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Clayton A, Keller A, McGarvey EL. Burden of phase-specific sexual dysfunction with SSRIs. J Affect Disord 2006; 91:27-32. [PMID: 16430968 DOI: 10.1016/j.jad.2005.12.007] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2005] [Revised: 11/18/2005] [Accepted: 12/07/2005] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study examines phase-specific sexual dysfunction among patients who are being treated for major depression and who do not meet criteria for global sexual dysfunction. METHODS 6297 adult outpatients receiving antidepressant monotherapy completed the Changes in Sexual Functioning Questionnaire (CSFQ). The sub-sample for this study (n = 3114) comprises participants who were receiving treatment with a SSRI or SNRI and did not meet the gender-specific criterion for global sexual dysfunction on the CSFQ. RESULTS Among this sub-sample, 95.6% of women and 97.9% of men exhibited impairment in at least one phase of sexual functioning. Men were significantly more likely than women to experience dysfunction in the desire phase (91.2% vs. 79.0%; OR = 2.76; 95% C.I. = 2.14 to 3.5) and the orgasmic phase (85.1% vs. 45.4%; OR = 6.9; 95% C.I. = 5.6 to 8.4) but were significantly less likely than women to experience dysfunction in the arousal phase (71.9% vs. 83.3%; OR = .51; 95% C.I. = .43 to .62). The prevalence of phase-specific dysfunction did not vary significantly by SSRI/SNRI for males or females. CONCLUSION Among patients who do not experience clinically significant global sexual dysfunction on SSRI/SNRI monotherapy, dysfunction in at least one phase of the sexual response cycle is very common and may reduce sexual health-related quality of life.
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377
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Lewis RW, Fugl-Meyer KS, Bosch R, Fugl-Meyer AR, Laumann EO, Lizza E, Martin-Morales A. Epidemiology/risk factors of sexual dysfunction. J Sex Med 2006; 1:35-9. [PMID: 16422981 DOI: 10.1111/j.1743-6109.2004.10106.x] [Citation(s) in RCA: 356] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Accurate estimates of prevalence/incidence are important in understanding the true burden of male and female sexual dysfunction and in identifying risk factors for prevention efforts. AIM To provide recommendations/guidelines concerning state-of-the-art knowledge for the epidemiology/risk factors of sexual dysfunctions in men and women. METHODS An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Epidemiology/Risk Factors Committee, there were seven experts from four countries. MAIN OUTCOME MEASURE Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. RESULTS Standard definitions of male and female sexual dysfunctions are needed. The incidence rate for erectile dysfunction is 25-30 cases per thousand person years and increases with age. There are no parallel data for women's sexual dysfunctions. The prevalence of sexual dysfunction increases as men and women age; about 40-45% of adult women and 20-30% of adult men have at least one manifest sexual dysfunction. Common risk factor categories associated with sexual dysfunction exist for men and women including: individual general health status, diabetes mellitus, cardiovascular disease, other genitourinary disease, psychiatric/psychological disorders, other chronic diseases, and socio-demographic conditions. Endothelial dysfunction is a condition present in many cases of erectile dysfunction and there are common etiological pathways for other vascular disease states. Increasing physical activity lowers incidence of ED in males who initiate follow-up in their middle ages. CONCLUSIONS There is a need for more epidemiologic research in male and female sexual dysfunction.
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Basson R, Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, Graziottin A, Heiman JR, Laan E, Meston C, Schover L, van Lankveld J, Schultz WW. Revised definitions of women's sexual dysfunction. J Sex Med 2006; 1:40-8. [PMID: 16422982 DOI: 10.1111/j.1743-6109.2004.10107.x] [Citation(s) in RCA: 241] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Existing definitions of women's sexual disorders are based mainly on genitally focused events in a linear sequence model (desire, arousal and orgasm). AIM To revise definitions based on an alternative model reflecting women's reasons/incentives for sexual activity beyond any initial awareness of sexual desire. METHODS An International Definitions Committee of 13 experts from seven countries repeatedly communicated, proposed new definitions and presented at the 2nd International Consultation on Sexual Medicine in Paris July 2003. MAIN OUTCOME MEASURE Expert opinions/recommendations are based on a process that involved review of evidence-based medical literature, extensive internal committee discussion, informal testing and re-testing of drafted definitions in various clinical settings, public presentation and deliberation. RESULTS Women have many reasons/incentives for sexual activity. Desire may be experienced once sexual stimuli have triggered arousal. Arousal and desire co-occur and reinforce each other. Women's subjective arousal may be minimally influenced by genital congestion. An absence of desire any time during the sexual experience designates disorder. Arousal disorder subtypes are proposed that separate an absence of subjective arousal from all types of sexual stimulation, from an absence of subjective arousal when the only stimulus is genital. A new arousal disorder has provisionally been suggested, namely that of persistent genital arousal. Orgasm disorder is limited to absence of orgasm despite high subjective arousal. Dyspareunia includes partial painful vaginal entry attempts as well as pain with intercourse. Variable reflex muscle tightening around the vagina and an absence of abnormal physical findings are noted in the definition of vaginismus. Women's sexuality is highly contextual and descriptors are recommended re past psychosexual development, current context, as well as medical status. Diagnosing sexual disorders need not imply intrinsic dysfunction of the woman's own sex response system. CONCLUSIONS The International Definitions Committee has recommended a number of fundamental changes to the existing definitions of women's sexual disorders.
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Meston C, Trapnell P. Development and validation of a five-factor sexual satisfaction and distress scale for women: the Sexual Satisfaction Scale for Women (SSS-W). J Sex Med 2006; 2:66-81. [PMID: 16422909 PMCID: PMC2859306 DOI: 10.1111/j.1743-6109.2005.20107.x] [Citation(s) in RCA: 177] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION This article presents data based on the responses of over 800 women who contributed to the development of the Sexual Satisfaction Scale for Women (SSS-W). AIM The aim of this study was to develop a comprehensive, multifaceted, valid, and reliable self-report measure of women's sexual satisfaction and distress. METHODS Phase I involved the initial selection of items based on past literature and on interviews of women diagnosed with sexual dysfunction and an exploratory factor analysis. Phase II involved an additional administration of the questionnaire, factor analyses, and refinement of the questionnaire items. Phase III involved administration of the final questionnaire to a sample of women with clinically diagnosed sexual dysfunction and controls. RESULTS Psychometric evaluation of the SSS-W conducted in a sample of women meeting DSM-IV-TR criteria for female sexual dysfunction and in a control sample provided preliminary evidence of reliability and validity. The ability of the SSS-W to discriminate between sexually functional and dysfunctional women was demonstrated for each of the SSS-W domain scores and total score. CONCLUSION The SSS-W is a brief, 30-item measure of sexual satisfaction and sexual distress, composed of five domains supported by factor analyses: contentment, communication, compatibility, relational concern, and personal concern. It exhibits sound psychometric properties and has a demonstrated ability to discriminate between clinical and nonclinical samples.
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380
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Droupy S, Ponsot Y, Giuliano F. How, why and when should urologists evaluate male sexual function? ACTA ACUST UNITED AC 2006; 3:84-94. [PMID: 16470207 DOI: 10.1038/ncpuro0406] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2005] [Accepted: 12/19/2005] [Indexed: 01/23/2023]
Abstract
Male sexual dysfunction-a term that is commonly used to refer to erectile dysfunction, premature ejaculation, decreased libido and impaired orgasm-is the primary complaint encountered by many urologists. Despite the high prevalence and bothersome nature of these complaints, they are frequently neglected in clinical practice. This paper highlights clinical situations in which urologists should systematically evaluate male sexual functioning. These include men who present with several common urologic disorders, such as pelvic trauma, malignancies, and lower urinary tract symptoms associated with benign prostatic hyperplasia, neurologic disorders and infertility. Studies have shown that erectile dysfunction might be a clinical marker of endothelial dysfunction, and consequently of undetected diabetes, hypertension, dyslipidemia, coronary artery disease and depression. We also address the question of whether urologists should adopt wide-ranging screening regimens for sexual dysfunction.
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381
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Haefliger T, Bonsack C. Antipsychotiques atypiques et dysfonction sexuelle : à propos de cinq cas associés à la rispéridone. Encephale 2006; 32:97-105. [PMID: 16633296 DOI: 10.1016/s0013-7006(06)76142-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LITERATURE FINDINGS Sexual and reproductive function side effects of atypical antipsychotics are frequent, often underestimated and badly tolerated. They contribute to the 50% rate of non-compliance reported for treated patients. Prevalence of sexual dysfunction associated with atypical antipsychotic treatment is high, varying from 18 to 96%. Atypical antipsychotics aren't, as a group, much better than typical antipsychotics, and among them, risperidone seems to induce more and quetiapine less sexual dysfunction. Most atypicals are non-selective, and have actions on multiple central and peripheral receptors. Among these, dopaminergic blockade could have a direct - altering motivation (desire) and reward (orgasm) - and an indirect negative influence on sexuality. Actually, the secondary hyperprolactinemia induced by some antipsychotics (typical antipsychotics, risperidone and amisulpiride), is dose-dependent, more pronounced for female patients, and may have a detrimental effect on sexual function. It also may result in hypogonadism, particularly for female patients. The long-term consequences of this secondary hypogonadism are subject to debate but potentially severe. Furthermore, the blocking and/or modulating actions of atypical antipsychotics on adrenaline, serotonine, histamine or acetyl-choline receptors all have the potential to contribute to secondary sexual problems. The pharmacological profile of risperidone, characterized by a strong affinity for D2 and alpha1 receptors, correlates with his tendency to significantly elevate prolactin levels and to produce ejaculatory disturbances. FIVE CASE-REPORTS: We describe five case-reports of sexual or hormonal disturbances associated with risperidone treatment: two cases of ejaculatory disturbance, one case of galactorrhea and two cases of amenorrhea. Alberto and David are two young male schizophrenic patients, treated with risperidone, and complaining of a total absence of ejaculation despite a preserved orgasm. Many recent case-reports describe the occurrence of retrograde ejaculation associated with risperidone but the exact prevalence is unknown. Retrograde ejaculation is thought to be related to the strong adrenolytic activity of risperidone. Alberto refused his medication because the ejaculatory dysfunction was unbearable for him. A switch to haloperidol depot was eventually well tolerated, without any sexual complaints. His case emphasizes the importance of sexual function for self-esteem and how this may amplify the intolerance to side-effects. David is on depot-risperidone in a setting of a legally forced treatment. Though he - reluctantly - accepts his medication, this side effect exacerbates his pre-existing delusions, strongly focused on sexual themes. His case illustrates how intolerance to sexual side-effects may be amplified by nature of delusions. Mireille is a 58 year old psychotic female patient, whose 2 mg risperidone treatment produced a unilateral galactorrhea. This sign became problematic because potentially visible at a time when Mireille started an activity in a sheltered occupation in town. Lowering dosage of antipsychotic allowed disappearance of the problem. Subjective responses to galactorrhea have been reported to be highly individual. Apart being a potentially visible side-effect, it may be misinterpreted as evidence of pregnancy or of a tumoral process. The cases of Ermina and Denise illustrate two contrasted situations in terms of subjective tolerability of reproductive function side-effects. Both were pre-menopausal patients with hyperprolactinemia secondary to risperidone treatment, resulting in amenorrhea. This was unbearable for Ermina. A switch to olanzapine allowed, one month later, the menses to resume. For Denise, on the other hand, the amenorrhea was a positive event, freeing her of unpleasant menses. DISCUSSION Amenorrhea occurs in about 30% of pre-menopausal women treated with risperidone. It is a consequence of hyperprolactinemia, which, although often silent, is not devoid of potential negative consequences (ie increased risk of osteoporosis or neoplasia, worsening of psychopathology) (34). When hyperprolactinemia is symptomatic, lowering of the dose of the antipsychotic, or switching to a prolactin-sparing agent (olanzapine, quetiapine, aripiprazole and clozapine) is recommended. Before this, women with amenorrhea secondary to antipsychotic-induced hyperprolactinemia should be advised that menses may resume. Especially after long-standing amenorrhea they may assume being menopaused, hence may believe birth control measures are no longer required. The prevalence of antipsychotic-induced sexual and reproductive function side-effects is high. Clinicians should be aware of them, because they are often badly tolerated, are associated with a low satisfaction and may therefore result in low adherence with treatment. This implies for the clinician to overtly discuss with the patient of his sexuality and the potential negative impact of antipsychotic treatment on it. The recognition of these problems allows the searching together for a solution. CONCLUSION The described cases indicate that solving the problem is often possible, provided that individual preferences and subjective impact are taken in account. Antipsychotic treatment is often prescribed for very long periods. A better knowledge of - and attention to - the associated side effects, particularly on the sexual and reproductive functions, is necessary in order to reduce some potentially negative long-term effects and to improve the adherence to treatment of our patients.
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382
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Azam U. Late-stage clinical development in lower urogenital targets: sexual dysfunction. Br J Pharmacol 2006; 147 Suppl 2:S153-9. [PMID: 16465180 PMCID: PMC1751495 DOI: 10.1038/sj.bjp.0706638] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
In recent years, late-stage clinical drug development that primarily focuses on urogenital targets has centered around four areas of medical need (both unmet need and aiming to improve on existing therapies). These include male sexual dysfunction (MSD), female sexual dysfunction (FSD), prostatic pathology (neoplastic, pre-neoplastic, and non-neoplastic), and improvement in lower urinary tract symptoms. Despite the regulatory approval of compounds to treat erectile dysfunction (ED), benign prostatic hyperplasia, a number of treatments for overactive bladder, and stress urinary incontinence, there remains a deficiency in addressing a number of conditions that arise out of pathophysiological dysfunction resulting in lower urogenital tract sexual conditions. In terms of late-stage clinical development, significant progress has most recently been made in MSD development, especially in understanding further a common and complex sexual dysfunction--that of premature ejaculation. The search also continues for compounds that improve ED in terms of better efficacy and superior safety profile compared to the currently marketed phosphodiesterase-5-inhibitors. Whilst there are no approved medications to treat the subtypes of FSD, there has been significant progress in attempting to better understand how to appropriately assess treatment benefit in clinical trial settings for this difficult to diagnose and treat condition. This review will focus on late-stage human clinical development pertaining to MSD and FSD.
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383
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Hirschfeld RMA, Mallinckrodt C, Lee TC, Detke MJ. Time course of depression-symptom improvement during treatment with duloxetine. Depress Anxiety 2006; 21:170-7. [PMID: 16035056 DOI: 10.1002/da.20071] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The aim of this study was to examine the longitudinal response for overall and individual symptoms during the treatment of major depressive disorder. Data were pooled from two 9-week trials, which compared duloxetine 60-mg QD (n=251) with placebo (n=261) in the treatment of MDD. Changes from baseline in the 17-item Hamilton Depression Rating Scale (HAMD17) and in the Visual Analog Scales for pain were analyzed. Compared to placebo-treated patients, duloxetine-treated patients experienced greater improvement (P<.05) in the HAMD17 total score at Week 2. The individual symptoms showing the most rapid improvements (Week 1) were depressed mood, guilt, suicidal ideation, work/activities, and psychic anxiety as well as VAS back pain and shoulder pain. At subsequent visits, significant improvements were observed in retardation (Week 2); hypochondriasis (Week 3); general somatic symptoms (Week 5); middle and late insomnia (Week 7); and gastrointestinal (GI) symptoms, genital symptoms (level of sexual interest or ease of sexual arousal), insight, and early insomnia (Week 9). Significant advantages for duloxetine were not achieved at any visit for agitation, somatic anxiety, or weight loss. At Weeks 1 and 2, placebo-treated patients had significantly lower GI symptoms and reported less weight loss compared with duloxetine-treated patients; however, differences were not significant at subsequent visits. Furthermore, duloxetine was superior to placebo on GI symptoms at endpoint compared to placebo-treated patients; duloxetine-treated patients had a significantly higher response rate at Week 2 and a higher remission rate at Week 5. These results may help clinicians establish more accurate expectations regarding treatment with duloxetine.
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384
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Abstract
In our times, sexuality has become an essential part of life for aging people. For the aging, psychosocial and biological changes, as well as increasing morbidity present challenges to a satisfying sexual life. Hence, the demand grows for health-care providers with basic sexological knowledge and counseling abilities. This article discusses relationships between frequent sexual difficulties and aging related organic processes. A therapeutic concept, the "Sexocorporal Approach", is introduced. This approach is based on a model of ongoing sexual development throughout the lifetime enabling adaptation to new life phases and limiting circumstances through sexual learning processes. Aside from pharmacological treatment, the encouragement of sexual learning presents an effective therapeutic approach for practitioners that can be easily learned and applied.
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385
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Burger HG, Papalia MA. A clinical update on female androgen insufficiency—testosterone testing and treatment in women presenting with low sexual desire. Sex Health 2006; 3:73-8. [PMID: 16800391 DOI: 10.1071/sh05055] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The diagnosis of female androgen deficiency syndrome is suggested by complaints of a diminished sense of well being, persistent unexplained fatigue and decreased sexual desire, sexual receptivity and pleasure in a woman who is oestrogen-replete and in whom no other significant contributing factors can be identified. The diagnosis is supported by the finding of low circulating concentrations of free testosterone. Barriers to its recognition include the non-specificity of the symptoms and methodological problems due to insensitive testosterone assays. Barriers to its treatment include the unavailability of satisfactory forms of testosterone for administration to women and lack of data regarding long-term safety. Although several conditions lead to clear-cut androgen deficiency, such as hypopituitarism, adrenal and ovarian insufficiency, glucocorticoid therapy and use of oral contraceptives and oral oestrogens, it is important for clinicians to recognise that in normal women, androgen levels decline by 50% from the early 20s to the mid 40s, and hence age-related androgen insufficiency may occur in women in their late 30s and 40s, as well as postmenopausally. Satisfactory measurements of free testosterone requires a sensitive and reliable assay for total testosterone, and quantitation of sex hormone binding globulin, from which free testosterone is readily calculated. Adverse effects of testosterone treatment are few if replacement is monitored to achieve physiological circulating testosterone concentrations. Currently, available methods include testosterone implants and testosterone creams, and transdermal patches and sprays are in development.
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386
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Keller A, McGarvey EL, Clayton AH. Reliability and construct validity of the Changes in Sexual Functioning Questionnaire short-form (CSFQ-14). JOURNAL OF SEX & MARITAL THERAPY 2006; 32:43-52. [PMID: 16234225 DOI: 10.1080/00926230500232909] [Citation(s) in RCA: 150] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The Changes in Sexual Functioning Questionnaire (CSFQ) is a 36-item clinical and research instrument identifying five scales of sexual functioning. This study documents the internal consistency and factor structure of a 14-item version of the CSFQ (CSFQ-14), which yields scores for three scales corresponding to the phases of the sexual response cycle (i.e., desire, arousal, and orgasm) as well as the five scales of the original CSFQ. Factor analysis confirms the construct validity of the CSFQ-14 as a global measure of sexual dysfunction. The CSFQ-14 and the individual scales exhibit strong internal reliability.
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387
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Abstract
The World Health Organization defines sexual health as "a state of physical, emotional, mental and sexual well-being related to sexuality." This broad definition goes beyond simply inquiring about sexual dysfunction and ideally fits the model of patient-centered primary care. As we observe that sexual health and physical health are often closely related, discussions about sexual activity can be very revealing. Sexual intimacy appears positively related to loving relationship satisfaction and stability. Sexual problems have a clear negative impact on both the quality of life and emotional state regardless of age. Learning about specific sexual dysfunctions among men can reveal a variety of as-yet-undiagnosed comorbid pathologic conditions such as: (i) depression and other emotional illnesses; (ii) psychosocial stress; (iii) actual cardiovascular disease as well as related risk factors such as hypertension, diabetes, and/or hyperlipidemia; (iv) hyperprolactinemia; and (v) low serum testosterone. Specific sexual dysfunctions among women can reveal pathologic conditions such as: (i) depression and other adverse imitational and psychosocial conditions; (ii) low serum estrogen or testosterone; and/or (iii) vaginal or pelvic disorders. A discussion about sexual health can be accomplished efficiently in a primary care office with the inquiring clinician having the option to deal with any sexual problems and dysfunctions directly, or to refer the patient to an appropriate specialized care source.
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388
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Abstract
Sexual dysfunctions are widespread and have an enormous effect on quality of life. To understand them, it is necessary to look at both somatic and psychosocial factors, especially those concerning partnership. Psychiatric and neurologic disorders play an important role. Normally, treatment consists of qualified sex counseling and, if necessary, intensive sex therapy. Somatic treatment options exist as well.
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389
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Rao D, Zajecka J, Skubiak T. The Modified Rush Sexual Inventory: preliminary psychometric findings. Psychiatry Res 2005; 137:175-81. [PMID: 16297981 DOI: 10.1016/j.psychres.2005.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2004] [Accepted: 05/31/2005] [Indexed: 12/30/2022]
Abstract
Sexual dysfunction associated with psychiatric disorders and the treatment of these disorders can impede a patient's optimal recovery and quality of life. Patients are typically reluctant to report their sexual difficulties. Therefore, self-report measures that comprehensively and concisely assess sexual difficulties are a beneficial contribution to clinical research and practice. The Modified Rush Sexual Inventory (MRSI) not only assesses sexual functioning and satisfaction using a multiple-choice format, but it also includes an introductory section for patients' medical histories and free responses. Though the MRSI has been used in clinical trial research, the reliability and validity of the measure is unknown. This study presents the initial reliability and validity findings of the MRSI.
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390
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Lombardo F, Gandini L, Jannini EA, Sgrò P, Gilio B, Toselli L, Dondero F, Lenzi A. Diagnosing erectile dysfunction: instruments for endocrine diagnosis. ACTA ACUST UNITED AC 2005; 28 Suppl 2:53-5. [PMID: 16236065 DOI: 10.1111/j.1365-2605.2005.00585.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Endocrine factors represent an important and potentially treatable cause of sexual dysfunction. The availability of a correct endocrinological diagnosis allows correct identification of most cases of sexual dysfunction in which the endocrine apparatus is involved. Not only the most frequent causes of endocrine sexual dysfunction, such as hypogonadism and hyperprolactinaemia, but almost all extra-gonadal endocrinopathies (hyper-and hypothyroidism, hyper- and hypocortisolism, steroidal secreting tumours, etc.) may have importance to a greater or lesser extent in sexual function. It is, therefore, necessary that the diagnostic process for sexual dysfunctions of an endocrine nature be as integrated and wide as possible, especially as such pathologies are normally extremely responsive to medical or surgical therapy.
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391
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Rellini AH, Nappi RE, Vaccaro P, Ferdeghini F, Abbiati I, Meston CM. Validation of the McCoy Female Sexuality Questionnaire in an Italian sample. ARCHIVES OF SEXUAL BEHAVIOR 2005; 34:641-7. [PMID: 16362248 DOI: 10.1007/s10508-005-7915-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2004] [Revised: 09/01/2004] [Accepted: 06/02/2005] [Indexed: 05/05/2023]
Abstract
This article presents the result of a study that translated into Italian and validated the McCoy Female Sexuality Questionnaire (MFSQ) on an Italian sample. The questionnaire was first administered to a sample of 240 Italian women (age range, 18-65 years) recruited from a gynecology clinic. A principal component analysis identified 2 factors: sexuality (9 items) and partnership (5 items). Both factors showed an adequate inter-item reliability (Cronbach's alpha of .88 and .75, respectively). The validity of the Italian MFSQ was then tested by administering the questionnaire to a sample of 16 women with sexual dysfunction and 46 control women. Sexual dysfunction diagnoses were assessed through a semi-standardized interview based on the DSM-IV-TR diagnoses for Female Sexual Arousal Disorder, Female Orgasmic Disorder, Dyspareunia, and Hypoactive Sexual Desire Disorder. A discriminant validity test showed significant differences between women with and without female sexual dysfunction. These results indicate that the translated version of the MFSQ is a reliable and valid measure of sexual dysfunction among Italian women. The results also indicated a difference in factor structure between the Italian and the original version of the MFSQ, which warrants further investigation.
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392
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Ficek L, Miotła P, Rechberger T. [Women's sexual life quality assessment with use of questionnaires in clinical trials--review of accessible tools, their characteristics and comparison of their properties]. Ginekol Pol 2005; 76:1000-7. [PMID: 16566382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
AIM Aim of the study is a review of women's sexual life quality assessment questionnaires available in literature, analysis of their construction, special properties and usability in clinical trials. MATERIAL AND METHODS Medline database and accessible literature has been reviewed. Seven questionnaires have been chosen for analysis. Analysis in scope of potential and usability of those questionnaires in clinical tests has been performed. CONCLUSIONS Suitability of The Female Sexual Function Index (FSFI) and The Brief Index of Sexual Functioning for Women (BISF-W) have been shown as universal tools for sexual function assessment in clinical trials. They meet current model of women's sexual reaction and criteria of sexual disfunction classification.
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393
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Seftel A. Sexual, psychological and dyadic qualities of the prostate cancer 'couple'. J Urol 2005; 174:1939. [PMID: 16217353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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394
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Seftel A. Practice Patterns of Physician Members of the American Urogynecologic Society Regarding Female Sexual Dysfunction: Results of a National Survey. J Urol 2005; 174:1938. [PMID: 16217351 DOI: 10.1097/01.ju.0000183198.48193.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
MESH Headings
- Attitude of Health Personnel
- Clinical Competence
- Education, Medical, Continuing
- Female
- Gynecology/education
- Health Care Surveys
- Humans
- Male
- Outcome Assessment, Health Care
- Practice Patterns, Physicians'/standards
- Practice Patterns, Physicians'/statistics & numerical data
- Sexual Dysfunction, Physiological/diagnosis
- Sexual Dysfunction, Physiological/therapy
- Sexual Dysfunctions, Psychological/diagnosis
- Sexual Dysfunctions, Psychological/etiology
- Societies, Medical/statistics & numerical data
- Surveys and Questionnaires
- United States
- Urology/education
- Women's Health
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395
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396
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Jakiel G, Baran A. [Androgen deficiency in women]. ENDOKRYNOLOGIA POLSKA 2005; 56:1016-20. [PMID: 16821229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Androgens are defined as the steroids having a binding affinity of the androgen receptor. In the reproduction age a daily production of testosterone is equally divided between the ovaries and adrenal and local tissue conversion of androstenedione and DHEA. After menopause the 80% of testosterone is produced in ovaries, but majority of precursors for peripheral conversion is adrenal origin. Androgen receptors are present throughout in the body; over 200 cellular actions of androgens have been described. Androgenic action is determined by quantitative level of the androgen present in the circulation, its degree of binding to proteins, the degree of interconversion to other androgens and estrogens, and the biological potency and androgen receptor binding affinity of the androgen. The most common clinical symptoms of androgen deficiency are the reduction of sex motivation, sex fantasy, sex enjoyment, sex arousal, vaginal vasocongestion, but also reduction of pubic hair, bone mass, muscle mass, worsening of quality of life (mood, affect, energy), more frequent vasomotors symptoms, insomnia, depression, headache. All these signs and symptoms can be multifactorial. Most common conditions associated with hypoandrogenism in women are hypothalamic-pituitary abnormalities, lack or insufficiency of ovaries, adrenal insufficiency, glucocorticoid therapy, exogenous estrogen administration. Besides the clinical picture the free testosterone measuring is important for diagnosis. The method of choice of this measure is equilibrium dialysis assay. Despite of clinical importance of androgen insufficiency in women, none of methods of androgen substitution is approved by FDA.
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Abstract
PURPOSE OF REVIEW Accumulating evidence suggests that premature ejaculation is the most common sexual symptom. This review focuses on the epidemiology of premature ejaculation from geographical and medical perspectives. RECENT FINDINGS In the past year many articles have been published using the data from the Global Study of Sexual Attitudes and Behaviors, a large survey that investigated various aspects of sex and relationships among 27 500 men and women aged 40-80 years. Despite some methodological bias, discussed herein, a prevalence of more than 21% seems a realistic figure for premature ejaculation. SUMMARY Premature ejaculation is the most prevalent sexual dysfunction in every country.
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398
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Sills T, Wunderlich G, Pyke R, Segraves RT, Leiblum S, Clayton A, Cotton D, Evans K. ORIGINAL RESEARCH—WOMEN's SEXUAL DYSFUNCTIONS: The Sexual Interest and Desire Inventory—Female (SIDI‐F): Item Response Analyses of Data from Women Diagnosed with Hypoactive Sexual Desire Disorder. J Sex Med 2005; 2:801-18. [PMID: 16422805 DOI: 10.1111/j.1743-6109.2005.00146.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Hypoactive sexual desire disorder (HSDD) is the most common sexual complaint in women. Currently there are no validated instruments for specifically assessing HSDD severity, or change in HSDD severity in response to treatment, in premenopausal women. The Sexual Interest and Desire Inventory-Female (SIDI-F) is a clinician-administered instrument that was developed to measure severity and change in response to treatment of HSDD. Seventeen items were included in a preliminary version of the SIDI-F, including 10 items related to desire, and seven items related to possible comorbid factors (e.g., other kinds of sexual dysfunction, general relationship satisfaction, mood, and fatigue). AIM The aim of the study was to use the outcome of item response analyses of blinded data from two randomized, placebo-controlled trials, to assist in the revision of the scale. METHODS A nonparametric item response (IRT) model was used to assess the relation between item functioning and HSDD severity on this preliminary version of the SIDI-F. RESULTS Results show that the majority of SIDI-F items demonstrated good sensitivity to differences in overall HSDD severity. That is, there was an orderly relation between differences in option selection for an item and differences in overall HSDD severity. The IRT analyses further indicated that revisions were warranted for a number of these items. Five items were not sensitive to differences in HSDD severity and were removed from the scale. CONCLUSION The SIDI-F is a brief, clinician-administered rating scale designed to assess severity of HSDD symptoms in women. IRT analyses show that majority of the items of the SIDI-F function well in discriminating individual differences in HSDD severity. A revised 13-item version of the SIDI-F is currently undergoing further validation.
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399
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Symonds T, Boolell M, Quirk F. Development of a questionnaire on sexual quality of life in women. JOURNAL OF SEX & MARITAL THERAPY 2005; 31:385-97. [PMID: 16169822 DOI: 10.1080/00926230591006502] [Citation(s) in RCA: 160] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The Sexual Quality of Life-Female (SQOL-F) questionnaire has been developed to assess the impact of female sexual dysfunction (FSD) on a woman's sexual quality of life. SQOL-F items were developed through interviews with 82 women. Three data sets from women's health surveys in the United Kingdom and the United States generated data for scale validation. The SQOL-F showed good psychometric properties: convergent validity, discriminant validity, and test-retest reliability. The SQOL-F is a valid instrument for assessing the impact of FSD on quality of life and as an adjunct in evaluating FSD in clinical trials. The SQOL-F sensitivity to changes in sexual function needs confirmation.
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Rowland DL, Incrocci L, Slob AK. Aging and sexual response in the laboratory in patients with erectile dysfunction. JOURNAL OF SEX & MARITAL THERAPY 2005; 31:399-407. [PMID: 16169823 DOI: 10.1080/00926230591006520] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Aging places men at increased risk for erectile problems, particularly beginning around their fifties and sixties. Using a psychophysiological assessment procedure that included visual erotic stimulation, vibrotactile stimulation, and intracavernosal injection, this study tested for possible age effects on erectile response and self-reported sexual arousal in a group of men clinically diagnosed with erectile dysfunction. We controlled for three factors of purported importance to erectile functioning: existing comorbidities, use of specific medications, and current tobacco and alcohol use. Results indicated effects from both age and tobacco use on erectile response, although these effects were not uniform across age groups. For example, age had inconsistent effects on erectile response in patients aged 50 to 90 years; tobacco use had its strongest effect on patients under 50 years of age. In general, such covariates were less able to account for variation in erectile response among patients with more-severe ED. Despite these effects, ED men even in the oldest group showed average penile circumference increases of 28 mm under ICI, an erectile response typically sufficient for vaginal intercourse.
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