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Kim NN. Testosterone and Female Sexual Desire: Direct or Indirect Effects? J Sex Med 2021; 19:5-7. [PMID: 34848139 DOI: 10.1016/j.jsxm.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Noel N Kim
- Institute for Sexual Medicine, San Diego, CA, USA.
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Van Overmeire R, Vesentini L, Vanclooster S, Muysewinkel E, Bilsen J. Sexual Desire, Depressive Symptoms and Medication Use Among Women With Fibromyalgia in Flanders. Sex Med 2021; 10:100457. [PMID: 34839232 PMCID: PMC8847810 DOI: 10.1016/j.esxm.2021.100457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/06/2021] [Accepted: 10/09/2021] [Indexed: 11/27/2022] Open
Abstract
Background Fibromyalgia (FM) is associated with sexual dysfunction, though much less is known about the sexual desire, and especially dyadic and solitary sexual desire, among women with fibromyalgia. Aim To investigate on the one hand the global sexual desire, the dyadic sexual and solitary sexual desire, and on the other hand the association with depressive symptoms, fibromyalgia symptoms and medication use among women with fibromyalgia in Flanders, Belgium. Methods An online survey was spread through the Flemish league for Fibromyalgia Patients to be completed by women with fibromyalgia. The sexual desire inventory-2 (SDI-2) was used to measure sexual desire (global, dyadic, solitary), the VASFIQ for fibromyalgia symptoms, and the PHQ-2 for depressive symptoms, while also including questions on demographic factors (time since FM, age) and medication usage (antidepressants, pain medication, sleeping medication). Main Outcome Measure Global sexual desire, dyadic sexual desire and solitary sexual desire were studied in relation to depressive symptoms, medication use and fibromyalgia symptoms. Results One hundred and three women with FM answered the survey. Depressive symptoms were significantly associated with a lower global, dyadic and solitary sexual desire, as was the use of antidepressant medication. The association between solitary sexual desire and depressive symptoms disappeared when controlled for antidepressant medication. Age, fibromyalgia symptoms nor time since diagnosis were significantly associated with any form of sexual desire. Conclusion Depressive symptoms and antidepressant medication, and not fibromyalgia symptoms, were associated with decreased sexual desire of women with FM. As antidepressant medication and depressive symptoms are associated with a decreased sexual desire, more attention should be paid towards the mental health issues associated with fibromyalgia, as well as the prescription of antidepressant medication. This study is the first to investigate sexual desire among women with fibromyalgia in Flanders, and one of the few internationally to have done so. It is limited by its cross-sectional design, and for not providing information on men with FM. Van Overmeire R, Vesentini L, Vanclooster S, et al. Sexual Desire, Depressive Symptoms and Medication Use Among Women With Fibromyalgia in Flanders. Sex Med 2022;10:100457.
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Affiliation(s)
- Roel Van Overmeire
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Ixelles, Belgium.
| | - Lara Vesentini
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Ixelles, Belgium
| | - Stephanie Vanclooster
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Ixelles, Belgium
| | - Emilie Muysewinkel
- Interuniversity Centre for Health Economics Research, Department of Public Health, Vrije Universiteit Brussel, Ixelles, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Ixelles, Belgium
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Vowels LM, Vowels MJ, Mark KP. Uncovering the Most Important Factors for Predicting Sexual Desire Using Explainable Machine Learning. J Sex Med 2021; 18:1198-1216. [PMID: 37057427 DOI: 10.1016/j.jsxm.2021.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/02/2021] [Accepted: 04/21/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Low sexual desire is the most common sexual problem reported with 34% of women and 15% of men reporting lack of desire for at least 3 months in a 12-month period. Sexual desire has previously been associated with both relationship and individual well-being highlighting the importance of understanding factors that contribute to sexual desire as improving sexual desire difficulties can help improve an individual's overall quality of life. AIM The purpose of the present study was to identify the most salient individual (eg, attachment style, attitudes toward sexuality, gender) and relational (eg, relationship satisfaction, sexual satisfaction, romantic love) predictors of dyadic and solitary sexual desire from a large number of predictor variables. METHODS Previous research has relied primarily on traditional statistical models which are limited in their ability to estimate a large number of predictors, non-linear associations, and complex interactions. We used a machine learning algorithm, random forest (a type of highly non-linear decision tree), to circumvent these issues to predict dyadic and solitary sexual desire from a large number of predictors across 2 online samples (N = 1,846; includes 754 individuals forming 377 couples). We also used a Shapley value technique to estimate the size and direction of the effect of each predictor variable on the model outcome. OUTCOMES The outcomes included total, dyadic, and solitary sexual desire measured using the Sexual Desire Inventory. RESULTS The models predicted around 40% of variance in dyadic and solitary desire with women's desire being more predictable than men's overall. Several variables consistently predicted dyadic sexual desire such as sexual satisfaction and romantic love, and solitary desire such as masturbation and attitudes toward sexuality. These predictors were similar for both men and women and gender was not an important predictor of sexual desire. CLINICAL TRANSLATION The results highlight the importance of addressing overall relationship satisfaction when sexual desire difficulties are presented in couples therapy. It is also important to understand clients' attitudes toward sexuality. STRENGTHS & LIMITATIONS The study improves on existing methodologies in the field and compares a large number of predictors of sexual desire. However, the data were cross-sectional and there may have been variables that are important for desire but were not present in the datasets. CONCLUSION Higher sexual satisfaction and feelings of romantic love toward one's partner are important predictors of dyadic sexual desire whereas regular masturbation and more permissive attitudes toward sexuality predicted solitary sexual desire. Vowels LM, Vowels MJ, Mark KP. Uncovering the Most Important Factors for Predicting Sexual Desire Using Explainable Machine Learning. J Sex Med 2021;18:1198-1216.
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Affiliation(s)
- Laura M Vowels
- Department of Psychology, University of Southampton, Southampton, UK; Blueheart Technologies Ltd, London, UK.
| | - Matthew J Vowels
- Centre for Computer Vision, Speech and Signal Processing (CVSSP), University of Surrey, Guildford, UK
| | - Kristen P Mark
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
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Velten J, Hirschfeld G, Meyers M, Margraf J. Psychometric Properties of a Self-Report Version of the Sexual Interest and Desire Inventory-Female (SIDI-F-SR). J Sex Med 2021; 18:990-995. [PMID: 33903043 DOI: 10.1016/j.jsxm.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/13/2021] [Accepted: 03/01/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The Sexual Interest and Desire Inventory-Female (SIDI-F) is a clinician-administered scale that allows for a comprehensive assessment of symptoms related to Hypoactive Sexual Desire Dysfunction (HSDD). As self-report questionnaires may facilitate less socially desirable responding and as time and resources are scarce in many clinical and research settings, a self-report version was developed (Sexual Interest and Desire Inventory- Female Self-Report; SIDI-F-SR). AIM To assess the psychometric properties of the SIDI-F-SR and to investigate the agreement between the SIDI-F and SIDI-F-SR. METHODS A total of 170 women (Mage = 37, SD = 11, range = 20-69) with HSDD answered the SIDI-F, administered by a clinical psychologist via telephone, first, followed by the SIDI-F-SR, delivered as an Internet-based questionnaire. A subset of 19 women answered the SIDI-F-SR twice over a period of 14 weeks. OUTCOMES Convergent validity of the SIDI-F-SR was assessed via correlations with the desire subscale of the Female Sexual Function Index and the Female Sexual Distress Scale Revised. Internal consistency and test-retest reliability as well as intraclass correlation and predictors of absolute agreement between SIDI-F and SIDI-F-SR were examined. RESULTS Test-retest-reliability was good (r = 0.74). Convergent validity was low but comparable between SIDI-F and SIDI-F-SR. Internal consistency of the SIDI-F-SR was acceptable (α = 0.76) and comparable to the SIDI-F (α = 0.74). When corrections for the restriction of range were applied, internal consistency of the SIDI-F-SR increased to 0.91. There was high agreement between SIDI-F and SIDI-F-SR (ICC = 0.86). On average, women scored about one point higher (indicated more desire) in the self-report vs the clinician-administered scale. CLINICAL IMPLICATIONS The SIDI-F-SR can be used in settings where time and resources are limited. Whether the clinical cutoff point for the SIDI-F is adequate for the SIDI-F-SR has yet to be determined. STRENGTHS AND LIMITATIONS Large sample of diverse women with HSDD. Lack of control groups (ie, healthy controls, women with other sexual dysfunctions). CONCLUSION The SIDI-F-SR showed promising psychometric properties in a sample of women with HSDD. Velten J, Hirschfeld G, Meyers M, et al. Psychometric Properties of a Self-Report Version of the Sexual Interest and Desire Inventory-Female (SIDI-F-SR). J Sex Med 2021;18:990-995.
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Affiliation(s)
- Julia Velten
- Mental Health Research and Treatment Center, Clinical Psychology and Psychotherapy, Ruhr University Bochum, Bochum, Germany.
| | - Gerrit Hirschfeld
- Faculty of Business and Health, CareTech OWL Center for Health, Welfare and Technology, University of Applied Sciences Bielefeld, Bielefeld, Germany
| | - Milena Meyers
- Mental Health Research and Treatment Center, Clinical Psychology and Psychotherapy, Ruhr University Bochum, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Clinical Psychology and Psychotherapy, Ruhr University Bochum, Bochum, Germany
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Abstract
BACKGROUND Empirical data on sexual boredom are scarce and unsystematized, contrasting with the literature on general boredom. AIM The aim of this review of literature is to verify how sexual boredom is defined in previous research and which relationships were found with sexual functioning, relationship dynamics, or gender. METHODS A systematic search was conducted in EBSCO, Scopus, Web of Science, and PubMed databases for papers published until August 2020. Search terms used were "sexual boredom" or "sexual tedium" or "sexual indifference" or "sexual monotony" or a combination of "boredom" and "sexual activity" or "intercourse". This systematic review followed PRISMA guidelines. OUTCOMES Articles were grouped in general boredom and sexuality research and in sexual boredom research. RESULTS This review consists of 43 articles, of which 31 are quantitative studies, 8 are qualitative studies, and 4 are mixed-method studies. Studies concerning general boredom and sexuality include research on diverse aspects of sexual behavior, namely solitary sexual behavior, extra-dyadic sex, compulsive sexual behavior, and risky sexual behavior. Sexual boredom research included papers regarding personality, sexual response, and varied aspects of sexual behavior. CLINICAL IMPLICATIONS Findings suggest sexual boredom is related with sexual response, sexual satisfaction, and hypersexuality, which renders clinical relevance. Sexual boredom impacts well-being, and further research should focus on exploring potential mechanisms underpinning this sexual problem. STRENGTHS AND LIMITATIONS To the authors' knowledge, this is the only existing systematic review of sexual boredom and allowed identifying key features of sexual boredom and related aspects. However, because most studies are correlational, and several do not use comprehensive measures of sexual boredom, no causal relationships were identified. CONCLUSION This review indicates the construct of sexual boredom includes individual, relationship, and societal aspects. However, no definition of sexual boredom includes these, and current knowledge does not allow formulating a model or a theory of sexual boredom. de Oliveira L, Carvalho J, Nobre P. A Systematic Review on Sexual Boredom. J Sex Med 2021;18:565-581.
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Affiliation(s)
- Leonor de Oliveira
- Center for Psychology at University of Porto, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal.
| | - Joana Carvalho
- Center for Psychology at University of Porto, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Pedro Nobre
- Center for Psychology at University of Porto, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
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Attaky A, Schepers J, Kok G, Dewitte M. The Role of Sexual Desire, Sexual Satisfaction, and Relationship Satisfaction in the Sexual Function of Arab Couples Living in Saudi Arabia. Sex Med 2021; 9:100303. [PMID: 33529812 PMCID: PMC8072168 DOI: 10.1016/j.esxm.2020.100303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 12/03/2020] [Accepted: 12/06/2020] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION This study is one of the first to examine the association between relationship and sexual variables as approached from a dyadic perspective in Saudi Arabian couples. Theoretical models assign an important role to relationship factors in women's sexuality. AIM We examined the role of sexual and relationship satisfaction relative to sexual desire in explaining sexual function in a sample of clinical versus nonclinical couples. METHODS This is a cross-sectional, observational study in a sample of 50 heterosexual couples with sexual problems and 50 control couples without problems (N = 100 couples; 200 men and women). MAIN OUTCOME MEASURE All participants completed an Arabic version of measures of relationship satisfaction, sexual satisfaction, sexual desire, sexual distress, and sexual function. RESULTS Results showed that in the clinical group, sexual function of women was predicted by their own and their partner's level of sexual satisfaction, and their own level of solitary and dyadic sexual desire. Men's sexual function was predicted by their own sexual satisfaction and their partner's relationship satisfaction. In the control group, the sexual function of women was predicted only by their level of sexual satisfaction. In men, sexual function was predicted by their own sexual satisfaction and their level of dyadic sexual desire. CONCLUSION These results suggest that sexual desire rather than relationship satisfaction plays an important role in women's sexual dysfunction. Being the most consistent determinant of male and female sexual functioning, sexual satisfaction is an important target of intervention in Arabian couples. A Attaky, J Schepers, G Kok, et al. The Role of Sexual Desire, Sexual Satisfaction, and Relationship Satisfaction in the Sexual Function of Arab Couples Living in Saudi Arabia. Sex Med 2021;9:100303.
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Affiliation(s)
- Atia Attaky
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Neuropsychiatry, Al-Mattaria Teaching Hospital, Cairo, Egypt; Mutmaena Medical Psychiatric Center Riyadh. 1622. KSA.
| | - Jan Schepers
- Department of Methodology and Statistics, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Gerjo Kok
- Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marieke Dewitte
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Suen YT, Chan RCH, Wong EMY. To Have or Not to Have Sex? COVID-19 and Sexual Activity Among Chinese-Speaking Gay and Bisexual Men in Hong Kong. J Sex Med 2021; 18:29-34. [PMID: 33223429 PMCID: PMC10016824 DOI: 10.1016/j.jsxm.2020.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/31/2020] [Accepted: 10/02/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) outbreak has fundamentally changed daily routine, including sexual activity. However, most research on sexual activity during the COVID-19 pandemic focused on heterosexual individuals. The only study so far on men who have sex with men was conducted in the United States. AIM Our study expands the understanding of sexual activity during the COVID-19 pandemic by studying gay and bisexual men in Hong Kong. Although sexual desire and sexual activity continue to be important aspects of one's life during the COVID-19 pandemic, there are COVID-19-related barriers to having sex. This study therefore examined the association between sexual desire, COVID-19-related barriers, and whether to engage in sexual activity or not during the COVID-19 pandemic. METHODS 857 cisgender sexual minority people in Hong Kong participated in an online survey study, and for this article, only male participants were included in the analysis, yielding an analytical sample of 376 gay and bisexual men. OUTCOMES Participants were asked to assess their sexual desire (ie, sexual drive and sexual motivation), COVID-19-related barriers (ie, perceived difficulties to have sex with another person during the pandemic and perceived risk of COVID-19 infection), and sexual activity during the COVID-19 pandemic. RESULTS It was found that while sexual desire remained prevalent among the gay and bisexual men, COVID-19-related barriers were also commonly observed. Sexual drive and sexual motivation were positively associated with sexual activity. Perceived difficulties to have sex with another person during the pandemic and perceived risk of COVID-19 infection were negatively predictive of engaging in sexual activity, after controlling for general sexual desire. CLINICAL IMPLICATIONS Understanding the ambivalence and driving and inhibiting factors for having sex during the COVID-19 pandemic can provide a new framework for understanding people's sexual activity during an unprecedented scale of the pandemic. It is likely that abstinence would not work as the respondents expressed strong sexual desire and that the pandemic is going to last for a long time. Governments, policy makers, and sexual scientists need to work together to come up with practicable, feasible, and easy-to-follow guidelines for having sex during the pandemic. STRENGTH & LIMITATIONS This is one of the first studies to examine the impact of COVID-19 on sexual activity among gay and bisexual men. The results should be interpreted with caution because of the use of cross-sectional design and nonprobability sampling. CONCLUSION Sexual desire and COVID-19-related barriers serve as driving and inhibiting factors in explaining whether or not people have sex during the COVID-19 pandemic. Suen YT, Chan RCH, Wong EMY. To Have or Not to Have Sex? COVID-19 and Sexual Activity Among Chinese-Speaking Gay and Bisexual Men in Hong Kong. J Sex Med 2021;18:29-34.
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Affiliation(s)
- Yiu Tung Suen
- Gender Studies Programme, Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Randolph C H Chan
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Eliz Miu Yin Wong
- Department of Social Policy, London School of Economics and Political Science, London, United Kingdom
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Willoughby BJ, Leonhardt ND, Augustus RA. Associations Between Pornography Use and Sexual Dynamics Among Heterosexual Couples. J Sex Med 2020; 18:179-192. [PMID: 33288440 DOI: 10.1016/j.jsxm.2020.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 10/09/2020] [Accepted: 10/20/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND While links between pornography use and couple relational well-being have been the subject of multiple research studies, less attention has been paid to the associations between pornography use and specific sexual behavior within the relationship. AIM This study aimed to explore associations between each partner's pornography use, sexual desire, sexual satisfaction, and intercourse/non-intercourse sexual behavior. The confounding and moderating role of religiosity was also explored. METHODS A dyadic sample of 240 heterosexual couples was used. Measurement assessed pornography use, sexual desire, sexual satisfaction, and sexual behavior. OUTCOMES Sexual satisfaction as well as intercourse and non-intercourse sexual behaviors were examined. RESULTS Results suggested consistent gendered differences where female pornography use was directly associated with higher reports of female sexual desire, whereas male pornography use was directly associated with more male but less female partner desire and lower overall male sexual satisfaction. Male pornography use was also indirectly associated with sexual satisfaction for both partners and non-intercourse behaviors within the relationship through sexual desire. Overall, religiosity had little impact on the results of the study. CLINICAL TRANSLATION The complex associations between pornography use, sexual desire, and sexual behaviors suggested by our results highlight the importance of comprehensive and systemic assessment and education around sexuality when working with individuals and couples. STRENGTHS & LIMITATIONS The main strength of this study is the use of dyadic data. The main limitation is the cross-sectional nature of the data CONCLUSION: The associations between pornography use and a variety of outcomes are highly nuanced. This study provides an important step forward in more fully accounting for the complications of pornography use in a relationship. Willoughby BJ, Leonhardt ND, Augustus RA. Associations Between Pornography Use and Sexual Dynamics Among Heterosexual Couples. J Sex Med 2021;18:179-192.
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Longo M, Cirillo P, Scappaticcio L, Tomasuolo M, Pernice V, Caruso P, Bellastella G, Maiorino MI, Esposito K. Female Sexual Function in Young Women With Type 1 Diabetes and Additional Autoimmune Diseases. J Sex Med 2020; 18:219-223. [PMID: 33223430 DOI: 10.1016/j.jsxm.2020.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/03/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Female sexual dysfunctions (FSDs) are frequent concerns in women with type 1 diabetes (T1D), which is frequently associated with other autoimmune diseases (ADs). AIM To assess sexual function in young type 1 diabetic women with or without additional ADs. METHODS Women with T1D aged 18-35 years with a stable couple relationship and no oral contraceptive use were enrolled. Diabetic women with concomitant ADs were also identified. All women completed the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale. OUTCOMES The main outcome was the prevalence of FSD. The FSFI-single domain scores were also evaluated in diabetic women with or without additional ADs. RESULTS The global population included 154 diabetic women, of whom 66 (42%) had at least one additional AD. The prevalence of FSD was similar among diabetic women with and those without (30% vs 32%, P = .980) additional ADs. The FSFI-desire score was significantly lower among diabetic women with concomitant ADs than those without ADs [median (interquartile range), 4.1 (3.6, 4.8) vs 4.6 (4.0, 5.0), P = .042]. CLINICAL IMPLICATIONS An early evaluation of sexual function in women with T1D and concomitant ADs should be encouraged. STRENGTHS & LIMITATIONS Major strengths are the use of 2 validated tools to diagnose FSD and the relatively large number of subjects investigated. The limitations include the cross-sectional nature of the study, which does not allow to make inference regarding the cause and effect. CONCLUSION Diabetic women with additional ADs show an impairment in sexual desire as compared with those suffering only from diabetes. Longo M, Cirillo P, Scappaticcio L, et al. Female Sexual Function in Young Women With Type 1 Diabetes and Additional Autoimmune Diseases. J Sex Med 2021;18:219-223.
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Affiliation(s)
- Miriam Longo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy; Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paolo Cirillo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Lorenzo Scappaticcio
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Tomasuolo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Vlenia Pernice
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paola Caruso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Bellastella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy; Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Ida Maiorino
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy; Unit of Diabetes, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Katherine Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy; Unit of Diabetes, University of Campania "Luigi Vanvitelli", Naples, Italy
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Karsiyakali N, Sahin Y, Ates HA, Okucu E, Karabay E. Evaluation of the Sexual Functioning of Individuals Living in Turkey During the COVID-19 Pandemic: An Internet-Based Nationwide Survey Study. Sex Med 2020; 9:100279. [PMID: 33291042 PMCID: PMC7718780 DOI: 10.1016/j.esxm.2020.10.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/09/2022] Open
Abstract
Introduction Although many countries in the world prioritize self-isolation measures during the corona virus disease 2019 (COVID-19) pandemic period, the effects of this process on sexual functioning are not yet known. Aim To evaluate the effects of the COVID-19 pandemic on the sexual functioning of individuals who declared no medical history of the COVID-19 disease. Methods A total of 1,356 participants filled out an Internet-based survey between June 1 and June 20, 2020. The data from these participants were analyzed to determine sexual functioning in terms of sexual intercourse frequency and sexual desire during the COVID-19 pandemic. Subgroups analyses were also performed, wherein the subgroups were developed according to the population density of the cities in which the participants lived to examine whether population density has any effect on the sexual functions of the participants during the COVID-19 pandemic. Main Outcome Measure The study outcomes were obtained using a study-specific questionnaire to assess the changes in people's sexual functioning. Results The mean age of the participants was 33.16 ± 8.31 years. There was a statistically significant difference between the participants according to the decrease in the number of weekly sexual intercourses when they were compared in terms of smoking status, alcohol consumption, marital and parental status, being a health-care worker, having a regular sexual partner, and the working status during the COVID-19 pandemic (P < .05, for each). In the subgroup analyses, it was observed that there was a statistically significant difference between the groups for change in the number of sexual intercourses, the number of masturbations, and sexual desire during the COVID-19 pandemic (P < .05, for each). Conclusion A decline in sexual functioning was observed during the COVID-19 pandemic period. Living in a metropolitan area was associated with a decline in both sexual intercourse frequency and sexual desire during the COVID-19 pandemic. Karsiyakali N, Sahin Y, Ates HA, et al. Evaluation of the Sexual Functioning of Individuals Living in Turkey During the COVID-19 Pandemic: An Internet-Based Nationwide Survey Study. Sex Med 2021;9:100279.
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Affiliation(s)
- Nejdet Karsiyakali
- Department of Urology, Acibadem M.A. Aydinlar University, Altunizade Hospital, Istanbul, Turkey.
| | - Yusuf Sahin
- Department of Urology, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | | | - Emrah Okucu
- Department of Urology, Idil State Hospital, Sirnak, Turkey
| | - Emre Karabay
- Department of Urology, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Rosen NO, Corsini-Munt S, Dubé JP, Boudreau C, Muise A. Partner Responses to Low Desire: Associations With Sexual, Relational, and Psychological Well-Being Among Couples Coping With Female Sexual Interest/Arousal Disorder. J Sex Med 2020; 17:2168-2180. [PMID: 32978067 DOI: 10.1016/j.jsxm.2020.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/06/2020] [Accepted: 08/23/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The experience of distressing low sexual interest/arousal-female sexual interest/arousal disorder (FSIAD)-is prevalent in women of all ages and is associated with poorer sexual, relationship, and psychological well-being than women without this difficulty. Women who are partnered are almost 5 times more likely to be distressed by low desire and to receive a diagnosis of FSIAD than unpartnered women, indicating that interpersonal factors are highly relevant, although largely neglected in past research. AIM In a dyadic cross-sectional and longitudinal study, we examined whether partner responses to FSIAD were associated with the sexual, relationship, and psychological well-being of couples, and whether any effects persisted 1 year later. METHODS Women diagnosed with FSIAD (N = 89) completed a validated measure of perceived partner positive vs negative responses to their low sexual interest/arousal and their partners reported on their own responses, as well as measures of sexual desire, sexual satisfaction, relationship satisfaction, sexual distress, and anxiety. 1 year later, couples (N = 66) completed the outcome measures again. Data were analyzed according to the Actor-Partner Interdependence Model. OUTCOMES Outcomes included were the Sexual Desire Inventory-Solitary and Partner-Focused Subscales; Global Measure of Sexual Satisfaction; Female Sexual Distress Scale; Couple Satisfaction Index; and State-Trait Anxiety Inventory-Short-Form. RESULTS When women with FSIAD perceived more positive partner responses (eg, warm, supportive, compassionate) than negative responses (eg, hostile, unsupportive, indifferent), they were more satisfied with the relationship and they and their partners reported lower anxiety. When partners reported more positive than negative responses, they had greater relationship and sexual satisfaction and lower sexual distress and anxiety. Exploratory analyses revealed that women's perceptions of their partners' responses accounted for the link between partners' own responses and women's relationship satisfaction and anxiety. Partner responses did not predict any change in outcomes over time. CLINICAL IMPLICATIONS Findings support interpersonal conceptualizations of FSIAD and may inform the development of future couple-based interventions. STRENGTHS & LIMITATIONS This study is one of the few dyadic investigations of FSIAD, as diagnosed via a clinical interview. Significant associations were only observed cross-sectionally, limiting causal conclusions. There was limited power to detect longitudinal effects. CONCLUSION More positive responses to women's low sexual interest/arousal by partners is linked to better adjustment among couples affected by FSIAD. Rosen NO, Corsini-Munt S, Dubé JP, et al. Partner Responses to Low Desire: Associations With Sexual, Relational, and Psychological Well-Being Among Couples Coping With Female Sexual Interest/Arousal Disorder. J Sex Med 2020;17:2168-2180.
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Affiliation(s)
- Natalie O Rosen
- Department of Psychology and Neuroscience, Life Sciences Centre, Dalhousie University, Halifax, NS, Canada; Department of Obstetrics and Gynaecology, IWK Health Centre, Halifax, NS, Canada.
| | | | - Justin P Dubé
- Department of Psychology and Neuroscience, Life Sciences Centre, Dalhousie University, Halifax, NS, Canada
| | - Carmen Boudreau
- Department of Psychology and Neuroscience, Life Sciences Centre, Dalhousie University, Halifax, NS, Canada
| | - Amy Muise
- Department of Psychology, York University, Behavioural Science Building, Toronto, ON, Canada
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Mitchell VE, Mogilski JK, Donaldson SH, Nicolas SCA, Welling LLM. Sexual Motivation and Satisfaction Among Consensually Non-Monogamous and Monogamous Individuals. J Sex Med 2020; 17:1072-1085. [PMID: 32205084 DOI: 10.1016/j.jsxm.2020.02.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 01/27/2020] [Accepted: 02/14/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Previous research has found differences in sexual motives and, separately, sexual satisfaction in consensually non-monogamous (CNM) and monogamous individuals and that these constructs are related to relationship outcomes (eg, relationship quality). AIMS The present study sought to refine and expand on previous research by (i) using a more common, validated measure of sexual motives, (ii) measuring sexual satisfaction with multiple partners within CNM relationships, and (iii) examining how sexual motives are related to sexual satisfaction in CNM relationships. METHODS Participants were recruited from a university and using online forums that CNM individuals frequently use (eg, reddit, Facebook). Individuals recruited included those in non-exclusive relationships with one partner ("non-exclusive single-partner;" n = 40), those in non-exclusive relationships with more than one partner ("non-exclusive multipartner;" n = 87), and monogamous individuals (n = 322). Data were analyzed using multivariate analysis of variance and hierarchical multiple regressions. OUTCOMES The main outcome measures of this study are scores on the Why Humans Have Sex Scale and the New Scale for Sexual Satisfaction. RESULTS Non-exclusive multipartner participants were more motivated to have sex for physical motivations compared with monogamous participants. Although there were no significant differences in sexual satisfaction when comparing monogamous with non-exclusive multipartner participant's secondary and primary partners, unique patterns of sexual motivations were associated with sexual satisfaction based on relationship configuration. CLINICAL TRANSLATION Understanding the unique sexual motives associated with sexual satisfaction in various relationship configurations may help improve clinical approaches to couples counseling for both CNM and non-CNM populations. STRENGTHS AND LIMITATIONS Data were collected from CNM participants in a variety of relationship configurations and provide analyses comparing primary and secondary partners. However, these results are limited by a small sample of CNM participants who were intentionally recruited from self-identified CNM e-forums. CONCLUSIONS These findings add further understanding to the unique traits that characterize CNM individuals and the underlying motivational framework that may encourage individuals to initiate and maintain CNM relationships. Mitchell VE, Mogilski JK, Donaldson SH, et al. Sexual Motivation and Satisfaction Among Consensually Non-Monogamous and Monogamous Individuals. J Sex Med 2020;17:1072-1085.
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Affiliation(s)
| | - Justin K Mogilski
- Department of Psychology, Oakland University, Rochester, MI, USA; Department of Psychology, University of South Carolina Salkehatchie, Walterboro, SC, USA
| | - Sarah H Donaldson
- Department of Psychology, Oakland University, Rochester, MI, USA; Department of Psychology, University of Oregon, Eugene, OR, USA
| | | | - Lisa L M Welling
- Department of Psychology, Oakland University, Rochester, MI, USA.
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Marieke D, Joana C, Giovanni C, Erika L, Patricia P, Yacov R, Aleksandar Š. Sexual Desire Discrepancy: A Position Statement of the European Society for Sexual Medicine. Sex Med 2020; 8:121-131. [PMID: 32192965 PMCID: PMC7261674 DOI: 10.1016/j.esxm.2020.02.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/31/2020] [Accepted: 02/05/2020] [Indexed: 12/20/2022] Open
Abstract
Introduction There is a lack of theoretical and empirical knowledge on how sexual desire functions and interacts in a relationship. Aim To present an overview of the current conceptualization and operationalization of sexual desire discrepancy (SDD), providing clinical recommendations on behalf of the European Society of Sexual Medicine. Methods A comprehensive Pubmed, Web of Science, Medline, and Cochrane search was performed. Consensus was guided by a critical reflection on selected literature on SDD and by interactive discussions between expert psychologists, both clinicians and researchers. Main Outcome Measure Several aspects have been investigated including the definition and operationalization of SDD and the conditions under which treatment is required. Results Because the literature on SDD is scarce and complicated, it is precocious to make solid statements on SDD. Hence, no recommendations as per the Oxford 2011 Levels of Evidence criteria were possible. However, specific statements on this topic, summarizing the ESSM position, were provided. This resulted in an opnion-based rather than evidence-based position statement. Following suggestions were made on how to treat couples who are distressed by SDD: (i) normalize and depathologize variation in sexual desire; (ii) educate about the natural course of sexual desire; (iii) emphasize the dyadic, age-related, and relative nature of SDD; (iv) challenge the myth of spontaneous sexual desire; (v) promote open sexual communication; (vi) assist in developing joint sexual scripts that are mutually satisfying in addition to search for personal sexual needs; (vii) deal with relationship issues and unmet relationship needs; and (viii) stimulate self-differentiation. Conclusion More research is needed on the conceptualization and underlying mechanisms of SDD to develop clinical guidelines to treat couples with SDD. Marieke D, Joana G, Giovanni C, et al. Sexual Desire Discrepancy: A Position Statement of the European Society for Sexual Medicine. J Sex Med 2020;8:121–131.
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Affiliation(s)
- Dewitte Marieke
- Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands
| | - Carvalho Joana
- Escola de Psicologia e Ciências da Vida, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
| | - Corona Giovanni
- Endocrinology Unit, Medical Department, Azienda USL, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Limoncin Erika
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Pascoal Patricia
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisboa, Portugal; Universidade Lusófona, Escola de Psicologia e Ciências da Vida, Lisboa, Portugal; Faculdade de Psicologia e Ciências da Educação & CPUP, Universidade do Porto, Portugal
| | - Reisman Yacov
- Health Clinic, Amstelland Hospital, Amsterdam, the Netherlands
| | - Štulhofer Aleksandar
- Department of Sociology, Faculty of Humanities and Social Sciences, Zagreb, Croatia.
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Defreyne J, Elaut E, Kreukels B, Fisher AD, Castellini G, Staphorsius A, Den Heijer M, Heylens G, T'Sjoen G. Sexual Desire Changes in Transgender Individuals Upon Initiation of Hormone Treatment: Results From the Longitudinal European Network for the Investigation of Gender Incongruence. J Sex Med 2020; 17:812-825. [PMID: 32008926 DOI: 10.1016/j.jsxm.2019.12.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/13/2019] [Accepted: 12/13/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Several steps in the transitioning process may affect sexual desire in transgender people. This is often underexposed by those providing gender-affirming care. AIM To prospectively assess sexual desire during the first 3 years of hormonal therapy (HT) in transgender people. METHODS This prospective cohort study was part of the European Network for the Investigation of Gender Incongruence. At baseline, different psychological questionnaires were administered. Sex steroids were measured at each follow-up visit. Data were analyzed cross-sectionally and prospectively. MAIN OUTCOME MEASURE Prospective analysis of total, dyadic (with another person), and solitary (with oneself) sexual desire in 766 participants (401 transgender women [TW], 364 transgender men [TM]) was carried out using the Sexual Desire Inventory (SDI) questionnaire during a 3-year follow-up period, starting at the initiation of HT. Other factors associated with prospective changes were assessed. RESULTS In TW, total, dyadic, and solitary SDI scores decreased during the first 3 months of HT. However, after 36 months, total and dyadic SDI scores were higher than baseline scores. Solitary scores after 36 months were comparable with baseline scores. In TM, total, dyadic, and solitary SDI scores increased over the first 3 months, remaining stable thereafter. However, total and dyadic SDI scores after 36 months were comparable with baseline scores, whereas solitary scores remained higher than baseline. Factors associated with a prospective increase in SDI scores included having undergone gonadectomy, no longer experiencing menstrual bleeding or higher gender dysphoria levels at baseline (in TM only). CLINICAL IMPLICATIONS This study offers clear data on the time course of sexual desire after starting HT and thereby helps to inform people who want to start HT. Transgender people can be informed that changes in sexual desire after initiating HT are temporary. Over a longer period of time, the current research does not suggest induction of hypoactive sexual disorder in TW or long-term increased sexual desire in TM. STRENGTH & LIMITATIONS Strengths include the prospective design of this large multicentric study, the well-defined cohort, controlling for HT, sex steroids, and other factors. Limitations include performing a data lock, the absence of an objective measure of sexual desire, and the timing of laboratory measurements. CONCLUSION Gender-affirming HT only induces short-term changes in sexual desire in transgender people. Over a longer period of time, a net increase in dyadic sexual desire in TW receiving feminizing HT and sexual desire scores comparable with baseline in TM receiving virilizing HT, were observed. Defreyne J, Elaut E, Kreukels B, et al. Sexual Desire Changes in Transgender Individuals Upon Initiation of Hormone Treatment: Results From the Longitudinal European Network for the Investigation of Gender Incongruence Study. J Sex Med 2020;17:812-825.
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Affiliation(s)
- Justine Defreyne
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium.
| | - Els Elaut
- Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium
| | - Baudewijntje Kreukels
- Department of Psychology and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, VUmc, HV Amsterdam, the Netherlands
| | - Alessandra Daphne Fisher
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Giovanni Castellini
- Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Annemieke Staphorsius
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, VUmc, HV Amsterdam, the Netherlands
| | - Martin Den Heijer
- Department of Endocrinology and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, VUmc, HV Amsterdam, the Netherlands
| | - Gunter Heylens
- Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium
| | - Guy T'Sjoen
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium; Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium
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Wang C, Stephens-Shields AJ, DeRogatis LR, Cunningham GR, Swerdloff RS, Preston P, Cella D, Snyder PJ, Gill TM, Bhasin S, Matsumoto AM, Rosen RC. Validity and Clinically Meaningful Changes in the Psychosexual Daily Questionnaire and Derogatis Interview for Sexual Function Assessment: Results From the Testosterone Trials. J Sex Med 2019; 15:997-1009. [PMID: 29960633 DOI: 10.1016/j.jsxm.2018.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 05/24/2018] [Accepted: 05/28/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Limited information is available on the performance characteristics of 2 questionnaires commonly used in clinical research, the Psychosexual Daily Questionnaire (PDQ) and the Derogatis Interview for Sexual Function (DISF)-II Assessment, especially in older men with low testosterone (T) and impaired sexual function. AIM To determine reliability of PDQ and DISF-II by assessing the correlation within and between domains in the questionnaires and to define clinically meaningful changes in sexual activity (PDQ question 4 [Q4]) and desire (DISF-II sexual desire domain [SDD]) domains. METHODS Data from 470 men participating in the T Trials were used to calculate Spearman correlation coefficients of individual items and total score among questionnaires to determine convergent and construct validity. Clinically meaningful changes for sexual desire and activity were determined by randomly dividing the sample into training and validation sets. Anchor- and distribution-based clinically meaningful change criteria were defined in the training set, and selected changes were evaluated in the validation set. OUTCOMES Validity of the PDQ and DISF-II and clinically meaningful changes in sexual desire and activity were determined in older men in T Trials. RESULTS Moderate to strong correlations were shown within and between domains from different questionnaires. Using Patient Global Impression of Change as an anchor, clinically meaningful change in PDQ sexual activity was ≥0.6, and in DISF-SDD was ≥5.0. Applying these change cut-points to the validation set, a greater proportion of T-treated men achieved clinically meaningful improvement in their sexual desire and activity compared to placebo-treated men. CLINICAL IMPLICATIONS The PDQ-Q4 and DISF-II-SDD can be used to reliably assess clinically meaningful changes in sexual activity and sexual desire in hypogonadal men treated with T. STRENGTHS & LIMITATIONS Strengths of this study include a large sample size, long trial duration, and inclusion of men with low libido and unequivocally low T levels. Limitations include using data from a single study that enrolled only older hypogonadal men, and only 1 anchor for both sexual desire and activity. CONCLUSION Moderate to strong correlations were demonstrated within and between different sexual domains of the PDQ and DISF-II confirming construct and convergent validity. Clinically meaningful improvement in elderly hypogonadal men was change of ≥0.6 score in the PDQ-Q4 and ≥5.0 in the DISF-SDD. Improvements in sexual activity and desire in the T Trials were modest but clinically meaningful. Wang C, Stephens-Shields AJ, DeRogatis LR, et al. Validity and Clinically Meaningful Changes in the Psychosexual Daily Questionnaire and Derogatis Interview for Sexual Function Assessment: Results From the Testosterone Trials. J Sex Med 2018;15:997-1009.
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Affiliation(s)
- Christina Wang
- Division of Endocrinology, Department of Medicine, Harbor-University of California, Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA.
| | - Alisa J Stephens-Shields
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Leonard R DeRogatis
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Glenn R Cunningham
- Division of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine and Baylor St Luke's Medical Center, Houston, TX, USA
| | - Ronald S Swerdloff
- Division of Endocrinology, Department of Medicine, Harbor-University of California, Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - Peter Preston
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David Cella
- Department of Medical Social Science, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Peter J Snyder
- Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas M Gill
- Section of Geriatrics, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Shalender Bhasin
- Research Program in Men's Health: Aging and Metabolism; Boston Claude D. Pepper Older Americans Independence Center; Harvard Medical School; Brigham and Women's Hospital, Boston, MA, USA
| | - Alvin M Matsumoto
- Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Puget Sound Health Care System, and Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Raymond C Rosen
- HealthCore/New England Research Institutes Inc, Watertown, MA, USA
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Wåhlin-Jacobsen S, Flanagan JN, Pedersen AT, Kristensen E, Arver S, Giraldi A. Androgen Receptor Polymorphism and Female Sexual Function and Desire. J Sex Med 2018; 15:1537-46. [PMID: 30415810 DOI: 10.1016/j.jsxm.2018.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The effect of testosterone depends on the exposure of and the sensitivity of the androgen receptor (AR). It has been shown that a cytosine-adenine-guanine (CAG) trinucleotide repeat polymorphism in the AR gene has an impact on AR functional capacity in men. However, large studies are lacking on the impact of this polymorphism on female sexual function. AIM To determine whether the CAG repeat length was associated with different aspects of women's sexual function and dysfunction, including desire, arousal, lubrication, orgasm, satisfaction, sexual pain, and sexually related personal distress. METHODS This cross-sectional study included 529 healthy women, aged 19-65 years. Participants completed a questionnaire to provide demographic and sexual data. The CAG repeat length was analyzed in a blood sample. The correlations between CAG repeat lengths and different aspects of sexual function were calculated. Independent Student t-tests were performed to evaluate differences in the mean number of CAG repeats in the short and long allele and of the biallelic mean length determined by simple calculation and X-inactivation analysis, respectively, between women with sexual problems and women without sexual problems. P values <.05 were considered statistically significant. MAIN OUTCOME MEASURE We used the Female Sexual Function Index, with 6 subdomains, to distinguish between women without and women with impaired sexual function; low sexual desire; impaired arousal, lubrication, or orgasm; diminished satisfaction; or pain during sex. The Female Sexual Distress Scale was used to measure sexually related personal distress. RESULTS Overall, we found that increasing numbers of CAG repeats were correlated to increased sexual function. We found that women with problems achieving orgasm had a significantly lower number of CAG repeats than women that reported no problems reaching orgasm. We found no associations between CAG repeat lengths and other aspects of female sexual dysfunction, including hypoactive sexual desire disorder. CLINICAL IMPLICATIONS The results could indicate an impact of the AR on women's sexual function, including the ability to reach orgasm. STRENGTH & LIMITATIONS This is a large study using validated sexual questionnaires. A limitation is the cross-sectional design. Owing to the study design, this study is explorative and hypothesis generating. CONCLUSION In this large cross-sectional study, we demonstrated that CAG repeat length is positively correlated to sexual function and that women with a reduced ability to reach orgasm had smaller numbers of CAG repeats in the AR gene than women with no orgasmic problems. These findings indicated that androgens and ARs might play a role in women's sexual function. Wåhlin-Jacobsen S, Flanagan JN, Pedersen AT, Kristensen E, Arver S, Giraldi A. Androgen Receptor Polymorphism and Female Sexual Function and Desire. J Sex Med 2018;15:1537-1546.
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Beutel ME, Burghardt J, Tibubos AN, Klein EM, Schmutzer G, Brähler E. Declining Sexual Activity and Desire in Men-Findings From Representative German Surveys, 2005 and 2016. J Sex Med 2019; 15:750-756. [PMID: 29699759 DOI: 10.1016/j.jsxm.2018.03.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/19/2018] [Accepted: 03/06/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Surveys have indicated an increase of sexual activity in aging men; recently, however, a decrease of sexual activity has been reported in young men. AIM To assess (i) sexual activity and desire and their determinants across the age range in a population-based male sample and (ii) their changes over 11 years. METHODS A representative survey of men (N = 1,095) 18 to 93 years old from 2016 was compared with a survey from 2005 (N = 1,106 men) with the same age range. Samples were drawn from the German population at random using standardized sampling procedures. Questions were filled out by participants in the presence of a trained interviewer. Sexual activity was compared using logistic regression with the factors survey (2005 vs 2016), living with a partner (yes vs no), and age. Frequency of sexual desire was compared using analysis of covariance with the factors survey (2005 vs 2016), living with a partner (yes vs no), and the covariate age. OUTCOMES Sexual activity was assessed as having been intimate with someone in the past year; frequency of sexual desire was evaluated within the past 4 weeks. RESULTS The great majority of men cohabiting with a partner in 2016 was sexually active and indicated sexual desire until 70 years of age; half did so at an older age. Across the age range, men living without a partner reported considerably less sexual activity and desire. Compared with 2005, fewer men reported living with a partner. The overall proportion of men reporting sexual activity deceased from 81% to 73% in 2016 and absent sexual desire increased from 8% to 13%. CLINICAL TRANSLATION The findings highlight the relevance of living with a partner for sexual activity and desire. We advocate using a measure of sexual activity that encompasses many variants of intimate behavior. STRENGTHS AND LIMITATIONS Large and methodologically comparable population-based samples were compared. However, interpretations are limited by the absence of longitudinal data. We did not assess the effect of having a partner living elsewhere. CONCLUSION Sexual activity and desire decreased, especially in the young and middle-age groups. The decrease of men living with a partner contributed to this decreased sexual activity and desire. There was a generation effect, with younger and middle-age men living without a partner becoming less sexually active and experiencing less desire compared with the previous survey. The findings unveil changes in sexual activity and desire in a short time span. Beutel ME, Burghardt J, Tibubos AN, et al. Declining Sexual Activity and Desire in Men-Findings From Representative German Surveys, 2005 and 2016. J Sex Med 2018;15:750-756.
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Affiliation(s)
- Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Juliane Burghardt
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
| | - Ana N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Eva M Klein
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Gabriele Schmutzer
- Selbständige Abteilung für Medizinische Psychologie, Universität Leipzig, Leipzig, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
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Fischer OJ, Marguerie M, Brotto LA. Sexual Function, Quality of Life, and Experiences of Women with Ovarian Cancer: A Mixed-Methods Study. Sex Med 2019; 7:530-539. [PMID: 31501030 PMCID: PMC6963110 DOI: 10.1016/j.esxm.2019.07.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/21/2019] [Accepted: 07/29/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction Ovarian cancer impacts approximately 1 in 75 women. Sexual health is receiving increasing attention as a critical aspect of gynecologic cancer treatment and a component of quality of life. Therefore, investigating how women with ovarian cancer experience and express sexuality is an important area of inquiry. Aims To evaluate how women with ovarian cancer experience and express sexuality, a major determinant of quality of life, in the context of their illness. Methods In a mixed-methods approach, 6 validated self-report questionnaires (n = 64) and an in-depth focus group (n = 3) were used to gather data. Results The quantitative phase of the study showed that women with ovarian cancer have a poorer quality of life and higher rates of sexual dysfunction and sexual distress compared with published norms from the general population. They also have lower levels of relationship satisfaction and increased rates of depression. The qualitative phase of the study revealed 6 themes: (i) changes to relationship satisfaction; (ii) sexual difficulties; (iii) challenges with body image; (iv) gaps in communication with healthcare providers; (v) feelings of guilt, grief, resentment, anxiety, and fear; and (vi) strategies used for coping. Conclusions Ovarian cancer impacts women’s lives beyond mere survival, including their sexual function and quality of life. Healthcare providers are urged to prepare women with ovarian cancer for these challenges and offer information and resources to help improve their quality of life and sexuality. Fischer OJ, Marguerie M, Brotto LA. Sexual Function, Quality of Life, and Experiences of Women with Ovarian Cancer: A Mixed-Methods Study. Sex Med 2019;7:530–539.
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Affiliation(s)
- Olivia J Fischer
- Department of Counselling Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Monique Marguerie
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lori A Brotto
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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Simon JA, Kingsberg SA, Goldstein I, Kim NN, Hakim B, Millheiser L. Weight Loss in Women Taking Flibanserin for Hypoactive Sexual Desire Disorder (HSDD): Insights Into Potential Mechanisms. Sex Med Rev 2019; 7:575-86. [PMID: 31196764 DOI: 10.1016/j.sxmr.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 04/27/2019] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Flibanserin, a multifunctional serotonin receptor agonist and antagonist, is currently approved in the United States and Canada for the treatment of acquired, generalized hypoactive sexual desire disorder (HSDD) in premenopausal women. A post hoc analysis of HSDD clinical trial data found that flibanserin treatment was associated with statistically significant weight loss relative to placebo, even though study patients were not selected for being overweight/obese and were provided no expectation for weight reduction or interventions intended to promote weight loss. AIM To understand possible mechanisms by which flibanserin may produce weight loss. METHODS A literature review was performed using Medline database for relevant publications on the mechanisms of action by which flibanserin may provide weight loss and the links between sexual function and weight management. MAIN OUTCOME MEASURES Examination of (i) biopsychosocial factors regulating sexual desire, food intake, and weight regulation; (ii) clinical pharmacology of flibanserin; (iii) neurobiology of brain reward circuitry; and (iv) identification of possible mechanisms common to flibanserin and weight loss. RESULTS Based on flibanserin clinical trial data, there was no consistent correlation between weight loss and improvement in sexual function, as assessed by HSDD outcome measures. Nausea, a common adverse event associated with flibanserin use, also did not appear to be a contributing factor to weight loss. Hypothetical links between flibanserin treatment and weight loss include modulation of peripheral 5-HT2A receptors and factors such as improved mood and improved sleep. CONCLUSION Mechanisms of flibanserin-induced weight loss have not been well characterized but may involve indirect beneficial effects on peripheral 5-HT2A receptors and central regulation of mood and sleep. Future research may better elucidate the links between sexual function and weight management and the mechanism(s) by which flibanserin use may result in weight loss. Simon JA, Kingsberg SA, Goldstein I, et al. Weight Loss in Women Taking Flibanserin for Hypoactive Sexual Desire Disorder (HSDD): Insights into Potential Mechanisms. Sex Med Rev 2019;7:575-586.
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Stephens-Shields AJ, Wang C, Preston P, Snyder PJ, Swerdloff RS. Clinically Meaningful Change in Sexual Desire in the Psychosexual Daily Questionnaire in Older Men from the TTrials. J Sex Med 2019; 16:951-953. [PMID: 31101538 DOI: 10.1016/j.jsxm.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/29/2019] [Accepted: 04/03/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND A recent study of older men participating in the Testosterone Trials (TTrials) defined a clinically meaningful change in the Psychosexual Daily Questionnaire (PDQ) question 4 in hypogonadal men age ≥65 years. This study defines clinically meaningful change in the same population for sexual desire assessed by PDQ question 1. AIM To determine a clinically meaningful change in the answers to question 1 of the PDQ in hypogonadal older men. METHODS Participants in the Sexual Function Trial of the TTrials were randomly divided into a training and test set. Anchor-based methods, including regression analysis, receiver operating characteristic curves, and empirical cumulative distribution functions, were used to determine a clinically meaningful change on question 1 in the training set, and the selected threshold was evaluated in the test set for an effect of testosterone treatment. RESULTS A clinically meaningful increase in question 1 of the PDQ was determined to be ≥0.7 points. CLINICAL IMPLICATIONS Question 1 of the PDQ can be used to assess sexual desire in response to testosterone treatment. STRENGTHS & LIMITATIONS Data were obtained from a single large study of older hypogonadal men. CONCLUSION Clinically meaningful improvement of sexual desire is a change of ≥0.7 in the score of question 1 of the PDQ. Stephens-Shields AJ, Wang C, Preston P, et al. Clinically Meaningful Change in Sexual Desire in the Psychosexual Daily Questionnaire in Older Men from the TTrials. J Sex Med 2019;16:951-953.
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Affiliation(s)
- Alisa J Stephens-Shields
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Christina Wang
- Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - Peter Preston
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Peter J Snyder
- Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ronald S Swerdloff
- Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
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Nimbi FM, Tripodi F, Rossi R, Navarro-Cremades F, Simonelli C. Male Sexual Desire: An Overview of Biological, Psychological, Sexual, Relational, and Cultural Factors Influencing Desire. Sex Med Rev 2019; 8:59-91. [PMID: 30803921 DOI: 10.1016/j.sxmr.2018.12.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/15/2018] [Accepted: 12/16/2018] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The literature showed the need for a better understanding of the male sexual response, which has historically been considered as simpler and more mechanistic compared with that in women. AIM To examine the literature on biopsychosocial factors associated with the level of sexual desire in men and discuss some interesting directions for future research. METHODS A systematic literature review was conducted. MAIN OUTCOME MEASURES 169 articles published in Google Scholar, Web of Science, Scopus, EBSCO, and Cochrane Library about male sexual desire and related biopsychosocial factors. RESULTS We found a lack of multidimensional studies on male sexual desire. Most existing research has focused on hypoactive sexual desire disorder in coupled heterosexual men. Biological factors play important roles in the level of sexual desire, but they are insufficient to explain the male sexual response. Psychological, relational, and sexual factors (eg depression, anxiety, emotions, attraction, conflicts, communication, sexual functioning, distress, satisfaction) are involved in the development/maintenance of lack of sexual interest in men. Cultural influence is also relevant, with cognitive factors linked to gender roles and sexual scripts of masculinity identified as important predictors of low sexual desire. CONCLUSION Male sexual desire is characterized by an interplay among biological, psychological, sexual, relational, and cultural elements. This interplay merits further study to better understand how sexual desire works and how treatments for low sexual interest could be improved. Nimbi FM,Tripodi F, Rossi R, et al. Male Sexual Desire: An Overview of Biological, Psychological, Sexual, Relational, and Cultural Factors Influencing Desire. Sex Med Rev 2020;8:59-91.
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Affiliation(s)
- Filippo Maria Nimbi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy; Institute of Clinical Sexology, Rome, Italy.
| | | | | | | | - Chiara Simonelli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy; Institute of Clinical Sexology, Rome, Italy
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Rastrelli G, Guaraldi F, Reismann Y, Sforza A, Isidori AM, Maggi M, Corona G. Testosterone Replacement Therapy for Sexual Symptoms. Sex Med Rev 2019; 7:464-475. [PMID: 30803919 DOI: 10.1016/j.sxmr.2018.11.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/02/2018] [Accepted: 11/03/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Several data have clearly shown that the endocrine system-and androgens in particular-play a pivotal role in regulating all the steps involved in the male sexual response cycle. Accordingly, testosterone (T) replacement therapy (TRT) represents a cornerstone of pharmacologic management of hypogonadal subjects with erectile dysfunction. AIM The aim of this review is to summarize all the available evidence supporting the role of T in the regulation of male sexual function and to provide a comprehensive summary regarding the sexual outcomes of TRT in patients complaining of sexual dysfunction. METHODS A comprehensive PubMed literature search was performed. MAIN OUTCOME MEASURE Specific analysis of preclinical and clinical evidence on the role of T in regulating male sexual function was performed. In addition, available evidence supporting the role of TRT on several sexual outcomes was separately investigated. RESULTS T represents an important modulator of male sexual response function. However, the role of T in sexual functioning is less evident in epidemiologic studies because other factors, including organic, relational, and intrapsychic determinants, can orchestrate their effect independently from the state of androgens. Nonetheless, it is clear that TRT can ameliorate several aspects of sexual functioning, including libido, erectile function, and overall sexual satisfaction. Conversely, data on the role of TRT in improving orgasmic function are more conflicting. Finally, further controlled studies are needed to investigate the combination of TRT and PDE5 inhibitors. CONCLUSION Positive effects of TRT are observed only in the presence of a hypogonadal status (ie, total T < 12 nmol/L). In addition, TRT alone can be effective in restoring only milder forms of erectile dysfunction, whereas the combined therapy with other drugs is required when more severe vascular damage is present. Rastrelli G, Guaraldi F, Reismann Y, et al. Testosterone Replacement Therapy for Sexual Symptoms. Sex Med Rev 2019;7:464-475.
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Affiliation(s)
- Giulia Rastrelli
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Federica Guaraldi
- Pituitary Unit, IRCCS Institute of Neurological Science of Bologna, Bologna, Italy; Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Yacov Reismann
- Amstelland Hospital, Department of Urology, Amsterdam, The Nederland
| | - Alessandra Sforza
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy.
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Bolmont M, Bianchi-Demicheli F, Boisgontier MP, Cheval B. The Woman's Body (Not the Man's One) Is Used to Evaluate Sexual Desire: An Eye-Tracking Study of Automatic Visual Attention. J Sex Med 2019; 16:195-202. [PMID: 30770068 DOI: 10.1016/j.jsxm.2018.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/05/2018] [Accepted: 12/08/2018] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Vision of the human body has been shown to be key in eliciting sexual desire. However, whether the visual pattern characterizing sexual desire is different in women and men is still unclear. AIM To investigate the effect of gender on visual patterns triggered by an identical set of stimuli depicting attractive heterosexual couples. METHODS Heterosexual women and men (n = 106) were tested on a picture-viewing task associated with eye tracking. The context of sexual desire was activated by asking the participant whether they perceived such desire while looking at sensual pictures of heterosexual couples. Data were analyzed using mixed-subject design analyses of variance. MAIN OUTCOME MEASURE Fixation durations were used to investigate visual patterns. 2 areas of interest were created to investigate visual patterns (face vs body area). RESULTS Results showed longer fixations on body rather than face areas irrespective of participant gender. Moreover, all participants looked longer at women's than men's bodies and at the faces of the opposite sex. CLINICAL IMPLICATIONS These findings shed light on the automatic processes underlying sexual desire, which has the potential to improve the care of patients suffering from sexual disorders by optimizing interventions. STRENGTHS & LIMITATIONS The strengths of this study are the use of an eye-tracking paradigm, the dissociation between 2 fixation areas (ie, face and body), and the use of an identical set of stimuli allowing an accurate between-gender comparison of the visual pattern. The limitations are the small sample size, the use of healthy heterosexual individuals, and the absence of measures of sexual arousal and genital response. CONCLUSIONS These findings confirm the association between the human body and sexual desire. They also reveal the unique attentional attractiveness of woman's bodies across genders. Bolmont M, Bianchi-Demicheli F, Boisgontier MP, et al. The Woman's Body (Not the Man's One) Is Used to Evaluate Sexual Desire: An Eye-Tracking Study of Automatic Visual Attention. J Sex Med 2019;16:195-202.
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Palmer-Hague JL, Tsang V, Skead C, Wassersug RJ, Nasiopoulos E, Kingstone A. Androgen Deprivation Alters Attention to Sexually Provocative Visual Stimuli in Elderly Men. Sex Med 2017; 5:e245-e254. [PMID: 29150010 PMCID: PMC5693430 DOI: 10.1016/j.esxm.2017.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/20/2017] [Accepted: 10/01/2017] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Testosterone is known to regulate male sexual interest, but the exact way that androgens influence men's sexual cognition remains unclear. AIM To investigate the influence of androgen deprivation (AD) on visual responses to sexually suggestive stimuli in men treated for prostate cancer with AD therapy. METHODS Patients with AD-treated prostate cancer, patients with prostate cancer not on AD therapy, and age-matched healthy control participants were exposed to images of male and female runway models fully or minimally clothed. Eye tracking was used to compare looking behavior among groups. MAIN OUTCOME MEASURES Proportion of fixations on fully clothed vs minimally clothed models and proportion of fixations on target areas of interest (ie, legs, chest, pelvis, and face) of fully clothed and minimally clothed models were analyzed and compared among groups. RESULTS Although men not on AD exhibited a larger proportion of fixations on the minimally clothed compared with the fully clothed images, there was no difference between the 2 image types for men on AD. This was true regardless of whether the images depicted male or female models. Groups did not differ in their fixations to target areas of interest. CONCLUSION These results suggest that testosterone can influence men's visual attention to sexual stimuli; specifically, AD can attenuate the time spent fixated on sexualized targets. Palmer-Hague JL, Tsang V, Skead C, et al. Androgen Deprivation Alters Attention to Sexually Provocative Visual Stimuli in Elderly Men. Sex Med 2017;5:e245-e254.
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Affiliation(s)
| | - Vivian Tsang
- Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Charlenn Skead
- Department of Psychology, Trinity Western University, Langley, BC, Canada
| | - Richard J Wassersug
- Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada; Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Eleni Nasiopoulos
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Alan Kingstone
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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DeLamater JD, Weinfurt KP, Flynn KE. Patients' Conceptions of Terms Related to Sexual Interest, Desire, and Arousal. J Sex Med 2017; 14:1327-1335. [PMID: 29017897 PMCID: PMC5675768 DOI: 10.1016/j.jsxm.2017.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 08/04/2017] [Accepted: 09/09/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Measurement of sexual function typically uses self-report, which, to work as intended, must use language that is understood consistently by diverse respondents. Commonly used measures employ multiple terms, primarily (sexual) interest, desire, and arousal, that might not be understood in the same way by laypeople and professionals. AIM To inform self-reported measurement efforts for research and clinical settings by examining how US men and women recruited from a health care setting understand and interpret different terms. METHODS We conducted 10 focus groups in Durham, NC (N = 57). Discussions were audio-recorded and transcribed, and the content of the discussions was systematically analyzed in 2 phases of coding by the research team, facilitated by Nvivo qualitative analysis software (QSR International, Doncaster, VIC, Australia). OUTCOMES Patient focus group discussions about the meanings and connotations of multiple terms related to sexual function, especially interest, desire, and arousal. RESULTS 5 groups included male participants and 5 included female participants. Participants characterized (sexual) interest as a cognitive phenomenon and a situational response to a specific person. Similarly, they characterized (sexual) desire as a situational person-specific experience with some support for it as a cognitive phenomenon but more support for it as a physical phenomenon. In contrast, participants characterized sexual arousal as a physical phenomenon occurring in response to physical or visual stimulation and not related to a specific person. CLINICAL IMPLICATIONS These results can help us understand how laypeople are using and responding to these terms when they are used in clinical and research settings. STRENGTHS AND LIMITATIONS Patient participants in these groups were diverse in age, gender, sexual orientation, and health, with the potential to voice diverse perspectives on sexual functioning; however, the sample was limited to a single city in the southeastern United States. CONCLUSION The meanings of interest, desire, and arousal were defined, compared, and contrasted in the context of patient focus groups. Qualitative coding showed that interest was considered the most "cognitive," arousal the most "physical," and desire somewhere in between. DeLamater JD, Weinfurt KP, Flynn KE. Patients' Conceptions of Terms Related to Sexual Interest, Desire, and Arousal. J Sex Med 2017;14:1327-1335.
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Affiliation(s)
- John D DeLamater
- Department of Sociology, University of Wisconsin, Madison, WI, USA
| | - Kevin P Weinfurt
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - Kathryn E Flynn
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
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Sansone A, Sansone M, Proietti M, Ciocca G, Lenzi A, Jannini EA, Romanelli F. Relationship Between Use of Videogames and Sexual Health in Adult Males. J Sex Med 2017; 14:898-903. [PMID: 28579336 DOI: 10.1016/j.jsxm.2017.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/03/2017] [Accepted: 05/06/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Videogame use is increasingly prevalent in people of all ages, and despite the wide amount of scientific evidence proving a role for electronic entertainment in human health, there is no evidence about the relation between use of videogames and sexual health. AIM To investigate the association between use of videogames and male sexual health. METHODS We administered the two validated questionnaires, the Premature Ejaculation Diagnostic Tool (PEDT) and the International Index of Erectile Function (IIEF-15), to men 18 to 50 years old recruited through social networks and specific websites. In addition to the questionnaires, volunteers were asked to provide information on their gaming habit and lifestyle. OUTCOMES An extended version of the IIEF-15 and PEDT, including data about gaming habits and relevant lifestyles. RESULTS From June 18, 2014 through July 31, 2014, 599 men 18 to 50 years old completed the questionnaires. One hundred ninety-nine men reported no sexual activity during the previous 4 weeks; four records were rejected because of inherent errors. The remaining 396 questionnaires were analyzed, with 287 "gamers" (playing >1 hour/day on average) and 109 "non-gamers" providing all the required information. We found a lower prevalence of premature ejaculation in gamers compared with non-gamers (mean PEDT score = 3.57 ± 3.38 vs 4.52 ± 3.7, P < .05, respectively). Analysis of the IIEF-15 showed no significant differences between gamers and non-gamers in the domains of erectile function, orgasmic function, and overall satisfaction. Median scores for the sexual desire domain were higher for non-gamers (median score [interquartile range] 9 [8-9] vs 9 [8-10], respectively; P = .0227). CLINICAL IMPLICATIONS These results support the correlation between videogame use and male sexual health. Compared with non-gamers, men playing videogames for more than 1 hour/day were less likely to have premature ejaculation but more likely to have decreased sexual desire. STRENGTHS AND LIMITATIONS This is the first study aimed to assess male sexual health in gamers. We identified an association between PEDT and IIEF scores and videogame use; however, these findings require validation through interventional studies. Furthermore, volunteers were recruited through social networks, thus increasing the risk of recruitment bias. CONCLUSION To our knowledge, this is the first observational study investigating the link between electronic entertainment and male sexuality, specifically for ejaculatory response and sexual desire. Sansone A, Sansone M, Proietti M, et al. Relationship Between Use of Videogames and Sexual Health in Adult Males. J Sex Med 2017;14:898-903.
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Gutsche M, Burri A. What Women Want-An Explorative Study on Women's Attitudes Toward Sexuality Boosting Medication in a Sample of Swiss Women. J Sex Med 2017; 14:404-412. [PMID: 28130017 DOI: 10.1016/j.jsxm.2016.12.238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/20/2016] [Accepted: 12/24/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The recent approval of flibanserin to treat hypoactive sexual desire disorder in premenopausal women has once again fueled the ongoing debate about medicalization of female sexual problems and the necessity of such a drug. AIM To investigate women's attitudes toward sexuality-boosting medication (SBM) and the role of factors potentially associated with these attitudes, including sexual functioning, sexual quality of life, relationship satisfaction, and personality, in an exploratory survey. METHODS A population sample of 159 women 18 to 73 years old (mean = 31.8) participated in this cross-sectional online survey. Study variables were assessed using a combination of validated questionnaires and self-constructed questions. MAIN OUTCOME MEASURES Descriptive statistics in the form of proportions and percentages and correlation and moderation analyses. RESULTS Sixty-one percent of women were willing to take SBM, mostly to increase orgasm frequency and intensity and sexual desire. Likeliness to take SBM correlated negatively with age (r = -0.24; P < .005) and with levels of arousal, lubrication, orgasm, and sexual satisfaction (P < .05 for all comparisons). Higher relationship satisfaction and conscientiousness moderated the association between willingness to take SBM and desire levels (P < .05 for the two comparisons). For desired properties of SBM, 48.2% of women considered an onset of action of "up to 1 hour" ideal, 41% preferred "less than 15 minutes," and 66.9% considered a window of action of "an hour" to be ideal. CONCLUSION The demand for a drug to enhance sexual performance in women exists and ideally should target desire and orgasm intensity and frequency. By taking such as drug, women hope to benefit in increased sexual satisfaction and fun with sex. Furthermore, the willingness to take SBM seems to greatly depend on the woman's relationship satisfaction and some personality characteristics. Gutsche M, Burri A. What Women Want-An Explorative Study on Women's Attitudes Toward Sexuality Boosting Medication in a Sample of Swiss Women. J Sex Med 2017;14:404-412.
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Affiliation(s)
- Melanie Gutsche
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Andrea Burri
- Department of Psychology, University of Zurich, Zurich, Switzerland; Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand; Waitemata Pain Service, Department of Anaesthesia and Perioperative Medicine, North Shore Hospital, Auckland, New Zealand.
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Wåhlin-Jacobsen S, Kristensen E, Pedersen AT, Laessøe NC, Cohen AS, Hougaard DM, Lundqvist M, Giraldi A. Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women ∗: ∗2016 ISSM Female Sexual Dysfunction Prize. J Sex Med 2017; 14:366-379. [PMID: 28117267 DOI: 10.1016/j.jsxm.2016.12.237] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 12/14/2016] [Accepted: 12/23/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The female sexual response is complex and influenced by several biological, psychological, and social factors. Testosterone is believed to modulate a woman's sexual response and desire, because low levels are considered a risk factor for impaired sexual function, but previous studies have been inconclusive. AIM To investigate how androgen levels and psychosocial factors are associated with female sexual dysfunction (FSD), including hypoactive sexual desire disorder (HSDD). METHODS The cross-sectional study included 428 premenopausal women 19 to 58 years old who completed a questionnaire on psychosocial factors and had blood sampled at days 6 to 10 in their menstrual cycle. Logistic regression models were built to test the association among hormone levels, psychosocial factors, and sexual end points. MAIN OUTCOME MEASURES Five different sexual end points were measured using the Female Sexual Function Index and the Female Sexual Distress Scale: impaired sexual function, sexual distress, FSD, low sexual desire, and HSDD. Serum levels of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate, and androsterone glucuronide were analyzed using mass spectrometry. RESULTS After adjusting for psychosocial factors, women with low sexual desire had significantly lower mean levels of free testosterone and androstenedione compared with women without low sexual desire. None of the androgens were associated with FSD in general or with HSDD in particular. Relationship duration longer than 2 years and mild depressive symptoms increased the risk of having all the sexual end points, including FSD in general and HSDD in particular in multivariate analyses. CONCLUSION In this large cross-sectional study, low sexual desire was significantly associated with levels of free testosterone and androstenedione, but FSD in general and HSDD in particular were not associated with androgen levels. Length of relationship and depression were associated with FSD including HSDD. Wåhlin-Jacobsen S, Kristensen E, Tønnes Pedersen A, et al. Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women. J Sex Med 2017;14:366-379.
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Affiliation(s)
- Sarah Wåhlin-Jacobsen
- Department of Sexological Research, Psychiatric Center Copenhagen, Copenhagen, Denmark.
| | - Ellids Kristensen
- Department of Sexological Research, Psychiatric Center Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anette Tønnes Pedersen
- Department of Gynecology and Fertility Clinic, JMC Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Arieh S Cohen
- Department for Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark
| | - David M Hougaard
- Department for Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark
| | - Marika Lundqvist
- Department for Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark
| | - Annamaria Giraldi
- Department of Sexological Research, Psychiatric Center Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Corona G, Isidori AM, Aversa A, Burnett AL, Maggi M. Endocrinologic Control of Men's Sexual Desire and Arousal/Erection. J Sex Med 2016; 13:317-37. [PMID: 26944463 DOI: 10.1016/j.jsxm.2016.01.007] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/13/2016] [Accepted: 01/15/2016] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Several hormones and neurotransmitters orchestrate men's sexual response, including the appetitive (sexual desire) and consummative (arousal and penile erection) phases. AIM To provide an overview and recommendations regarding endocrinologic control of sexual desire and arousal and erection and their disturbances. METHODS Medical literature was reviewed by the subcommittee of the International Consultation of Sexual Medicine, followed by extensive internal discussion, and then public presentation and discussion with other experts. The role of pituitary (prolactin, oxytocin, growth hormone, and α-melanocyte-stimulating hormone), thyroid, and testicular hormones was scrutinized and discussed. MAIN OUTCOME MEASURES Recommendations were based on grading of evidence-based medical literature, followed by interactive discussion. RESULTS Testosterone has a primary role in controlling and synchronizing male sexual desire and arousal, acting at multiple levels. Accordingly, meta-analysis indicates that testosterone therapy for hypogonadal individuals can improve low desire and erectile dysfunction. Hyperprolactinemia is associated with low desire that can be successfully corrected by appropriate treatments. Oxytocin and α-melanocyte-stimulating hormone are important in eliciting sexual arousal; however, use of these peptides, or their analogs, for stimulating sexual arousal is still under investigation. Evaluation and treatment of other endocrine disorders are suggested only in selected cases. CONCLUSION Endocrine abnormalities are common in patients with sexual dysfunction. Their identification and treatment is strongly encouraged in disturbances of sexual desire and arousal.
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Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda USL Bologna, Maggiore-Bellaria Hospital, Bologna, Italy.
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonio Aversa
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy; Deptartment of Experimental and Clinical Medicine, University Magna Graecia, Catanzaro, Italy
| | - Arthur L Burnett
- Department of Urology, the James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Biomedical, Clinical and Experimental Sciences, University of Florence, Florence, Italy
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Abstract
INTRODUCTION Data concerning the impact of amphetamine on male sexual functions are limited, although amphetamine has been used as an aphrodisiac. AIMS This cross-sectional study was to assess the impact of illicit use of amphetamine on male sexual functions. METHODS Male illicit drug users in a Drug Abstention and Treatment Center were recruited to complete a self-administered questionnaire, and data were compared with age-matched controls. MAIN OUTCOME MEASURES The International Index of Erectile Function (IIEF) and global assessment questions were used to assess sexual functions. RESULTS Of 1,159 amphetamine mono-illicit drug users, the mean age was 31.9 ± 7.5 (18-57) years, and mean duration of drug use was 30.7 ± 52.2 (median 9, range 0.1-252) months. Half of them reported that drug use had no impact on their sexual functions. The other half reported drug impacts as reduced erectile rigidity and sexual life satisfaction, enhanced orgasmic intensity, and prolonged ejaculation latency time more often than the opposite effects, while they reported enhanced or reduced effect equally on sexual desire. Dosing frequency of amphetamine was associated with its impact on sexual functions, but duration of its use had little association with that. Compared with 211 age-matched controls, the amphetamine mono-illicit drug users had lower IIEF scores in the domains of erectile function, orgasmic function, and overall satisfaction, but there are no significant differences in intercourse satisfaction and sexual desire scores. The prevalence of erectile dysfunction (ED) was significantly higher in the drug users than in the controls (29.3% vs. 11.9%). The odds ratio of ED for amphetamine use was 2.1 (95% confidence interval 1.2-3.6) after adjustment for other risk factors. CONCLUSIONS The impact of illicit use of amphetamine on male sexual functions varied among users, and their ED prevalence was higher than the controls.
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Affiliation(s)
- Nan-Hua Chou
- Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung and School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yung-Jui Huang
- Human Clinical Trial and Subject Protection Center, Kaohsiung Veterans General Hospital, Kaohsiung and Graduate School of Human Sexuality, Shu-Te University, Kaohsiung, Taiwan
| | - Bang-Ping Jiann
- Division of Basic Medical Research, Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung and School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Ferreira LC, Fraenkel P, Narciso I, Novo R. Is committed desire intentional? A qualitative exploration of sexual desire and differentiation of self in couples. Fam Process 2015; 54:308-326. [PMID: 25308721 DOI: 10.1111/famp.12108] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The question of what heightens or diminishes sexual desire has long been a passionate theme across cultures in literature, arts, media, and medicine. Yet, little research has been conducted to determine what affects level of desire within couples. The degree of differentiation of self has been suggested as an important variable in shaping partners' level of desire. Through a qualitative analysis of dyadic couple interviews, this study provides an account of characteristics, processes, and trajectories of sexual desire and differentiation in 33 heterosexual couples of varying ages and relationship duration. Factors associated with high desire were change and autonomy, whereas conflict and children were reported to be desire-diminishing factors. Innovation, sharing, autonomy, and effort emerged as desire-promoting strategies, while fostering personal interests, investing in a positive connection, and enhancing personal integrity were identified as couples' strategies to promote and preserve differentiation of self. The results also shed light on couples' perceptions of whether and how sexual desire changes over the course of the relationship and challenge common cultural assumptions about desire in committed relationships-namely the myth that the only authentic expression of desire is that which occurs spontaneously and without intention and planning. Implications for couple therapy are discussed.
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Affiliation(s)
- Luana Cunha Ferreira
- Clinical Systemic Psychology, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Peter Fraenkel
- Ackerman Institute for the Family, Department of Psychology, Webster University Vienna, Austria
| | - Isabel Narciso
- Clinical Systemic Psychology, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
| | - Rosa Novo
- Clinical Systemic Psychology, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
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Ferdenzi C, Delplanque S, Vorontsova-Wenger O, Pool E, Bianchi-Demicheli F, Sander D. Perception of men's beauty and attractiveness by women with low sexual desire. J Sex Med 2014; 12:946-55. [PMID: 25496510 DOI: 10.1111/jsm.12795] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Despite the high prevalence of hypoactive sexual desire disorder (HSDD), especially among women, this sexual disorder remains poorly understood. Among the multiple factors possibly involved in HSDD, particularities in the cognitive evaluations of social stimuli need to be better characterized. Especially, beauty and attractiveness judgments, two dimensions of interpersonal perception that are related but differ on their underlying motivational aspects, may vary according to the level of sexual desire. AIM The main goal of this study was to investigate whether women with and without HSDD differ in their evaluations of beauty and attractiveness of men's faces and voices. METHODS Young women from the general population (controls, n = 16) and with HSDD (patients, n = 16) took part in the study. They were presented with a series of neutral/nonerotic voices and faces of young men from the GEneva Faces And Voices database. MAIN OUTCOME MEASURES Ratings of beauty (i.e., assessments of aesthetic pleasure) and of attractiveness (i.e., assessments of the personal propensity to feel attracted to someone) and the frequency to which the participants pressed a key to see or listen to each stimulus again were the main outcome measures. RESULTS Ratings of attractiveness were lower than ratings of beauty in both groups of women. The dissociation between beauty and attractiveness was larger in women with HSDD than in control participants. Patients gave lower attractiveness ratings than the controls and replayed the stimuli significantly less often. CONCLUSION These results suggest that women with HSDD are characterized by specific alterations of the motivational component of men's perception, very early in the process of interpersonal relationships. Our findings have significant implications, both in better understanding the specific cognitive processes underlying hypoactive sexual desire and more largely the evaluative processes involved in human mate choice.
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Affiliation(s)
- Camille Ferdenzi
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland; Laboratory for the Study of Emotion Elicitation and Expression (E3 Lab), Department of Psychology, FPSE, University of Geneva, Geneva, Switzerland
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Kalmbach DA, Kingsberg SA, Ciesla JA. How changes in depression and anxiety symptoms correspond to variations in female sexual response in a nonclinical sample of young women: a daily diary study. J Sex Med 2014; 11:2915-27. [PMID: 25200390 DOI: 10.1111/jsm.12692] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION A large body of literature supports the co-occurrence of depression, anxiety, and sexual dysfunction. However, the manner in which affective symptoms map onto specific female sexual response indices is not well understood. AIMS The present study aimed to examine changes in depression and anxiety symptoms and their correspondence to fluctuations in desire, subjective arousal, genital response, orgasmic function, and vaginal pain. METHODS The study used a 2-week daily diary approach to examine same-day and temporal relations between affective symptoms and sexual function. MAIN OUTCOME MEASURES The unique relations between shared and disorder-specific symptoms of depression and anxiety (i.e., general distress, anhedonia, and anxious arousal) and female sexual response (i.e., desire, subjective arousal, vaginal lubrication, orgasmic function, and sexual pain) were examined, controlling for baseline levels of sexual distress, depression, and anxiety, as well as age effects and menstruation. RESULTS Analyses revealed that changes in depression and anxiety severity corresponded to same-day variations in sexual response. Specifically, anhedonia (depression-specific symptom) was related to poorer same-day sexual desire, whereas greater anxious arousal (anxiety-specific symptom) was independently related to simultaneous increases in subjective sexual arousal, vaginal lubrication, and sexual pain. Increases in general distress (i.e., shared symptoms) were associated with greater same-day difficulties achieving orgasm. Notably, only one temporal relation was found; it indicated that higher levels of anhedonia predicted a next-day decrease in sexual desire. CONCLUSIONS It is proposed that the simultaneous changes in affective symptoms and sexual function may indicate that they are products of shared underlying mechanisms. That is, in response to stress, the processes manifesting as feelings of weak positive affect and amotivation are the very same processes responsible for diminished capacity for sexual desire. In contrast, the physiological hyperarousal associated with anxiety also gives rise to sexual arousal difficulties and vaginal pain.
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Affiliation(s)
- David A Kalmbach
- Sleep and Chronophysiology Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychology, Kent State University, Kent, OH, USA
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Herbenick D, Mullinax M, Mark K. Sexual desire discrepancy as a feature, not a bug, of long-term relationships: women's self-reported strategies for modulating sexual desire. J Sex Med 2014; 11:2196-206. [PMID: 25052706 DOI: 10.1111/jsm.12625] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Sexual desire discrepancy is commonly reported by couples in long-term romantic relationships. Given the idiosyncratic nature of desire, and the lack of a "one size fits all" model approach to address desire concerns, it is useful to understand more about the range of ways that women and their partners modulate sexual desire. AIM This study aims to assess women's strategies to influence their sexual desire and the self-reported effectiveness of these strategies. METHODS One hundred seventy-nine women who had been in a relationship with a male partner for 5+ years completed an anonymous Internet-based survey. MAIN OUTCOME MEASURES Participants responded to three open-ended items about the strategies they use to address desire issues and how helpful those strategies are. RESULTS The most common responses regarding what participants did to get desire back on track included: communication, trying to meet partner's needs, having sex without desire, and having patience/letting time work out the problem. Women also mentioned several specific strategies they had employed: communication, scheduling sex, lingerie, and a date night. However, a large number of women discussed that the issue was not resolved, and they were dissatisfied with attempted strategies. CONCLUSIONS This research provides valuable insight into the construction of women's sexual desire and the strategies used to navigate sexual desire in long-term relationships.
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Affiliation(s)
- Debby Herbenick
- Center for Sexual Health Promotion, Indiana University, Bloomington, IN, USA; Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
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Abstract
INTRODUCTION The progress and determinants of sexual dysfunction in middle-aged and elderly men remain unclear. AIM To describe the incidence or remission and biopsychosocial predictors of erectile dysfunction (ED) and low sexual desire (SD). MAIN OUTCOME MEASURES Erectile function (International Index of Erectile Function) and sexual desire (Sexual Desire Inventory 2) were assessed at follow-up. Sociodemographic, lifestyle, and health-related factors were examined in multivariate models of ED and low SD. METHODS Data were collected from 810 randomly selected men residing in northern and western Adelaide, Australia, and aged 35-80 years at baseline, who made clinic visits 5 years apart. RESULTS At baseline, 23.2% (n = 123) of men had ED. ED incidence and remission were observed in 31.7% (n = 179) and 29.0% (n = 71) of eligible men, respectively. At baseline, 19.2% (n = 165) had low solitary sexual desire, and 6.0% (n = 50) had low dyadic sexual desire; incidence of low sexual desire occurred in 17.6% (n = 83) (solitary) and 8.3% (n = 51) (dyadic), while remission occurred in 15.4% (n = 68) (solitary) and 22.6% (n = 40) (dyadic) of men. In the final regression models, predictors of incident ED were higher age, lower income, higher abdominal fat mass, low alcohol intake, higher risk of obstructive sleep apnea (OSA) risk, voiding lower urinary tract symptoms (LUTS), depression, and diabetes. Predictors of ED remission were lower age, current employment, and absence of voiding LUTS, angina, diabetes, and dyslipidemia. Predictors of low dyadic SD incidence included higher age, never having been married, widowhood, being unemployed, being retired, insufficient physical activity, and low alcohol intake. Predictors of low dyadic SD remission were being married, not being widowed, higher income, lower abdominal fat mass, lower OSA risk, and higher plasma testosterone. Predictors of low solitary SD included never having been married, being unemployed, low alcohol intake, lower testosterone, storage LUTS, and hypertension. Predictors of low solitary SD remission were being married, being employed, higher income, higher physical activity, moderate alcohol intake, and depression. CONCLUSIONS Sexual dysfunction in aging men is a dynamic disorder whose incidence and remission are predicted by a range of modifiable risk factors.
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Affiliation(s)
- Sean A Martin
- Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, South Australia, Australia; Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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Teimourpour N, Moshtagh Bidokhti N, Pourshahbaz A, Bahrami Ehsan H. Sexual desire in Iranian female university students: role of marital satisfaction and sex guilt. Iran J Psychiatry Behav Sci 2014; 8:64-9. [PMID: 25798176 PMCID: PMC4364479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 04/12/2013] [Accepted: 01/16/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine association between sexual desire and marital satisfaction and sex guilt among a sample of Iranian female university students. METHODS The data presented here were obtained from a total of 192 married Iranian female university students who were selected via a multi-cluster sampling method from universities of Social Welfare and Rehabilitation, Tarbiat Modarres, and Islamic Azad. The subjects' sociodemographic data, marital satisfaction (using ENRICH Marital Satisfaction Questionnaire), sex guilt (using Mosher Revised Sex-Guilt Inventory), and sexual desire (using Hurlbert Index of Sexual Desire) were gathered. Pearson correlation coefficient and regression analysis methods were used to analyse the data. RESULTS Findings showed there are significant relationships between sexual desire and marital satisfaction (r = 0.51, p < 0.01) and also between sexual desire and sex guilt (r = -0.44, p < 0.01). Also marital satisfaction and sex guilt were able to predict 31 percent of the variance of sexual desire. CONCLUSION Marital satisfaction and sex guilt are two factors that significantly affect fluctuations in sexual desire of Iranian female university students.
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Affiliation(s)
- Negar Teimourpour
- PhD Student, Department of Clinical Psychology and Educational Sciences, University of Tehran, Tehran, Iran
| | - Nahaleh Moshtagh Bidokhti
- Associate Professor, Department of Clinical Psychology, University of Social Welfare and Rehabilitation, Tehran, Iran. ,Corresponding author: Nahaleh Moshtagh Bidokhti, University of Social Welfare and Rehabilitation, Koodakyar St, Daneshjou Blvd, Evin, Tehran, Iran. postal code: 1985713834, Tel:+98 2122810045, Fax:+98 2122810046, E-mail:
| | - Abbas Pourshahbaz
- Assistant Professor, Department of Clinical Psychology, University of Social Welfare and Rehabilitation, Tehran, Iran
| | - Hadi Bahrami Ehsan
- Associate Professor, Department of Clinical Psychology and Educational Sciences, University of Tehran, Tehran, Iran
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