Amphetamine/Dextroamphetamine Salts for Delayed Orgasm and Anorgasmia in Men: A Pilot Study

OBJECTIVE

To describe our experience with amphetamine/dextroamphetamine salts (AMP) as a treatment for delayed orgasm/anorgasmia (DO/AO).

METHODS

We identified patients with DO/AO from September 2017 to September 2019. Baseline characteristics and patient-reported orgasmic latency time (OLT) were recorded. After extensive screening, patients were treated with AMP. Validated questionnaires were administered including International Index of Erectile Function, quantitative Androgen Deficiency in the Aging Male and Adult ADHD Self-Report Scale. OLT change, adverse effects, and patient satisfaction were assessed. Baseline characteristics were compared using chi-squared test. OLT changes were compared with one-way ANOVA. Multivariable logistic regression was performed to identify predictors of treatment success. P < 0.05 was statistically significant.

RESULTS

Seventeen men received AMP - 6 of 17 (35.3%) for AO and 11 of 17 (64.7%) for DO, with median follow-up 1.0 year (interquartile range [IQR] 1.0 year). Amongst responders, AMP improved subjective experience of sex in 8 of 17 (47.1%) patients (2/6 with AO). Of those, 6 of 17 (35.3%; 1/6 with AO) experienced reduced OLT or increased frequency of orgasm. Non-responders were older than responders, with median age 69.5 (IQR 4.3) vs 61.0 years (IQR 12.3; P = 0.024). There were no other significant differences in baseline characteristics among responders. Of note, 6 of 8 (75%) responders and 8 of 9 (88.9%) non-responders failed other treatment modalities prior to AMP. Among responders with DO and improved OLT, mean OLT decreased by 72.3% (40.7 to 11.1 minutes, P = 0.049) during intercourse. Minimal side effects were noted including insomnia and jitters, each in one patient respectively.

CONCLUSION

AMP as a treatment for AO/DO merits further investigation. Measurable improvements in OLT or frequency of orgasm occurred in more than a third of patients. Larger prospective multicenter studies with strict inclusion and exclusion criteria are warranted.

Sexual Self-Efficacy and Entitlement to Pleasure: The Association of the Female Sexual Subjectivity Inventory with Sexual Risk Taking and Experience of Orgasm

Young women's understanding of their own sexuality has increasingly been acknowledged as an important component of their sexual health. The Female Sexual Subjectivity Inventory (FSSI) was developed to measure five distinct factors of young women's experiences of sexual pleasure and empowerment. No studies have explicitly evaluated the association between FSSI scores and clinical sexual health outcomes. We conducted a cross-sectional survey of women to assess the association between FSSI factors and the occurrence of three clinical sexual health outcomes in the prior 12 months: acquisition of an STI, unwanted pregnancy, or taking emergency contraception (Plan B). We also assessed the association between FSSI scores and self-reported orgasm frequency during partnered sexual activity. We used multivariate logistic regression models to estimate associations. Finally, we used the FSSI scale in a novel way to identify a population of women who are discordant on their levels of entitlement to pleasure from a partner and self-efficacy in achieving sexual pleasure. We did not find any statistically significant associations between mean score on any of the FSSI factors and clinical sexual health outcomes of interest in the prior year. We found that all FSSI factors except Sexual Self-Reflection were positively associated with increased orgasm frequency. Our study underscores the validity of the FSSI as a measure to assess psychosocial constructs relevant to young women's ability to experience sexual pleasure with a partner and introduces a novel way to use the scale to assess the development of women's sexual subjectivity.

A Structural Equation Model of Sexual Satisfaction and Relationship Functioning Among Sexual and Gender Minority Individuals Assigned Female at Birth in Diverse Relationships

While there is a sizeable literature on sexual satisfaction among male-female mixed-sex couples, research examining other types of relationships (e.g., same-sex) is limited. The current study aimed to broaden our understanding of sexual satisfaction across the diverse relationships of sexual and gender minority individuals assigned female at birth (SGM-AFAB) and inform models of sexual satisfaction for this population. We examined: (1) differences in sexual satisfaction and characteristics of sexual activity (frequency of sex, frequency of orgasm, duration of sex) by relationship type (same-sex, mixed-sex, gender-diverse) among SGM-AFAB; (2) a model of sexual satisfaction and its correlates; and (3) differences in this model by relationship type. Results indicated cisgender women in relationships with cisgender women (same-sex) reported higher duration of sex, frequency of orgasm, and sexual satisfaction compared to cisgender women in relationships with cisgender men (mixed-sex). There were few differences in characteristics of sexual activity between SGM-AFAB in gender-diverse relationships (involving one or more gender minority partners) and those in same- or mixed-sex relationships. Results indicated similarities across relationship types in a model of sexual satisfaction and its correlates. For all relationship types, more frequent and longer duration of sexual activity predicted higher orgasm frequency, more frequent orgasm predicted higher sexual satisfaction, and higher sexual satisfaction predicted better relationship functioning. Only the association between orgasm frequency and sexual satisfaction varied by relationship type. As one of the first studies examining sexual satisfaction among SGM-AFAB in mixed-sex and gender-diverse relationships, findings substantially further our understanding of sexual satisfaction in this population.

When Orgasms Do Not Equal Pleasure: Accounts of "Bad" Orgasm Experiences During Consensual Sexual Encounters

Orgasms during consensual sex are often assumed to be wholly positive experiences. This assumption overshadows the possibility that orgasm experiences during consensual sex could be "bad" (i.e., negative and/or non-positive). In the present study, we employed an online survey to explore the possibility that orgasm experiences could be "bad" during consensual sex by asking participants of diverse gender and sexual identities (N = 726, M age = 28.42 years, SD = 7.85) about a subset of potential bad orgasm experiences. Specifically, we asked participants whether they have ever had an orgasm during coerced sex, compliant sex, and/or when they felt pressured to have an orgasm (i.e., orgasm pressure). We also asked participants who had such an experience to describe it, resulting in qualitative descriptions from 289 participants. Using mixed quantitative and qualitative analyses, we found compelling evidence that orgasm experiences can be "bad" during consensual sex. Specifically, many participants described their experiences in negative and/or non-positive ways despite orgasm occurrence, reported that their orgasms were less pleasurable compared to other experiences, and suggested that their orgasm experiences had negative impacts on their relationships, sexuality, and/or psychological health. Participants also suggested that social location shaped their bad orgasm experiences, citing gender and sexual identity, gender identity conflict, race/ethnicity, and religion as important to their perceptions of and responses to their experiences. Results directly challenge the assumption that orgasms during consensual sex are always and/or unilaterally positive experiences.

Women's Sexual Satisfaction, Communication, and Reasons for (No Longer) Faking Orgasm: Findings from a U.S. Probability Sample

We aimed to assess, among a U.S. probability sample of adult women: (1) the prevalence of, and reasons given for, faking and no longer faking orgasm, (2) women's histories of sexual non-communication and reasons for non-communication, (3) associations between sexual non-communication and sexual satisfaction and faking orgasm, (4) associations between specific sexual communication and recent sexual satisfaction, and (5) associations between specific sexual communication and faking orgasm. Respondents were 1008 adult women ages 18-94 from the GfK KnowledgePanel (a nationally representative probability sample of non-institutionalized and English-speaking adults), who completed a confidential Internet-based survey. Although 58.8% of female respondents reported having ever faked/pretended orgasm, 67.3% of those who had ever faked orgasm no longer did. Women who continued to fake orgasms were more likely to indicate embarrassment talking about sex with their partner in explicit ways and were less likely to agree that they and their partner are able to talk specifically about what makes sex more pleasurable for them. More than half (55.4%) of women reported they had wanted to communicate with a partner regarding sex but decided not to; the most common reasons were not wanting to hurt a partner's feelings (42.4%), not feeling comfortable going into detail (40.2%), and embarrassment (37.7%). Greater self-reported sexual satisfaction was associated with more comfortable sexual communication. Study findings and implications for professionals are discussed in the context of adult sexual development and learning. This includes growing more comfortable talking with a partner about sexual preferences and sexual pleasure.

Beliefs About Gender Predict Faking Orgasm in Heterosexual Women

The majority of women have faked an orgasm at least once in their lives. In the current study, we assessed how women's worldviews about gender relate to their faking orgasm behavior. A survey of 462 heterosexual women from the UK (M_age=38.38 years) found that those who espoused anti-feminist values-that is, those high in hostile sexism-had faked significantly more orgasms over their lifetime. In contrast, those who espoused ostensibly positive but restrictive ideas of gender relations-that is, those high in benevolent sexism-had faked significantly fewer orgasms over their lifetime. Furthermore, the more that women believed female orgasm was necessary for men's sexual gratification, the more likely they were to have faked an orgasm at least once in their lives compared to women who had never faked an orgasm. These effects were small to moderate and emerged after controlling for demographics, sexual history, ease of orgasm, and previously established psychological correlates of faking orgasm, including suspected partner infidelity and intrasexual competition.

Different Ways to Get There: Evidence of a Variable Female Sexual Response Cycle

Research has suggested women's sexual response cycle may vary more than previously thought. We asked 769 sexually active women between the ages of 18-70 to report on their sexual desire and arousal patterns during their last sexual experience. Using a latent class mixture model from retrospective sexual response data, we found six classes of desire and arousal patterns (Low, Middle Steady, High Fluctuation, Low Fluctuation, Upper Steady, High). We examined how these patterns were related to demographics, outcomes during the sexual experience, and outcomes for the global relationship. The Low sexual response class (8% of women) was significantly different from other classes in duration of the sexual experience, orgasms, and overall satisfaction with the sexual experience. Most sexual response patterns were associated with healthy relational and sexual outcomes. All classes except for the Low arousal and desire class showed associations with a neutral or positive sexual satisfaction evaluation. The non-problematic variation of women's sexual experience is an important concept to consider as it impacts determinations of dysfunction and women's self-evaluations. Not all women need to experience high levels of arousal throughout the sexual experience or to have desire at the outset in order to have positive sexual experiences and sexual outcomes.

Couples' Sexual Communication and Dimensions of Sexual Function: A Meta-Analysis

Research and clinical data have shown that couples with sexual problems report a lack of sexual communication. However, no published meta-analyses have evaluated the relationship between sexual communication and sexual function. This meta-analysis examines the correlation between couples' sexual communication and dimension of sexual function across 48 studies. Sexual communication was positively associated with sexual desire (r = .16), sexual arousal (r = .21), lubrication (r = .17), orgasm (r = .23), erectile function (r = .19), less pain (r = .12), and overall sexual function (r = .35). The effect sizes for sexual desire (r = .21; r = .12) and orgasm (r = .26; r = .16) were higher for women than for men. For overall sexual function, studies with married participants (r = .47) had a larger effect size than studies with participants with multiple relationship types (r = .31) or than studies with dating participants (r = .11). Effect sizes were larger for studies conducted outside of the United States (r = .39) compared to studies conducted in the United States (r = .12). We discuss the importance of addressing the relationship between sexual communication and sexual function, as well as future directions for research in this area.

Cultural anorgasmia: considerations in the evaluation of male infertility in the Hasidic community

There are many factors that may contribute to infertility, including psychosocial issues. The understanding of the cultural and spiritual background of patients can help elicit a sexual history that may lead to a diagnosis and subsequent successful treatment plan. Within this context, we present a case report of a Hasidic couple with primary infertility. Evaluation revealed what we are referring to as "cultural anorgasmia," with the male partner having never been educated about nor experienced an orgasm due to his religious upbringing. Counseling about basic anatomy and the physiology of sexual arousal and orgasm was successful in overcoming anorgasmia and achieving pregnancy.

An Analysis of Popular Online Erectile Dysfunction Supplements

INTRODUCTION

Erectile dysfunction supplements (ED-Ss) are featured on online marketplaces like Amazon.com, with dedicated pages and claims that they naturally treat ED. However, their efficacy and safety are largely unknown, limiting the ability to counsel patients regarding their use.

AIM

To evaluate the highest rated and most frequently reviewed ED-Ss on Amazon.com to facilitate patient counseling regarding marketing myths, ingredient profiles, and evidence for product efficacy and safety.

METHODS

The Amazon marketplace was queried using the key term "erectile dysfunction" with default search settings and ranking items based on relevance. The top 6 ED-S products identified on September 29, 2018, were reviewed based on price, ratings, reviews, manufacturer, and ingredients. Consumer reviews were categorized using subtopics within the International Index of Erectile Function (IIEF) questionnaire to better understand ED-S efficacy and then reanalyzed following filtration of untrustworthy comments using ReviewMeta.com, a proprietary Amazon review analysis software.

OUTCOMES

Quantitative and qualitative evaluation of ED-S products sold on Amazon.com.

RESULTS

The top 6 ED-Ss had an average of 2,121 ± 1,282 reviews and a mean rating of 3.92 ± 0.42 stars. A total of 21 ingredients were identified in these ED-Ss. Ginseng, horny goat weed, L-arginine, and tongkat ali were the most popular ingredients included in the analyzed products. Our literature review identified 413 studies involving the 21 identified ingredients, of which 59 (16%) involved human subjects. Among these 69 human studies, only 12 (17%) investigated supplement ingredients individually and reported improvement in ED. Analysis of top-ranked customer reviews from the first 2 pages of reviews for each supplement revealed differences in IIEF scores before and after ReviewMeta.com filtration. After filtration, we observed a 77% decrease in reviews reporting improved erection strength, an 83% decrease in reviews reporting improved ability to maintain erection, a 90% decrease in reviews reporting increased sexual satisfaction, an 88% decrease in reviews reporting increased enjoyment with intercourse, and an 89% decrease in reviews reporting increased erection confidence.

STRENGTHS & LIMITATIONS

Study strengths include a novel approach to ascertaining consumers' perceptions and satisfaction with ED-Ss and practical summary information that clinicians can provide to patients. Limitations include selection bias, the small number of supplements analyzed, and the proprietary nature of the Amazon review analysis software.

CONCLUSIONS

Our investigation revealed that human studies evaluating the efficacy of ED-S ingredients are limited and have yielded no definitive findings of the effects on ED. Patients considering ED-S use should receive appropriate counseling, given the prevalence of disingenuous reviews and the ready availability of Food and Drug Administration-approved drug therapies. Balasubramanian A, Thirumavalavan N, Srivatsav A, et al. An Analysis of Popular Online Erectile Dysfunction Supplements. J Sex Med 2019;16:843-852.

Intimacy Mediates the Relation Between Maltreatment in Childhood and Sexual and Relationship Satisfaction in Adulthood: A Dyadic Longitudinal Analysis

Trauma theories suggest that childhood maltreatment (CM) may partly explain intimacy problems in romantic relationships. However, empirical studies have yielded conflicting findings, likely due to the varying conceptualizations of intimacy. Findings that support long-term negative effects of CM on sexual and relationship satisfaction are almost exclusively based on cross-sectional intra-individual data, precluding the examination of mediating pathways and of dyadic interactions between individuals reporting CM and their partners. This study used a dyadic perspective to examine the associations between CM and the different components of intimacy based on the interpersonal process model of intimacy: self-disclosure, perceived partner disclosure, and perceived partner responsiveness. We also tested the mediating role of these intimacy components at Time 1 in the relations between CM and sexual and relationship satisfaction 6 months later. A sample of 365 heterosexual couples completed self-report questionnaires. Results of path analyses within an actor-partner interdependence framework showed that women and men's higher levels of CM did not affect self-disclosure, but was negatively associated with their own perception of partner disclosure and responsiveness. In turn, women and men's perception of partner responsiveness at Time 1 was positively associated with their own sexual satisfaction, as well as their own and their partner's relationship satisfaction at Time 2. Thus, perception of partner responsiveness mediated the associations between CM and poorer sexual and relationship satisfaction. The overall findings may inform the development of couple intervention that targets the enhancement of intimacy to promote sexual and relationship well-being in couples where one partner experienced CM.

Body Movement Is Associated With Orgasm During Vaginal Intercourse in Women

Very few studies have investigated the relationship between women's ability to experience an orgasm during vaginal intercourse and specific stimulation techniques. We examined two common techniques during vaginal intercourse both with and without simultaneous external clitoral stimulation: (1) body movement, in particular back-and-forth swinging movements of the pelvis and trunk; and (2) precise rubbing of the clitoris with an immobilized body. Structural equation modeling was used to compare the effects of the two stimulation techniques on women's orgasm frequency (N = 1,239). As hypothesized, the frequency of orgasm during vaginal intercourse with simultaneous clitoral stimulation was positively associated with a preference for body movement during arousal. Body movement, as opposed to body immobilization, was also associated with a higher frequency of orgasm during vaginal intercourse without simultaneous clitoral stimulation. We conclude that body movement is associated with more orgasms during vaginal intercourse, whereas precise rubbing of the clitoris with an immobilized body is not associated with more orgasms. Teaching women to move their pelvis and trunk in a swinging back-and-forth movement during vaginal intercourse might therefore facilitate reaching an orgasm, whereas encouraging them to self-stimulate the clitoris might be less helpful if done with an immobilized body.

Using spectral and cross-spectral analysis to identify patterns and synchrony in couples' sexual desire

Sexual desire discrepancy is one of the most frequently reported sexual concerns for individuals and couples and has been shown to be negatively associated with sexual and relationship satisfaction. Sexual desire has increasingly been examined as a state-like construct that ebbs and flows, but little is known about whether there are patterns in the fluctuation of sexual desire. Utilizing spectral and cross-spectral analysis, we transformed 30 days of dyadic daily diary data for perceived levels of sexual desire for a non-clinical sample of 133 couples (266 individuals) into the frequency domain to identify shared periodic state fluctuations in sexual desire. Spectral analysis is a technique commonly used in physics and engineering that allows time series data to be analyzed for the presence of regular cycles of fluctuation. Cross-spectral analysis allows for dyadic data to be analyzed for shared rates of fluctuation between partners as well as the degree of (a)synchrony (or phase shift) between these fluctuations. Men and women were found to exhibit fluctuations in sexual desire at various frequencies including rates of once and twice per month, and to have sexual desire that was unlikely to fluctuate over periods of three days or less and therefore exhibited persistence. Similar patterns of fluctuation were exhibited within couples and these patterns were found to be largely synchronous. While instances of desire discrepancy may arise due to differences in rates of sexual desire fluctuation and random fluctuations, such instances may be normal for romantic relationships. The results have important implications for researchers, clinicians, and educators in that they corroborate the supposition that sexual desire ebbs and flows and suggest that it does so with predictable regularity.

Evaluation of sexual function in women with labia minora hypertrophy: A preliminary study

OBJECTIVE

To compare the sexual functions in women with labia minora hypertrophy and age-matched healthy controls.

MATERIAL AND METHOD

43 patients with labia minora hypertrophy and 30 age-matched healthy controls were enrolled in the present study. The sexual functions of the women were evaluated by using the index of female sexual function (IFSF).

RESULTS

Mean ages of the patients and controls were 30.06±7.11 and 31.34±4.12 (p=0.41), respectively. Mean total IFSF scores of the patients and controls were 24.18±3.24 and 27.53±4.43 (p<0.05), respectively. The subscale scores of IFSF-lubrication, orgasm, satisfaction and pain in the patient group were significantly lower than in the control group (respectively, p<0.001, p<0.05, p<0.001 and p<0.05). There was no statistically significant difference between IFSF-arousal scores of the patient and control groups (p=0.30). The mean IFSF-desire scores of the patient group was higher than the controls (p<0.001). Labia minora hypertrophy was significantly associated with female sexual dysfunction (odds ratio [OR]=14.97, 95% confidence interval [Cl]=[3.66-61.21], p<0.001).

CONCLUSION

This study suggests that patients with labia minora hypertrophy have poorer lubrication, satisfaction, pain, and orgasm scores on the IFSF scale compared to age-matched healthy controls.

Risk factors of transient global amnesia: Three case reports

INTRODUCTION

Transient global amnesia (TGA) is characterized by a sudden onset of anterograde and retrograde amnesia, sometimes associated with mild subclinical neuropsychological deficits and vegetative symptoms, lasting for days after the episode. Migraine history, cardiovascular risk factors, and emotional stress are considered possible risk factors. TGA usually occurs during the seventh decade of life, that is, when risk factors and concomitant pathologies have a higher incidence.

CASE PRESENTATION

We report 3 cases of TGA triggered by different causes (cardiovascular risk factors, emotional stress, and orgasm) with an unusual young onset (patient 1 was a 40-year-old woman, patient 2 was a 21-year-old woman, and patient 3 a 32-year-old man). The patients underwent neuroimaging and cardiovascular examination, and neuropsychological evaluation, without important abnormalities. TGA completely recovery within 1 to 7 days.

CONCLUSIONS

The occurrence of different precipitating events and accurate questioning (in the absence of head trauma) seem to be key features in making the diagnosis of TGA, besides a complete neuropsychiatric and cardiovascular assessment.

The Mediating Role of Sexual Behavior in Event-Level Associations Between Sexual Difficulties and Sexual Satisfaction in Newlywed Mixed-Sex Couples

INTRODUCTION

Many sexual difficulties encountered by couples in their day-to-day lives, although of insufficient intensity and persistence to warrant a clinical diagnosis of sexual disorder, are nevertheless frequent and a source of individual and relational distress.

AIM

The aim of this study was to assess the event-level associations between couples' everyday, subclinical sexual difficulties (specifically, low subjective sexual arousal, low physiological sexual arousal, and genito-pelvic pain), the range of sexual behaviors that these couples engage in, and their sexual satisfaction.

METHODS

70 Newlywed participants (35 couples, average age = 25.6 years, SD = 3.2 years; average duration of relationship = 5.4 years, SD = 3.4 years) individually completed daily diaries about sexual difficulties, range of activities performed during sex, and sexual satisfaction over the course of 5 weeks. Analyses were guided by the actor-partner interdependence model.

MAIN OUTCOME MEASURE

The main outcome was sexual satisfaction, measured at the event-level on a 5-point Likert scale using a single-item question.

RESULTS

On days of sexual activity, men and women's difficulties with subjective sexual arousal were associated with lower sexual satisfaction in both partners (actor and partner effects). This association was mediated by the range of couples' sexual behaviors, such that lower subjective arousal was associated with a more restricted range of sexual activities, which in turn was associated with lower sexual satisfaction. Men's and women's difficulties with physiological sexual arousal, and women's genito-pelvic pain, were each associated with their own lower sexual satisfaction. No partner effects were observed for these sexual difficulties, nor were they mediated by the range of couples' sexual activities.

CLINICAL IMPLICATIONS

The study's results highlight how couples' sexual difficulties can interfere with same-day sexual satisfaction, and how for subjective sexual arousal, this interference is reflected by a more restricted range of sexual behaviors.

STRENGTH & LIMITATIONS

Strengths of the study include the daily diary methodology, which allowed a focus on event-level sexual activities with minimal retrospective bias. Further, the dyadic analyses allowed both intra-individual and inter-individual effects to be assessed. Limitations include the lack of a more general measure of sexual desire and of a more diverse sample, in terms of age, race, and sexual orientation.

CONCLUSION

These findings underscore the importance of treatments that include both partners, and that target the types as well as range of sexual activities in which couples engage. Jodouin J-F, Bergeron S, Janssen E. The Mediating Role of Sexual Behavior in Event-Level Associations Between Sexual Difficulties and Sexual Satisfaction in Newlywed Mixed-Sex Couples. J Sex Med 2018;15:1384-1392.

The Relationship Between Sexual Concordance and Orgasm Consistency in Women

Sexual concordance (the relationship between genital and self-reported sexual responses) may be associated with orgasm consistency (OC; the proportion of sexual acts leading to orgasm) during penile-vaginal intercourse (PVI) in women. We investigated the relationship between women's sexual concordance (assessed using different stimulus modalities and self-reported sexual arousal methods) and OC during various sexual activities (assessed using different types of questions). For Study 1 (n = 51), when sexual concordance was assessed using audiovisual sexual stimuli, we did not find a statistically significant relationship between OC and poststimulus self-reports of sexual arousal or genital sensations, raw values of OC, or ranges of OC. For Study 2 (n = 44), where sexual concordance was assessed using audionarrative sexual stimuli, we did find a statistically significant relationship between PVI OC and sexual concordance using change in self-reported sexual arousal, and ranges of orgasm consistency. Two findings were inconsistent with previous research. First, OC varied significantly by activity type in both studies; masturbation yielded the highest OC. Second, PVI OC was significantly related to oral sex and masturbation OC (Study 2). We discuss the need for further research and various factors that may affect women's orgasm consistency and sexual concordance.

Not All Orgasms Were Created Equal: Differences in Frequency and Satisfaction of Orgasm Experiences by Sexual Activity in Same-Sex Versus Mixed-Sex Relationships

Which sexual activities result in the most frequent and most satisfying orgasms for men and women in same- and mixed-sex relationships? The current study utilized a convenience sample of 806 participants who completed an online survey concerning the types of sexual activities through which they experience orgasms. Participants indicated how frequently they reached orgasm, how satisfied they were from orgasms resulting from 14 sexual activities, and whether they desired a frequency change for each sexual activity. We present the overall levels of satisfaction, frequency, and desired frequency change for the whole sample and also compare responses across four groups of participants: men and women in same-sex relationships and men and women in mixed-sex relationships. While all participants reported engaging in a wide variety of activities that either could, or often did, lead to the experience of orgasm, there were differences in the levels of satisfaction derived from different types of orgasms for different types of participants, who also engaged in such activities with varying degrees of frequency. We discuss group differences within the context of sexual scripts for same- and mixed-sex couples and question the potential explanations for gender differences in the ability to experience orgasm during partnered sexual activity.

The effect of mirabegron, used for overactive bladder treatment, on female sexual function: a prospective controlled study

BACKGROUND

Αim of the study was to determine the effect of mirabegron, used for overactive bladder (OAB) treatment, on female sexual function.

METHODS

Eighty five sexually active women suffering from overactive bladder were prospectively enrolled in this study. Females were divided into two groups. In Group A (control), 48 patients received no treatment and in Group B, 37 patients received mirabegron 50 mg/daily for 3 months. Patients were evaluated with FSFI-Gr at the beginning of the study and again after a period of 3 months.

RESULTS

In Group B, there was a significant increase post-treatment compared to baseline (p < 0.001) in total FSFI (20.3 (3.8) to 26.6 (4.2)) and all domains (desire: 3.0 (1.2) to 4.8 (1.2)), arousal: 3.0 (0.8) to 4.8 (0.9), lubrication: 3.9 (1.1) to 4.8 (1.2), orgasm: 3.6 (0.8) to 4.8 (1.0), satisfaction: 3.2 (0.4) to 4.0 (0.8) and pain: 3.2 (0.8) to 4.4 (1.2)). In Group A, there were no statistically significant changes in pre- and post-observation values.

CONCLUSIONS

This study is one of the few demonstrating that management of OAB with mirabegron improves female sexual function.

TRIAL REGISTRATION

TRN ISRCTN17199301 , 20/10/2017, retrospectively registered.

A Longitudinal Assessment of Associations Between Women's Tendency to Pretend Orgasm, Orgasm Function, and Intercourse-Related Pain in Different Partner Relationship Constellations

The aim of the present study was to investigate how women's tendency to pretend orgasm during intercourse is associated with orgasm function and intercourse-related pain, using a longitudinal design where temporal stability and possible causal relationships could be modeled. The study sample consisted of 1421 Finnish women who had participated in large-scale population-based data collections conducted at two time points 7 years apart. Pretending orgasm was assessed for the past 4 weeks, and orgasm function and pain were assessed using the Female Sexual Function Index for the past 4 weeks. Associations were also computed separately in three groups of women based on relationship status. Pretending orgasm was considerably variable over time, with 34% of the women having pretended orgasm a few times or more at least at one time point, and 11% having done so at both time points. Initial bivariate correlations revealed associations between pretending orgasm and orgasm problems within and across time, whereas associations with pain were more ambiguous. However, we found no support in the path model for the leading hypotheses that pretending orgasms would predict pain or orgasm problems over a long period of time, or that pain or orgasm problems would predict pretending orgasm. The strongest predictor of future pretending in our model was previous pretending (R ² = .14). Relationship status did not seem to affect pretending orgasm in any major way.

Women's Experience of Orgasm During Intercourse: Question Semantics Affect Women's Reports and Men's Estimates of Orgasm Occurrence

Most women report reliably experiencing orgasm from masturbation, but a smaller proportion of women report regularly experiencing orgasm from intercourse. Research suggests that concurrent clitoral stimulation during intercourse increases the likelihood of orgasm, yet most surveys of orgasm during intercourse leave unspecified whether vaginal intercourse does or does not include concurrent clitoral stimulation (assisted intercourse or unassisted intercourse, respectively). Using an online sample of 1569 men and 1478 women, we tested whether phrasing of questions about the occurrence of orgasm in intercourse modulates women's reported frequency and men's estimates of women's frequency of orgasm in intercourse. Participants provided estimates of orgasm when asked explicitly about intercourse with stimulation unspecified, assisted intercourse, and unassisted intercourse. Women's reports of orgasm occurrence were highest in response to assisted intercourse (51-60%), second highest in response to intercourse with clitoral stimulation unspecified (31-40%), and lowest in response to unassisted intercourse (21-30%). Men's estimates of women's orgasms were highest in response to assisted intercourse (61-70%), and lowest in response to unassisted intercourse (41-50%); in both conditions, men's estimates were significantly higher than women's reports. When clitoral stimulation was unspecified, women interpreted "orgasm in intercourse" in three ways: as from intercourse alone, as including concurrent clitoral stimulation though it was unspecified, or as an average of assisted and unassisted intercourse. Taken together, these results demonstrate that the phrasing of questions about women's orgasm produces markedly different orgasm estimates, and suggest that concurrent clitoral stimulation increases the likelihood of women experiencing orgasm in intercourse.

Women's Experiences With Genital Touching, Sexual Pleasure, and Orgasm: Results From a U.S. Probability Sample of Women Ages 18 to 94

The study purpose was to assess, in a U.S. probability sample of women, experiences related to orgasm, sexual pleasure, and genital touching. In June 2015, 1,055 women ages 18 to 94 from the nationally representative GfK KnowledgePanel® completed a confidential, Internet-based survey. While 18.4% of women reported that intercourse alone was sufficient for orgasm, 36.6% reported clitoral stimulation was necessary for orgasm during intercourse, and an additional 36% indicated that, while clitoral stimulation was not needed, their orgasms feel better if their clitoris is stimulated during intercourse. Women reported diverse preferences for genital touch location, pressure, shape, and pattern. Clinical, therapeutic, and educational implications are discussed.

Differences in Orgasm Frequency Among Gay, Lesbian, Bisexual, and Heterosexual Men and Women in a U.S. National Sample

There is a notable gap between heterosexual men and women in frequency of orgasm during sex. Little is known, however, about sexual orientation differences in orgasm frequency. We examined how over 30 different traits or behaviors were associated with frequency of orgasm when sexually intimate during the past month. We analyzed a large US sample of adults (N = 52,588) who identified as heterosexual men (n = 26,032), gay men (n = 452), bisexual men (n = 550), lesbian women (n = 340), bisexual women (n = 1112), and heterosexual women (n = 24,102). Heterosexual men were most likely to say they usually-always orgasmed when sexually intimate (95%), followed by gay men (89%), bisexual men (88%), lesbian women (86%), bisexual women (66%), and heterosexual women (65%). Compared to women who orgasmed less frequently, women who orgasmed more frequently were more likely to: receive more oral sex, have longer duration of last sex, be more satisfied with their relationship, ask for what they want in bed, praise their partner for something they did in bed, call/email to tease about doing something sexual, wear sexy lingerie, try new sexual positions, anal stimulation, act out fantasies, incorporate sexy talk, and express love during sex. Women were more likely to orgasm if their last sexual encounter included deep kissing, manual genital stimulation, and/or oral sex in addition to vaginal intercourse. We consider sociocultural and evolutionary explanations for these orgasm gaps. The results suggest a variety of behaviors couples can try to increase orgasm frequency.

Oxytocin plasma levels in orgasmic and anorgasmic women

The study aimed to evaluate oxytocin (Oxt) serum levels before and after sexual intercourse in women affected by anorgasmia. The sample was constituted of 15 anorgasmic women and 16 orgasmic women. The Female Sexual Function Index (FSFI, cutoff ≤26.55) and the Female Sexual Distress Scale (FSDS, cutoff ≥15) questionnaires were used to assess sexual function and sexual distress, respectively. Serum Oxt levels were measured before sexual intercourse (T0) and 5 min after coital sexual activity (T1). Anorgasmic women had an unpleasant sexual experience (FSFI total score, 20.1 ± 1.2;) and were stressed (FSDS score, 19.4 ± 1.3), whereas orgasmic women were fully satisfied with their sexual activity (FSFI total score 28.7 ± 1.3; FSDS score 11.5 ± 1.8). At T0, anorgasmic women had lower levels of Oxt than orgasmic women, 1.8 ± 0.2 pg/mL versus 2.1 ± 0.5 pg/mL, respectively, [95% CI: (-0.58, -0.01); p < .04]. At T1, Oxt levels did not change in anorgasmic women (1.8 ± 0.2 pg/mL versus 2 ± 0.4 pg/mL, p = .09). Finally, orgasmic women had higher levels of Oxt than anorgasmic women, 4.6 ± 0.7 pg/mL versus 2 ± 0.4 pg/mL, respectively [95% CI: (-3.02, -2.17); p < .001]. The repetitive processes to experience the sexual body sensations could represent a survival behavior of species by attachment to a partner.