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Gollapudi M, Thomas A, Yogarajah A, Ospina D, Daher JC, Rahman A, Santistevan L, Patel RV, Abraham J, Oommen SG, Siddiqui HF. Understanding the Interplay Between Premenstrual Dysphoric Disorder (PMDD) and Female Sexual Dysfunction (FSD). Cureus 2024; 16:e62788. [PMID: 39036127 PMCID: PMC11260262 DOI: 10.7759/cureus.62788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
Premenstrual dysphoric disorder (PMDD) is a severe variant of premenstrual syndrome (PMS), categorized as a mood disorder due to marked symptoms of depression and anxiety, compounded with severe physical symptoms. Female sexual dysfunction (FSD) can manifest as low libido, difficulty achieving sexual pleasure, and dyspareunia, causing functional and psychological distress. PMDD and FSD are globally prevalent conditions with postulated biological, psychological, and social associations between them. Nevertheless, sexual dysfunction in PMDD is an important aspect of women's health that has been understudied and has notable methodological limitations. In this narrative review, we summarize the existing literature on sexual function in women with PMDD and PMS, specify the distinctions between PMDD and other general symptoms of PMS, highlight the significance of understanding sexual dysfunction in the female population, and outline some available therapeutic options. Studies show that women frequently experience debilitating sexual distress during the premenstrual phase; however, there is an essential need to formulate standardized tools for definite diagnosis. Selective serotonin re-uptake inhibitors (SSRIs) and combined oral contraceptive pills (COCPs) are approved medications for PMDD, while flibanserin and bremelanotide are effective in treating FSD. However, the potential effects of these treatment modalities on the two comorbid conditions render them inconclusive. Awareness of PMDD and FSD among clinicians and society can allow the implementation of targeted interventions to alleviate the suffering of women and enhance their quality of life.
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Affiliation(s)
- Mahati Gollapudi
- Department of Medicine, Saba University School of Medicine, Caribbean, NLD
| | - Angelica Thomas
- Department of Internal Medicine, Anhui Medical University, Hefei, CHN
| | - Angelina Yogarajah
- Department of Family Medicine, Medical University of the Americas, Devens, USA
| | - David Ospina
- Department of Internal Medicine, Universidad de los Andes, Bogotá, COL
| | - Jean C Daher
- Department of Medicine, Lakeland Regional Health, Lakeland, USA
- Department of Medicine, Universidad de Ciencias Médicas Andrés Vesalio Guzman, San José, CRI
| | - Aaliya Rahman
- Department of Internal Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| | - Lucia Santistevan
- Department of Medicine, University of San Martín de Porres, Lima, PER
| | - Ruby V Patel
- Department of Surgery, Hemchandracharya North Gujarat University, Ahmedabad, IND
| | - Jeby Abraham
- Department of General Medicine, Yenepoya Medical College, Mangalore, IND
| | - Sheethal G Oommen
- Department of Psychiatry, University of Medicine and Pharmacy "Gr. T. Popa", Iași, ROU
| | - Humza F Siddiqui
- Department of Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
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Robison K, Kulkarni A, Dizon DS. Sexual Health in Women Affected by Gynecologic or Breast Cancer. Obstet Gynecol 2024; 143:499-514. [PMID: 38207333 DOI: 10.1097/aog.0000000000005506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/29/2023] [Indexed: 01/13/2024]
Abstract
Sexual health problems are prevalent among women affected by gynecologic or breast cancer. It is important to understand the effects cancer treatment can have on sexual health and to have the tools necessary to identify and treat sexual health problems. This Clinical Expert Series discusses practical methods for routinely screening for sexual dysfunction and reviews sexual health treatment options for women affected by cancer. We review the limitations of the current literature in addressing sexual health problems among sexually and gender minoritized communities. Finally, we discuss appropriate timing of referrals to sexual health experts, physical therapists, and sex therapists. Multiple resources available for both patients and clinicians are included.
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Affiliation(s)
- Katina Robison
- Tufts Medical Center, Boston, Massachusetts; Columbia University, New York, New York; and the Lifespan Cancer Institute and Legorreta Cancer Center, Brown University, Providence, Rhode Island
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Gil-Perotin S, Reddam S, González-Mingot C, Gil-Sánchez A, González-Suarez I, Peralta S, Escrivá P, Barea-Moya L, Sánchez-Sánchez B. Reliability, validity and distribution of the Spanish female sexual function index in women with relapsing multiple sclerosis. BMC Womens Health 2023; 23:663. [PMID: 38082275 PMCID: PMC10712072 DOI: 10.1186/s12905-023-02811-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The Female Sexual Function Index (FSFI) is a widely recognized tool for assessing sexual dysfunction (SD). However, its validation for Spanish women suffering from multiple sclerosis (MS) has not yet been conducted. AIM The study aimed to examine the psychometric properties of the 19-item Spanish version of the FSFI (svFSFI) in women with relapsing MS. METHOD A total of 137 women with relapsing MS from three Spanish centers participated in the study and completed the svFSFI. The psychometric properties of the questionnaire were evaluated. The prevalence of SD in the study cohort was determined, and its association with clinical and sociodemographic variables was analyzed using bi- and multivariate regression analyses. RESULTS The svFSFI demonstrated excellent test-retest reliability and substantial-to-excellent internal consistency in the context of relapsing MS. There was significant convergent validity in the intercorrelations of domains. Discriminant validity showed differences in SD between women with high and low neurological disability, as measured by the Expanded Disability Status Scale (EDSS) scores. An exploratory factor analysis indicated a five-factor structure for the svFSFI. The prevalence of SD in the MS cohort was found to be 42.6%, with the 'desire' and 'arousal' domains being the most affected. Factors such as EDSS score, fatigue, depression, and having a stable partner were found to influence the total svFSFI score. CONCLUSION The study validates the svFSFI as a reliable and valid instrument for evaluating sexual dysfunction in Spanish women with MS.
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Affiliation(s)
- Sara Gil-Perotin
- Research group in Immunotherapy and Biomodels for Autoimmunity, Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
- Multiple Sclerosis Unit, Neurology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
- CIBER, Instituto de Salud Carlos III, Madrid, Spain.
| | - Salma Reddam
- Research group in Immunotherapy and Biomodels for Autoimmunity, Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Anna Gil-Sánchez
- Multiple Sclerosis Unit, Hospital Arnau de Vilanova, Lleida, Spain
| | | | - Silvia Peralta
- Multiple Sclerosis Unit, Hospital Arnau de Vilanova, Lleida, Spain
| | - Patricia Escrivá
- Sexual and Reproductive Health Unit, Centro de Salud Trinitat, Valencia, Spain
| | - Lucas Barea-Moya
- Research group in Immunotherapy and Biomodels for Autoimmunity, Health Research Institute, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Beatriz Sánchez-Sánchez
- Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Physiotherapy in Women's Health (FPSM) Research Group, Madrid, Spain.
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Saus‐Ortega C, Sierra‐Garcia E, Martínez‐Sabater A, Chover‐Sierra E, Ballestar‐Tarín ML. Effect of pelvic floor muscle training on female sexual function: A systematic review protocol and meta-analysis. Nurs Open 2023; 10:5790-5796. [PMID: 37232024 PMCID: PMC10416017 DOI: 10.1002/nop2.1826] [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: 08/13/2022] [Revised: 02/24/2023] [Accepted: 05/05/2023] [Indexed: 05/27/2023] Open
Abstract
AIM To recognize, appraise and summarize the research evidence that has explored the results of pelvic floor muscle training on female sexual function. DESIGN Systematic review and possible meta-analysis. METHODOLOGY Between September and October 2022, the Cochrane Library, CINAHL, MEDLINE, EMBASE, PsycINFO and Scopus electronic databases will be searched. We will include RCT's in English, Spanish and Portuguese that investigate the results of pelvic floor muscle training on female sexual function. The data will be extracted by two researchers independently. Risk of bias will be measured from the Cochrane Risk of Bias Tool. The meta-analysis of the results will be performed using Comprehensive Meta-Analysis Version 2. RESULTS This systematic review and possible meta-analysis will contribute significantly to the promotion of pelvic floor health and women's sexual function and to strengthen clinical practice and define other areas of study.
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Affiliation(s)
- Carlos Saus‐Ortega
- Nursing School La FeAdscript Centre to the University of ValenciaValenciaSpain
- Research Group GREIACCHealth Research Institute La FeValenciaSpain
| | | | - Antonio Martínez‐Sabater
- Nursing Care and Education Research Group (GRIECE), GIUV2019‐456, Nursing DepartmentUniversitat de ValenciaValenciaSpain
- Care Research Group (INCLIVA), Hospital Clínico Universitario de ValenciaValenciaSpain
| | - Elena Chover‐Sierra
- Nursing Care and Education Research Group (GRIECE), GIUV2019‐456, Nursing DepartmentUniversitat de ValenciaValenciaSpain
- Internal MedicineConsorci Hospital General Universitari de ValenciaValenciaSpain
| | - María Luisa Ballestar‐Tarín
- Nursing Care and Education Research Group (GRIECE), GIUV2019‐456, Nursing DepartmentUniversitat de ValenciaValenciaSpain
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Koops TU, Klein V, Bei der Kellen R, Hoyer J, Löwe B, Briken P. Association of sexual dysfunction according to DSM-5 diagnostic criteria with avoidance of and discomfort during sex in a population-based sample. Sex Med 2023; 11:qfad037. [PMID: 37465531 PMCID: PMC10350482 DOI: 10.1093/sexmed/qfad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/30/2023] [Accepted: 06/07/2023] [Indexed: 07/20/2023] Open
Abstract
Background Sexual dysfunction frequencies and diagnostic indicators among older populations are relevant for public health measures, but evidence from large population-based studies is still scarce. Aim To determine sexual dysfunction frequencies for women and men according to the Diagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM-5) among 45- to 74-year-old participants of the population-based Hamburg City Health Study and the factors associated with sexual dysfunction diagnoses. Methods We determined sexual dysfunction frequencies according to the DSM-5 and the factors associated with sexual dysfunction diagnoses (quality/avoidance of and discomfort during sex) among 45- to 74-year-olds from 7786 participants of the population-based Hamburg City Health Study. We analyzed cross-sectional self-report questionnaire data collected between 2016 and 2019 using descriptive statistics, comparative tests (Fisher test, Mann-Whitney U test), and logistic regression. Outcomes Outcomes included sexual dysfunction frequencies - specifically, sexual difficulties experienced frequently or more often, over at least six months in the last year, causing severe or very severe distress, and not associated with physical health or relationship problems - and items on quality/avoidance of and discomfort during sex. Results Participants' median age was 62.0 years (IQR, 14) and 51.1% were women. The frequency of sexual dysfunction according to the DSM-5 was 9.3% (95% CI, 8.3%-10.4%) in women and 6.2% (95% CI, 5.4%-7.1%) in men, with women's sexual interest/arousal and men's erectile disorder being most common. Sexual dysfunction rates increased with age: whereas complaints were more frequent among women than men in the younger groups, participants aged ≥65 years with a sexual dysfunction were more often men. Quality/avoidance of and discomfort during sex were significantly associated with a diagnosis of sexual dysfunction. Clinical Implications Results suggest that sexual dysfunction caused by other than physical health or relationship factors is important to consider in this population. In addition, the avoidance of, perceived quality of, and discomfort during sex serve as valuable diagnostic indicators for the presence of sexual dysfunction. Strengths and Limitations This study draws on robust data from a large sample to give valuable insight on the frequency of sexual difficulties and dysfunctions as defined by DSM-5 criteria. Limitations represent the restriction to self-report questionnaire data, the focus on participants living in a metropolitan area, and the lack of experience of sexual difficulties due to a lack of sexual activity not being taken into account. Conclusion The study provides estimates for DSM-5 sexual dysfunction frequencies among Germans from a metropolitan area and points to the diagnostic value of age-related changes as well as the quality/avoidance of and discomfort during sex.
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Affiliation(s)
- Thula U Koops
- Corresponding author: Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany.
| | - Verena Klein
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg 20246, Germany
- Department of Psychology, University of Southampton, Southampton, United Kingdom
| | - Ramona Bei der Kellen
- Epidemiological Study Center, University Medical Centre Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Jürgen Hoyer
- Institute for Clinical Psychology and Psychotherapy, Dresden University of Technology, Dresden 01062, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg 20246, Germany
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Fanshawe AM, De Jonge A, Ginter N, Takács L, Dahlen HG, Swertz MA, Peters LL. The Impact of Mode of Birth, and Episiotomy, on Postpartum Sexual Function in the Medium- and Longer-Term: An Integrative Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5252. [PMID: 37047868 PMCID: PMC10094321 DOI: 10.3390/ijerph20075252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
(1) Background: Sexual function can be affected up to and beyond 18 months postpartum, with some studies suggesting that spontaneous vaginal birth results in less sexual dysfunction. This review examined the impact of mode of birth on sexual function in the medium- (≥6 months and <12 months postpartum) and longer-term (≥12 months postpartum). (2) Methods: Literature published after January 2000 were identified in PubMed, Embase and CINAHL. Studies that compared at least two modes of birth and used valid sexual function measures were included. Systematic reviews, unpublished articles, protocols and articles not written in English were excluded. Quality was assessed using the Newcastle Ottawa Scale. (3) Results: In the medium-term, assisted vaginal birth and vaginal birth with episiotomy were associated with worse sexual function, compared to caesarean section. In the longer-term, assisted vaginal birth was associated with worse sexual function, compared with spontaneous vaginal birth and caesarean section; and planned caesarean section was associated with worse sexual function in several domains, compared to spontaneous vaginal birth. (4) Conclusions: Sexual function, in the medium- and longer-term, can be affected by mode of birth. Women should be encouraged to seek support should their sexual function be affected after birth.
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Affiliation(s)
- Anne-Marie Fanshawe
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- Department of Genetics, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
| | - Ank De Jonge
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
| | - Nicole Ginter
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Lea Takács
- Department of Psychology, Faculty of Arts, Charles University, 128 08 Prague, Czech Republic
| | - Hannah G. Dahlen
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
| | - Morris A. Swertz
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Lilian L. Peters
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
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Semple EA, Harberson MT, Xu B, Rashleigh R, Cartwright TL, Braun JJ, Custer AC, Liu C, Hill JW. Melanocortin 4 receptor signaling in Sim1 neurons permits sexual receptivity in female mice. Front Endocrinol (Lausanne) 2023; 14:983670. [PMID: 37033219 PMCID: PMC10080118 DOI: 10.3389/fendo.2023.983670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 03/14/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Female sexual dysfunction affects approximately 40% of women in the United States, yet few therapeutic options exist for these patients. The melanocortin system is a new treatment target for hypoactive sexual desire disorder (HSDD), but the neuronal pathways involved are unclear. Methods In this study, the sexual behavior of female MC4R knockout mice lacking melanocortin 4 receptors (MC4Rs) was examined. The mice were then bred to express MC4Rs exclusively on Sim1 neurons (tbMC4RSim1 mice) or on oxytocin neurons (tbMC4ROxt mice) to examine the effect on sexual responsiveness. Results MC4R knockout mice were found to approach males less and have reduced receptivity to copulation, as indicated by a low lordosis quotient. These changes were independent of body weight. Lordosis behavior was normalized in tbMC4RSim1 mice and improved in tbMC4ROxt mice. In contrast, approach behavior was unchanged in tbMC4RSim1 mice but greatly increased in tbMC4ROxt animals. The changes were independent of melanocortin-driven metabolic effects. Discussion These results implicate MC4R signaling in Oxt neurons in appetitive behaviors and MC4R signaling in Sim1 neurons in female sexual receptivity, while suggesting melanocortin-driven sexual function does not rely on metabolic neural circuits.
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Affiliation(s)
- Erin A. Semple
- Department of Physiology and Pharmacology, University of Toledo College of Medicine, Toledo, OH, United States
| | - Mitchell T. Harberson
- Department of Physiology and Pharmacology, University of Toledo College of Medicine, Toledo, OH, United States
| | - Baijie Xu
- Center for Hypothalamic Research, University of Texas Southwestern, Dallas, TX, United States
| | - Rebecca Rashleigh
- Department of Physiology and Pharmacology, University of Toledo College of Medicine, Toledo, OH, United States
| | - Tori L. Cartwright
- Department of Physiology and Pharmacology, University of Toledo College of Medicine, Toledo, OH, United States
| | - Jessica J. Braun
- Department of Physiology and Pharmacology, University of Toledo College of Medicine, Toledo, OH, United States
| | - Amy C. Custer
- Department of Physiology and Pharmacology, University of Toledo College of Medicine, Toledo, OH, United States
| | - Chen Liu
- Center for Hypothalamic Research, University of Texas Southwestern, Dallas, TX, United States
| | - Jennifer W. Hill
- Department of Physiology and Pharmacology, University of Toledo College of Medicine, Toledo, OH, United States
- Center for Diabetes and Endocrine Research, University of Toledo, Toledo, OH, United States
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Gonçalves WS, Gherman BR, Abdo CHN, Coutinho ESF, Nardi AE, Appolinario JC. Prevalence of sexual dysfunction in depressive and persistent depressive disorders: a systematic review and meta-analysis. Int J Impot Res 2022:10.1038/s41443-022-00539-7. [PMID: 35194149 DOI: 10.1038/s41443-022-00539-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/29/2022] [Accepted: 02/02/2022] [Indexed: 11/09/2022]
Abstract
The aim of this study was to estimate the prevalence of sexual dysfunction in depressive disorders in individuals not in pharmacological treatment. For this purpose, we performed a systematic review and meta-analysis using the PRISMA guidelines, and the review was registered in PROSPERO (registration number CRD42020179709). Studies that evaluated sexual function and dysfunction in major depressive disorder (MDD) and persistent depressive disorder (PDD) were identified through searches in PubMed/Medline, Web of Science, PsychINFO, Scopus, and Scielo. Twelve cross-sectional studies were eligible. In women with MDD, the pooled prevalence rates of sexual impairment were: 47.22% (95% CI: 34.86-59.58) for arousal; 65.30% (95% CI: 45.86-84.73) for desire; 36.98% (95% CI: 28.42-45.54) for lubrication; 34.17% (95% CI: 17.87-50.46) for orgasm; and 33.91% (95% CI: 17.48-50.34) for sexual satisfaction. In men, the sexual impairment prevalence rates were: 26.45% (95% CI: 12.26-40.63) for arousal; 40.32% (95% CI: 22.19-58.46) for desire; 32.07% (95% CI: 26.14-37.99) for erection; 35.27% (95% CI: 5.13-65.41) for orgasm; and 23.05% (95% CI: 13.60-32.51) for sexual satisfaction. Overall sexual dysfunction was found in 82.75% of women (95% CI: 74.71-90.78) and 63.26% of men (95% CI: 52.83-73.69). Our results show that various sexual functions are impaired in MDD, making imperative the systematic evaluation of these alterations by clinicians. Future studies should be conducted, especially in PDD, to elucidate the role of these disorders in sexual function.
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Affiliation(s)
- Walter Santos Gonçalves
- Treatment-Resistant Depression Group, Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil.
| | - Bruno Rabinovici Gherman
- Treatment-Resistant Depression Group, Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil
| | | | - Evandro Silva Freire Coutinho
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Antonio Egidio Nardi
- Treatment-Resistant Depression Group, Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil
| | - Jose Carlos Appolinario
- Treatment-Resistant Depression Group, Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil
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9
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Care of the Patient with Sexual Concerns. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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10
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Selice L, Morris KL. Mindfulness and Sexual Dysfunction: A Systematic Research Synthesis. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:323-342. [PMID: 34693896 DOI: 10.1080/0092623x.2021.1991536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Throughout the previous decade, research exploring the associations between mindfulness and sexual dysfunction has grown exponentially. Researchers have highlighted inverse associations between mindfulness and various sexual dysfunctions, including erectile dysfunction, hypersexuality, and sexual distress, as well as positive associations between mindfulness and sexual desire, sexual satisfaction, and overall sexual functioning. This study sought to describe the state of extant literature exploring the association between mindfulness and sexual dysfunction, identify areas for future study within this area of research, and inform clinical practice when working with those experiencing sexual dysfunction. A systematic search of peer-reviewed journal articles revealed a final sample of 18 articles. After collecting data from all included articles, results support the inverse association between mindfulness and various sexual dysfunctions. Additionally, results highlight that current mindfulness and sexual dysfunction literature focuses more on the individual's experience and does not fully consider how the couple system is often impacted by, and may contribute to, the maintenance of sexual dysfunction. Furthermore, results demonstrate the importance of including LGBTQ + populations in future research, as extant literature in this area has focused primarily on the heterosexual experience.
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Affiliation(s)
- Lauren Selice
- Department of Human Development and Family Science, Florida State University, Tallahassee, Florida, USA
| | - Katherine L Morris
- Department of Human Development and Family Science, Florida State University, Tallahassee, Florida, USA
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11
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Pretorius D, Couper ID, Mlambo MG. Neglected sexual dysfunction symptoms amongst chronic patients during routine consultations in rural clinics in the North West province. Afr J Prim Health Care Fam Med 2021; 13:e1-e7. [PMID: 33970010 PMCID: PMC8111628 DOI: 10.4102/phcfm.v13i1.2850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/19/2021] [Accepted: 03/04/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Sexual dysfunction contributes to personal feelings of loss and despair and being a cause of exacerbated interpersonal conflict. Erectile dysfunction is also an early biomarker of cardiovascular disease. As doctors hardly ever ask about this problem, it is unknown how many patients presenting for routine consultations in primary care suffer from symptoms of sexual dysfunction. AIM To develop an understanding of sexual history taking events, this study aimed to assess the proportion of patients living with symptoms of sexual dysfunction that could have been elicited or addressed during routine chronic illness consultations. SETTING The research was carried out in 10 primary care facilities in Dr Kenneth Kaunda Health District, the North West province, South Africa. This rural area is known for farming and mining activities. METHODS This study contributed to a broader research project with a focus on sexual history taking during a routine consultation. A sample of 151 consultations involving patients with chronic illnesses were selected to observe sexual history taking events. In this study, the patients involved in these consultations completed demographic and sexual dysfunction questionnaires (FSFI and IIEF) to establish the proportions of patients with sexual dysfunction symptoms. RESULTS A total of 81 women (78%) and 46 men (98%) were sexually active. A total of 91% of the women reported sexual dysfunction symptoms, whilst 98% of men had erectile dysfunction symptoms. The youngest patients to experience sexual dysfunction were a 19-year-old woman and a 26-year-old man. Patients expressed trust in their doctors and 91% of patients did not consider discussion of sexual matters with their doctors as too sensitive. CONCLUSION Clinical guidelines, especially for chronic illness care, must include screening for sexual dysfunction as an essential element in the consultation. Clinical care of patients living with chronic disease cannot ignore sexual well-being, given the frequency of problems. A referral to a sexual medicine specialist, psychologist or social worker can address consequences of sexual dysfunction and improve relationships.
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Affiliation(s)
- Deidre Pretorius
- Division of Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg.
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12
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Thomas EJ, Gurevich M. Difference or dysfunction?: Deconstructing desire in the DSM-5 diagnosis of Female Sexual Interest/Arousal Disorder. FEMINISM & PSYCHOLOGY 2021. [DOI: 10.1177/0959353521989536] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This article answers ongoing calls within critical sexuality scholarship to explore how constructions of women’s bodies influence and are influenced by broader sociocultural contexts. Specifically, this article offers a conceptual analysis of female sexual desire, highlighting the deeply political nature of its pathologization. We briefly explore dominant definitions and models of sexual desire to highlight the erasure of embodied desire as an important part of healthy female sexuality. The DSM-5 diagnosis of Female Sexual Interest/Arousal Disorder is critically analyzed to highlight how desire differences are framed as gendered, individual problems which sidelines relational, contextual, and sociopolitical factors contributing to individual distress. When the language of desire is displaced by the language of interest (particularly when framed as receptivity), the capacity to theorize wanting and entitlement is undermined. We argue that the pathologization of diverse desires obscures possibilities for embodied wanting and neglects the consideration that all types of desire (absent, frequent, physical, emotional) may represent normal sexual variations.
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Gupta A, Priyadarshi S, Vyas N, Sharma G, Swain PK. Novel predictive risk factor for Erectile Dysfunction: Serum folic acid. Andrologia 2020; 53:e13890. [PMID: 33141950 DOI: 10.1111/and.13890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/04/2020] [Indexed: 12/26/2022] Open
Abstract
The purpose of this study was to compare the serum Folic Acid (FA) levels in patients with Erectile Dysfunction (ED) and healthy controls and whether levels vary with its severity. The study was carried out on 77 sexually active individuals, out of which 41 complained of ED and 36 were apparently normal. Patients were excluded if they had any diseases known to cause ED. The severity was further categorised based on IIEF-5 scores. Blood serum levels of testosterone, lipid profile, random blood sugar, liver function test, renal function test and FA levels were obtained in each patient. Independent-samples t test of significance was used when comparing between two means. Pearson's correlation coefficient (r) test was used for correlating data. All clinical and biochemical parameters except FA were comparable in both the groups. FA levels were significantly decreased in ED group (5.29 vs. 10.8; p value = .004). Smoking habits were comparable between the groups, and FA levels did not vary among smokers and nonsmokers (p value = .46). Serum FA levels significantly declined with increasing severity of ED (8.28 vs. 5.56 vs. 4.37 vs. 3.5; p value < .001). Thus, decreased FA might possibly be one of the novel risk factors for ED.
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Affiliation(s)
- Abhimanyu Gupta
- Department of Urology and Renal Transplant, SMS Medical College and Hospital, Jaipur, India
| | - Shivam Priyadarshi
- Department of Urology and Renal Transplant, SMS Medical College and Hospital, Jaipur, India
| | - Nachiket Vyas
- Department of Urology and Renal Transplant, SMS Medical College and Hospital, Jaipur, India
| | - Govind Sharma
- Department of Urology and Renal Transplant, SMS Medical College and Hospital, Jaipur, India
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Harrison TG, Skrtic M, Verdin NE, Lanktree MB, Elliott MJ. Improving Sexual Function in People With Chronic Kidney Disease: A Narrative Review of an Unmet Need in Nephrology Research. Can J Kidney Health Dis 2020; 7:2054358120952202. [PMID: 32953127 PMCID: PMC7485155 DOI: 10.1177/2054358120952202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/20/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose of review: Sexual dysfunction occurs commonly in people with chronic kidney
disease (CKD) and has been recognized as a research priority. We
sought to evaluate the current state of the literature
addressing sexual dysfunction in people with CKD and identify
barriers and strategies to improve our management of this
important symptom. Sources of information: OVID Medline and Google Scholar were searched for English,
peer-reviewed studies using keywords and terms related to
“Chronic Kidney Disease,” “sexuality,” and “sexual dysfunction
OR function.” Methods: In this narrative review, we describe definitions of sexual
dysfunction and contributors exacerbated by CKD, barriers to
researching sexual dysfunction in people with CKD, and possible
avenues for future research. Key findings: Sexual dysfunction is common in people with CKD and results from a
combination of kidney disease itself, as well as its associated
physical (ie, comorbidities) and nonphysical factors. Barriers
to the study of sexual dysfunction in CKD include inconsistent
disease definitions, stigma, variable efficacy and safety of
established therapies, and evolving gender roles in sexual
function. Potential avenues for future research to improve the
sexual function in people with CKD may include evaluating the
safety and efficacy of established therapies in people with CKD
using a variety of observational and interventional study
designs, engaging people with CKD and multidisciplinary team
members in research, and using implementation science methods to
translate what is known about sexual function into clinical
practice. Concerted efforts are required to break down barriers
and improve sexual function in people with CKD. Patients have
identified this as an important research priority, and national
networks need to direct efforts to reduce symptom burden. Limitations: This narrative review was limited by a paucity of high-quality
studies examining sexual dysfunction specifically in people with
kidney disease.
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Affiliation(s)
- Tyrone G Harrison
- Section of Nephrology, Department of Medicine, University of Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, AB, Canada
| | - Marko Skrtic
- Division of Nephrology, Department of Medicine, University Health Network, Toronto, ON, Canada.,Department of Cell Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Nancy E Verdin
- Patient and Community Engagement Research Unit, O'Brien Institute for Public Health, University of Calgary, AB, Canada
| | - Matthew B Lanktree
- Division of Nephrology, Department of Medicine, St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada
| | - Meghan J Elliott
- Section of Nephrology, Department of Medicine, University of Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, AB, Canada
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Kim SM, Won YS, Kim SK. Gold Thread Implantation for Female Sexual Dysfunction and Vaginal Laxity: A Preliminary Investigation. J Menopausal Med 2020; 26:130-134. [PMID: 32893514 PMCID: PMC7475290 DOI: 10.6118/jmm.19024] [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: 12/26/2019] [Revised: 07/03/2020] [Accepted: 08/04/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives We evaluated the efficacy of gold thread implantation (GTI) in the vulva and vagina to improve female sexual dysfunction (FSD) and vaginal laxity. Methods A retrospective chart review was conducted on 46 women who underwent GTI between 2017 and 2018 at our institution. Physicians interviewed patients using questionnaires at baseline and 1–3 months post-treatment. The questionnaires consisted of eight questions: vaginal laxity, vaginal dryness, pain during intercourse, sexual satisfaction during intercourse, sexual arousal confidence, sexual satisfaction of partner, frequency, and maintaining lubrication. Results Overall, participants experienced significant improvement after GTI treatment (P < 0.0001). The median score of vaginal laxity was 3 (slightly loose) at baseline and 5 (slightly tight) at post-treatment. Vaginal dryness also improved from 4 (moderate) at baseline to 2 (little) at post-treatment. The degree of pain during intercourse decreased from 3 to 1. The sexual satisfaction score was 3 (moderately dissatisfied) at baseline and 4 (about equally satisfied and dissatisfied) at post-treatment. Sexual confidence of arousal increased from a score of 3 (low confidence) at baseline to 4 (moderate confidence) at post-treatment. They perceived greater partner sexual satisfaction, moving from a score of 2 to 4. Participants reported lubrication was more frequent during sexual activity, which was maintained until completion of sexual activity. Both scores regarding lubrication increased from 3.5 at baseline to 5 at post-treatment. Conclusions GTI may be an option for FSD and vaginal laxity.
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Affiliation(s)
- Su Mi Kim
- Department of Obstetrics and Gynecology, Chungbuk National University Hospital, Cheongju, Korea
| | | | - Seul Ki Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
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Bumphenkiatikul T, Panyakhamlerd K, Chatsuwan T, Ariyasriwatana C, Suwan A, Taweepolcharoen C, Taechakraichana N. Effects of vaginal administration of conjugated estrogens tablet on sexual function in postmenopausal women with sexual dysfunction: a double-blind, randomized, placebo-controlled trial. BMC WOMENS HEALTH 2020; 20:173. [PMID: 32787848 PMCID: PMC7424993 DOI: 10.1186/s12905-020-01031-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/23/2020] [Indexed: 01/23/2023]
Abstract
Background Female sexual dysfunction (FSD) is prevalent in women with genitourinary syndrome of menopause (GSM). Vaginal estrogen is effective GSM treatment. This study was primarily aimed to evaluate the effects of vaginal administration of conjugated estrogens tablet on postmenopausal FSD using the Female Sexual Function Index (FSFI). Secondary aims were to evaluate vaginal pH, Vaginal Maturation Value (VMV), Normal Flora Index (NFI) and Most Bothersome Symptoms (MBS) changes. Methods A double-blind trial was conducted in postmenopausal women with FSD (FSFI ≤26.55). Sixty-seven participants were randomized into two arms; vaginally administered conjugated estrogens tablet (0.625 mg, daily for 3 weeks then twice weekly for 9 weeks, n = 33), or placebo (n = 34). Results There was no significant improvement of FSFI observed in estrogens arm compared to placebo in each domain and overall index (p = 0.182). The estrogens significantly improved vaginal pH and VMV, toward more acidity (p = < 0.001), higher VMV (p = < 0.001) and more superficial cells (p = < 0.001). We observed no significant difference in NFI and MBS between arms (p = 0.282, 0.182). Conclusion We found no significant changes in FSFI, NFI, and MBS, but significant improvement in vaginal pH and VMV in postmenopausal women with FSD treated with vaginally administered conjugated estrogens tablet. Few side-effects were reported. Trial registration Thai Clinical Trial Registry identification number TCTR20180219001, prospectively registered since 2018-02-19 11:33:21.
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Affiliation(s)
- Thanapob Bumphenkiatikul
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Bangkok, 10330, Thailand.
| | - Krasean Panyakhamlerd
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Bangkok, 10330, Thailand
| | - Thanittha Chatsuwan
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chai Ariyasriwatana
- Division of Gynecologic Cyto-Pathology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Ammarin Suwan
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Bangkok, 10330, Thailand
| | - Charoen Taweepolcharoen
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Bangkok, 10330, Thailand
| | - Nimit Taechakraichana
- Department of Medical Education and Clinical Research Center, Bumrungrad International Hospital, Bangkok, 10110, Thailand
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Kingsberg SA, Simon JA. Female Hypoactive Sexual Desire Disorder: A Practical Guide to Causes, Clinical Diagnosis, and Treatment. J Womens Health (Larchmt) 2020; 29:1101-1112. [PMID: 32460605 DOI: 10.1089/jwh.2019.7865] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Hypoactive sexual desire disorder (HSDD) in women is defined as the persistent or recurrent absence of sexual thoughts or fantasies and/or lack of desire for sexual activity that is associated with marked personal distress and/or interpersonal difficulties, and cannot be better attributed to another primary disorder, medication, or general medical condition. Notably, HSDD shares some similarity with depression, as its etiology can be explained using a biopsychosocial model that includes biological, psychological, and sociocultural factors, as well as interpersonal influences. Due to its high prevalence and negative impact on the overall health and well-being of women, primary care health professionals and women's health practitioners need to be actively aware of HSDD, particularly because patients may be reluctant or unwilling to initiate a discussion about their sexual concerns during routine visits. HSDD is well established as a valid and treatable clinical entity. Even for those inexperienced in treating sexual problems, there are simple and validated screening tools such as the Decreased Sexual Desire Screener that can help identify HSDD and a need for further evaluation and treatment. There have been few established pharmacologic treatments for HSDD. Flibanserin was the first drug approved for the treatment of HSDD by the U.S. Food and Drug Administration (FDA). Bremelanotide, a novel melanocortin receptor agonist, was recently approved by the FDA for the treatment of acquired, generalized HSDD in premenopausal women. Increased awareness and recognition of HSDD as a medical condition should provide an incentive for further clinical development of effective treatments for HSDD.
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Affiliation(s)
- Sheryl A Kingsberg
- Division of Behavioral Medicine, University Hospitals Cleveland Medical Center, MacDonald Women's Hospital, Cleveland, Ohio, USA.,Departments of Reproductive Biology and Psychiatry, Case Western Reserve University School of Medicine, MacDonald Women's Hospital, Cleveland, Ohio, USA
| | - James A Simon
- IntimMedicine™ Specialists, George Washington University School of Medicine, Washington, District of Columbia, USA
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Tzeng NS, Yeh HW, Chung CH, Chang HA, Kao YC, Chiang WS, Chien WC. Risk of Psychiatric Morbidity in Psychosexual Disorders in Male Patients: A Nationwide, Cohort Study in Taiwan. Am J Mens Health 2020; 13:1557988319842985. [PMID: 30971176 PMCID: PMC6460890 DOI: 10.1177/1557988319842985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
This study aimed to investigate the association between males with psychosexual disorders (PSDs) and the risk of developing psychiatric disorders. A total of 34,972 enrolled patients, with 8,743 subjects who had suffered from PSD and 26,229 controls (1:3) matched for age and index year, from Taiwan’s Longitudinal Health Insurance Database (LHID) from 2000 to 2015, selected from the National Health Insurance Research Database (NHIRD). After adjusting all the confounding factors, the multivariate Cox regression model was used to compare the risk of developing psychiatric disorders, between the PSD and non-PSD groups, during the 15 years of follow-up. Of the all enrollees, 1,113 in the PSD cohort and 2,611 in the non-PSD cohort (1,180.96 vs. 954.68 per 100,000 person-year) developed psychiatric disorders. Multivariate Cox regression model survival analysis revealed that, after adjusting for gender, age, monthly income, urbanization level, geographic region, and comorbidities, the adjusted hazard ratio (HR) was 2.448 (95% CI [2.227, 2.633], p < .001). PSD has been associated with the increased risk in anxiety disorders, depressive disorders, bipolar disorders, sleep disorders, and psychotic disorders, respectively. Sexual dysfunctions, paraphilia, and gender identity disorders were associated with the overall psychiatric disorders with adjusted HRs as 1.990 (p < .001), 11.622 (p < .001), and 5.472 (p < .001), respectively. Male patients who suffered from PSD have a higher risk of developing psychiatric disorders, and this finding should be considered as a timely reminder for the clinicians to provide much more attention for these patients because of their mental health issues.
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Affiliation(s)
- Nian-Sheng Tzeng
- 1 Department of Psychiatry, School of Medicine, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,2 Student Counseling Center, National Defense Medical Center, Taipei, Republic of China
| | - Hui-Wen Yeh
- 1 Department of Psychiatry, School of Medicine, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,3 Institute of Bioinformatics and System Biology, National Chiao Tung University, Hsin-Chu, Republic of China.,4 Department of Nursing, Tri-Service General hospital, and School of Nursing, National Defense Medical Center, Taipei, Republic of China.,5 Department of Nursing, Kang-Ning University (Taipei Campus), Taipei, Republic of China
| | - Chi-Hsiang Chung
- 6 Department of Medical Research, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,7 School of Public Health, National Defense Medical Center, Taipei, Republic of China.,8 Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Republic of China
| | - Hsin-An Chang
- 1 Department of Psychiatry, School of Medicine, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,2 Student Counseling Center, National Defense Medical Center, Taipei, Republic of China
| | - Yu-Chen Kao
- 1 Department of Psychiatry, School of Medicine, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,9 Department of Psychiatry, Song-Shan Branch, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China
| | - Wei-Shan Chiang
- 1 Department of Psychiatry, School of Medicine, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China
| | - Wu-Chien Chien
- 6 Department of Medical Research, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,7 School of Public Health, National Defense Medical Center, Taipei, Republic of China.,10 Graduate of Life Sciences, National Defense Medical Center, Taipei, Republic of China
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19
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Care of the Patient with Sexual Concerns. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_65-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Ghorbani Z, Mirghafourvand M, Charandabi SMA, Javadzadeh Y. The effect of ginseng on sexual dysfunction in menopausal women: A double-blind, randomized, controlled trial. Complement Ther Med 2019; 45:57-64. [DOI: 10.1016/j.ctim.2019.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/24/2019] [Accepted: 05/12/2019] [Indexed: 12/30/2022] Open
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21
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Xiao Z, Wu J, Wang C, Jia N, Yang X. Computer-aided diagnosis of school-aged children with ASD using full frequency bands and enhanced SAE: A multi-institution study. Exp Ther Med 2019; 17:4055-4063. [PMID: 31007742 PMCID: PMC6468934 DOI: 10.3892/etm.2019.7448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 02/06/2019] [Indexed: 11/17/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental and network-level disorder mainly diagnosed in children. The aim of the current study was to develop a computer-aided diagnosis method with high accuracy to distinguish school-aged children (5–12 years) with ASD from those typically developing (TD). The current study used multi-institutional functional magnetic resonance imaging (fMRI) datasets of 198 school-aged participants from the Autism Brain Imaging Data Exchange II database and employed enhanced stacked auto-encoders to distinguish between school-aged children with ASD from those TD. In the current study, the average diagnostic accuracy was 96.26% (average sensitivity=98.03%; average specificity=93.62%); these results of classification were higher than that observed in previous studies using single or two frequency bands. The current study demonstrated that the proposed computer-aided diagnosis method may be used to distinguish between school-aged children with ASD from those TD. Attempts to use full frequency bands, deep learning based algorithm and multi-institutional fMRI datasets to distinguish between school-aged children with ASD from TD may be a key step towards clinical auxiliary diagnosis independent of sex, handedness, intellectual level or scanning parameters of fMRI data.
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Affiliation(s)
- Zhiyong Xiao
- School of Mechatronics Engineering, Nanchang University, Nanchang, Jiangxi 330031, P.R. China.,School of Software, Jiangxi Agricultural University, Nanchang, Jiangxi 330045, P.R. China
| | - Jianhua Wu
- School of Information Engineering, Nanchang University, Nanchang, Jiangxi 330031, P.R. China
| | - Canhua Wang
- School of Mechatronics Engineering, Nanchang University, Nanchang, Jiangxi 330031, P.R. China.,School of Computer Sciences, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi 300004, P.R. China
| | - Nan Jia
- School of Information Engineering, Nanchang University, Nanchang, Jiangxi 330031, P.R. China
| | - Xiaoling Yang
- School of Engineering, Jiangxi Agricultural University, Nanchang, Jiangxi 330045, P.R. China
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Lakshmi M, Khan SD. Female Sexual Dysfunction. Sex Med 2019. [DOI: 10.1007/978-981-13-1226-7_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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23
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Gündüz A, Kumru Bayazit R, Gündoğmuş İ, Sertçelik S, Gönül H, Yaşar AB, Oğuz G, Sungur MZ. Turkish validity and reliability of the Sexual Complaints Screener for Women. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1525811] [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: 10/28/2022] Open
Affiliation(s)
- Anıl Gündüz
- Department of Psychiatry, Haydarpaşa Numune Training and Research Hospital, İstanbul, Türkiye
| | | | - İbrahim Gündoğmuş
- Department of Psychiatry, Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Türkiye
| | - Sencan Sertçelik
- Department of Psychiatry, Haydarpaşa Numune Training and Research Hospital, İstanbul, Türkiye
| | - Hatice Gönül
- Department of Psychiatry, Haydarpaşa Numune Training and Research Hospital, İstanbul, Türkiye
| | - Alişan Burak Yaşar
- Department of Psychiatry, Marmara University Research And Educational Hospital, Pendik, İstanbul
| | - Gülay Oğuz
- Psychiatry Specialist in Private Practice, İlkadım, Samsun
| | - Mehmet Zihni Sungur
- Department of Psychiatry, Marmara University Research And Educational Hospital, Pendik, İstanbul
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Roxo L, Virgolino A, Costa J, Alarcao V. Understanding the relationship between BMI and sexual dysfunction: Can DSM-5 shed light into this topic? Rev Int Androl 2018; 17:130-137. [PMID: 30195481 DOI: 10.1016/j.androl.2018.07.003] [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: 03/22/2018] [Revised: 07/06/2018] [Accepted: 07/16/2018] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The links between body weight and sexuality, notably sexual dysfunction (SD), are intricate and not yet fully understood. A more individual-focused evaluation of sexual difficulties, as recently provided by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), contributes to improve precision in SD diagnosis and has the potential to advance our knowledge on the association between body weight and SD. OBJECTIVES To identify gender differences in sexual behaviors and SD among Portuguese men and women within different classes of body mass index (BMI); and to explore the association between BMI and SD by using the new DSM-5 criteria. MATERIAL AND METHODS Face-to-face interviews followed by self-completed questionnaires of primary healthcare users in Portugal (n=323). Data on sociodemographic variables, BMI, sexual behaviors and SD were collected. DSM-5 criteria were used to assess sexual dysfunction. The International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) for men and women, respectively, were used for comparison purposes. RESULTS Overweight and obese women reported less sexual partners, less satisfaction with sexual frequency and rated sexual life as less important. These differences were not found among men. Normal weight men and women had a higher score of IIEF and FSFI, respectively, than those overweight and obese. No significant effects of BMI scale on SD following DMS-5 were detected. CONCLUSIONS Women's sexual function is more impacted by BMI than men's. Individual-orientated approaches, as proposed in DSM-5, may allow a better understanding on the relation between body size and sexuality in both genders.
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Affiliation(s)
- Luis Roxo
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal; Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT) Universidade Nova de Lisboa (UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal.
| | - Ana Virgolino
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Joana Costa
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Violeta Alarcao
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal; Centro de Investigação e Estudos de Sociologia (CIES-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Avenida das Forças Armadas, 1649-026 Lisboa, Portugal
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25
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McDonagh LK, Nielsen EJ, McDermott DT, Davies N, Morrison TG. "I Want to Feel Like a Full Man": Conceptualizing Gay, Bisexual, and Heterosexual Men's Sexual Difficulties. JOURNAL OF SEX RESEARCH 2018; 55:783-801. [PMID: 29261328 DOI: 10.1080/00224499.2017.1410519] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Current understandings of sexual difficulties originate from a model that is based on the study of heterosexual men and women. Most research has focused on sexual difficulties experienced by heterosexual men incapable of engaging in vaginal penetration. To better understand men's perceptions and experiences of sexual difficulties, seven focus groups and 29 individual interviews were conducted with gay (n = 22), bisexual (n = 5), and heterosexual (n = 25) men. In addition, the extent to which difficulties reported by gay and bisexual men differ from heterosexual men was explored. Data were analyzed using thematic analysis applying an inductive approach. Two intercorrelated conceptualizations were identified: penis function (themes: medicalization, masculine identity, psychological consequences, coping mechanisms) and pain (themes: penile pain, pain during receptive anal sex). For the most part, gay, bisexual, and heterosexual men reported similar sexual difficulties; differences were evident regarding alternative masculinity, penis size competition, and pain during receptive anal sex. The results of this study demonstrate the complexity of men's sexual difficulties and the important role of sociocultural, interpersonal, and psychological factors. Limitations and suggested directions for future research are outlined.
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Affiliation(s)
- Lorraine K McDonagh
- a Research Department of Primary Care and Population Health , University College London
| | | | | | - Nathan Davies
- a Research Department of Primary Care and Population Health , University College London
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Abstract
A growing body of evidence suggests a role for homocysteine (Hcys) and folate (FA) in erectile function (EF): Hcys appears to impair EF affecting endothelium via several mechanism whereas the role of FA remains to be elucidated, besides decreasing Hcys. To assess correlation between erectile dysfunction (ED) and serum levels of FA, Hcys, and B12, we enrolled 31 patients affected by ED (Group A; age 52.83 ± 11.89 years) and 31 healthy adults (Group B; age 49.14 ± 13.63 years). Fasting blood samples were taken for each subject. ED was assessed by the International Index of Erectile Function-5 (IIEF-5). IIEF-5 mean score was significantly lower in Group A than in Group B (10.71 ± 4.24 versus 23.32 ± 1.33, p < .001). Compared to Group B, Group A also showed significantly lower serum FA levels (5.11 ± 1.79 versus 7.9 ± 3.55 ng/ml, p < .001) and significantly higher serum Hcys levels (13.61 ± 3.55 versus 9.17 ± 2.32 µmol/L, p < .001). No significant correlation was observed between Hcys and FA both groups. Our results showed a significant association among ED, FA deficiency and hyperomocisteinemia. Lack of correlation between FA and Hcys suggests that FA deficit may directly impair EF.
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Affiliation(s)
- Massimiliano Sansone
- a Department of Experimental Medicine , Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza Università di Roma , Rome , Italy
| | - Andrea Sansone
- a Department of Experimental Medicine , Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza Università di Roma , Rome , Italy
| | - Mariagrazia Romano
- a Department of Experimental Medicine , Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza Università di Roma , Rome , Italy
| | - Silvia Seraceno
- a Department of Experimental Medicine , Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza Università di Roma , Rome , Italy
| | - Luigi Di Luigi
- b Department of Movement Human and Health Sciences , Unit of Endocrinology, Università degli Studi di Roma "Foro Italico" , Rome , Italy
| | - Francesco Romanelli
- a Department of Experimental Medicine , Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza Università di Roma , Rome , Italy
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27
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The sexual health approach in postmenopause: The five-minutes study. Maturitas 2018; 108:31-36. [DOI: 10.1016/j.maturitas.2017.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/25/2017] [Accepted: 11/09/2017] [Indexed: 01/23/2023]
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Chokka PR, Hankey JR. Assessment and management of sexual dysfunction in the context of depression. Ther Adv Psychopharmacol 2018; 8:13-23. [PMID: 29344340 PMCID: PMC5761906 DOI: 10.1177/2045125317720642] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/22/2017] [Indexed: 12/19/2022] Open
Abstract
Sexual dysfunction (SD) is pervasive and underreported, and its effects on quality of life are underestimated. Due in part to its bidirectional relationship with depression, SD can be difficult to diagnose; it is also a common side effect of many antidepressants, leading to treatment noncompliance. While physicians often count on patients to spontaneously report SD, treatment is optimized when the clinician instead performs a thorough assessment of sexual functioning before and during drug therapy using a standardized questionnaire such as the Arizona Sexual Experiences Scale (ASEX). Separating the effects of the disorder from those of medications is challenging; we present a concise, evidence-based schematic to assist physicians in minimizing treatment-emergent sexual dysfunction (TESD) while treating depression. Vascular, hormonal, neurogenic, and pharmacological factors should be considered when a patient presents with SD. We also recommend that physicians obtain patient information about baseline and historical sexual functioning before prescribing a drug that may lead to SD and follow up accordingly. When the goal is to treat depression while attenuating the risk of sexual symptoms, physicians may wish to consider agomelatine, bupropion, desvenlafaxine, moclobemide, trazodone, vilazodone, and vortioxetine.
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29
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Stelzl M, Stairs B, Anstey H. A narrow view: The conceptualization of sexual problems in human sexuality textbooks. J Health Psychol 2017; 23:148-160. [PMID: 29179570 DOI: 10.1177/1359105317742920] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined the ways in which the meaning of 'sexual problems' is constructed and defined in undergraduate human sexuality textbooks. Drawing on feminist and critical discourse frameworks, the dominant as well as the absent/marginalized discourses were identified using critical discourse analysis. Sexual difficulties were largely framed by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Thus, medical discourse was privileged. Alternative conceptualizations and frameworks, such as the New View of Women's Sexual Problems, were included marginally and peripherally. We argue that current constructions of sexuality knowledge reinforce, rather than challenge, existing hegemonic discourses of sexuality.
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O'Mullan C, Doherty M, Coates R, Tilley PJM. Using Interpretative Phenomenological Analysis (IPA) to provide insight into female sexual difficulties. SEXUAL AND RELATIONSHIP THERAPY 2017. [DOI: 10.1080/14681994.2017.1386300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Cathy O'Mullan
- School of Medical, Health & Applied Sciences, Central Queensland University, Bundaberg, Queensland, Australia
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Maryanne Doherty
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Rosemary Coates
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - P. J. Matt Tilley
- School of Public Health, Curtin University, Perth, Western Australia, Australia
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31
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Grubbs JB, Exline JJ, Pargament KI, Volk F, Lindberg MJ. Internet Pornography Use, Perceived Addiction, and Religious/Spiritual Struggles. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1733-1745. [PMID: 27351579 DOI: 10.1007/s10508-016-0772-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 12/15/2015] [Accepted: 05/10/2016] [Indexed: 05/10/2023]
Abstract
Prior work has demonstrated that religious beliefs and moral attitudes are often related to sexual functioning. The present work sought to examine another possibility: Do sexual attitudes and behaviors have a relationship with religious and spiritual functioning? More specifically, do pornography use and perceived addiction to Internet pornography predict the experience of religious and spiritual struggle? It was expected that feelings of perceived addiction to Internet pornography would indeed predict such struggles, both cross-sectionally and over time, but that actual pornography use would not. To test these ideas, two studies were conducted using a sample of undergraduate students (N = 1519) and a sample of adult Internet users in the U.S. (N = 713). Cross-sectional analyses in both samples found that elements of perceived addiction were related to the experience of religious and spiritual struggle. Additionally, longitudinal analyses over a 1-year time span with a subset of undergraduates (N = 156) and a subset of adult web users (N = 366) revealed that perceived addiction to Internet pornography predicted unique variance in struggle over time, even when baseline levels of struggle and other related variables were held constant. Collectively, these findings identify perceived addiction to Internet pornography as a reliable predictor of religious and spiritual struggle.
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Affiliation(s)
- Joshua B Grubbs
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA.
- Department of Psychology, Bowling Green State University, Bowling Green, OH, 43403, USA.
| | - Julie J Exline
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Kenneth I Pargament
- Department of Psychology, Bowling Green State University, Bowling Green, OH, 43403, USA
| | - Fred Volk
- Department of Counselor Education and Family Studies, Liberty University, Lynchburg, VA, USA
| | - Matthew J Lindberg
- Department of Psychology, Youngstown State University, Youngstown, OH, USA
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32
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Brotto LA. Evidence-based treatments for low sexual desire in women. Front Neuroendocrinol 2017; 45:11-17. [PMID: 28237271 DOI: 10.1016/j.yfrne.2017.02.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 02/14/2017] [Accepted: 02/16/2017] [Indexed: 02/06/2023]
Abstract
Low sexual desire is the most common sexual complaint in women, with multinational studies finding that at least a third of women experience low sexual desire. No single etiology for the development of Female Sexual Interest/Arousal Disorder, the diagnosis laid out by the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, has been established. There has been considerable interest in pharmacological approaches to improving low desire, and agents targeting a range of neurotransmitters have been examined. To date, only flibanserin, a centrally acting medication targeting the serotonin, dopamine, and norepinephrine systems, has been approved by the Food and Drug Administration (FDA). Despite statistically significant effects on sexual desire, sexual distress, and sexually satisfying events, side-effects are significant, and flibanserin is completely contraindicated with alcohol. As such, there has been renewed interest in advancing the science of psychological approaches to low desire, including cognitive behavioral and mindfulness therapies.
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Affiliation(s)
- Lori A Brotto
- University of British Columbia, Department of Obstetrics and Gynaecology, Canada.
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Abstract
In August 2015, flibanserin (brand name Addyi) was approved by the Food and Drug Administration (FDA) for treatment of acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. This article summarizes and promotes discussion regarding the numerous controversies that have enclosed flibanserin since the very beginning. This includes questions related to flibanserin's safety and efficacy and the validity of the clinical trials. Also included are philosophical considerations surrounding the diagnosis of hypoactive sexual desire disorder and pharmacological treatment of low libido. Based on the review of literature, authors judge flibanserin to be modestly effective and reasonably safe, and discuss the differences in philosophical perspectives with less definitive answers.
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34
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Leanza F, Maritato A. Care of the Patient with Sexual Concerns. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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35
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Pellow J, McGrath L. Herbal medicine for low sexual desire in menopausal women: A clinical review. Complement Ther Clin Pract 2016; 25:122-129. [PMID: 27863600 DOI: 10.1016/j.ctcp.2016.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/16/2016] [Indexed: 10/21/2022]
Abstract
Many women typically experience a significant reduction in sexual desire during the late perimenopausal and early postmenopausal stages, with the biggest decline in sexual desire occurring from three years prior to two years after the final menstrual period. Despite being a prevalent female complaint, currently no standard treatment for low sexual desire exists. Herbal medicines have been used therapeutically all around the world, and are an important component of Traditional and Complementary Medicine. There have been numerous trials and pharmacological studies of specific herbal preparations related to the treatment of low sexual desire. This article serves to provide a clinical review of the evidence relating to the herbal treatment options for this common condition.
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Affiliation(s)
- Janice Pellow
- Department of Homoeopathy, University of Johannesburg, Doornfontein Campus, P.O. Box 17011, Doornfontein, Gauteng, 2028, South Africa.
| | - Linda McGrath
- Department of Homoeopathy, University of Johannesburg, Doornfontein Campus, P.O. Box 17011, Doornfontein, Gauteng, 2028, South Africa.
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36
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Pereira R, Margarida Oliveira C, Nobre P. Sexual Functioning and Cognitions During Sexual Activity in Men With Genital Pain: A Comparative Study. JOURNAL OF SEX & MARITAL THERAPY 2016; 42:602-615. [PMID: 26548315 DOI: 10.1080/0092623x.2015.1113582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Male genital pain is frequently associated with sexual dysfunction, and some studies suggest it is influenced by cognitive factors. However, there is little evidence on how these factors discriminate male genital pain from other sexual problems. This study intends to explore differences on sexual functioning and self-reported cognitions during sexual activity between men with genital pain, men with sexual dysfunction, and sexually healthy men. A total of 134 men divided in three groups based on their clinical condition (i.e., genital pain, sexual dysfunction, or no sexual/pain complaints) and matched for demographic variables completed measures of sexual functioning (IIEF) and thoughts during sexual activity (SMQ). Findings showed that men with genital pain and men with sexual dysfunctions reported significantly lower levels of overall satisfaction with sexual life, compared to men without sexual problems. Additionally, men with genital pain and men with sexual dysfunctions presented significantly more failure anticipation thoughts in comparison to sexually healthy men. Overall, findings emphasize the role of negative cognitions as a common factor associated with male genital pain and sexual dysfunctions, suggesting that genital pain should be regarded as a sexual problem and that clinical interventions should include sex therapy techniques as well as cognitive-behavioral procedures.
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Affiliation(s)
- Raquel Pereira
- a University of Porto, Faculty of Psychology and Educational Sciences , Porto , Portugal
| | | | - Pedro Nobre
- a University of Porto, Faculty of Psychology and Educational Sciences , Porto , Portugal
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37
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Mitchell KR, Jones KG, Wellings K, Johnson AM, Graham CA, Datta J, Copas AJ, Bancroft J, Sonnenberg P, Macdowall W, Field N, Mercer CH. Estimating the Prevalence of Sexual Function Problems: The Impact of Morbidity Criteria. JOURNAL OF SEX RESEARCH 2016; 53:955-967. [PMID: 26605494 PMCID: PMC5044769 DOI: 10.1080/00224499.2015.1089214] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Establishing the clinical significance of symptoms of sexual dysfunction is challenging. To address this, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced two new morbidity criteria (duration and symptom severity) to the existing criteria of distress. This study sought to establish the impact of these three criteria on the population prevalence of sexual function problems. The data come from a national probability survey (Natsal-3) and are based on 11,509 male and female participants aged 16-74, reporting at least one sexual partner in the past year. The key outcomes were: proportion of individuals reporting proxy measures of DSM-5 problems, and the proportion of those meeting morbidity criteria. We found that among sexually active men, the prevalence of reporting one or more of four specific sexual problems was 38.2%, but 4.2% after applying the three morbidity criteria; corresponding figures for women reporting one or more of three specific sexual problems, were 22.8% and 3.6%. Just over a third of men and women reporting a problem meeting all three morbidity criteria had sought help in the last year. We conclude that the DSM-5 morbidity criteria impose a focus on clinically significant symptoms.
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Affiliation(s)
- Kirstin R. Mitchell
- Centre for Reproductive and Sexual Health, London School of Hygiene and Tropical Medicine
- Address correspondence to Kirstin R. Mitchell, MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Top Floor, 200 Renfield Street, Glasgow, G2 3QB, UK. E-mail:
| | - Kyle G. Jones
- Dept of Infection and Population Health, University College London
| | - Kaye Wellings
- Centre for Reproductive and Sexual Health, London School of Hygiene and Tropical Medicine
| | - Anne M. Johnson
- Dept of Infection and Population Health, University College London
| | | | - Jessica Datta
- Centre for Reproductive and Sexual Health, London School of Hygiene and Tropical Medicine
| | - Andrew J. Copas
- Dept of Infection and Population Health, University College London
| | | | - Pam Sonnenberg
- Dept of Infection and Population Health, University College London
| | - Wendy Macdowall
- Centre for Reproductive and Sexual Health, London School of Hygiene and Tropical Medicine
| | - Nigel Field
- Dept of Infection and Population Health, University College London
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38
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Reed GM, Drescher J, Krueger RB, Atalla E, Cochran SD, First MB, Cohen‐Kettenis PT, Arango‐de Montis I, Parish SJ, Cottler S, Briken P, Saxena S. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations. World Psychiatry 2016; 15:205-221. [PMID: 27717275 PMCID: PMC5032510 DOI: 10.1002/wps.20354] [Citation(s) in RCA: 183] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In the World Health Organization's forthcoming eleventh revision of the International Classification of Diseases and Related Health Problems (ICD-11), substantial changes have been proposed to the ICD-10 classification of mental and behavioural disorders related to sexuality and gender identity. These concern the following ICD-10 disorder groupings: F52 Sexual dysfunctions, not caused by organic disorder or disease; F64 Gender identity disorders; F65 Disorders of sexual preference; and F66 Psychological and behavioural disorders associated with sexual development and orientation. Changes have been proposed based on advances in research and clinical practice, and major shifts in social attitudes and in relevant policies, laws, and human rights standards. This paper describes the main recommended changes, the rationale and evidence considered, and important differences from the DSM-5. An integrated classification of sexual dysfunctions has been proposed for a new chapter on Conditions Related to Sexual Health, overcoming the mind/body separation that is inherent in ICD-10. Gender identity disorders in ICD-10 have been reconceptualized as Gender incongruence, and also proposed to be moved to the new chapter on sexual health. The proposed classification of Paraphilic disorders distinguishes between conditions that are relevant to public health and clinical psychopathology and those that merely reflect private behaviour. ICD-10 categories related to sexual orientation have been recommended for deletion from the ICD-11.
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Affiliation(s)
- Geoffrey M. Reed
- Department of Mental Health and Substance AbuseWorld Health OrganizationGenevaSwitzerland,School of PsychologyUniversidad Nacional Autónoma de MéxicoMexico CityMexico
| | - Jack Drescher
- Department of PsychiatryNew York Medical CollegeNew YorkNYUSA
| | - Richard B. Krueger
- Department of PsychiatryColumbia University, College of Physicians and Surgeons, New York State Psychiatric Institute and New York Presbyterian HospitalNew YorkNYUSA
| | - Elham Atalla
- Primary Care and Public Health Directorate, Ministry of HealthManamaBahrain
| | - Susan D. Cochran
- Fielding School of Public HealthUniversity of CaliforniaLos AngelesCAUSA
| | - Michael B. First
- Department of PsychiatryColumbia University, College of Physicians and Surgeons, New York State Psychiatric Institute and New York Presbyterian HospitalNew YorkNYUSA
| | - Peggy T. Cohen‐Kettenis
- Department of Medical PsychologyVU University Medical Centre, and Center of Expertise on Gender DysphoriaAmsterdamThe Netherlands
| | | | - Sharon J. Parish
- Departments of Medicine and PsychiatryWeill Cornell Medical College and New York Presbyterian Hospital/Westchester DivisionWhite PlainsNYUSA
| | - Sara Cottler
- Department of Reproductive Health and ResearchWorld Health OrganizationGenevaSwitzerland
| | - Peer Briken
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg‐EppendorfHamburgGermany
| | - Shekhar Saxena
- Department of Mental Health and Substance AbuseWorld Health OrganizationGenevaSwitzerland
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39
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Nappi RE, Cucinella L, Martella S, Rossi M, Tiranini L, Martini E. Female sexual dysfunction (FSD): Prevalence and impact on quality of life (QoL). Maturitas 2016; 94:87-91. [PMID: 27823751 DOI: 10.1016/j.maturitas.2016.09.013] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 09/18/2016] [Accepted: 09/20/2016] [Indexed: 01/23/2023]
Abstract
Female sexual dysfunction (FSD) and quality of life (QOL) are both multidimensional and have a bidirectional relationship across the reproductive life span and beyond. Methodological difficulties exist in estimating the real prevalence of FSD because it is hard to determine the level of distress associated with sexual symptoms in a large-scale survey. Approximately 40-50% of all women report at least one sexual symptom, and some conditions associated with hormonal changes at menopause, such as vulvovaginal atrophy (VVA) and hypoactive sexual desire disorder (HSDD), have a significant impact on sexual function and QOL. Sexual distress peaks at midlife, declines with age and is strongly partner-related. Many postmenopausal women are still sexually active, especially if they are in a stable partnership. Even though sexual functioning is impaired, a variety of psychosocial factors may maintain sexual satisfaction. That being so, health care providers (HCPs) should proactively address sexual symptoms at midlife and in older women, from a balanced perspective. Adequate counselling should be offered. Women with distressing symptoms may benefit from tailored hormonal and non-hormonal therapies, whereas women without distress related to their sexual experiences should not receive any specific treatment.
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Affiliation(s)
- Rossella E Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Dept of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy.
| | - Laura Cucinella
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Dept of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Silvia Martella
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Dept of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Margherita Rossi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Dept of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Lara Tiranini
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Dept of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Ellis Martini
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Dept of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
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40
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Doggweiler R, Whitmore KE, Meijlink JM, Drake MJ, Frawley H, Nordling J, Hanno P, Fraser MO, Homma Y, Garrido G, Gomes MJ, Elneil S, van de Merwe JP, Lin ATL, Tomoe H. A standard for terminology in chronic pelvic pain syndromes: A report from the chronic pelvic pain working group of the international continence society. Neurourol Urodyn 2016; 36:984-1008. [PMID: 27564065 DOI: 10.1002/nau.23072] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 05/23/2016] [Indexed: 12/27/2022]
Abstract
AIMS Terms used in the field of chronic pelvic pain (CPP) are poorly defined and often confusing. An International Continence Society (ICS) Standard for Terminology in chronic pelvic pain syndromes (CPPS) has been developed with the aim of improving diagnosis and treatment of patients affected by chronic pelvic pain syndromes. The standard aims to facilitate research, enhance therapy development and support healthcare delivery, for healthcare providers, and patients. This document looks at the whole person and all the domains (organ systems) in a systematic way. METHODS A dedicated working group (WG) was instituted by the ICS Standardisation Steering Committee according to published procedures. The WG extracted information from existing relevant guidelines, consensus documents, and scientific publications. Medline and other databases were searched in relation to each chronic pelvic pain domain from 1980 to 2014. Existing ICS Standards for terminology were utilized where appropriate to ensure transparency, accessibility, flexibility, and evolution. Consensus was based on majority agreement. RESULTS The multidisciplinary CPPS Standard reports updated consensus terminology in nine domains; lower urinary tract, female genital, male genital, gastrointestinal, musculoskeletal, neurological aspects, psychological aspects, sexual aspects, and comorbidities. Each is described in terms of symptoms, signs and further evaluation. CONCLUSION The document presents preferred terms and definitions for symptoms, signs, and evaluation (diagnostic work-up) of female and male patients with chronic pelvic pain syndromes, serving as a platform for ongoing development in this field. Neurourol. Urodynam. 36:984-1008, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Kristene E Whitmore
- Chair of Urology and Female Pelvic Medicine and Reconstructive Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Jane M Meijlink
- International Painful Bladder Foundation, Naarden, Netherlands
| | - Marcus J Drake
- Department of Urology, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - Helena Frawley
- Physiotherapy at La Trobe University, Melbourne, Cabrini Health, Melbourne, Australia
| | - Jørgen Nordling
- Department of Urology, University of Copenhagen, Herlev Hospital, Herlev, Denmark
| | - Philip Hanno
- Department of Urology, Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Matthew O Fraser
- Department of Urology Surgery, Duke University and Durham Veterans Affairs Medical Centers, Durham, North Carolina
| | - Yukio Homma
- Department of Urology, The University of Tokyo, Tokyo, Japan
| | - Gustavo Garrido
- Head of Voiding Dysfunctions and Urodynamics Section, Urology Division, Hospital de Clínicas, University of Buenos Aires, Argentina
| | - Mario J Gomes
- Department of Urology, St. António Hospital, Oporto, Portugal
| | - Sohier Elneil
- Department of Urogynecology, University College Hospital, National Hospital for Neurology and Neurosurgery, GB
| | | | - Alex T L Lin
- Department of Urology, Taipei Veterans General Hospital, National Yang Ming University, Taipei, Taiwan
| | - Hikaru Tomoe
- Department of Urogynecology, Chair of Pelvic Reconstructive Surgery and Urology, Tokyo Women's Medical University Medical Center East, Japan
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41
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Nowosielski K, Wróbel B, Kowalczyk R. Women's Endorsement of Models of Sexual Response: Correlates and Predictors. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:291-302. [PMID: 26601676 DOI: 10.1007/s10508-015-0611-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 08/17/2015] [Accepted: 08/25/2015] [Indexed: 06/05/2023]
Abstract
Few studies have investigated endorsement of female sexual response models, and no single model has been accepted as a normative description of women's sexual response. The aim of the study was to establish how women from a population-based sample endorse current theoretical models of the female sexual response--the linear models and circular model (partial and composite Basson models)--as well as predictors of endorsement. Accordingly, 174 heterosexual women aged 18-55 years were included in a cross-sectional study: 74 women diagnosed with female sexual dysfunction (FSD) based on DSM-5 criteria and 100 non-dysfunctional women. The description of sexual response models was used to divide subjects into four subgroups: linear (Masters-Johnson and Kaplan models), circular (partial Basson model), mixed (linear and circular models in similar proportions, reflective of the composite Basson model), and a different model. Women were asked to choose which of the models best described their pattern of sexual response and how frequently they engaged in each model. Results showed that 28.7% of women endorsed the linear models, 19.5% the partial Basson model, 40.8% the composite Basson model, and 10.9% a different model. Women with FSD endorsed the partial Basson model and a different model more frequently than did non-dysfunctional controls. Individuals who were dissatisfied with a partner as a lover were more likely to endorse a different model. Based on the results, we concluded that the majority of women endorsed a mixed model combining the circular response with the possibility of an innate desire triggering a linear response. Further, relationship difficulties, not FSD, predicted model endorsement.
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Affiliation(s)
- Krzysztof Nowosielski
- Department of Gynecology and Obstetrics, Specialist Teaching Hospital in Tychy, ul. Edukacji 102, 43-100, Tychy, Poland.
- Department of Sexology and Family Planning, Faculty of Health Science, Medical College in Sosnowiec, ul. Wojska Polskiego 6, 41-200, Sosnowiec, Poland.
| | - Beata Wróbel
- Department of Gynecology and Obstetrics, Specialist Teaching Hospital in Tychy, ul. Edukacji 102, 43-100, Tychy, Poland
- Center for Sexual Medicine, ul Staszica 58, 41-300, Dabrowa Gornicza, Poland
| | - Robert Kowalczyk
- Department of Sexology, Faculty of Psychology and Arts, Andrzej Frycz Modrzewski Krakow University, ul. Gustawa Herlinga-Grudzińskiego 1, 30-705, Kraków, Poland
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Alarcão V, Machado FL, Giami A. Traditions and contradictions of sexual function definitions for Portuguese heterosexual men and women: medicalization and socially constructed gender effects. SEXUAL AND RELATIONSHIP THERAPY 2015. [DOI: 10.1080/14681994.2015.1088643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
Strokes are the second leading cause of death and the third leading cause of disability worldwide. Thanks in part to better and more available diagnosis, treatment, and rehabilitation, the vast majority of stroke patients tend to survive strokes, particularly in the industrialized world. Motor disability and cognitive changes such as aphasia and visuospatial disorders are most often considered among the major contributors to stroke burden. This chapter discusses disorders of sexual functions as another frequent sequel of strokes. Strokes generally induce hyposexuality, but in some instances they may be followed by hypersexuality. There is some evidence suggesting that lesions of either hemisphere affect sexual activities, but for different reasons: aphasia and depression after left-hemisphere lesions, a deficit in arousal and perhaps visuospatial disorders after right-hemisphere lesions. Psychologic, psychosocial, and physical factors, as well as medications, play an important role. A better understanding of the psychosocial and physiologic mechanisms underlying sexual functioning can provide insight into improving sexual activity and therefore quality of life in patients affected by strokes and other brain lesions.
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Abstract
This volume of the Handbook of Clinical Neurology deals with neurologic disorders of sex and bladder. Sexuality is for the large majority of humans a component of a fulfilled life, even though it is not "vital" in the usual sense of the word. However, dysfunctions of the lower urinary tract (LUT) are vital, as they may lead to chronic infection, dilatation of the upper urinary tract, renal insufficiency, and death. Sexual disorders and LUT are often mentioned in ancient literature, but most contemporary methods of diagnosis and treatment were only introduced in the 20th century. Despite the relatively high prevalence of these disorders, most physicians are ill prepared to discuss them with their patients, let alone to diagnose and treat them. It is the aim of this volume of the Handbook to try to reverse this attitude and convince neurologists that sexual and LUT function need to be addressed in their patients, for reasons of correct diagnosis and possible therapeutic consequences, as well as gaining overall trust from the patient.
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Leanza F, Maritato A. Care of the Patient with Sexual Concerns. Fam Med 2015. [DOI: 10.1007/978-1-4939-0779-3_65-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
PURPOSE OF REVIEW To analyze literature on sexual pain disorders and to review and summarize the articles published throughout 2013 which contribute to the current knowledge on this subject. RECENT FINDINGS By age 40, 7.8% of women reported vulvar pain. Diagnostic and Statistical Manual of Mental Disorders, fifth edition, has combined vaginismus and dyspareunia into the same diagnostic label. The research reviewed in this article seems to differently point toward two conditions, focusing on different aspects both on the etiological and on the treatment area. Higher levels of partner-perceived self-efficacy and lower levels of partner catastrophizing were associated with less pain intensity in women with entry dyspareunia, independent of women's pain perception and self-efficacy. Alexithymia and fear were found to be important etiological factors in vaginismus. SUMMARY The present findings did not provide clear evidence in support of the superiority of any treatment and highlight the need for randomized, placebo-controlled trials that compare treatments in the future. A lot of work remained to be done to understand such a complex and multifaceted disturbance as genital sexual pain, but the articles examined showed that we are slowly adding more knowledge on the etiological cause and treatment models for such conditions.
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Advances in the understanding and behavioural management of sexual dysfunctions. Curr Opin Psychiatry 2014; 27:369-73. [PMID: 25055043 DOI: 10.1097/yco.0000000000000081] [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: 11/27/2022]
Abstract
PURPOSE OF REVIEW Sexual medicine is a branch often neglected by professionals from different specialties associated with it. However, research in this field has picked up in recent years, owing to recently renewed interest in upholding the sexual rights of the population in general and lesbian, gay, bisexual and transgender groups in particular. The recently released Diagnostic and statistical manual of mental disorders, fifth edition, by the American Psychiatric Association in May 2013 has stirred up the supporters and critics (of Diagnostic and statistical manual of mental disorders, fifth edition) alike. RECENT FINDINGS Diagnostic and statistical manual of mental disorders, fifth edition, has updated diagnostic criteria for some of the sexual disorders to improve understanding and diagnostic validity. Certain sexual dysfunctions have been regrouped and sexual response cycle-based classification has been partially withdrawn. Research in the area of behavioral management of sexual dysfunctions has given some novel concepts, particularly for women. SUMMARY Although improvements in behavioral management (of sexual dysfunctions) and classification/diagnostic criteria in Diagnostic and statistical manual of mental disorders, fifth edition, is a step forward in the field of sexual medicine, we need to further improve our understanding in many of the lacunae, still bearing on the field of sexual medicine, lest we may fall at the first hurdle.
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