The relationship between childhood sexual abuse and adult male sexual dysfunction.

PubMed

Sarwer, D B; Crawford, I; Durlak, J A

1997-07-01

The present study investigated the relationship between childhood sexual abuse and adult sexual dysfunction in men. In addition, the investigation compared sexually abused men and women on the characteristics of the sexual abuse. Subjects were 359 men who sought sexual dysfunction treatment. Thirty men reported a history of sexual abuse. Characteristics of the sexual abuse experienced by these men also were compared to the sexual abuse experienced by 73 women initially investigated elsewhere (Sarwer & Durlak 1996). Sexual abuse was not found to predict sexual dysfunction in these men. Rather, unemployment served as the only significant predictor of male sexual dysfunction. Comparisons of the sexual abuse reported by male and female victims indicated that males were more likely to experience physical force, but were less likely than female victims to be abused more than once and to be abused by an adult. The results support the notion that childhood sexual abuse may not be as disruptive to adult sexual functioning in men as it is in women. This difference may be a function of the specific circumstances of the sexual abuse. Suggestions for future research on male sexual abuse are provided.

The use of the sexual function questionnaire as a screening tool for women with sexual dysfunction.

PubMed

Quirk, Frances; Haughie, Scott; Symonds, Tara

2005-07-01

To determine if the validated Sexual Function Questionnaire (SFQ), developed to assess efficacy in female sexual dysfunction (FSD) clinical trials, may also have utility in identifying target populations for such studies. Data from five clinical trials and two general population surveys were used to analyze the utility of the SFQ as a tool to discriminate between the presence of specific components of FSD (i.e., hypoactive sexual desire disorder, female sexual arousal disorder, female orgasmic disorder, and dyspareunia). Sensitivity/specificity analysis and logistic regression analysis, using data from all five clinical studies and the general population surveys, confirmed that the SFQ domains have utility in detecting the presence of specific components of FSD and provide scores indicative of the presence of a specific sexual disorder. The SFQ is a valuable new tool for detecting the presence of FSD and identifying the specific components of sexual functions affected (desire, arousal, orgasm, or dyspareunia).

Sexual side effects of antidepressant drugs.

PubMed

Gelenberg, A J; Delgado, P; Nurnberg, H G

2000-06-01

Sexual functioning often suffers during depression, although depressed people continue to value sex. Many popular antidepressants further impair sexual functioning, with highly serotonergic agents affecting orgasm and libido prominently. This paper addresses clinical assessment of sexual side effects from antidepressant drugs and reviews treatment strategies, including purported antidotes. We pay particular attention to sildenafil, on which there are impressive data and ongoing controlled studies.

Perceived parental attachment, personality characteristics, and cognition in male incest.

PubMed

Lu, Yi-Ching; Lung, For-Wey

2012-06-01

The aim of this study was to investigate the multiple pathways of perceived child-rearing practices, cognitive-executive functions, and personality characteristics in incest and other sexual offenders. The participants consisted of 217 male sexual offenders who were in custody in southern Taiwan. Participants were divided into two groups of 25 incest and 192 nonincest sexual offenders. The incest offenders tended to be less extraverted and worse in abstract reasoning ability, and to have more perseverative thinking, and perceived less parental care than other sexual offenders. Moreover, the structural equation model showed that the effect of parental care on the type of sexual offense is mediated by cognitive-executive functions and personality traits. This finding suggests that the personality traits, cognitive function, and parental attachment of incest offenders differ from other sexual offenders. This result can be a helpful reference in sexual-offender intervention programs for relapse prevention.

Screening for Child Sexual Exploitation in Online Sexual Health Services: An Exploratory Study of Expert Views.

PubMed

Spencer-Hughes, Victoria; Syred, Jonathan; Allison, Alison; Holdsworth, Gillian; Baraitser, Paula

2017-02-14

Sexual health services routinely screen for child sexual exploitation (CSE). Although sexual health services are increasingly provided online, there has been no research on the translation of the safeguarding function to online services. We studied expert practitioner views on safeguarding in this context. The aim was to document expert practitioner views on safeguarding in the context of an online sexual health service. We conducted semistructured interviews with lead professionals purposively sampled from local, regional, or national organizations with a direct influence over CSE protocols, child protection policies, and sexual health services. Interviews were analyzed by three researchers using a matrix-based analytic method. Our respondents described two different approaches to safeguarding. The "information-providing" approach considers that young people experiencing CSE will ask for help when they are ready from someone they trust. The primary function of the service is to provide information, provoke reflection, generate trust, and respond reliably to disclosure. The approach values online services as an anonymous space to test out disclosure without commitment. The "information-gathering" approach considers that young people may withhold information about exploitation. Therefore, services should seek out information to assess risk and initiate disclosure. This approach values face-to-face opportunities for individualized questioning and immediate referral. The information-providing approach is associated with confidential telephone support lines and the information-gathering approach with clinical services. The approach adopted online will depend on ethos and the range of services provided. Effective transition from online to clinic services after disclosure is an essential element of this process and further research is needed to understand and support this transition. ©Victoria Spencer-Hughes, Jonathan Syred, Alison Allison, Gillian Holdsworth, Paula Baraitser. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 14.02.2017.

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.

Hormones and sexuality in postmenopausal women: a psychophysiological study.

PubMed

Laan, E; van Lunsen, R H

1997-06-01

Sexual function, including vaginal atrophy, and hormonal status, were studied in 42 naturally postmenopausal women. Vaginal pulse amplitude and subjective sexual responses during self-induced erotic fantasy and during erotic films were compared with responses of a small number of premenopausal women. As predicted, vaginal atrophy was related to estrogens but not to complaints of vaginal dryness and dyspareunia. No significant relationship was found between hormones and sexual function. Unexpectedly, most of the few correlations that did reach significance involved prolactin. The fact that prolactin was negatively associated with sexual desire, sexual arousal and vaginal lubrication during sexual activity, suggests that psychosocial factors are more important than hormone levels in postmenopausal sexual function. Comparisons with a number of premenopausal women revealed that although postmenopausal women displayed lower vaginal pulse amplitude responses prior to erotic stimulation than the premenopausal women, this difference disappeared during subsequent erotic stimulation. We argued that this finding can be interpreted as being supportive of the notion that complaints of vaginal dryness and dyspareunia should not be attributed to vaginal atrophy associated with menopause. Rather, vaginal dryness and dyspareunia seem to reflect sexual arousal problems.

Patient-Reported Quality of Life Progression in Men with Prostate Cancer following Primary Cryotherapy, Cyberknife, or Active Holistic Surveillance

PubMed Central

Werneburg, Glenn T.; Kongnyuy, Michael; Halpern, Daniel M.; Salcedo, Jose M.; Kosinski, Kaitlin E.; Haas, Jonathan A.; Schiff, Jeffrey T.; Corcoran, Anthony T.; Katz, Aaron E.

2017-01-01

Background Technological advancements have led to the success of minimally invasive treatment modalities for prostate cancer such as CyberKnife and Cryotherapy. Here, we investigate patient-reported urinary function, bowel habits, and sexual function in patients following CyberKnife (CK) or Cryotherapy treatment, and compare them with active holistic surveillance (AHS) patients. Methods An IRB-approved institutional database was retrospectively reviewed for patients who underwent CK, Cryotherapy, or AHS. Quality of life (QoL) survey responses were collected every three months and the mean function scores were analyzed in yearly intervals over the 4 years post-treatment. Results 279 patients (767 survey sets) were included in the study. There was no difference among groups in urinary function scores. The CyberKnife group had significantly lower bowel habit scores in the early years following treatment (year two mean difference: −5.4, p<0.01) but returned to AHS level scores by year four. Cryotherapy patients exhibited initially lower, but not statistically significant, bowel function scores, which then improved and approached those of AHS. Both CyberKnife (year 1 mean difference: −26.7, p<0.001) and Cryotherapy groups (−35.4, p<0.001) had early lower sexual function scores relative to AHS, but then gradually improved and were not significantly different from AHS by the third year post-treatment. A history of hormonal therapy was associated with a lower sexual function scores relative to those patients who did not receive hormones in both CyberKnife (−18.45, p<0.01) and Cryotherapy patients (−14.6, p<0.05). Conclusions After initially lower bowel habits and sexual function scores, CyberKnife or Cryotherapy-treated patients had no significant difference in QoL relative to AHS patients. These results highlight the benefit of CyberKnife and Cryotherapy in the management of organ-confined prostate cancer. PMID:29217830

Urogenital function in robotic vs laparoscopic rectal cancer surgery: a comparative study.

PubMed

Panteleimonitis, Sofoklis; Ahmed, Jamil; Ramachandra, Meghana; Farooq, Muhammad; Harper, Mick; Parvaiz, Amjad

2017-02-01

Urological and sexual dysfunction are recognised risks of rectal cancer surgery; however, there is limited evidence regarding urogenital function comparing robotic to laparoscopic techniques. The aim of this study was to assess the urogenital functional outcomes of patients undergoing laparoscopic and robotic rectal cancer surgery. Urological and sexual functions were assessed using gender-specific validated standardised questionnaires. Questionnaires were sent a minimum of 6 months after surgery, and patients were asked to report their urogenital function pre- and post-operatively, allowing changes in urogenital function to be identified. Questionnaires were sent to 158 patients (89 laparoscopy, 69 robotic) of whom 126 (80 %) responded. Seventy-eight (49 male, 29 female) of the responders underwent laparoscopic and 48 (35 male, 13 female) robotic surgery. Male patients in the robotic group deteriorated less across all components of sexual function and in five components of urological function. Composite male urological and sexual function score changes from baseline were better in the robotic cohort (p < 0.001). In females, there was no difference between the two groups in any of the components of urological or sexual function. However, composite female urological function score change from baseline was better in the robotic group (p = 0.003). Robotic rectal cancer surgery might offer better post-operative urological and sexual outcomes compared to laparoscopic surgery in male patients and better urological outcomes in females. Larger scale, prospective randomised control studies including urodynamic assessment of urogenital function are required to validate these results.

Orgasmic dysfunction

MedlinePlus

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

Dyspareunia and depressive symptoms are associated with impaired sexual functioning in women with endometriosis, whereas sexual functioning in their male partners is not affected.

PubMed

De Graaff, A A; Van Lankveld, J; Smits, L J; Van Beek, J J; Dunselman, G A J

2016-11-01

To what extent are endometriosis and its related physical and mental symptoms associated with the perceived level of sexual functioning in women and their male partners? Dyspareunia and depressive symptoms are associated with impaired sexual functioning in women with endometriosis, whereas sexual functioning in their male partners is not affected. Women with endometriosis suffer from more dyspareunia, lower sexual functioning, and lower quality of life. In qualitative studies, partners of women with endometriosis report that endometriosis affected their quality of life and produced relational distress. In this cross-sectional study, sexual functioning in women with endometriosis (n = 83) and their partners (n = 74) was compared with sexual functioning in a control group of women attending the outpatient department for issues related to contraception (n = 40), and their partners (n = 26). Women and partners were recruited in the Maastricht University Medical Centre (MUMC) and the VieCuri Medical Centre Venlo between June 2011 and December 2012. All participants were asked to complete a set of online questionnaires. Response rates were 59.3% (83/140) for women with endometriosis and 52.3% (74/140) for their partners. Response rates in the control group were respectively 43.2% and 27.4% (41/95 and 27/95), of whom 40 women and 26 partners could be included in the study. Women with endometriosis as compared with the control group, reported significantly more frequent pain during intercourse (53% versus 15%, P < 0.001); higher levels of chronic pain (median VAS 2.0 cm versus 0.0 cm, P < 0.001); more impairment of sexual functioning (median Female Sexual Function Index 25.4 versus 30.6, P < 0.001); more impairment of quality of life (median Short Form-12 66.3 versus 87.2, P < 0.001); more pain catastrophizing (mean Pain Catastrophizing Scale 17.8 versus 8.5, P < 0.001), more depression and anxiety symptoms (median Hospital Anxiety and Depression Scale for depression 7 versus 4, P < 0.001 and for anxiety 4 versus 1, P < 0.001). Sexual functioning was comparable between male partners of women with endometriosis and male partners of the control group based on the International Index of Erectile Function. Logistic regression analyses showed that dyspareunia (OR 0.54; 95% CI 0.39-0.75) and depressive symptoms (OR 0.761; 95% CI 0.58-0.99) were independent and significant negative predictors for sexual functioning. Chronic pelvic pain (OR 0.53; 95% CI 0.35-0.81) and depressive symptoms (OR 0.65; 95% CI 0.44-0.96) were independent and significant negative predictors for quality of life. Patient recruitment was performed in one tertiary care centre and to a lesser extent one general hospital, possibly leading to an over-representation of patients with more severe endometriosis. All participating women had a partner and are therefore 'survivors' in relationship terms. This may have led to an underestimation of the impact of endometriosis on sexual functioning. It would be worthwhile to further explore the role of depressive symptoms in women with symptomatic endometriosis and to assess the effect of treatment of depressive symptoms on sexual functioning and quality of life. The fact that the partners did not report impaired sexual functioning could be a reassuring thought to women that might be discussed in the consulting room. The study was funded by the MUMC. An unconditional research grant was given by the Dutch Society of Psychosomatic Obstetrics and Gynaecology (21 June 2011). Not applicable. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Female Sexual Function Following Surgical Treatment of Stress Urinary Incontinence: Systematic Review and Meta-Analysis.

PubMed

Bicudo-Fürst, Maria Cláudia; Borba Leite, Pedro Henrique; Araújo Glina, Felipe Placco; Baccaglini, Willy; de Carvalho Fürst, Rafael Vilhena; Bezerra, Carlos Alberto; Glina, Sidney

2018-04-01

The impact of surgery for stress urinary incontinence (SUI) on female sexual function has received attention in the medical literature, but not in a structured manner. To assess the most recent evidence on the impact of surgical management for female SUI on female sexual function. The review and meta-analysis of available articles published in Medline, Cochrane, LILACS, SCOPUS, Web of Science, CINHAL, and EMBASE included prospective randomized and non-randomized studies that assessed patients who underwent surgical treatment for UI through 2 validated questionnaires: the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ-12) and the Female Sexual Function Index (FSFI). The following terms were searched: (urinary incontinence OR female OR woman OR women) AND (suburethral slings OR transobturator tape* OR transobturator suburethral tape OR trans-obturator tape* OR urethral sling* OR midurethral sling* OR mid-urethral sling* OR "standard midurethral slings" OR tensionless vaginal tape* OR mini sling* OR Burch* OR "Burch colposuspension" OR "urologic surgical procedures" OR "tension-free vaginal tape" OR pubovaginal sling) AND (sexual behavior OR "Female Sexual Function Index" OR FSFI OR sexual function OR "Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire" OR PISQ-12). 1,043 articles were retrieved; 9 studies were included for qualitative analysis and 4 were included for meta-analysis. 25 articles were excluded because they used questionnaires other than the FSFI and PISQ-12. Meta-analysis of 2 studies composed of 411 women who underwent to retropubic and transobturator sling intervention and completed the PISQ-12 questionnaire showed an increase in sexual function of 2.40 points after transobturator compared with retropubic sling intervention (95% CI = -2.48 to -2.32; I 2  = 35%, P < .00001). However, 2 other studies composed of 183 women comparing the same techniques, but using the FSFI, did not show a statistically significant difference (95% CI = -1.77 to 3.78; I 2  = 0%, P = .48). The impact of UI surgery on sexual function is uncertain because of the imprecision of the effect and inconsistency among studies. Only limited evidence on the impact of the transobturator vs the retropubic sling was found. Bicudo-Fürst MC, Borba Leite PH, Araújo Glina FP, et al. Female Sexual Function Following Surgical Treatment of Stress Urinary Incontinence: Systematic Review and Meta-Analysis. Sex Med Rev 2018;6:224-233. Copyright © 2017. Published by Elsevier Inc.

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

PubMed

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

2011-11-01

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

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

PubMed Central

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

2013-01-01

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

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.

Sexual function, incontinence, and wellbeing in women after rectal cancer--a review of the evidence.

PubMed

Panjari, Mary; Bell, Robin J; Burney, Susan; Bell, Stephen; McMurrick, Paul J; Davis, Susan R

2012-11-01

Colorectal cancer (CRC) is the second most common cancer. One-third of these cancers occur in the rectum. Treatment of rectal cancer involves surgery with/without radiotherapy and chemotherapy. Surgery is undertaken to prevent damage to the nerves controlling bladder, bowel, and sexual organs, whether this translates into preservation of urinary and fecal continence and sexual function and, ultimately, quality of life (QoL) is not known. The aim of this review was to summarize the literature regarding the impact of treatment for rectal cancer on bladder and bowel continence, sexual function and QoL in women. A comprehensive review of the current literature on sexual function, incontinence and wellbeing in women after treatment for rectal cancer highlighting prevalence rates, trial design, and patient population. We conducted a systematic search of the literature using A systematic search of the literature using Medline (Ovid, 1946-present) and PubMed (1966-2011) for English-language studies that included the following search terms: "colorectal cancer," or "rectal cancer," or "rectal neoplasm," and "sexual function," or "sexual dysfunction," or "wellbeing," or "QoL," or "urinary or fecal incontinence." Although around 1/3 of women aged 50 to 70 years report lack of sexual desire, sexual function problems after treatment for rectal cancer are in the order of 60% among women. QoL improves with length of survival. Urinary and fecal incontinence are ongoing concerns for many women after treatment with rates up to 60%. There is a gap in our knowledge of the effects of rectal cancer and its treatment on urinary and fecal continence, sexual function and QoL in women. There is a need for studies of sufficient size and duration to gain a better understanding of the disease and its management and the long-term effects on these parameters. This information is needed to develop preventative health care plans for women treated for rectal cancer that target those most at risk for these adverse outcomes. © 2012 International Society for Sexual Medicine.

Psychological interventions for the sexual sequelae of cancer: a review of the literature.

PubMed

Brotto, Lori A; Yule, Morag; Breckon, Erin

2010-12-01

Despite the frequency of sexual side effects of cancer, treatment outcome studies focus almost exclusively on pharmacologic agents, most of which are completely ineffective for women. We conducted a systematic review of the literature on psychological interventions for sexual difficulties following cancer. We searched eight research databases using the terms "sexual dysfunction," "cancer," and "psychological therapy" for empirical studies (not case illustrations). Three independent raters evaluated studies using a modified version of the Oxford Centre for Evidence-Based Medicine System to rate the level of evidence for every retrieved study. We identified 27 papers ranging in level of evidence from 1b (randomized controlled trial) to 4 (expert committee report or clinical experience). Youth showed positive outcomes on sexual knowledge, body image, and sexual functioning, and treatments administered by paraprofessionals were equally effective. Thematic counseling, addressing mental health, social functioning, and sexual functioning, significantly improved quality of sexual relationships, independent partner presence, whereas other studies revealed more pronounced benefits if the partner participated. Despite the importance of talking to a cancer care provider about sexual difficulties, interventions designed to empower patients to do so were ineffective. Treatments addressing sex education were more effective if they also addressed motivation and self-efficacy. Only three treatment outcome studies focused on ethnic minority (African-American or Hispanic) sexual concerns and one focused on sexual minority (Lesbian) issues. There was moderate support for the effectiveness and feasibility of psychological interventions targeting sexual dysfunction following cancer but attrition rates are high, placebo response is notable, and there are often barriers impeding survivors from seeking out psychological interventions for sexual concerns. Despite the prevalence of sexual difficulties following cancer treatment, psychological interventions are a viable, but not often sought after option to help improve sexual functioning, intimacy, and quality of life for cancer survivors and their partners.

The impact of OAB on sexual health in men and women: results from EpiLUTS.

PubMed

Coyne, Karin S; Sexton, Chris C; Thompson, Christine; Kopp, Zoe S; Milsom, Ian; Kaplan, Steven A

2011-06-01

Prior research suggests that overactive bladder (OAB) is common and adversely affects sexuality in both men and women. However, more data are needed from population-based studies to evaluate the impact OAB on sexual health. To describe sexual health outcomes in men and women with continent and incontinent OAB (C-OAB, I-OAB) compared to those with no/minimal urinary symptoms (NMS) and to evaluate correlates of decreased sexual activity and enjoyment in men and women, and correlates of erectile dysfunction (ED), ejaculatory dysfunction (EjD), and premature ejaculation (PE) in men. A cross-sectional, population-representative survey was conducted via the Internet in the United Kingdom, Sweden, and United States. OAB was assessed via a questionnaire based on current International Continence Society definitions. Descriptive statistics were used to compare outcomes for those with I-OAB, C-OAB and NMS, and logistic regressions were used to evaluate predictors of sexual functioning. Participants responding to the sexual health portion of the survey were asked questions about sexual activity and satisfaction. Other outcomes included two domains from the Abbreviated Sexual Function Questionnaire, the erectile function domain of the International Index of Erectile Function, and questions assessing EjD and PE. Survey response was 59.2%; 6,326 men and 8,085 women participated in the sexual health portion of the survey. Across outcomes, I-OAB and C-OAB were associated with worse sexual health as compared to those with NMS. Logistic regressions showed that those with I-OAB and C-OAB were significantly (P<0.0001) more likely to report diminished sexual activity and enjoyment of sex. I-OAB and C-OAB were also significant predictors of ED and EjD in men, but not PE. The impact of OAB is evident across domains of sexual health in both men and women. Sexual health should be assessed in men and women presenting with OAB. © 2011 International Society for Sexual Medicine.