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Thorpe S, Hargons CN, Malone N, Iyiewuare P, Jester JK, Stevens-Watkins D. An Interpretative Phenomenological Analysis of Black Women's Meaning and Experiences of Sexual Anxiety. JOURNAL OF SEX RESEARCH 2024; 61:614-628. [PMID: 36534478 PMCID: PMC11214808 DOI: 10.1080/00224499.2022.2156449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Sexual anxiety can activate the stress response cycle during sex, compromising a woman's ability to experience sexual pleasure. Black women face additional cultural and contextual factors, such as hypersexualization, partner scarcity, and higher rates of sexual trauma that may increase the magnitude, frequency, and odds of experiencing sexual anxiety. However, limited research has explored this phenomenon among Black women. Thus, we sought to qualitatively explore how N = 25 premenopausal Black women living in the southern United States make meaning of experiences with sexual anxiety. We analyzed the interview data using an interpretive phenomenological approach. Three components of the phenomenon of sexual anxiety were gleaned: 1) causes of sexual anxiety, 2) characteristics of sexual anxiety, and 3) coping strategies. Each component included three to six elements of meaning making. For these Black women, causes of sexual anxiety included fears of sexual pain, partner unfamiliarity, previous traumas, mental health concerns, and intersecting socio-structural factors. Characteristics of sexual anxiety included mental, somatic, and emotional elements. Coping strategies included having a reassuring and supportive sex partner, supporting themselves with affirmations and mindfulness, attending therapy, and using substances. Through reflection about their perceived causes of, experienced characteristics of, and intentional coping with sexual anxiety, meanings were co-constructed through an intersectional frame. Implications for intersectionality-informed interventions and suggestions for mental health professionals and partners are discussed.
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Affiliation(s)
- Shemeka Thorpe
- Department of Kinesiology & Health Promotion, University of Kentucky
| | - Candice N. Hargons
- Department of Educational, School, and Counseling Psychology, University of Kentucky
| | - Natalie Malone
- Department of Educational, School, and Counseling Psychology, University of Kentucky
| | | | - Jasmine K. Jester
- Department of Educational, School, and Counseling Psychology, University of Kentucky
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Zhang F, Yang Z, Li X, Wang A. Factors influencing the quality of sexual life in the older adults: A scoping review. Int J Nurs Sci 2023; 10:167-173. [PMID: 37128494 PMCID: PMC10148255 DOI: 10.1016/j.ijnss.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/09/2023] [Accepted: 03/16/2023] [Indexed: 05/03/2023] Open
Abstract
Objective Older people are often considered asexual, but sex is still important for older adults. So, this review aimed to analyze relevant studies on the sexual life of older adults to clarify factors, and provide a basis for their quality of sexual life. Method A scoping review was performed according to Arksey and O'Malley's framwork, aiming to identify eligible research studies in PubMed, Web of Science, CINAHL, and PsycINFO, Cochrane Library, and Scopus databases. Peer-reviewed articles published in Chinese or English language from January 2012 to April 2022 were retrieved. All of identified studies were screened, extracted, and analyzed independently by two researchers. Result A total of 7,374 studies were retrieved, and 13 eligible studies were finally included. The factors affect the sexual quality of life in older adults that included physiological, sociocultural, and health factors and being affected by marital relationships and a lack of relevant knowledge. Conclusion The factors that affect the quality of old people's sex life interact and influence each other. Medical and health professionals can assist with the improvement of sexual health.
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Arthur E, Flynn K, Jeffery D, Cusatis R. Associations between Relationship Status, Anxiety, Sexual Function, and Sexual Satisfaction in Lesbian, Gay, and Bisexual People. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:41-51. [PMID: 38596763 PMCID: PMC10903708 DOI: 10.1080/19317611.2023.2172510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 10/29/2022] [Accepted: 11/24/2022] [Indexed: 04/11/2024]
Abstract
Objectives The purpose of this study was to describe associations between relationship status, anxiety, and sexual function and satisfaction in lesbian, gay, and bisexual (LGB) adults. Methods Linear regression determined associations between sexual function, relationship characteristics and anxiety in 979 LGB participants. Results Relationship status was not related to sexual interest in gay men. Partnered relationship status was associated with higher sexual satisfaction for gay men, lesbians, and bisexual women. Anxiety symptoms were negatively associated with sexual interest, satisfaction, and orgasm pleasure for gay men but not associated with sexual outcomes in lesbian women. Conclusion Using a nationally representative sample of LGB adults, differences were found in factors related to sexual function and satisfaction by gender and sexual orientation.
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Affiliation(s)
- Elizabeth Arthur
- Nursing Research Department, The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard. J. Solove Research Institute, Columbus, Ohio, USA
| | - Kathryn Flynn
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Rachel Cusatis
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Fernandes J, Pedro J, Costa ME, Martins MV. Effect of depression and anxiety on sexual functioning in couples trying to conceive with and without an infertility diagnosis. Psychol Health 2023; 38:37-54. [PMID: 34279131 DOI: 10.1080/08870446.2021.1955115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study examined the effects of anxiety and depression on sexual functioning in couples trying to conceive, and tested the moderating role of infertility diagnosis on this association. DESIGN An online questionnaire was completed by 1453 individuals in a heterosexual relationship for more than one year. The final sample had 107 couples who were actively attempting a pregnancy (63 had an infertility diagnosis; 44 were presumably fertile). Data was analyzed with the Actor-Partner Interdependence Model (APIM). MAIN OUTCOME MEASURES Depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS), and male and female sexual functioning were assessed through the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI), respectively. RESULTS Actor effects were found between depression and sexual functioning in both men (β= -.28, p= .003) and women (β= -.43, p < .001), with no significant partner effects. The moderation analysis showed that the relationship between depression and sexual functioning is stronger in infertile men than in presumably fertile men (β= -.29; p= .002). CONCLUSION Psychological interventions with couples trying to conceive should address the role of depression in sexual functioning, particularly in infertile men.
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Affiliation(s)
- Joana Fernandes
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Juliana Pedro
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Maria Emília Costa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology, University of Porto, Porto, Portugal
| | - Mariana Veloso Martins
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.,Centre for Psychology, University of Porto, Porto, Portugal
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Bittoni C, Kiesner J. Sexual Desire in Women: Paradoxical and Nonlinear Associations with Anxiety and Depressed Mood. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3807-3822. [PMID: 36123564 PMCID: PMC9663363 DOI: 10.1007/s10508-022-02400-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 08/03/2022] [Accepted: 08/12/2022] [Indexed: 06/01/2023]
Abstract
The aim of the present study was to expand previous findings regarding paradoxical effects of negative mood on sexual desire. This was done by considering the full range of depressed mood and anxiety symptoms and using methods that are unaffected by recall bias and that don't require participants to infer causal associations between their mood and sexual desire. A convenience sample of 213 university students completed daily questionnaires for approximately two months. Multilevel random-effects models were used to estimate average effects for the entire sample and to test for variability across participants in the associations between negative mood and sexual desire, controlling also for potential influences of the menstrual cycle. Previous findings showing that some women report decreased sexual desire and others increased sexual desire when depressed or anxious were confirmed. More importantly, for both depressed mood and anxiety, results demonstrated the presence of within-person paradoxical associations, whereby there were some women for whom both low and high levels of negative mood were associated with the same change (an increase or a decrease) in sexual desire. Related to these diverse response patterns, paradoxical associations between negative mood and sexual desire were also present at low levels of negative mood. The discussion underlines the importance of considering individual variability and multifactorial nonlinear models when studying sexual desire.
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Affiliation(s)
- Celeste Bittoni
- Department of Development and Social Psychology, University of Padova, via Venezia 8, 35131, Padua, Italy
| | - Jeff Kiesner
- Department of Development and Social Psychology, University of Padova, via Venezia 8, 35131, Padua, Italy.
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Schippers EE, Smid WJ, Both S, Smit JH. Excitation Transfer Between Sexual Arousal and Other Emotions in a Community Sample. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3905-3918. [PMID: 35471677 DOI: 10.1007/s10508-021-02235-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 06/14/2023]
Abstract
Excitation transfer, the transfer of arousal from one emotion to another, might be a mechanism in the development of unusual sexual interests. In this pilot study, we investigated whether we could induce excitation transfer between various emotions and sexual arousal in a laboratory setting with 30 male volunteers. We induced low-level sexual arousal in four different emotional states (aggression/dominance, endearment, fear, disgust) and a neutral state. Sexual arousal was measured using penile plethysmography and self-report. Although there was no mean group effect, possibly due to large interindividual variations, 60% of the subjects showed more sexual arousal in response to sexual stimulation in at least one of the emotional states than in the neutral state. Excitation transfer was most prominent with aggression/dominance and least prominent with disgust. Genital excitation transfer was strongly related to lower penile reactivity and to higher self-reported erotophilia. This pilot study paves the way for further research into excitation transfer as a mechanism to increase the salience of stimuli that otherwise would not have been sexual in nature.
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Affiliation(s)
- Eveline E Schippers
- Forensic Care Specialists, Oudlaan 9, 3515 GA, Utrecht, The Netherlands.
- Faculty of Psychology and Neuroscience, Section Forensic Psychology, Maastricht University, Maastricht, The Netherlands.
| | - Wineke J Smid
- Forensic Care Specialists, Oudlaan 9, 3515 GA, Utrecht, The Netherlands
| | - Stephanie Both
- Department of Psychosomatic Gynaecology and Sexology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Johannes H Smit
- Department of Research and Innovation, GGZ INGEEST Specialized Mental Health Care, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam Public Health, Free University Amsterdam, Amsterdam, The Netherlands
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Rahmani A, Afsharnia E, Fedotova J, Shahbazi S, Fallahi A, Allahqoli L, Ghanei-Gheshlagh R, Abboud S, Alkatout I. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022; 19:1098-1115. [PMID: 35752457 DOI: 10.1016/j.jsxm.2022.03.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Changes in sex hormones during menopause may have detrimental effects on a woman's sexual function and cause mood disorders. The treatment of both conditions is a challenge in gynecology. AIM To review the published literature on sexual function and mood disorders among peri- and postmenopausal women. METHODS The review is based on the methodological framework of scoping reviews. We searched electronic databases including Medline (PubMed), Scopus, Embase, and Web of Science (WoS). Publications that reported data about the relationship between sexual function and mood disorders among menopausal women were included in the review. The search was not subject to any limitation in terms of time or method. OUTCOMES The main outcome measures used for the review were sexual dysfunction and mood disorders. RESULTS We found 106 total records. After a full-text screening we included 19 studies from 1986 to 2020 based on various methodologies; the majority of the studies16 were cross-sectional. Investigations that addressed the symptoms of mood disorders and some domains of sexual function showed a close relationship between sexual dysfunction and mood disorders among menopausal women. CLINICAL IMPLICATIONS In clinical practice, it would be appropriate to screen women for at least one mood disorder or sexual dysfunction. If a woman suffers from either, it will be necessary to assess for a further disorder as well. STRENGTHS & LIMITATIONS The review was based on a detailed search of the published literature concerning mood disorders and sexual dysfunction among menopausal women compared to women of reproductive age. Despite the clinical importance of the subject, the number of studies eligible for inclusion in the review are rather small. Further investigation of the topic is clearly warranted. CONCLUSIONS While the association between sexual dysfunction and mood disorders appears to be bidirectional, future studies will have to investigate the specific mechanisms by which sexual dysfunction could lead to mood disorders (or vice versa). Future studies should specifically address sexual dysfunctions and attitudes of partners, BMI, family support, sleep, and multiparity. Azam Rahmani, Elahe Afsharnia, Julia Fedotova, Shirin Shahbazi, Arezoo Fallahi, Leila Allahqoli, Reza GhaneipoklGheshlagh, Sarah Abboud, Ibrahim Alkatout. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022;19:1098-1115.
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Affiliation(s)
- Azam Rahmani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Afsharnia
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Julia Fedotova
- International Research Centre "Biotechnologies of the Third Millennium", St. Petersburg, Russian Federation. Laboratory of Neuroendocrinology, ITMO University, I.P. Pavlov Institute of Physiology RASci., St. Petersburg, Russia
| | - Shirin Shahbazi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran; Breastfeeding Research Center-Family Health Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Fallahi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Leila Allahqoli
- School of Public Health, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Reza Ghanei-Gheshlagh
- Social Determinants of Health Research Center, Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Kurdistan University of Medical, Sciences, Sanandaj, Iran
| | - Sarah Abboud
- Department of Women, Children, and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Kiel, Germany
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Inhibitory framing in hypersexual patients with Parkinson's disease. An fMRI pilot study. Exp Brain Res 2022; 240:2097-2107. [PMID: 35763033 PMCID: PMC9288360 DOI: 10.1007/s00221-022-06397-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/07/2022] [Indexed: 11/04/2022]
Abstract
Hypersexuality in medicated patients with PD is caused by an increased influence of motivational drive areas and a decreased influence of inhibitory control areas due to dopaminergic medication. In this pilot study, we test a newly developed paradigm investigating the influence of dopaminergic medication on brain activation elicited by sexual pictures with and without inhibitory contextual framing. Twenty PD patients with and without hypersexuality were examined with fMRI either OFF or ON standardized dopaminergic medication. The paradigm consisted of a priming phase where either a neutral context or an inhibitory context was presented. This priming phase was either followed by a sexual or a neutral target. Sexual, compared to neutral pictures resulted in a BOLD activation of various brain regions implicated in sexual processing. Hypersexual PD patients showed increased activity compared to PD controls in these regions. There was no relevant effect of medication between the two groups. The inhibitory context elicited less activation in inhibition-related areas in hypersexual PD, but had no influence on the perception of sexual cues. The paradigm partially worked: reactivity of motivational brain areas to sexual cues was increased in hypersexual PD and inhibitory contextual framing lead to decreased activation of inhibitory control areas in PD. We could not find a medication effect and the length of the inhibitory stimulus was not optimal to suppress reactivity to sexual cues. Our data provide new insights into the mechanisms of hypersexuality and warrant a replication with a greater cohort and an optimized stimulus length in the future.
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Martín-Vivar M, Villena-Moya A, Mestre-Bach G, Hurtado-Murillo F, Chiclana-Actis C. Treatments for Persistent Genital Arousal Disorder in Women: A Scoping Review. J Sex Med 2022; 19:961-974. [PMID: 35396171 DOI: 10.1016/j.jsxm.2022.03.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 02/23/2022] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Persistent genital arousal disorder (PGAD) is characterized by elevated discomfort associated with persistent genital arousal in the absence of sexual desire. AIM To perform a scoping review of the proposed treatments for PGAD and their efficacy. METHODS A scoping review was carried out (PRISMA-Scr) that included articles on PGAD as the main disorder, only in women, which explained, in detail, the treatment and its efficacy, was empirical, was written in English and Spanish. No prior filtering by years was performed. OUTCOMES Three different effective treatments were found (Physical therapies, pharmacological therapies, and psychotherapeutics in combination with other therapies). RESULTS Thirty-eight articles were selected. From physical therapies, treatments using neuromodulation, transcutaneous electrical stimulation, Botox, surgery, electroconvulsive therapy, manual therapy, pelvic floor therapy, dietary changes, and transcranial magnetic stimulation showed effectiveness. Using the pharmacological approach, paroxetine, duloxetine, pramipexole, ropinirole, and clonazepam treatments were effective. Psychotherapy treatments showed effectiveness only in combination with other types of treatments, specifically a combination of cognitive-behavioral strategies with pharmacological treatment. CLINICAL IMPLICATIONS Pharmacological treatment, specifically SSRIs, have proven to be the therapy of choice for different subtypes of patients. STRENGTHS AND LIMITATIONS This study analyzed treatment effectiveness with different approaches and took into consideration those articles where psychotherapy was used as a combination treatment with pharmacological and physical therapy. The main limitation is that it was focused exclusively on women, and the results cannot be generalized to include men. CONCLUSIONS To date, a combination of pharmacological interventions with physical therapy and, in some occasions, with psychological therapy is main strategy followed to accomplish effective treatment of PGAD. Martín-Vivar M, Villena-Moya A, Mestre-Bach G, et al. Treatments for Persistent Genital Arousal Disorder in Women: A Scoping Review. J Sex Med 2022;19:961-974.
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Affiliation(s)
- María Martín-Vivar
- Unidad de Sexología Clínica y Salud Sexual, Consulta Dr. Carlos Chiclana, Madrid, Spain; Universidad Francisco de Vitoria, Madrid, Spain
| | | | | | - Felipe Hurtado-Murillo
- Doctor Peset University Hospital, Center for Sexual and Reproductive Health, Valencia, Spain
| | - Carlos Chiclana-Actis
- Unidad de Sexología Clínica y Salud Sexual, Consulta Dr. Carlos Chiclana, Madrid, Spain; Universidad Internacional de la Rioja, La Rioja, Spain; University CEU San Pablo, Madrid, Spain
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Ågmo A, Laan E. Sexual incentive motivation, sexual behavior, and general arousal: Do rats and humans tell the same story? Neurosci Biobehav Rev 2022; 135:104595. [PMID: 35231490 DOI: 10.1016/j.neubiorev.2022.104595] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/28/2022] [Accepted: 02/24/2022] [Indexed: 12/13/2022]
Abstract
Sexual incentive stimuli activate sexual motivation and heighten the level of general arousal. The sexual motive may induce the individual to approach the incentive, and eventually to initiate sexual acts. Both approach and the ensuing copulatory interaction further enhance general arousal. We present data from rodents and humans in support of these assertions. We then suggest that orgasm is experienced when the combined level of excitation surpasses a threshold. In order to analyze the neurobiological bases of sexual motivation, we employ the concept of a central motive state. We then discuss the mechanisms involved in the long- and short-term control of that state as well as those mediating the momentaneous actions of sexual incentive stimuli. This leads to an analysis of the neurobiology behind the interindividual differences in responsivity of the sexual central motive state. Knowledge is still fragmentary, and many contradictory observations have been made. Nevertheless, we conclude that the basic mechanisms of sexual motivation and the role of general arousal are similar in rodents and humans.
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Affiliation(s)
- Anders Ågmo
- Department of Psychology, University of Tromsø, Norway.
| | - Ellen Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam UMC, University of Amsterdam, The Netherlands
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11
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Clephane K, Sartin-Tarm A, Lorenz TK. Four Additional Questions for the Preparation Hypothesis. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:737-742. [PMID: 32681459 DOI: 10.1007/s10508-020-01798-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Kirstin Clephane
- Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Stadium East C66, Lincoln, NE, 68588-0156, USA
| | - Anneliis Sartin-Tarm
- Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Stadium East C66, Lincoln, NE, 68588-0156, USA
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Tierney K Lorenz
- Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Stadium East C66, Lincoln, NE, 68588-0156, USA.
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA.
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Clephane K, Wilson MC, Craig AN, Heiman JR, Lorenz TK. Inflammation predicts sexual arousability in healthy women. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 8. [PMID: 35669911 PMCID: PMC9165647 DOI: 10.1016/j.cpnec.2021.100086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Though many women report sexual arousal difficulties, the mechanisms driving these difficulties are unclear. Sexual response relies on a host of psychophysiological processes that have bidirectional relationships with inflammation. Additionally, chronic inflammation may impair genital blood flow, which in turn may impact sexual arousal. C-reactive protein (CRP) is an acute-phase marker of inflammation produced in response to cytokine signaling throughout the body, which makes it a useful marker of systemic inflammation. Aim The present study examined interactions between inflammation and women's sexual arousal. Methods CRP, self-reported frequency of partnered sexual activity, and subjective and vaginal arousal were assessed in 91 healthy, pre-menopausal women. Data were collected during a single laboratory session. Main outcome measures Subjective sexual arousal and vaginal pulse amplitude (a measure of vaginal arousal) were the main outcome measures. Results Change in subjective sexual arousal in response to a sexual film was unaffected by baseline CRP and sexual frequency. However, there were significant interactions between inflammation and sexual frequency in predicting vaginal arousal during the sexual film. Among women reporting more frequent sexual activity, higher CRP predicted lower magnitude arousal response and longer time to maximum vaginal arousal. Among women reporting less frequent sex, higher CRP predicted shorter time to maximum arousal and greater magnitude of arousal response. Controlling for cortisol strengthened the effects seen for time to maximum vaginal arousal but weakened those observed for percent change. Conclusions Among healthy young women, higher CRP may be associated with vaginal arousal, but not subjective sexual arousal. Specifically, our results suggest that higher baseline CRP is associated with lower genital sexual arousal for women who have sex frequently, which is consistent with clinical evidence that elevated inflammation can be detrimental to sexual function. Among healthy young women, higher CRP may be associated with vaginal sexual arousal, but not subjective sexual arousal. Frequency of sexual activity interacts with CRP levels to contribute to vaginal arousal in healthy women. Higher CRP predicted lower genital sexual arousal in women who engage in sexual activity more than once a week. However, higher CRP predicted greater genital sexual arousal in women who engage in sexual activity less than once a week.
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Scavello I, Maseroli E, Cipriani S, Di Stasi V, Verde N, Menafra D, Scannerini S, Marchiani S, Rastrelli G, Ricca V, Sorbi F, Fambrini M, Petraglia F, Maggi M, Vignozzi L. Cardiometabolic risk is unraveled by color Doppler ultrasound of the clitoral and uterine arteries in women consulting for sexual symptoms. Sci Rep 2021; 11:18899. [PMID: 34552164 PMCID: PMC8458448 DOI: 10.1038/s41598-021-98336-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 06/30/2021] [Indexed: 02/06/2023] Open
Abstract
Female sexual dysfunction (FSD) may be a mirror of a poor cardiometabolic state. In a small pilot study enrolling 71 women with FSD, we previously demonstrated that clitoral Pulsatility Index (PI) evaluated by using color Doppler ultrasound (CDU), reflecting vascular resistance, was associated with cardiometabolic risk factors. Data on uterine CDU in this context are lacking. First, to confirm previously reported data on the direct association between clitoral PI and cardiometabolic risk factors on a larger study population of women consulting for sexual symptoms; second, to investigate eventual similar correlations between cardiometabolic risk factors and CDU parameters of the uterine artery. We also ascertained whether uterine artery PI, similarly to what had previously been observed for clitoral artery PI, was directly related to body image uneasiness and psychopathological symptoms, assessed by validated questionnaires. N = 230 women consulting our clinic for sexual symptoms were examined with clitoral CDU and blood sampling and were asked to fill out the Female Sexual Function Index, the Middlesex Hospital Questionnaire (MHQ) and the Body Uneasiness Test (BUT). In a subgroup of women (n = 164), we also performed transvaginal CDU with measurement of uterine artery parameters. At multivariate analysis, we found a direct association between clitoral PI and body mass index (BMI) (p = 0.004), waist circumference (WC) (p = 0.004), triglycerides (p = 0.006), insulin (p = 0.029) and HOMA-IR (p = 0.009). Furthermore, a correlation between obesity and Metabolic Syndrome (MetS) and a higher clitoral PI was observed (p = 0.003 and p = 0.012, respectively). Clitoral PI was also correlated with MHQ-S (p = 0.010), a scale exploring somatized anxiety symptoms, and BUT-B Positive Symptom Distress Index (p = 0.010), a measure of body image concerns. Similarly, when investigating the uterine artery, we were able to demonstrate an association between its PI and BMI (p < 0.0001), WC (p = 0.001), insulin (p = 0.006), glycated haemoglobin (p = < 0.0001), and HOMA-IR (p = 0.009). Women diagnosed with obesity and MetS showed significantly higher uterine PI values vs. those without obesity or MetS (p = 0.001 and p = 0.004, respectively). Finally, uterine PI was associated with BUT-A Global Severity Index (p < 0.0001) and with several other BUT-A subdomains. Vascular resistance of clitoral and uterine arteries is associated with cardiometabolic risk factors and body image concerns in women consulting for sexual symptoms. If further confirmed in different populations, our data could suggest CDU, a common examination method, as a useful tool for an identification—and possible correction—of cardiometabolic risk factors.
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Affiliation(s)
- I Scavello
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - E Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - S Cipriani
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - V Di Stasi
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy
| | - N Verde
- Clinical Medicine and Surgery Department, Section of Endocrinology, Unit of Andrology, Reproductive Medicine and Male and Female Sexuality (FERTISEXCARES), Federico II University of Naples, Naples, Italy
| | - D Menafra
- Clinical Medicine and Surgery Department, Section of Endocrinology, Unit of Andrology, Reproductive Medicine and Male and Female Sexuality (FERTISEXCARES), Federico II University of Naples, Naples, Italy
| | - S Scannerini
- Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - S Marchiani
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - G Rastrelli
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy.,Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - V Ricca
- Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - F Sorbi
- Gynecology Unit, Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - M Fambrini
- Gynecology Unit, Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - F Petraglia
- Gynecology Unit, Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - M Maggi
- Endocrinology Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Linda Vignozzi
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Viale Pieraccini 6, 50134, Florence, Italy. .,Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
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14
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Bowsfield ML, Cobb RJ. Sexual Anxiety Mediates Dyadic Associations Between Body Satisfaction and Sexual Quality in Mixed-Sex Couples. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2603-2619. [PMID: 34401993 DOI: 10.1007/s10508-021-01999-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 06/13/2023]
Abstract
Body satisfaction predicts sexual quality among women and men; however, mechanisms of the association are largely unknown. We hypothesized that sexual anxiety would mediate average associations over 1 year between individuals' body satisfaction and their own and their partner's sexual quality, which is comprised of their sexual satisfaction and dissatisfaction, in 123 mixed-sex cohabiting couples. Results of Actor-Partner Interdependence Models extended to Mediation (APIMeM) and tested via multilevel modelling partially supported the hypotheses. Specifically, individuals' body satisfaction indirectly predicted their own and their partner's sexual satisfaction through individuals' sexual anxiety, and indirectly predicted their own, but not their partner's sexual dissatisfaction through individuals' sexual anxiety. Thus, when individuals are relatively less satisfied with their bodies, they may experience anxiety during sexual encounters, which then interferes with their own and their partner's sexual quality.
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Affiliation(s)
- Marissa L Bowsfield
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Rebecca J Cobb
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
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15
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Banbury S, Moneta G, Chandler C. An exploratory study examining the relationship between sexual self efficacy and premature ejaculation mediated by depression, anxiety and sexual fantasy among a British cohort. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1932796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Samantha Banbury
- Psychology Department, School of Social Sciences, London Metropolitan University, London, UK
| | - Giovanni Moneta
- Psychology Department, School of Social Sciences, London Metropolitan University, London, UK
| | - Chris Chandler
- Psychology Department, School of Social Sciences, London Metropolitan University, London, UK
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16
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Rodríguez-Domínguez C, Lafuente-Bacedoni C, Durán M. Effect of the Lockdown Due to COVID-19 on Sexuality: The Mediating Role of Sexual Practices and Arousal in the Relationship Between Gender and Sexual Self-Esteem. Psychol Rep 2021; 125:2879-2901. [PMID: 34218738 DOI: 10.1177/00332941211028999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The scientific evidence suggests that COVID-19 is affecting much more than the physical health of individuals, particularly in places where a lockdown has been established to slow down the spread of the virus. An area that may be particularly affected is human sexuality. This study explored the impact of the situation generated by COVID-19 on the sexuality of 201 adults living in Spain. We collected data cross-sectionally through an online survey during the month of April 2020. Results showed a reduction of sexual self-esteem and a decrease in the number of interpersonal sexual relations, although the frequency of masturbation and the consumption of pornography did not vary compared to previous levels. A regression analysis showed that masturbation, the ability to maintain sexual arousal and interpersonal sex were mediating variables in the relationship between gender - specifically being male - and having higher sexual self-esteem during the lockdown. This study provides new insight on the relevance of certain sexual behaviors in a pandemic situation with considerable social restrictions and on the effect of this situation on sexual self-esteem and arousal. It brings some clarity on the relationship between sexual self-esteem and gender, about which there is currently no consensus in the scientific literature.
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Affiliation(s)
| | - Cristina Lafuente-Bacedoni
- Department of Psychology, Universidad Loyola Andalucía, Sevilla, Spain.,Department of Social Psychology, 16778Universidad de Sevilla, Sevilla, Spain
| | - Mercedes Durán
- Department of Social Psychology, 16778Universidad de Sevilla, Sevilla, Spain
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17
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Chou J, Kiebalo T, Jagiello P, Pawlaczyk K. Multifaceted Sexual Dysfunction in Dialyzing Men and Women: Pathophysiology, Diagnostics, and Therapeutics. Life (Basel) 2021; 11:life11040311. [PMID: 33918412 PMCID: PMC8065963 DOI: 10.3390/life11040311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/12/2022] Open
Abstract
Patient survival continues to increase with the growing quality of dialysis and management of chronic kidney disease (CKD). As such, chronic therapy must include considerations of quality of life (QOL), and this includes the disproportionate prevalence of sexual dysfunction (SD) in this patient population. This review aims to describe the pathophysiological and the psychosocial causes of SD with regard to renal replacement therapy, particularly hemo- and peritoneal dialysis. The differences in its manifestation in men and women are compared, including hormonal imbalances—and therefore fertility, libido, and sexual satisfaction—the experience of depression and anxiety, and QOL. The impact of comorbidities and the iatrogenic causes of SD are described. This review also presents validated scales for screening and diagnosis of SD in CKD patients and outlines novel therapies and strategies for the effective management of SD. Increased prevalence of CKD invariably increases the number of patients with SD, and it is crucial for health care professional teams to become familiar with the clinical tools used to manage this sensitive and under-quantified field. As a known predictor of QOL, sexual function should become a point of focus in the pursuit of patient-centered care, particularly as we seek to achieve as “normal” a life as possible for individuals who receive dialysis.
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18
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Vosper J, Irons C, Mackenzie-White K, Saunders F, Lewis R, Gibson S. Introducing compassion focused psychosexual therapy. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1902495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jane Vosper
- Clinical Psychology, Royal Holloway University of London, Egham, UK
- Barts Health NHS Trust, London, UK
| | - Chris Irons
- Balanced Minds, London, UK
- Department of Psychology, University College London, London, UK
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19
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Karagöz MA, Gül A, Borg C, Erihan İB, Uslu M, Ezer M, Erbağcı A, Çatak B, Bağcıoğlu M. Influence of COVID-19 pandemic on sexuality: a cross-sectional study among couples in Turkey. Int J Impot Res 2021; 33:815-823. [PMID: 33328620 PMCID: PMC7739794 DOI: 10.1038/s41443-020-00378-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/20/2020] [Accepted: 11/10/2020] [Indexed: 02/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19) pandemic has been continuing to affect the lives of all people globally. It has been shown that restrictions due to changes in lifestyles lead to mental health problems. This study aims to investigate the effect of COVID-19 pandemic on couples' sexuality. A total of 245 volunteers (148 men and 97 women) were enrolled in the study. Generalized Anxiety Disorder-7, Patient Health Questionnaire, Perceived Stress Scale were administered to screen anxiety and depression symptoms. International Index of Erectile Function (IIEF-15) and Female Sexual Function Index (FSFI) along with self-constructed sexual behavior questionnaire were administered to participants, in order to evaluate sexual functions and behavioral changes during the pandemic. Sexual function scores (IIEF erectile function domain and total FSFI) during pandemic (24.55 ± 5.79 and 24.87 ± 7.88, respectively) were lower compared to the prepandemic period (26.59 ± 4.51 and 26.02 ± 6.22, respectively) (p = 0.001 and p = 0.027, respectively). During pandemic compared to prepandemic period, the frequency of sexual intercourse decreased in men (p = 0.001) and women (p = 0.001) while sexual avoidance and solitary sexual approach behaviors (masturbation or watching sexual content videos, etc.) increased in men (p = 0.001) and women (p = 0.022). However, the couples that spent more time together during the pandemic reported better sexual function scores (men; p = 0.001, women; p = 0.006). Although this is the first study evaluating couples from Turkey with a convenience sample, further studies with a greater number may better elucidate the effects of this pandemic on sexuality.
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Affiliation(s)
- Mehmet Ali Karagöz
- grid.16487.3c0000 0000 9216 0511Department of Urology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Abdullah Gül
- Department of Urology, University of Health Sciences, Bursa Yuksek Ihtisas Training & Research Hospital, Bursa, Turkey
| | - Charmaine Borg
- grid.4830.f0000 0004 0407 1981Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - İsmet Bilger Erihan
- grid.16487.3c0000 0000 9216 0511Department of Urology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Mehmet Uslu
- grid.16487.3c0000 0000 9216 0511Department of Urology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Mehmet Ezer
- grid.16487.3c0000 0000 9216 0511Department of Urology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Ahmet Erbağcı
- grid.16487.3c0000 0000 9216 0511Department of Urology, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Binali Çatak
- grid.16487.3c0000 0000 9216 0511Department of Public Health, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Murat Bağcıoğlu
- grid.16487.3c0000 0000 9216 0511Department of Urology, Faculty of Medicine, Kafkas University, Kars, Turkey
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20
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Bilal A. Treatment of persistent genital arousal disorder: Single case study. COGENT PSYCHOLOGY 2020. [DOI: 10.1080/23311908.2020.1849949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Ahmad Bilal
- The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
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21
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Çankaya S, Alan Dikmen H. Effects of depression, anxiety, stress, and partner relationship satisfaction on sexual dysfunction in women in the postpartum period. SEXUAL AND RELATIONSHIP THERAPY 2020. [DOI: 10.1080/14681994.2020.1851026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Seyhan Çankaya
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
| | - Hacer Alan Dikmen
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
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22
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Rodríguez-Nieto G, Sack AT, Dewitte M, Emmerling F, Schuhmann T. The Modulatory Role of Cortisol in the Regulation of Sexual Behavior in Young Males. Front Behav Neurosci 2020; 14:552567. [PMID: 33250723 PMCID: PMC7674834 DOI: 10.3389/fnbeh.2020.552567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/07/2020] [Indexed: 11/13/2022] Open
Abstract
The proneness to be sexually aroused, to perform sexual acts, or to be sexually disinhibited during a particular mood varies across individuals. However, the physiological mechanisms underlying this specific and variable relationship between mood and sex-related processes are poorly understood. We propose that cortisol may act as an important moderator in this as it has shown to influence sexual arousal and to play a neuromodulatory role during emotion regulation. Here, we conducted a functional magnetic resonance imaging study in a sample of young males to investigate whether cortisol modulates the neural response during the approach of sexual stimuli in an approach-avoidance task and whether this potential relationship explains the individual differences in sexual inhibition and in mood-related sexual interest and activity. We revealed that cortisol associates with the anteromedial prefrontal cortex activation during the approach towards sexual stimuli. Moreover, this anteromedial prefrontal cortex response was dependent on individual differences in sexual inhibition and the improvements of negative mood as a result of sexual activity. The anteromedial prefrontal cortex is already known to process bottom-up information, reward, and risk estimation. The neuromodulatory role of cortisol within this region during sexual approach may represent a previously unknown yet key element in the regulation of sexual behavior in young males.
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Affiliation(s)
- Geraldine Rodríguez-Nieto
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Department of Movement Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Alexander T Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Marieke Dewitte
- Department of Clinical Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Franziska Emmerling
- Chair of Research and Science Management, Technical University of Munich, Munich, Gemany
| | - Teresa Schuhmann
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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23
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Donadelli M, Lalanne M. Sex and "the City": Financial stress and online pornography consumption. JOURNAL OF BEHAVIORAL AND EXPERIMENTAL FINANCE 2020; 27:100379. [PMID: 32835012 PMCID: PMC7398053 DOI: 10.1016/j.jbef.2020.100379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/08/2020] [Accepted: 07/20/2020] [Indexed: 05/19/2023]
Abstract
We examine the effects of financial stress on online pornography consumption. We use novel data on daily accesses to one of the most popular porn website (xHamster) for 43 different cities belonging to 10 countries for the year 2016. In financial cities, in which people are more likely to be affected by financial stress, we observe that on average online porn viewing decreases as financial stress increases. We present some evidence suggesting the causing channel to be altered mood.
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Affiliation(s)
- Michael Donadelli
- Department of Economics and Management, University of Brescia, via S. Faustino, 74/B, 25122 - Brescia, Italy
| | - Marie Lalanne
- University of Turin & Collegio Carlo Alberto, Piazza Arbarello 8, 10122 Turin, Italy
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24
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Parish SJ, Cottler-Casanova S, Clayton AH, McCabe MP, Coleman E, Reed GM. The Evolution of the Female Sexual Disorder/Dysfunction Definitions, Nomenclature, and Classifications: A Review of DSM, ICSM, ISSWSH, and ICD. Sex Med Rev 2020; 9:36-56. [PMID: 32800563 DOI: 10.1016/j.sxmr.2020.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The 2 most well-known classification systems that include sexual medicine diagnoses are the International Classification of Diseases and Statistics (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM). Sexual medicine experts from international societies representing an array of disciplines have revised and redefined female sexual dysfunctions (FSDs) to reflect current scientific evidence and the state of the art. AIM To summarize the evidence and interactive and chronological process by which sexual medicine societies' consensus groups developed the current nomenclature, classifications, and definitions for FSDs. METHODS We review the contributions and collaborations of the Fourth International Consultation in Sexual Medicine (ICSM), the International Society for the Study of Women's Sexual Health (ISSWSH), and the World Association of Sexual Health in conjunction with the World Health Organization. MAIN OUTCOME MEASURES The ICSM and ISSWSH diagnostic systems are contrasted with the DSM classification. We discuss innovations and strengths; relevant evidence regarding epidemiology, etiology, and risk factors; and key differences. We describe how sexual medicine expertise informed FSD codes in the ICD-11 classification. RESULTS ICSM and ISSWSH published evidence-based guidelines on the definitions, nomenclature, and diagnostic criteria for FSD that diverge from the DSM psychiatric compendia. These definitions and nomenclature recommend the separation of female sexual desire and arousal disorders, elaborate on subtypes of arousal problems, broaden the scope of sexual pain definitions, and provide a greater understanding of etiologies and risk factors for FSDs. CONCLUSIONS These collaborations among sexual medicine experts and their role in the ICD-11 development process provide confidence that the ICD-11 Sexual Dysfunction codes are based on current scientific evidence for diagnosing and coding FSDs in clinical settings worldwide, can serve as endpoints in clinical trials, and will provide specificity for treatment outcomes for FSD therapies. Parish SJ, Cottler-Casanova S, Clayton AH, et al. The Evolution of the Female Sexual Disorder/Dysfunction Definitions, Nomenclature, and Classifications: A Review of DSM, ICSM, ISSWSH, and ICD. Sex Med 2021;9:36-56.
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Affiliation(s)
- Sharon J Parish
- Departments of Psychiatry and Medicine, Weill Cornell Medical College, New York, NY, USA.
| | - Sara Cottler-Casanova
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Anita H Clayton
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA
| | - Marita P McCabe
- Health and Ageing Research Group, Swinburne University, Melbourne, VIC, Australia
| | - Eli Coleman
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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25
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26
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Moshfeghy Z, Tahari S, Janghorban R, Najib FS, Mani A, Sayadi M. Association of sexual function and psychological symptoms including depression, anxiety and stress in women with recurrent vulvovaginal candidiasis. J Turk Ger Gynecol Assoc 2020; 21:90-96. [PMID: 31640303 PMCID: PMC7294830 DOI: 10.4274/jtgga.galenos.2019.2019.0077] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective: Recurrent vulvovaginal candidiasis (RVVC) is a common vaginal infection which could affect the quality of life, romantic relationships, and sexual performance. There is some evidence that psychological problems result in an increased incidence of RVVC by changing the immune systems of individuals. The aim of this study was to determine the association of sexual function and psychological factors including depression, anxiety, and stress in women with RVVC. Material and Methods: Study design was case controlled. Equal numbers of women with RVVC and uninfected women referred to gynecology clinics were selected, using convenience purposive sampling. Two samples of vaginal discharge were prepared from each person. One sample was examined microscopically and the second was cultured on Sabouraud Agar. Data collection tools used for this study included demographic questionnaire, Female Sexual Function Index, Depression Anxiety Stress Scales-21. Data were analyzed using SPSS software (version 19). Results: Less sexual satisfaction [odds ratio (OR): 0.608, 95% confidence interval (CI): 0.421-0.878] and less orgasm (OR: 0.741, 95% CI: 0.530-0.998) was associated with RVVC. In patients with RVVC, the levels of depression, anxiety and stress were significantly higher compared to those of healthy individuals. Conclusion: Depression, anxiety and stress in the past four weeks are related to an increased risk of RVVC. There is an association between depression, anxiety and stress, sexual satisfaction, and orgasm with RVVC. It may be that psychological interventions and sexual counseling can be effective in improving RVVC.
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Affiliation(s)
- Zeinab Moshfeghy
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Tahari
- Student Research Committee, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roksana Janghorban
- Department of Midwifery, School of Nursing and Midwifery, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Sadat Najib
- Department of Obstetrics and Gynecology, School of Medicine, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Mani
- Department of Psychiatry, School of Medicine, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrab Sayadi
- Student Research Committee, Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran
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27
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Granados R, Moyano N, Sierra JC. Behavioral intention to have risky sex in young men and women: The role of sexual excitation and assertiveness. PLoS One 2020; 15:e0232889. [PMID: 32437352 PMCID: PMC7241822 DOI: 10.1371/journal.pone.0232889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/23/2020] [Indexed: 12/11/2022] Open
Abstract
Due to the complex role of sexual excitation in risky sexual behaviors, this study aimed to disentangle this phenomenon by jointly analyzing the combined role of three forms of sexual excitation: genital and subjective, and individual´s propensity. Therefore, we examined the relationship between the components of the Dual Control Model, that is, propensity for sexual excitation/inhibition, in addition to genital and subjective arousal, and sexual assertiveness and intention to engage in casual sexual encounters in which sexual risk was implicitly or explicitly present. The sample consisted of 99 heterosexual young adults (55 men and 45 women) with ages ranging from 18 to 32 years. Participants performed an experiment in the laboratory, which involved them watching a sexual clip and then being presented with two erotic excerpts (stories) depicting casual sexual encounters in which there was an existence of implicit and explicit sexual risks. In men, the propensity for sexual inhibition was the most determining variable in preventing them from sexual risk-taking. In women, intention to engage in risky sexual behaviors was better determined by their propensity for sexual excitation and sexual assertiveness in negotiating the use of contraceptive methods. This research highlights the relevance of excitation and inhibition as a trait, in addition to subjective arousal and sexual assertiveness in intention to engage in risky sexual behaviors.
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Affiliation(s)
- Reina Granados
- Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Nieves Moyano
- Department of Evolutionary Psychology and Education, Faculty of Humanities and Sciences Education, University of Jaén, Jaén, Spain
- * E-mail:
| | - Juan Carlos Sierra
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
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28
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Panic Disorder Correlates With the Risk for Sexual Dysfunction. J Psychiatr Pract 2020; 26:185-200. [PMID: 32421290 DOI: 10.1097/pra.0000000000000460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reports have suggested that sexual dysfunction is an underestimated complication of panic disorder, but little research has focused on sexual dysfunction associated specifically with panic disorder. The purpose of this systematic review was to investigate whether patients with panic disorder who are not currently receiving treatment had a higher risk of sexual dysfunction than healthy people, as well as to clarify the appropriate treatment for this patient group. METHODS Articles that reported panic disorder complicated with sexual dysfunction were identified by a systematic literature search of electronic databases, including PubMed, the Cochrane databases, EMBASE, and PsycINFO. RESULTS Six articles were included in the review. Patients with panic disorder showed a high prevalence of sexual aversion (35.7% to 64%) and sexual infrequency (36% to 44%). One cohort study indicated that untreated patients with panic disorders had a higher risk of erectile dysfunction than controls. Another article that focused specifically on female patients reported that the patients with panic disorder exhibited decreased frequency of sexual behavior and decreased sexual desire compared with the controls. However, 2 studies found conflicting results after adjustment for confounding factors. CONCLUSIONS Although the results were mixed, it appears that patients with panic disorder tended to be more susceptible to sexual dysfunction than the general population. Further trials with larger sample sizes and rigorous research designs are needed to establish the relationship between sexual dysfunction and panic disorder.
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29
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Granados R, Carvalho J, Sierra JC. Preliminary Evidence on How the Dual Control Model Predicts Female Sexual Response to a Bogus Negative Feedback. Psychol Rep 2020; 124:502-520. [PMID: 32183620 DOI: 10.1177/0033294120907310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Dual Control Model of sexual response has been mostly tested with men. As such, there is a lack of evidence on how such model applies to women's experience of sexual arousal, particularly when they face a threatening situation such as the threat of sexual performance failure. The aim of the current study was to test whether the Dual Control Model dimensions predict women's sexual responses to a bogus negative feedback about their sexual performance. In addition, 22 women were exposed to a sexually explicit film clip, while their genital arousal was being measured. During this presentation, a bogus negative feedback, aimed at increasing women's anxiety about their sexual performance, was provided. Vaginal photopletismography and self-report questions were used as means to evaluate women's genital and subjective sexual arousal, respectively. The Sexual Excitation/Sexual Inhibition Inventory for Women was further used to capture women's sexual dynamics. Regression analysis on the high-order factors revealed that sexual excitation proneness was the only predictor of the subjective sexual responses, while none of the factors has predicted genital arousal. "Arousability" and "Concerns about sexual function" dimensions predicted subjective sexual arousal. Sexual arousability may prevent women of lowering their subjective sexual responses in a sexually demanding situation, while "Concerns about sexual function" may have the opposite role, thus being a target of clinical interest. This work provides new data on the Dual Control Model of sexual response, and particularly on its role in women's sexual functioning.
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Affiliation(s)
- Reina Granados
- Mind, Brain, and Behavior Research Center, Universidad de Granada, Granada, Spain; Department of Nursing, Universidad de Granada, Granada, Spain
| | - Joana Carvalho
- Escola de Psicologia e Ciências da Vida, Universidade Lusófona, Lisboa, Portugal; HEI-Lab: Digital Human-Environment and Interactions Lab, Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal
| | - Juan Carlos Sierra
- Mind, Brain, and Behavior Research Center, Universidad de Granada, Granada, Spain
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Rossi MA, Maxwell JA, Rosen NO. Biased Partner Perceptions of Women's Pain Self-Efficacy in Postpartum Pain During Intercourse: A Dyadic Longitudinal Examination. THE JOURNAL OF PAIN 2020; 21:1047-1059. [PMID: 32006700 DOI: 10.1016/j.jpain.2020.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/19/2019] [Accepted: 01/06/2020] [Indexed: 11/25/2022]
Abstract
Postpartum pain during intercourse is a prevalent and distressing problem that has substantial consequences for affected couples. Partner perceptions-such as how partners perceive women's pain self-efficacy-contribute to an individual's pain experience. This study examined whether partners under- or over-estimate women's intercourse pain self-efficacy at 3-months postpartum and the implications of this bias for women's pain and couples' sexual functioning at 3- and 6-months postpartum. Women who reported pain during intercourse and their partners (N = 89 couples) completed online measures assessing pain self-efficacy (own or partner perceptions), pain intensity, and sexual functioning at 3- and 6-months postpartum. Analyses were based on the Truth and Bias Model of Judgement and Response Surface Analysis. Partners were accurate in their estimates of women's pain self-efficacy (ie, their estimates were positively correlated with women's), but they also underestimated it by perceiving women to be less efficacious than women themselves reported. When couples showed greater agreement for lower levels of pain self-efficacy at 3 months, women reported greater pain intensity and both partners reported poorer sexual functioning at 3- and 6-months postpartum. Findings may inform interventions that promote pain self-efficacy to improve partner support and couples' sexual functioning. PERSPECTIVE: When women report-and their partners perceive-low levels of women's self-efficacy for managing painful intercourse, women report greater postpartum pain during intercourse and couples indicate poorer sexual functioning. These findings suggest that interventions aimed at promoting couples' agreement at high pain self-efficacy may improve their adjustment to postpartum pain.
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Affiliation(s)
- Meghan A Rossi
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jessica A Maxwell
- Department of Psychology, University of Auckland, Auckland, New Zealand
| | - Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Obstetrics and Gynaecology, IWK Health Centre, Halifax, Nova Scotia, Canada.
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Fiacco S, Walther A, Ehlert U. Steroid secretion in healthy aging. Psychoneuroendocrinology 2019; 105:64-78. [PMID: 30314729 DOI: 10.1016/j.psyneuen.2018.09.035] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 01/16/2023]
Abstract
Nowadays, people spend a considerable amount of their lives as older adults, but this longer lifespan is often accompanied by an increase in chronic conditions and disease, resulting in reduced quality of life and unprecedented societal and economic burden. Healthy aging is therefore increasingly recognized as a healthcare priority. Physical and mental adaptations to changes over the life course, and the maintenance of well-being, represent pivotal challenges in healthy aging. To capture the complexity of healthy aging, we propose a specific phenotype based on body composition, cognition, mood, and sexual function as indicators of different dimensions of healthy aging. With increasing age, sex hormones as well as glucocorticoids undergo significant alterations, and different patterns emerge for women and men. This review describes age-related patterns of change for women and men, and sheds light on the underlying mechanisms. Furthermore, an overview is provided of the challenges for healthy aging resulting from these age-related steroid alterations. While clinical practice guidelines recommend hormonal treatment only in the case of consistently low hormone levels and symptoms of hormone deficiency, physical exercise and a healthy lifestyle emerge as preventive strategies which can counter age-related hormonal changes and at best prevent chronic conditions.
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Affiliation(s)
- Serena Fiacco
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Biopsychology, TU Dresden, Dresden, Germany
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
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Hartmann CJ, Sutter B, Fehr M, Stute P. Impact of body iron store on sexual function: a comprehensive review and pilot cohort study in midlife women. Arch Gynecol Obstet 2019; 300:469-480. [PMID: 31172305 DOI: 10.1007/s00404-019-05206-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 05/30/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Both iron deficiency (ID) and female sexual dysfunction (FSD) affect more than 25% of the world population. The aim of this study was to identify a connection between these two conditions based on the existing literature and to investigate this interrelation in a small pilot cross-sectional study. METHODS A database search for publications referring to ID and FSD was conducted. The resulting common denominators were used to formulate hypotheses regarding the interaction of these diseases. Simultaneously, 45 healthy middle-aged women completed questionnaires about their sexual function and provided a blood sample for the purpose of determining ferritin and haemoglobin levels. The main outcome measures included an analysis of responses to questions on sexuality and partnership and of blood ferritin and haemoglobin levels. The secondary outcomes included an assessment of further influences on libido, such as sex hormones, menopausal status, health, and life satisfaction. RESULTS Altered monoaminergic cerebral metabolism, hyperprolactinaemia and hypothyroidism, impaired socioemotional interaction, increased anxiety, and depression in both, ID and FSD, account for the most comprehensive explanations for the postulated association between the two conditions. Despite a feasible assumption, our empirical findings failed to demonstrate any correlation between ID and FSD. We identified a certain impact of menopausal hormonal status on sexual function. CONCLUSION ID has no influence on FSD in the given population, although the literature suggests that FSD may at least be partly due to ID. Further research seems justified given the potential advantages for sexual health, considering that ID is an easily treatable disease.
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Affiliation(s)
| | - Barbara Sutter
- Department of Internal Medicine, Hospital of Thun, Thun, Switzerland
| | - Manuela Fehr
- Department of General Surgery, Hospital of Muensingen, Münsingen, Switzerland
| | - Petra Stute
- Department of Gynaecologic Endocrinology and Reproductive Medicine, University Clinic of Obstetrics and Gynaecology, Inselspital Bern, Friedbühlstrasse 19, 3010, Bern, Switzerland.
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Sexuality Among Adults with Congenital Deafblindness: A Cross-Sectional Survey Study Among Primary Carers. SEXUALITY AND DISABILITY 2019. [DOI: 10.1007/s11195-019-09569-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Stanton AM, Boyd RL, Fogarty JJ, Meston CM. Heart rate variability biofeedback increases sexual arousal among women with female sexual arousal disorder: Results from a randomized-controlled trial. Behav Res Ther 2019; 115:90-102. [DOI: 10.1016/j.brat.2018.10.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/27/2018] [Accepted: 10/31/2018] [Indexed: 11/28/2022]
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Psychaesthenic Syndrome: A Review on its Implication in Female Sexual Arousal. JOURNAL OF PSYCHOSEXUAL HEALTH 2019. [DOI: 10.1177/2631831818821542] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: Psychaesthenic syndrome in the recent classification of DSM-5 comes under ‘Cultural Concepts of Distress.’ This can be the equivalent of Dhat syndrome in males. There is a paucity of literature regarding psychaesthenic syndrome. In this paper, we have tried to review the available literature regarding psychiatric and sexual comorbidities of psychaesthenic syndrome. Our paper also aims to ascertain the role and implication of psychaesthenic syndrome in female sexual arousal. Methods: PubMed, Google Scholar, and other databases were used to conduct the search. Research published in English was included. We searched the databases using the terms ‘psychaesthenic syndrome,’ ‘female Dhat syndrome,’ ‘nonpathological white discharge per vagina (NPWDPV),’ ‘leucorrhea,’ ‘female sexual disorders,’ etc. Results: For this review, we could find around 65 papers pertaining to the subject. These focused on the presence and effect of psychiatric disorders on sexual functioning. The effect of psychaesthenic syndrome on sexual functioning was also explored. The discomfort caused by NPWDPV may itself lead to decreased interest in sex. As inhibited sexual desire and sexual arousal disorder are estimated to be among the most common sexual disorders in women, it is probable that difficulty in sexual arousal is one of the major perceived effects of psychaesthenic syndrome. It has been found that depression often leads to difficulty in sexual arousal, amongst other sexual dysfunctions. Thus, there is an indirect causation of female sexual arousal disorder in psychaesthenic syndrome if depression is the manifestation of the syndrome. Conclusion: Very few studies have been done regarding the role of psychaesthenic syndrome in female sexual arousal till now. We are in the process of a major population-based study to delineate the epidemiological aspects, clinical features, management, and prevention aspects related to psychaesthenic syndrome. This review presents the available literature, issues of concern, and methods to manage NPWDPV.
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Sierra JC, Álvarez-Muelas A, Arcos-Romero AI, Calvillo C, Torres-Obregón R, Granados R. Relación entre la excitación sexual subjetiva y la respuesta genital: diferencias entre hombres y mujeres. Rev Int Androl 2019; 17:24-30. [DOI: 10.1016/j.androl.2017.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 09/21/2017] [Accepted: 12/30/2017] [Indexed: 02/08/2023]
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The relationship between iron deficiency anemia and sexual function and satisfaction among reproductive-aged Iranian women. PLoS One 2018; 13:e0208485. [PMID: 30521614 PMCID: PMC6283628 DOI: 10.1371/journal.pone.0208485] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 11/19/2018] [Indexed: 01/23/2023] Open
Abstract
Iron deficiency anemia (IDA) is a common micronutrient deficiency worldwide, and an important health problem especially in women of reproductive age. This study aimed to determine the relationship between IDA and sexual satisfaction and function among reproductive-aged Iranian women. In this study, 129 women (52 with IDA and 77 non-IDA) with age 18–45 in Mahshahr, Iran were recruited. Data was gathered by a demographic questionnaire, Female Sexual Function Index (FSFI) and Larson Sexual Satisfaction Questionnaire. Data were analyzed using an independent t-test, Mann-Whitney test, Chi-square, and correlation coefficient test. The results of this study showed that the means of hemoglobin (Hb), hematocrit (HCT), serum iron and ferritin were significantly lower in the IDA group than those in the non-IDA group (p<0.01). All dimensions of sexual function and satisfaction were significantly lower in women with IDA compared to the healthy women (p<0.001). Also, all blood indices for IDA had a significant relationship with all sexual function components and sexual satisfaction (p = 0.01) except for pain with Hb and ferritin. Health care providers should provide screening, education, and counseling about anemia and sexual function in reproductive age women.
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The role of body image concern, sexual body image, and sexual self-esteem in the happiness of women seeking rhinoplasty surgery. EUROPEAN JOURNAL OF PLASTIC SURGERY 2018. [DOI: 10.1007/s00238-017-1382-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tao L, Zhang X, Duan Z, Wang Y, Liu J, Hou H, Fang Q. Sexual dysfunction and associated factors in Chinese Han women with epilepsy. Epilepsy Behav 2018; 85:150-156. [PMID: 29940378 DOI: 10.1016/j.yebeh.2018.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 05/28/2018] [Accepted: 06/01/2018] [Indexed: 01/20/2023]
Abstract
PURPOSE Women with epilepsy (WWE) are believed to be at risk of sexual dysfunction (SD) and face many sexual challenges because of multiple factors. This study aimed to assess the factors associated with SD in Chinese Han WWE. METHODS This cross-sectional study examined 112 married WWE in the Affiliated Hospital of Yangzhou University with focal (FE) or generalized epilepsy (GE) on antiepileptic drugs (AEDs), and 120 healthy controls without epilepsy, all of Chinese Han nationality. Data collection tools included the Chinese version of Female Sexual Function Index (FSFI), the Chinese version of Zung Self-Rating Anxiety Scale (SAS), the Chinese version of the Zung Self-Rating Depression Scale (SDS), the Chinese version of the revised Morisky Medication Adherence Scale (MMAS-8), and the Chinese version of the National Hospital Seizure Severity Scale (NHS3). Chi-square test, t-test, one-way analysis of variance (ANOVA), and binary logistic regression were used for statistical analysis. RESULTS A high rate (70.5%) of SD was detected in WWE, with 24.2% in controls. Sexual dysfunction affected all dimensions: desire (85.7%), arousal (56.3%), lubrication (47.3%), orgasm (66.1%), satisfaction (58.9%), and pain (41.1%). Elevated rates of anxiety (40.2%) and depression (33%) and poor medication adherence (31.3%) were also found in WWE. Binary logistic regression found that poor economic status (odds ratio (OR) = 13.904, 95% confidence interval (CI): 2.025-95.472, P = 0.007 and OR = 6.350, 95% CI: 1.323-30.477, P = 0.021), anxiety (OR = 1.222, 95% CI: 1.055-1.415, P = 0.007), and poor medication adherence (OR = 0.297, 95% CI: 0.124-0.707, P = 0.006) were associated with SD. CONCLUSIONS The associated factors of SD in Chinese Han WWE are multifactorial. The WWE have higher levels of anxiety, poor family economic status, and poor medication adherence. Medical professionals should not only better control seizures but also evaluate and improve patients' sexual function so as to improve the quality of life of WWE.
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Affiliation(s)
- Lihong Tao
- Department of Neurology, The First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Suzhou, Jiangsu 215006, China; Department of Neurology, The Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Road, Yangzhou, Jiangsu 225012, China
| | - Xinjiang Zhang
- Department of Neurology, The Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Road, Yangzhou, Jiangsu 225012, China
| | - Zuowei Duan
- Department of Neurology, The Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Road, Yangzhou, Jiangsu 225012, China
| | - Yingge Wang
- Department of Neurology, The Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Road, Yangzhou, Jiangsu 225012, China
| | - Jiangbing Liu
- Department of Neurology, The Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Road, Yangzhou, Jiangsu 225012, China
| | - Hongling Hou
- Department of Neurology, The Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Road, Yangzhou, Jiangsu 225012, China
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Suzhou, Jiangsu 215006, China.
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Kingsberg SA, Althof S, Simon JA, Bradford A, Bitzer J, Carvalho J, Flynn KE, Nappi RE, Reese JB, Rezaee RL, Schover L, Shifrin JL. Female Sexual Dysfunction-Medical and Psychological Treatments, Committee 14. J Sex Med 2018; 14:1463-1491. [PMID: 29198504 DOI: 10.1016/j.jsxm.2017.05.018] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 05/15/2017] [Accepted: 05/17/2017] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Since the millennium we have witnessed significant strides in the science and treatment of female sexual dysfunction (FSD). This forward progress has included (i) the development of new theoretical models to describe healthy and dysfunctional sexual responses in women; (ii) alternative classification strategies of female sexual disorders; (iii) major advances in brain, hormonal, psychological, and interpersonal research focusing on etiologic factors and treatment approaches; (iv) strong and effective public advocacy for FSD; and (v) greater educational awareness of the impact of FSD on the woman and her partner. AIMS To review the literature and describe the best practices for assessing and treating women with hypoactive sexual desire disorder, female sexual arousal disorder, and female orgasmic disorders. METHODS The committee undertook a comprehensive review of the literature and discussion among themselves to determine the best assessment and treatment methods. RESULTS Using a biopsychosocial lens, the committee presents recommendations (with levels of evidence) for assessment and treatment of hypoactive sexual desire disorder, female sexual arousal disorder, and female orgasmic disorders. CONCLUSION The numerous significant strides in FSD that have occurred since the previous International Consultation of Sexual Medicine publications are reviewed in this article. Although evidence supports an integrated biopsychosocial approach to assessment and treatment of these disorders, the biological and psychological factors are artificially separated for review purposes. We recognize that best outcomes are achieved when all relevant factors are identified and addressed by the clinician and patient working together in concert (the sum is greater than the whole of its parts). Kingsberg SA, Althof S, Simon JA, et al. Female Sexual Dysfunction-Medical and Psychological Treatments, Committee 14. J Sex Med 2017;14:1463-1491.
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Affiliation(s)
| | - Stanley Althof
- Case Western Reserve University Medical School, Cleveland, OH, USA.
| | - James A Simon
- George Washington University School of Medicine, Washington, DC, USA
| | | | | | | | | | | | | | - Roya L Rezaee
- Case Western Reserve University Medical School, Cleveland, OH, USA
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Rullo JE, Lorenz T, Ziegelmann MJ, Meihofer L, Herbenick D, Faubion SS. Genital vibration for sexual function and enhancement: a review of evidence. SEXUAL AND RELATIONSHIP THERAPY 2018; 33:263-274. [PMID: 33223960 DOI: 10.1080/14681994.2017.1419557] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Vibration, as provided by a genital vibrator, is commonly regarded as a tool to enhance sexual pleasure and in modern day society falls under the category of a sex toy. However, the vibrator was not originally intended to be a toy, and its benefits reach far beyond that of a plaything. This article is a narrative review of the current evidence regarding the use of vibratory stimulation for the treatment of sexual dysfunction and/or sexual and relationship enhancement. The literature indicates that vibratory stimulation has evidence-based support for the treatment of erectile dysfunction, ejaculatory dysfunction and anorgasmia. Vibratory stimulation is positively correlated with increased sexual desire and overall sexual function. It has also shown benefit for sexual arousal difficulties and pelvic floor dysfunction. Though definitive evidence is lacking, genital vibration is a potential treatment for sexual dysfunction related to a wide variety of sexual health concerns in men and women.
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Affiliation(s)
- Jordan E Rullo
- Department of Psychology and Psychiatry, Mayo Clinic, Rochester, MN, USA.,Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Tierney Lorenz
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Laura Meihofer
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Debra Herbenick
- Center for Sexual Health Promotion, Indiana University, Bloomington, IN, USA
| | - Stephanie S Faubion
- Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Basson R, Gilks T. Women's sexual dysfunction associated with psychiatric disorders and their treatment. WOMEN'S HEALTH (LONDON, ENGLAND) 2018; 14:1745506518762664. [PMID: 29649948 PMCID: PMC5900810 DOI: 10.1177/1745506518762664] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/08/2017] [Accepted: 01/28/2018] [Indexed: 12/13/2022]
Abstract
Impairment of mental health is the most important risk factor for female sexual dysfunction. Women living with psychiatric illness, despite their frequent sexual difficulties, consider sexuality to be an important aspect of their quality of life. Antidepressant and antipsychotic medication, the neurobiology and symptoms of the illness, past trauma, difficulties in establishing relationships and stigmatization can all contribute to sexual dysfunction. Low sexual desire is strongly linked to depression. Lack of subjective arousal and pleasure are linked to trait anxiety: the sensations of physical sexual arousal may lead to fear rather than to pleasure. The most common type of sexual pain is 10 times more common in women with previous diagnoses of anxiety disorder. Clinicians often do not routinely inquire about their patients' sexual concerns, particularly in the context of psychotic illness but careful assessment, diagnosis and explanation of their situation is necessary and in keeping with patients' wishes. Evidence-based pharmacological and non-pharmacological interventions are available but poorly researched in the context of psychotic illness.
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Affiliation(s)
| | - Thea Gilks
- The University of British Columbia, Vancouver, BC, Canada
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Merwin KE, O'Sullivan LF, Rosen NO. We Need to Talk: Disclosure of Sexual Problems Is Associated With Depression, Sexual Functioning, and Relationship Satisfaction in Women. JOURNAL OF SEX & MARITAL THERAPY 2017; 43:786-800. [PMID: 28107110 DOI: 10.1080/0092623x.2017.1283378] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Women with sexual problems (e.g., difficulties with desire, arousal, lubrication, orgasm, and pain during sexual activity) experience more depressive symptoms, and poorer sexual functioning and relationship satisfaction compared with unaffected women. A robust literature highlights the importance of sexual communication, and sexual self-disclosures in particular, for the well-being of individuals in romantic relationships. However, little is known about the disclosure of sexual problems to romantic partners and its association with women's psychological, sexual, and relationship well-being. This study examined the proportion of women (N = 277) who disclose (vs. do not disclose) sexual problems to their partner, and the consequences of disclosure. Women (Mage = 29.79, SD = 6.54) completed online validated measures assessing sexual problems, relationship satisfaction, sexual functioning, and depressive symptoms. The majority (69.3%) reported disclosing sexual problems to their current romantic partner. Disclosers reported fewer depressive symptoms, and greater sexual functioning and relationship satisfaction compared to nondisclosers. Disclosing sexual problems may benefit women's well-being by enhancing intimacy or allowing couples to adapt sexual activities to accommodate sexual problems. Clinicians might use cognitive-behavioral strategies to assist women in disclosing sexual problems to partners to maximize the potential psychological, sexual, and relationship benefits.
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Affiliation(s)
- Kathleen E Merwin
- a Department of Psychology and Neuroscience , Dalhousie University , Halifax , NS , Canada
| | - Lucia F O'Sullivan
- b Department of Psychology , University of New Brunswick , Fredericton , NB , Canada
| | - Natalie O Rosen
- a Department of Psychology and Neuroscience , Dalhousie University , Halifax , NS , Canada
- c Department of Obstetrics and Gynaecology , IWK Health Centre , Halifax , NS , Canada
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Bell S, Reissing ED. Sexual Well-Being in Older Women: The Relevance of Sexual Excitation and Sexual Inhibition. JOURNAL OF SEX RESEARCH 2017; 54:1153-1165. [PMID: 27911092 DOI: 10.1080/00224499.2016.1250147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The aim of this study was to use the dual control model of sexual response (DCM) to investigate variation in sexual well-being among women 50 years of age and older. Data from 185 women 50 years of age and older (M = 59.46, SD = 6.96) were used to examine the relationships between sexual excitation (SE) and sexual inhibition (SI) and their lower-order factors to indicators of sexual well-being (i.e., sexual functioning, satisfaction, distress, frequency of sexual activity, and breadth of sexual behavior). Possible moderating factors were also explored. Independently, SE and SI were associated with the majority of the indicators of sexual well-being, and the directions of associations were consistent with the tenets of the DCM. SE and SI lower-order factors were significant predictors of sexual function, satisfaction, and frequency of sexual activity. Sexual distress was predicted more strongly by SI factors and breadth of sexual behavior by one SE lower-order factor (arousability). Partner physical and mental health and participant's own mental health were identified as moderating variables of these associations. Findings of this study are discussed considering the contribution of the DCM to understanding the role of diversity in older women's sexual well-being.
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Levin RJ, Both S, Georgiadis J, Kukkonen T, Park K, Yang CC. The Physiology of Female Sexual Function and the Pathophysiology of Female Sexual Dysfunction (Committee 13A). J Sex Med 2017; 13:733-59. [PMID: 27114190 DOI: 10.1016/j.jsxm.2016.02.172] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 01/01/2023]
Abstract
INTRODUCTION 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. AIM 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. CONCLUSION 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.
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Affiliation(s)
- Roy J Levin
- Reader in Physiology (Retired), Department of Biomedical Science, University of Sheffield, Sheffield, UK: Section 2.
| | - Stephanie Both
- Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, The Netherlands: Section 3
| | - Janniko Georgiadis
- Department of Neuroscience, University Medical Center, Groningen, University of Groningen, The Netherlands: Section 4
| | - Tuuli Kukkonen
- College of Social and Applied Human Science, University of Guelph, Guelph, ON, Canada: Section 6
| | - Kwangsung Park
- Department of Urology, Chonnan National University Medical School, Gwangju, Korea: Section 5
| | - Claire C Yang
- Department of Urology, University of Washington, Seattle, WA, USA: Section 1
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Forbes MK, Baillie AJ, Eaton NR, Krueger RF. A Place for Sexual Dysfunctions in an Empirical Taxonomy of Psychopathology. JOURNAL OF SEX RESEARCH 2017; 54:465-485. [PMID: 28121167 PMCID: PMC5433908 DOI: 10.1080/00224499.2016.1269306] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a manifestation of underlying dimensions of psychopathology (or "spectra"). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research.
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Affiliation(s)
- Miriam K Forbes
- a Departments of Psychiatry and Psychology , University of Minnesota
| | - Andrew J Baillie
- b Centre for Emotional Health and Centre of Research Excellence in Mental Health and Substance Use , Macquarie University
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Lin CY, Oveisi S, Burri A, Pakpour AH. Theory of Planned Behavior including self-stigma and perceived barriers explain help-seeking behavior for sexual problems in Iranian women suffering from epilepsy. Epilepsy Behav 2017; 68:123-128. [PMID: 28161676 DOI: 10.1016/j.yebeh.2017.01.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/07/2017] [Accepted: 01/07/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE To apply the Theory of Planned Behavior (TPB) and the two additional concepts self-stigma and perceived barriers to the help-seeking behavior for sexual problems in women with epilepsy. METHODS In this 18-month follow-up study, TPB elements, including attitude, subjective norm, perceived behavioral control, and behavioral intention along with self-stigma and perceived barriers in seeking help for sexual problems were assessed in n=818 women with epilepsy (94.0% aged ≤40years). The basic TPB model (model 1) and the TPB model additionally including self-stigma and perceived barriers (Model 2) were analyzed using structural equation modeling (SEM). RESULTS Both SEM models showed satisfactory model fits. According to model, attitude, subjective norms, perceived behavioral control, and intention explained 63.1% of the variance in help-seeking behavior. Variance was slightly higher (64.5%) when including self-stigma and perceived barriers (model 2). In addition, the fit indices of the models were better highlighting the importance of self-stigma and perceived barriers in help-seeking behavior for sexual problems. CONCLUSION Theory of Planned Behavior is useful in explaining help-seeking behavior for sexual problems in women with epilepsy. Self-stigma and perceived barriers are additional factors that should be considered in future interventions aiming to adopt TPB to improve help-seeking behavior for sexual problems.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Sonia Oveisi
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Shahid Bahonar Blvd, Qazvin 3419759811, Iran
| | - Andrea Burri
- Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand; Waitemata Pain Service, Department of Anaesthesia and Perioperative Medicine, North Shore Hospital, New Zealand
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Shahid Bahonar Blvd, Qazvin 3419759811, Iran; Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
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Ventus D, Gunst A, Kärnä A, Jern P. No Evidence for Long-Term Causal Associations Between Symptoms of Premature Ejaculation and Symptoms of Anxiety, Depression, and Sexual Distress in a Large, Population-Based Longitudinal Sample. JOURNAL OF SEX RESEARCH 2017; 54:264-272. [PMID: 27982691 DOI: 10.1080/00224499.2016.1255301] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Premature ejaculation (PE) is one of the most common male sexual complaints, but its etiology is unclear. Psychological problems, such as symptoms of anxiety and depression, have traditionally been seen as causal or maintaining etiological components of PE, and previous cross-sectional studies have found weak positive associations between them. The aim of the present study was to test possible causal pathways over time between PE and symptoms of the psychological problems anxiety, depression, and sexual distress. A sample of 985 male Finnish twins and brothers of twins completed a questionnaire in 2006 and 2012. Significant bivariate correlations were found both within and across time between PE and the psychological problems. When fitting structural equation models to test hypothesized causal pathways, symptoms of anxiety and sexual distress at the first measurement time point did not predict future PE. Likewise, PE symptoms at the first measurement did not predict increments or decrements in anxiety, sexual distress, or depression later on. These null findings regarding hypothesized associations may partly be explained by the relatively long time between measurements, or that the measures possibly did not capture the aspects of anxiety that are related to PE.
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Affiliation(s)
| | - Annika Gunst
- b Department of Psychology , University of Turku
| | | | - Patrick Jern
- a Department of Psychology , Åbo Akademi University
- b Department of Psychology , University of Turku
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Lin CY, Burri A, Fridlund B, Pakpour AH. Female sexual function mediates the effects of medication adherence on quality of life in people with epilepsy. Epilepsy Behav 2017; 67:60-65. [PMID: 28088682 DOI: 10.1016/j.yebeh.2016.12.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/28/2016] [Accepted: 12/12/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE 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). METHODS 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. RESULTS 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). CONCLUSION 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.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Andrea Burri
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand
| | - Bengt Fridlund
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Shahid Bahounar BLV, Qazvin 3419759811, Iran; Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
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Costa R, Costa D, Pestana J. Subjective sleep quality, unstimulated sexual arousal, and sexual frequency. ACTA ACUST UNITED AC 2017; 10:147-153. [PMID: 29410746 PMCID: PMC5760048 DOI: 10.5935/1984-0063.20170026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction REM sleep deprivation increases unstimulated erections in rats, and total sleep deprivation increases erections during audiovisual sexual stimulation in men, but the effects of sleep problems on human unstimulated sexual arousal are unknown. Objective We examined the associations of subjective sleep quality with unstimulated sexual arousal, satisfaction with sex life, and sexual frequency and desire over the past month. Methods 275 Portuguese (169 women) reported their anxiety, sexual arousal and sexual desire during a resting state, and completed the Pittsburgh Sleep Quality Index, the sexual satisfaction subscale of the LiSat scale, the Desire dimensions of the Female Sexual Function Index (women only) and International Index of Erectile Function (men only). They additionally reported how many days in the past month they engaged in penile-vaginal intercourse, noncoital sex, and masturbation. Salivary testosterone (T) was assayed by luminescence immunoassays. Results Poorer sleep quality correlated with greater unstimulated sexual arousal in men with higher T levels and in women with higher T levels not taking oral contraceptives. In women with lower T, poorer subjective sleep quality correlated with greater sexual dissatisfaction. In both sexes, sleep quality was uncorrelated with sexual desire and sexual frequency over the past month. Discussion Consistently with other studies in humans and animals, the findings are congruent with the notion that lack of sleep can increase sexual arousal, but not sexual frequency. T might play a role in the sexual arousal caused by lack of appropriate sleep.
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Affiliation(s)
- Rui Costa
- ISPA - Instituto Universitário, WJCR - William James Center for Research - Lisbon - Portugal
| | - David Costa
- ISPA - Instituto Universitário, WJCR - William James Center for Research - Lisbon - Portugal
| | - José Pestana
- ISPA - Instituto Universitário, - Lisbon - Portugal
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