A randomized comparison of online mindfulness-based group sex therapy vs supportive group sex education to address sexual dysfunction in breast cancer survivors

BACKGROUND

Sexual difficulties and vaginal pain are common following treatment for breast cancer.

AIM

The goal of this study was to evaluate an online mindfulness-based group sex therapy vs an online supportive sex education group therapy to address these sexual difficulties.

METHODS

Breast cancer survivors (n = 118) were randomized to 1 of the 2 arms; 116 provided informed consent and completed the time 1 assessment. Treatment included 8 weekly 2-hour online group sessions. Those randomized to the mindfulness group completed daily mindfulness exercises, and those in the comparison arm read and completed exercises pertaining to sex education.

OUTCOMES

Assessments were repeated at posttreatment and 6 months after the completion of the group.

RESULTS

There was a main effect of treatment on primary endpoints of sexual desire, sexual distress, and vaginal pain, with all outcomes showing significant improvements, with no differential impact by treatment arm. Secondary endpoints of interoceptive awareness, mindfulness, and rumination about sex also significantly improved with both treatments, with no group-by-time interaction.

CONCLUSION

Both mindfulness-based sex therapy and supportive sex education delivered in group format online are effective for improving many facets of sexual function, vaginal pain, rumination, mindfulness, and interoceptive awareness in breast cancer survivors.

STRENGTHS AND LIMITATIONS

We used a randomized methodology. Future studies should seek to diversify participants.

CLINICAL IMPLICATIONS

These findings highlight the need to offer similar treatments to more breast cancer survivors immediately after and in the years following cancer treatment as a means of improving survivorship quality of life.

Correlation of sexual desire with sexual hormone binding globulin and free androgen index in women using combined contraceptives

PURPOSE

To correlate the sexual desire levels with sexual hormone binding globulin and free androgen index in women taking different types of hormonal contraceptives (HCs) containing ethinylestradiol (EE), oestradiol valerate (E2V), 17β-oestradiol (E2), or estetrol (E4), combined or in phasic formulation with different progestogens having antiandrogenic properties.

METHODS

Three hundred and sixty-seven women (age range 18-46) participated in the study. SHBG and total testosterone (TT) were measured, and the Free Androgen Index (FAI) was calculated. The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) questionnaires were used to assess sexual function and distress, respectively.

RESULTS

The highest SHBG values and the lowest FAIs were obtained of women on HCs containing EE than those of women on HCs containing E2V/17β E2 or E4 (p < 0.001). Desire scores and FSFI total scores were lower in women on HCs with EE than in those using HCs containing E2V, 17β E2, or E4 (p ≤ 0.001). The women who were on HCs containing EE reported FSDS levels higher than those containing all the other types of oestrogen. Finally, sexual desire and FSFI total scores had a negative correlation with the SHBG values and a positive correlation with FAI percentage (p ≤ 0.0001).

CONCLUSIONS

A minority of women using HCs with EE might experience a decreased sexual desire. This was not observed in women on HCs containing E2V, 17 E2, or E4. To avoid HC discontinuation, due to sexual desire reduction, HCs having minor antiandrogenic effects could be taken into consideration.

Genital arousal and responsive desire among women with and without sexual interest/arousal disorder symptoms

BACKGROUND

Models depicting sexual desire as responsive to sexual arousal may be particularly apt for women experiencing arousal or desire difficulties, and the degree to which arousal triggers desire may depend on the relationship context and desire target and timing-yet, these associations have not been directly tested among women with and without sexual interest/arousal disorder (SIAD).

AIM

To assess the role of SIAD status and relationship satisfaction in the associations between genital arousal and 4 types of responsive desire.

METHODS

One hundred women (n = 27 meeting diagnostic criteria for SIAD) in romantic relationships with men viewed a sexual film (pleasurable intimate depiction of oral sex and penile-vaginal intercourse) while their genital arousal was recorded via vaginal photoplethysmography (n = 63) or thermal imaging of the labia (n = 37). Partner and solitary desire was assessed immediately before and after the film (immediate desire) and 3 days later (delayed desire).

OUTCOMES

Outcomes consisted of genital response (z scored by method) and associations between genital response and responsive sexual desire.

RESULTS

The key difference between women with and without SIAD was not in their ability to experience genital arousal but in how their genital responses translated to responsive sexual desire. Women with SIAD actually exhibited greater genital arousal than unaffected women. Associations between genital arousal and desire were significant only for women with SIAD and depended on relationship satisfaction and desire type. For women with SIAD with low relationship satisfaction, higher arousal predicted lower immediate desire for a partner; for those with high relationship satisfaction, arousal was either positively related (vaginal photoplethysmography) or unrelated (thermal imaging of the labia) to immediate desire for a partner. Associations with other desire types were not significant.

CLINICAL IMPLICATIONS

Patterns of genital arousal and partner-specific responsive desire among women affected with SIAD were indicative of an avoidance model in response to heightened genital arousal, unless relationship satisfaction was high; attending to genital arousal sensations could be a means of triggering sexual desire for women with SIAD who are satisfied in their relationships.

STRENGTHS AND LIMITATIONS

This is one of the first sexual psychophysiologic studies to connect relationship factors to patterns of sexual response. The differing arousal assessment procedures and lack of official diagnosis may have attenuated results. The homogeneous sample and in-person session requirement limit generalizability.

CONCLUSION

When compared with unaffected women, women affected by SIAD may exhibit stronger arousal responses with sufficiently incentivized sexual stimuli, and the connection between their genital arousal and responsive desire for their partners may be stronger and more dependent on relationship context.

Combined estrogen-progestin oral contraceptives and female sexuality: an updated review

INTRODUCTION

Sexual side effects of combined oral contraceptives (COCs) have not been fully understood, but increasing evidence prompts broader risk/benefit evaluation and merits inclusion in counseling on contraceptive options.

OBJECTIVES

The study sought to explore the impact of combined estrogens-progestin oral contraceptives on components of female sexuality, including sexual desire, anatomic genitourinary changes, lubrication, orgasm, provoked vestibulodynia, well-being, body image, partner preference, and relationship stability.

METHODS

A literature review was performed between April 2023 and January 2024 exploring the association between combined oral contraceptive pills and sexual health.

RESULTS

Although COCs decrease free testosterone, it is unclear if COCs affect sexual function, including desire. Antiandrogenic COCs do seem to have a negative effect on sexual arousal, lubrication, and orgasm. Provoked vestibulodynia may be related to early onset of COC use, low-estrogen pills, and antiandrogenic progestins. Emotional and sexual side effects are strong predictors of COC discontinuation. Longitudinal data indicate that using COCs when meeting and selecting a partner has implications on sexual satisfaction and relationship length. Analysis of data is complicated by various doses and forms of estrogen and progestin in COCs, which have changed over time.

CONCLUSION

Lack of randomized placebo-controlled studies and heterogenicity in study design hampers generalized statements about the effects of COCs on sexual function. Despite these challenges, consideration of sexual dysfunction when presenting and prescribing hormonal contraception is essential for informed consent, shared decision making, and ensuring reliable contraceptive choices.

Influence of Pregnancy on Sexual Desire in Pregnant Women and Their Partners: Systematic Review

Objectives: Pregnancy is a stage in which different physical and psychological changes take place that can affect the sexuality of the couple. The aim of the study is to identify how the physical and psychological changes derived from pregnancy affect the sexual desire of women and men. Methods: A systematic review of the literature was carried out in five databases, from which a total of 16,126 documents were obtained. After applying the PRISMA selection criteria, a total of 19 documents were selected. Results: Levels of sexual desire fluctuate during pregnancy, being the second trimester of gestation the period in which desire is at its highest and in which physical limitations and emotional changes decrease. Women have lower levels of sexual desire in the first trimester, while men have the lowest levels of desire in the third trimester. Conclusion: Pregnancy is a stage marked by physiological and psychological changes that modify several areas, including sexuality. Healthcare professionals should promote a healthy sexuality, avoiding the appearance of fears or sexual dysfunctions caused by the changes that occur during pregnancy.

A 2-week high-intensity interval training intervention improves ejaculation control among men with premature ejaculation

BACKGROUND

Premature ejaculation (PE), which leads to substantial distress in men and their partners, is a common male sexual dysfunction worldwide. However, there is still a lack of effective treatments without side effects.

OBJECTIVES

We investigated the effect of high-intensity interval training (HIIT) on PE symptoms.

MATERIALS AND METHODS

We recruited 92 Chinese men aged 18-36 to complete the experiment. There were 22 (13 in the control group; 9 in the HIIT group) men diagnosed with PE and 70 (41 in the control group; 29 in the HIIT group) men with normal ejaculatory function. In the HIIT group, participants completed HIIT exercises every morning for 14 days. Participants also completed surveys inquiring about demographic information, erectile function, PE symptoms, body image (including sexual body image), physical activity, and sexual desire. The heart rate was measured before and after each HIIT. In the control group, participants were instructed not to do HIIT, but other procedures were the same as in the HIIT group.

RESULTS

Results indicated that the HIIT intervention alleviated PE symptoms in men with PE. In addition, in the HIIT group, men with PE who had a higher heart-rate increase during the HIIT intervention reported the greatest overall decrements in PE symptoms. In men with normal ejaculatory function, HIIT did not decrease PE symptoms. In addition, increments in the heart rate during the intervention were associated with more pronounced PE symptoms post-intervention in this group. Analyses of secondary outcome measures suggested that the HIIT intervention improved general and sexual body image satisfaction of men with PE compared to before the intervention.

DISCUSSION AND CONCLUSION

In summary, HIIT intervention may reduce PE symptoms in men with PE. The heart-rate increase during the intervention may be a key factor influencing the effect of the HIIT intervention on PE symptoms.

When the brain turns on with sexual desire: fMRI findings, issues, and future directions

INTRODUCTION

More than 2 decades of neuroimaging research has sought to uncover the neurologic basis of sexual desire. However, the lack of a clear conceptual distinction between sexual desire and sexual arousal or even a broadly accepted definition of sexual desire has led to confusion in the literature regarding brain areas uniquely associated with sexual desire.

OBJECTIVES

(1) To critically review the neuroimaging literature that seeks to identify brain areas and networks involved in sexual desire; (2) to identify and discuss those brain areas and potential networks that are most promising for providing insights to sexual desire; and (3) to offer recommendations for future studies.

METHODS

Existing meta-analyses were used as a starting point to identify relevant neuroimaging studies on sexual desire, arousal, and love. This base was then expanded via Google Scholar and forward citation tracking of already identified studies.

RESULTS

Brain areas that are commonly associated with sexual desire and arousal include the amygdala, hypothalamus, dorsal and ventral striatum, anterior cingulate, insula, and prefrontal and orbitofrontal cortex. However, because the same basic paradigm has been used to study sexual desire and arousal, unambiguous conclusions regarding areas uniquely involved in sexual desire cannot be drawn. Moreover, the lack of connectivity analyses and a failure to acknowledge negative BOLD (blood-oxygen level dependent) significantly limit conclusions on the neural basis of sexual desire.

CONCLUSION

Five recommendations are made. First, stimulus types (ie, erotic vs sexually explicit) should be selected by the meaningful theoretical conceptualization of the constructs of interest. Second, participants should be provided with definitions of sexual desire, mental sexual arousal, and perceived genital sexual arousal, so they can choose which terms best describe their experience. Third, event-related designs should be used with caution when investigating sexual desire. Fourth, time series analyses should be used to identify both positive and negative BOLD. Fifth, connectivity analyses should be performed to identify brain networks.

The impact of intensive trauma-focused treatment on sexual functioning in individuals with PTSD

Background

Individuals with posttraumatic stress disorder (PTSD) often experience sexual disturbances.

Objective

To determine whether intensive trauma-focused treatment is associated with an improvement in sexual functioning (i.e., sexual satisfaction and sexual desire) in individuals with PTSD.

Method

In total, 227 patients with PTSD (68.7% women, mean age = 40.97) participated in an intensive eight-day trauma-focused treatment program consisting of prolonged exposure, eye movement and desensitization and reprocessing (EMDR) therapy, physical activity, and psychoeducation. Patients were assessed (i.e., Clinician Administered PTSD Scale and Sexual Functioning Questionnaire) pre- and post-treatment and at 6-months follow-up.

Results

Sexual satisfaction and sexual desire increased significantly associated with trauma-focused treatment from pre-treatment to 6-months follow-up, albeit the effect sizes were small (Cohen's d = 0.39 and 0.17, respectively). Although men reported greater overall sexual desire than women, sexual functioning improved after treatment in both men and women. Furthermore, those with remission of PTSD reported greater sexual functioning post-treatment and at 6-months follow-up, than those without remission. However, changes in PTSD symptoms associated with treatment were not predictive of the level of sexual satisfaction or sexual desire 6 months after treatment.

Conclusion

The results of this uncontrolled study suggest that intensive treatment for PTSD can have beneficial effects on sexual satisfaction and desire in both men and women; however, this may not necessarily be due to a decrease in PTSD symptoms.

Are COVID-19 lockdowns associated with a change in sexual desire? Results from an online survey of Australian women

In early 2020, the Australian government implemented lockdown restrictions to prevent the spread of COVID-19. Our study aims to investigate the impact of lockdowns on sexual desire and enjoyment of sex among Australian women. We conducted an online survey in August 2020 when Victoria was in strict lockdown, but all other states/territories had minimal restrictions. Here, we report on responses from female participants aged ≥18 years. Respondents were asked whether COVID-19 had impacted their desire and/or enjoyment of sex (yes/no). Those who responded "yes" were asked to elaborate in a free-text question. Factors associated with desire were investigated using the chi-square test. Conventional content analysis was used to explore free-text responses. Of the 622 participants, 44.1% reported COVID-19 related impacts on their sexual desire. Women living in Victoria, who were not heterosexual, and whose employment was negatively affected by lockdown were all more likely to report an impact on their sexual desire. Free-text comments revealed that mental health, living arrangements, and a reduced ability to meet with sexual partners were key reasons behind these impacts. The COVID-19 pandemic and lockdown measures clearly impacted the desire and enjoyment of sex for many women, important factors of people's relationships, health, and wellbeing.

Partner responses to low desire among couples coping with male hypoactive sexual desire disorder and associations with sexual well-being

BACKGROUND

Hypoactive sexual desire disorder (HSDD) is characterized by persistently low desire and associated distress. Low desire is one of the most common sexual complaints among men and is associated with poor well-being. Interpersonal factors are key to understanding low desire, yet there are few dyadic studies of HSDD in men. Previous work on genito-pelvic pain and low desire in women has established that greater facilitative (eg, affectionate) partner responses are associated with greater sexual satisfaction and function and that more negative (eg, critical) or solicitous (eg, sympathetic, avoidant) partner responses are associated with lower sexual satisfaction and function. Examining how partner responses are associated with adjustment to HSDD may shed light on the interpersonal dynamics of this understudied sexual dysfunction.

AIM

In a cross-sectional study, we examined whether partner responses to low desire in men were associated with sexual desire, sexual satisfaction, and sexual distress for both members of the couple.

METHODS

Men with HSDD and their partners (N  =  67 couples) completed measures of facilitative, negative, and avoidant partner responses to men's low sexual desire-as perceived by the man with HSDD and self-reported by their partner-and sexual desire, sexual satisfaction, and sexual distress. Data were analyzed using multilevel modeling guided by the actor-partner interdependence model.

OUTCOMES

Outcomes included the partner-focused subscale of the Sexual Desire Inventory-2, Global Measure of Sexual Satisfaction, and Sexual Distress Scale-Revised.

RESULTS

When men with HSDD perceived more facilitative partner responses to their low desire, they and their partners reported greater sexual satisfaction. When men with HSDD perceived and their partners self-reported more negative partner responses, they each reported lower sexual satisfaction. In addition, when men with HSDD perceived more avoidant partner responses, their partners reported greater sexual distress. Partner responses were not associated with sexual desire for either member of the couple.

CLINICAL IMPLICATIONS

Findings support the importance of the interpersonal context for HSDD in men and suggest potential future targets of treatment when working with affected couples.

STRENGTHS AND LIMITATIONS

This study is one of the only dyadic studies of HSDD in men, as assessed via clinical interview or self-report symptoms reviewed by the clinical team. Despite our best efforts to recruit this sample over 6 years, the small size limited power to detect all predicted effects.

CONCLUSION

More facilitative and fewer negative or avoidant partner responses to low desire are associated with greater sexual well-being in couples coping with HSDD.

Menstrual cycle-driven vs noncyclical daily changes in sexual desire

BACKGROUND

Past research on the association between sexual desire and the menstrual cycle has provided inconclusive results and has not considered the potential influence of psychological and physical changes that are frequently associated with the menstrual cycle.

AIM

To test the strength of association between the menstrual cycle (and associated symptoms) and changes in sexual desire.

METHODS

Prospective daily reports across 2 full menstrual cycles (2 months) from a sample of female university students (n = 213), were analysed. Analyses tested for average effects of the menstrual cycle on sexual desire, individual differences in these effects, and cyclical and noncyclical associations between sexual desire and the 9 menstrual cycle-related changes. Note that data presented in the current article come from a larger study from which other reports have been published.

OUTCOMES

Target variables were (1) daily change in sexual desire and (2) daily reports of 5 psychological changes and 4 physical changes that are commonly associated with the menstrual cycle.

RESULTS

Results showed that when considering average effects across participants, the menstrual cycle was associated with a small midcycle increase in sexual desire. However, multilevel analyses showed large individual differences in how the menstrual cycle influences sexual desire. Specifically, some participants showed a midcycle increase, others a perimenstrual increase, and others no change across the menstrual cycle. Moreover, results demonstrated that psychological changes were more important for predicting sexual desire as compared with physical changes.

CLINICAL IMPLICATIONS

These results suggest that daily measurement of sexual desire across multiple menstrual cycles may be an important tool in the assessment of sexual desire among some females.

STRENGTHS AND LIMITATIONS

Strengths of this study are the daily assessment of sexual desire and all symptoms for 2 menstrual cycles and multilevel analyses that allow the study of individual differences. Limitations include limited measurement of sexual desire based on only 2 questions and the lack of measures of relationship status and sexual orientation.

CONCLUSION

Emphasis is placed on the need to apply more rigorous research methods and to abandon simplistic average-effects models that are based on outdated theories and stereotypes.

Sexual Desire and Erotic Fantasies Questionnaire: The Development and Validation of the Erotic Fantasy Use Scale (SDEF2) on Experience, Attitudes, and Sharing Issues

BACKGROUND

The investigation of sexual fantasies is a delicate issue within sex research. Most studies have focused on the content of these fantasies, rather than on use, experiences, attitudes, and sharing issues, which are fundamental aspects within sexual therapy. The main aim of the present study was to develop and validate the "Sexual Desire and Erotic Fantasies questionnaire-Part 2. Use of Erotic Fantasies (SDEF2)".

METHODS

The SDEF2 was completed by 1773 Italian participants (1105 women, 645 men, and 23 other genders).

RESULTS

The final 21-item version presented a five-factor structure (fantasies frequency, fantasies normality, fantasies importance, negative emotions, and sharing and experiencing). The SDEF2 showed good psychometric properties, internal reliability, construct, and discriminant validity, appearing to be able to differentiate between sexually clinical and functional women and men (based on the FSFI and IIEF cut-off scores).

CONCLUSIONS

The possibility of assessing fantasies frequency, attitudes, and emotions may be extremely useful both for research and clinical purposes. The current study seems to validate that the SDEF2 is a useful measure of assessing the different aspects related to a fantasizing activity, which was shown to be associated with sexual functioning and satisfaction.

Sexual desire, mood disorders and sleep disturbances in female BMS patients: A controlled study

BACKGROUND

Burning mouth syndrome is a chronic orofacial pain with intraoral burning and other oral dysaesthetic symptoms that significantly affects the quality of life. The aim of this study is to evaluate the sexual desire in women with BMS and to investigate the possible related factors.

METHODS

A case-control study was performed. BMS patients were enrolled according to the International Classification of OroFacial Pain criteria. Demographic variables were collected. We evaluated pain with the Numeric Rating Scale (NRS), Visual Analogue Scale (VAS) and Total Pain Rating Index (T-PRI), anxiety and depression using the Hospital Anxiety and Depression Scale (HADS-A e HADS-D), sleep disturbances with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), and sexual desire using Sexual Desire Inventory (SDI).

RESULTS

A total of 50 BMS women and 50 healthy controls were enrolled. Compared with the controls, the BMS patients showed higher scores in the NRS (7,81 ± 1,71 vs. 0,14 ± 0.40; p < 0.0001), TPR-I (10,50 ± 4,86 vs. 0,36 ± 1,06; p < 0.0001), HADS-A (11,86 ± 2,85 vs. 3,90 ± 2,81; p < 0.0001), HADS-D (8,04 ± 3,18 vs. 1,42 ± 1,86; p < 0.0001) and PSQI (9,04 ± 2,62 vs. 4,64 ± 3,27; p < 0.0001). The mean SDI in the study group was significantly lower compared to healthy controls (32,36 ± 14,45 vs. 69,70 ± 19,94; p < 0.0001). No correlation was found between SDI and others items explored.

CONCLUSION

In line with previous studies, anxiety, depression and sleep disturbances are more common in BMS patients than in healthy population. This pilot study demonstrates for the first time an association between BMS and low sexual desire.

A Scoping Review of the Influence of Mindfulness on Men's Sexual Activity

Mindfulness practice and mindfulness-based interventions are widely known, especially for women's sexuality. However, it is currently unknown how this practice affects the experience of male sexuality, possibly due to the existence of pharmacological treatments that are usually the first choice of treatment for men. The objectives of this study are to explore the influence of mindfulness on different components of men's sexuality from a scoping review of relevant scientific articles existing in the literature. A literature search from 2010 to 2022 was carried out in the electronic databases MEDLINE, Embase, PsycINFO, Web of Science, Scopus, PubMed, Dialnet, SciELO Citation Index, and Redalyc. Out of the 238 studies, 12 that met the defined selection criteria were selected. The analysis of these studies seems to indicate that the practice of mindfulness favours different variables of male sexuality, such as satisfaction and sexual functioning or genital self-image. Mindfulness-based interventions represent a valuable and promising contribution. No adverse effects were detected from the review of scientific articles considered in this work. Nevertheless, more randomized studies with active control groups are necessary to establish the benefits of mindfulness-based interventions in sex therapy for men.

The Impact of Nutritional Status on Sexual Function in Male Kidney Transplant Recipients

Background and Objectives: Sexual function and nutritional status assessment are relevant topics in chronic kidney disease patients. This study was designed to investigate whether bioelectrical impedance analysis-derived nutritional parameters, nutritional biomarkers, and handgrip strength influence sexual function and to analyze the changes in sexual function after kidney transplantation in men. Materials and Methods: Fifty-four men with kidney failure who had undergone replacement therapy entered the study. In addition, sexual function and nutritional status were evaluated before kidney transplantation and 12 months after. We used the International Index of Erectile Function, bioelectrical impedance analysis, three different malnutrition screening tools, handgrip strength, and anthropometric measurements. The demographic profiles and biochemical nutritional markers were collected. Results: Sexual inactivity was associated with a lower phase angle (6 (1) vs. 7 (1), p < 0.05) and a higher fat mass index (7 (5) vs. 3 (4), p < 0.05). Normal erectile function before kidney transplantation was significantly related to higher fat-free mass (67 (11) vs. 74 (7), p < 0.05) and lean mass (64 (10) vs. 70 (7), p < 0.05). The improvement in erectile function after kidney transplantation was nonsignificant (44% vs. 33%, p = 0.57). Only a weak association between muscle mass and sexual desire 12 months after kidney transplantation was found (rS = 0.36, p = 0.02). Further, linear regression revealed that higher muscle mass could predict better sexual desire after kidney transplantation following adjustment for age, estimated glomerular filtration rate, and diabetes mellitus. Conclusions: Kidney transplantation did not significantly improve erectile dysfunction in our study population. Sexual desire and intercourse satisfaction are the most affected domains in patients with chronic kidney disease. Higher muscle mass predicts higher sexual desire after kidney transplantation. Higher levels of fat-free and lean mass are associated with normal erectile function before kidney transplantation.

Sexual boredom and sexual desire in long-term relationships: a latent profile analysis

BACKGROUND

Research suggests a general link between sexual boredom and sexual desire, but its understanding is currently very limited.

AIM

To identify distinct (latent) groups of women and men in long-term relationships based on their reported levels of sexual boredom and sexual desire.

METHODS

Latent profile analysis (LPA) was conducted in an online sample of 1223 Portuguese participants aged 18 and 66 years (mean ± SD, 32.75 ± 6.11), using indicators of sexual boredom and partner-related, attractive other-related, and solitary sexual desire to categorize participants. Multinomial logistic regression analysis was carried out to explore predictors and correlates of the latent profiles.

OUTCOMES

Sexual boredom was assessed by the Sexual Boredom Scale, while sexual desire was measured with the Sexual Desire Inventory.

RESULTS

As compared with women, men reported higher levels of sexual boredom and sexual desire. LPA indicated 3 profiles in women and 2 profiles in men. Among women, P1 was characterized by above-average sexual boredom, below-average partner- and attractive other-related sexual desire, and very low solitary sexual desire; P2 by below-average sexual boredom, attractive other-related sexual desire, and solitary sexual desire and above-average partner-related sexual desire; and P3 by above-average sexual boredom, attractive other-related sexual desire, and solitary sexual desire and below-average partner-related sexual desire. In men, P1 was characterized by high sexual boredom, above-average partner-related sexual desire, and high attractive other-related and solitary sexual desire and P2 by below-average sexual boredom and above-average partner-related, attractive other-related, and solitary sexual desire. The latent profiles did not differ according to relationship duration. Overall, the sole consistent correlate of the latent categorization was sexual satisfaction.

CLINICAL IMPLICATIONS

In women, above-average levels of sexual boredom were linked to below-average levels of partner-related desire, which suggests likely benefits of helping the couple to minimize or cope better with their sexual routines. In men, participants in the 2 profiles did not differ in partner-related sexual desire, suggesting that clinical interventions dealing with male sexual boredom should investigate factors beyond the current relationship.

STRENGTHS AND LIMITATIONS

This study explored different facets of sexual desire and used LPA, rendering advantages over previous research. The male sample has lower statistical power than the female sample.

CONCLUSION

Patterns of sexual boredom and sexual desire among individuals in long-term monogamous relationships are distinct and consistently related to sexual satisfaction in women and men and to relationship satisfaction among only women, which have important clinical ramifications.

Sexual Desire of Women With Fast and Slow Life History Throughout the Ovulatory Cycle

Findings on female sexual motivation across the ovulatory cycle are mixed. Some studies have reported increased female sexual desire on fertile days or midway through the ovulatory cycle, whereas others have reported increased sexual desire on nonfertile days. We postulated and tested the hypothesis that the pattern of the cyclical change of female sexual desire is associated with women's life history. Female participants completed life-history measures and rated their levels of sexual desire on the survey day and reported the first day of their current and subsequent cycle, respectively (Study 1), or recorded their sexual desire throughout an entire cycle by submitting daily reports (Study 2). Results indicate that women with a fast life history experienced peak sexual desire midcycle, whereas women with a slow life history experienced two peaks of sexual desire midcycle and around their menses. These findings suggest that, consistent with the underlying life history, cyclically differential peaking of sexual desire may serve different reproductive functions.

Sexuality in Older Adults in A Primary Care Unit of Thailand during the COVID-19 Pandemic: A Cross-sectional Survey

OBJECTIVES

To investigate sexuality in older Thai adults during the coronavirus disease (COVID-19) pandemic and the associated factors.

METHODS

This cross-sectional survey was conducted on older adults visiting a primary care unit (PCU) in Thailand. A hundred and ninety older adults were enrolled by convenience sampling. Multiple logistic regression analysis with a backward stepwise algorithm was used to analyze factors associated with sexual desire and activity in older Thai adults.

RESULTS

The median age of participants was 67.99 (60.01-88.57) years, and 63.2% were women. Overall, 37.4% of participants had sexual desires, and 54.2% were sexually active during the COVID-19 pandemic; however, more than half reported a decrease in sexual activity, fearing COVID-19 transmission as the most common reason. Men had more sexual desire and activity than women (adjusted OR [95% CI] = 13.92 [4.76, 40.73] and 6.63 [2.59, 16.94], respectively).

CONCLUSIONS

Older Thai adults in the PCU displayed decreased sexual desire and activity during the COVID-19 pandemic. Sexual health is a lifestyle aspect that required investigation and care during the pandemic.

CLINICAL IMPLICATIONS

Older Thai adults should be educated in that sexual activities can be broader than sexual intercourse, and sexual health should be cared for during an eventual new pandemic disease.

Coercive Sexual Experiences that Include Orgasm Predict Negative Psychological, Relationship, and Sexual Outcomes

Psychological sexual coercion is known to negatively impact those who experience it, yet sexual encounters where orgasm is present are often presumed to be positive and absent of coercion. In the present study, we conducted an online survey with women (n = 179) and men (n = 251) to test associations between sexually coercive experiences that include orgasm and negative psychological, sexual, and relationship outcomes. To do so, we focused on three experiences: having an orgasm during coerced sex (CS), having a coerced orgasm during desired sex (CO), and having a coerced orgasm during coerced sex (COS). Using structural equation modeling, we found that ever having any of these coercion-plus-orgasm experiences with a current partner predicted significantly higher avoidance motivations (i.e., engaging in sex to avoid conflict with one's partner), which in turn predicted significantly worse psychological distress, sexual satisfaction, relationship satisfaction, and sexual functioning (but not dyadic sexual desire). We also found that CS, CO, and COS predicted negative outcomes to a similar degree. However, testing gender/sex as a moderator clarified that CS predicted significantly lower sexual satisfaction, sexual functioning, and sexual desire for women but not men. Furthermore, CO predicted faking orgasms in women, but COS predicted faking orgasms in men. Together, results demonstrate that experiencing psychological sexual coercion and/or orgasm coercion is significantly associated with negative outcomes even if the coerced person's orgasm occurs.

Relational and Trait Factors Mediate the Associations between Women's Intoxication-Related Unwanted Sexual Experiences, Pleasure, and Desire

Despite documented negative sexual health sequelae of unwanted sexual contact (USC), it is unclear why individuals who have experienced USC within the context of intoxication (intoxication-related USC) are at particular risk for poor sexual functioning. Intoxication-related USC may impact relational factors like relationship satisfaction, as trauma symptoms interfere with emotional closeness during sex. Additionally, although individual traits - such as sexual excitation and sensation seeking - affect the relationship between trauma and sexual functioning, it is unknown whether these factors differentially impact those who have experienced intoxication-related USC. Finally, because presence of a partner may evoke trauma-related symptoms during partnered (dyadic) sexual activity, mediators may differ across solitary versus dyadic sexual pleasure and desire. We tested relational and individual trait mediators of the association between intoxication-related USC and solitary and dyadic sexual pleasure and desire in a sample of heterosexual and sexual minority women. Trait factors consistently mediated the association between intoxication-related USC and both dyadic and solitary desire and pleasure, while relational factors such as emotional closeness were inconsistently related to sexual wellbeing. If replicated, these findings would suggest that trait factors may be useful targets for clinical sexual wellness interventions among sexuality-diverse women who have experienced intoxication-related USC.

Effects of testosterone suppression on desire, hypersexuality, and sexual interest in children in men with pedophilic disorder

Effects of testosterone withdrawal on significant correlates of paedophilic disorder (PeD) are largely unknown. The purpose of this study was to explore in detail the effects of testosterone suppression from degarelix as compared to placebo on desire, hypersexuality, and subjectively experienced sexual interest in participants with PeD.We compared the sexual effects of degarelix, a GnRH antagonist, on men with PeD assigned to degarelix (n = 26) or placebo (n = 26) in a double-blind randomised clinical trial. Sexual Desire Inventory scores decreased significantly at two weeks (between-group difference p = 0.001, d = -0.96 [-0.38 to -1.55) and ten weeks (p < 0.001, d = -1.30 [-0.69 to -1.91) in participants assigned degarelix, whereas HBI ratings did not differ significantly at two weeks (p = 0.07, d = -0.52 [0.05 to -1.08), but did so at ten weeks (p = 0.01, d = -0.72 [-0.15 to -1.29). Fifteen out of 26 (58%) individuals in the group assigned degarelix and 3 out of 26 (12%) in the group assigned to placebo reported no further sexual interest in children at ten weeks (Fisher's exact test, p < 0.0001), an effect unmodified by autistic, antisocial, or impulsive traits, age, age at onset of, or duration of paedophilic attraction.

Androgens and male sexual function

Sexual symptoms are the most specific determinants of low testosterone (T) observed during adulthood. In this narrative review, we summarize the most important evidence supporting the positive relationships between endogenous T levels and sexual activity in the adult male, by using preclinical and clinical observations. In addition, we also report an update of our previous meta-analysis evaluating the effects of T treatment (TRT) on sexual functioning in subjects with T deficiency. Available data indicate that TRT of symptomatic hypogonadal men can improve several aspects of sexual life, including erection. However, the effect is rather modest and lower in subjects with associated metabolic conditions. The specific observed effects are similar to those derived from lifestyle intervention. Since TRT might result in body composition improvement, it is reasonable to suppose that an initial treatment with T can improve the willingness of hypogonadal subjects to perform physical exercise and to adhere to a healthier behavior. Similar data were derived from animal models. However, it should be important to recognize that lifestyle modifications should be the first step to promote weigh reduction. TRT can be combined with lifestyle interventions only in symptomatic hypogonadal subjects especially in the presence of comorbid metabolic conditions.

Women's Estrus and Extended Sexuality: Reflections on Empirical Patterns and Fundamental Theoretical Issues

How do women's sexual interests change across their ovulatory cycles? This question is one of the most enduring within the human evolutionary behavioral sciences. Yet definitive, agreed-upon answers remain elusive. One empirical pattern appears to be robust: Women experience greater levels of sexual desire and interest when conceptive during their cycles. But this pattern is not straightforward or self-explanatory. We lay out multiple possible, broad explanations for it. Based on selectionist reasoning, we argue that the conditions that give rise to sexual interests during conceptive and non-conceptive phases are likely to differ. Because conceptive and non-conceptive sex have distinct functions, the sexual interests during conceptive and non-conceptive phases are likely to have different strategic ends. We discuss provisional evidence consistent with this perspective. But the exact nature of women's dual sexuality, if it exists, remains unclear. Additional empirical research is needed. But perhaps more crucially, this topic demands additional theory that fruitfully guides and interprets future empirical research.

Methamphetamine administration dose effects on sexual desire, sexual decision making, and delay discounting

Correlational evidence has linked methamphetamine use and HIV sexual risk behavior, but the direct effects of methamphetamine on sexual desire and sexual decision making in humans have not been tested. This study was designed to test the effect of methamphetamine administration on sexual desire and hypothetical condom-use decisions as measured by the Sexual Delay Discounting Task. Recreational stimulant users (n = 19) participated in this within-subject, placebo-controlled study comparing the effects of 0 mg, 20 mg, and 40 mg of oral methamphetamine. Compared to placebo, methamphetamine caused dose-related and time-related increases in a single-item sexual desire rating and some standard stimulant abuse liability ratings, as well as dose-related increases in the Sexual Arousal and Desire Inventory (SADI; a multidimensional scale capturing positive and negative aspects of desire/arousal). However, methamphetamine caused no significant mean differences in likelihood of condom use within the Sexual Delay Discounting Task or the Monetary Discounting Task. SADI scores were negatively correlated with change from placebo in condom use likelihood in the Sexual Delay Discounting Task for some partner conditions (i.e., decreased reported likelihood of condom use in participants who experienced increased desire/arousal and vice versa). These mixed results may be consistent with methamphetamine's role as both a treatment for attention-deficit/hyperactivity disorder and as a drug of abuse associated with increased delay discounting, and they suggest that methamphetamine's effects on discounting may be modulated by the reinforcing properties of what is being discounted. Delay discounting may be an understudied element of risky sexual decision making, particularly among individuals who use methamphetamine. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Investigation of the effect of mindfulness on sexual desire and sexual satisfaction in primigravida pregnant women

BACKGROUND

Pregnancy causes a set of complex physiological and psychological changes that affect marital relationships. Mindfulness is a form of meditation that can promote person's performance and perception of sexual relationships. The present study aimed to determine the effect of mindfulness on sexual desire and sexual satisfaction in primigravida pregnant women.

MATERIALS AND METHODS

The present study is a quasi-experimental that has investigated on 72 primigravida pregnant women. The samples were selected randomly and assigned to experimental and control groups. The experimental group received six 90-min sessions of mindfulness intervention, and the control group received the educational pamphlet. The female sexual function index (FSFI) was filled by the subjects of the two groups in three stages of before the intervention, a week, and a month after the intervention. Data analysis was done by SPSS20 (Statistics 20 software; SPSS Inc., Chicago, IL, USA) at the significance level of 0.05.

RESULTS

According to the statistical tests, there was no significant difference between the two groups in terms of demographic characteristics and pregnancy information. The findings suggest no significant difference between the mean pretest and posttest score of sexual desire in the two groups (P > 0.05). However, the two groups were significantly different in terms of the mean score of sexual satisfaction before and after the intervention (P<0.05).

CONCLUSION

By increasing the concentration on the present moment and avoiding judgment, mindfulness can increase sexual satisfaction. However, sexual desire can be affected by various factors such as the cultural context, the quality of marital relationships, and the pregnancy hormonal changes that can influence the sexual response.

Discontinuation of hormonal contraception due to changes in mood and decreases in sexual desire: the role of adverse childhood experiences

PURPOSE

To evaluate if adverse childhood experiences are associated with hormonal contraception discontinuation due to mood and sexual side effects.

MATERIALS AND METHODS

Women, ages 18-40 (N = 826), with current and/or previous hormonal contraceptive use completed surveys on demographics, contraceptive history, and the Adverse Childhood Experiences Questionnaire. We characterised women into high (≥2 adverse experiences) and low (0 or 1) adverse childhood experience groups. We calculated risk ratios for associations between adverse childhood experiences and outcomes of interest using log binomial generalised linear models, and adjusted for relevant demographic variables.

RESULTS

Women in the high adverse childhood experiences group (n = 355) were more likely to report having discontinued hormonal contraception due to decreases in sexual desire (adjusted risk ratio 1.44, 1.03-2.00, p = .030). Covariates included age, current hormonal contraception use, and various demographic variables associated with discontinuation. Adverse childhood experiences were not associated with mood or sexual side effects among current (n = 541) hormonal contraceptive users.

CONCLUSIONS

Self-reported adverse childhood experiences were associated with greater likelihood of discontinuing hormonal contraception due to behavioural side effects, particularly decreases in sexual desire. Identification of risk factors for behavioural side effects can assist patients and clinicians in making informed choices on contraception that minimise risk of early discontinuation.

Androgens and estrogens predict sexual function after autologous hematopoietic stem cell transplant in men

BACKGROUND

Autologous hematopoietic stem cell transplantation (AHSCT) is associated with sexual dysfunction and hypogonadism. Androgens are associated with sexual function in healthy men, but the role of estrogens is less well-known, and the association of these sex steroids with sexual function during AHSCT has not been characterized.

OBJECTIVES

The purpose of this study was to determine the predictive value of sex hormones before and acutely after AHSCT on sexual function recovery.

MATERIALS AND METHODS

We examined sex hormones and self-reported sexual function before (PRE) and 1-month post-AHSCT (MONTH1; n = 19), and sexual function again 1-year post-AHSCT in men (YEAR1; n = 15).

RESULTS

Sexual function decreased from PRE to MONTH1 (p ≤ 0.05) with no differences between PRE and YEAR1. Erectile dysfunction was prevalent at PRE (68.4%) and increased at MONTH1 (100%; p ≤ 0.05) but was not different between PRE and YEAR1 (60.0%). From PRE to MONTH1, total testosterone (TT), dihydrotestosterone (DHT), follicle-stimulating hormone, and sex-hormone-binding globulin (SHBG) increased (p ≤ 0.02) while estradiol (p ≤ 0.026) and estrone decreased (p ≤ 0.001). MONTH1 TT and DHT were associated with sexual function at MONTH1, while PRE SHBG, MONTH1 estradiol, and change in estrone predicted sexual function at YEAR1.

DISCUSSION

Sexual dysfunction is very prevalent prior to AHSCT and is transiently and severely worsened acutely after. AHSCT induces acute decreases in total and free estrogens, with SHBG increases leading to increases in total androgens, without changes in free androgens.

CONCLUSION

Androgens and estrogens are both adversely affected by AHSCT but may predict sexual dysfunction in this population. This supports the premise that estrogen impacts sexual function independent from androgens and that steroid hormones are associated with acute changes in sexual function in this setting. Larger, controlled trials with long-term sex hormone assessment will need to confirm the association between early changes in estrogens and long-term sexual function recovery.

The Measurement of Female Early Adolescent Sexual Desire

We used the developmental systems model to deduce a definition of female early adolescent sexual desire. We evaluated a measure of this phenomenon with a secondary analysis of data from a randomized group sexual health intervention trial involving low-income, English-speaking, seventh grade Latinas enrolled in a Miami-Dade County public school (n = 542). As part of this study, girls completed a four-item early adolescent sexual desire (EASD) measure. Study findings supported internal consistency (Cronbach's alpha = .81 to .82) and stability over a 1-month period (r = .74). Developmental sensitivity was supported by a decline in stability over 12- (r = .66) and 24-month periods (r = .56). Validity was supported by correlations with puberty changes, sexual intentions, sexting, and sexual behavior, and hypothesized mean differences associated with dating and preference for shoes culturally associated with female sexual attractiveness (p < .01). Research implications include validation work with other ethnic/racial groups and using the EASD as a starting point for a measurement continuum tracking development of sexual desire across adolescence and into adulthood. Directions for future research also include measuring the development of sexual desire in boys and transgendered youth across adolescence and into adulthood.

Hypoactive Sexual Desire Disorder in Women: Physiology, Assessment, Diagnosis, and Treatment

Nearly half of women in the United States report problems with sexual function. Many health care providers do not ask about sexual concerns during routine clinical encounters because of personal discomfort, lack of familiarity with treatment, or the belief that they lack adequate time to address this complex issue. This may be especially true for hypoactive sexual desire disorder (HSDD), the most commonly identified sexual problem among women. HSDD is characterized by a deficiency of sexual thoughts, feelings, or receptiveness to sexual stimulation that has been present for at least 6 months, causes personal distress, and is not due to another medical condition. This is an up-to-date overview of HSDD for clinicians, discussing its physiology, assessment, diagnosis, and treatment strategies. Although a definitive physiology of HSDD is still unknown, multiple hormones and neurotransmitters likely participate in a dual-control model to balance excitation and inhibition of sexual desire. For assessment and diagnosis, validated screening tools are discussed, and the importance of a biopsychosocial assessment is emphasized, with guidance on how this can be implemented in clinical encounters. The 2 recently approved medications for HSDD, flibanserin and bremelanotide, are reviewed as well as off-label treatments. Overall, HSDD represents a common yet likely underrecognized disorder that midwives and other health care providers who care for women across the life span are in a unique position to address.

Regenerative technology to restore and preserve erectile function in men following prostate cancer treatment: evidence for penile rehabilitation in the context of prostate cancer survivorship

Introduction

Erectile dysfunction (ED) following prostate cancer treatment is not uncommon and penile rehabilitation is considered the standard of care in prostate cancer survivorship (PCS), where both patient and his partner desire to maintain and/or recover pre-treatment erectile function (EF). There is a clinical interest in the role of regenerative therapy to restore EF, since existing ED treatments do not always achieve adequate results.

Aim

To review regenerative therapies for the treatment of ED in the context of PCS.

Materials and Methods

A review of the existing PubMed literature on low-intensity extracorporeal shockwave therapy (LIESWT), stem cell therapy (SCT), platelet-rich plasma (PRP), gene therapy, and nerve graft/neurorrhaphy in the treatment of ED and penile rehabilitation, was undertaken.

Results

IESWT promotes neovascularization and neuroprotection in men with ED. While several systematic reviews and meta-analyses showed positive benefits, there is limited published clinical data in men following radical prostatectomy. Cellular-based technology such as SCT and PRP promotes cellular proliferation and the secretion of various growth factors to repair damaged tissues, especially in preclinical studies. However, longer-term clinical outcomes and concerns regarding bioethical and regulatory frameworks need to be addressed. Data on gene therapy in post-prostatectomy ED men are lacking; further clinical studies are required to investigate the optimal use of growth factors and the safest vector delivery system. Conceptually interpositional cavernous nerve grafting and penile re-innervation technique using a somatic-to-autonomic neurorrhaphy are attractive, but issues relating to surgical technique and potential for neural 'regeneration' are questionable.

Conclusion

In contrast to the existing treatment regime, regenerative ED technology aspires to promote endothelial revascularization and neuro-regeneration. Nevertheless, there remain considerable issues related to these regenerative technologies and techniques, with limited data on longer-term efficacy and safety records. Further research is necessary to define the role of these alternative therapies in the treatment of ED in the context of penile rehabilitation and PCS.

Italian Validation of the Sexual Desire Inventory (SDI-2): Psychometric Properties and Factorial Structure

OBJECTIVE

Sexual desire is a psychological state that prompts individuals to engage in sexual activity. Although interest about this topic is constantly increasing, there are no validated instruments to measure sexual desire in Italy, making scientific studies difficult. This paper aims to provide a contribution to validation of the Sexual Desire Inventory-2 (SDI-2) for the Italian population, investigating factorial structure, invariance, reliability and validity.

METHOD

The sample was composed of 389 Italian participants from a nonclinical population. The thirteen-item SDI-2 and the Barratt Impulsiveness Scale (BIS-11) for measuring impulsiveness were administered.

RESULTS

The results supported two dimensions, i.e. dyadic and solitary desire, and partially measurement invariance across gender. Furthermore, good validity and reliability indicators have been gained.

CONCLUSIONS

the Italian version of the SDI-2 supports good psychometrics properties. It may be considered a valid and reliable measure for assessing dyadic and solitary sexual desire. Therefore, the present inventory may be used, in the research and clinical field, as an innovative instrument in order to investigate sexual desire and its relationship with clinical disorders.

Impact of COVID-19 Related Stress on Sexual Desire and Behavior in a Canadian Sample

Objectives

We evaluated various facets of sexual health in Canadians across phases of the COVID-19 pandemic.

Methods

Online questionnaires every four weeks from April-August 2020.

Results

Higher COVID-19 stress predicted higher baseline dyadic sexual desire, lower relationship satisfaction, higher desire for solitary sexual behavior, and higher likelihood of experiencing sexual coercion among people with a live-in romantic partner. Dyadic sexual desire and pandemic-related stress both decreased with time, whereas solitary sexual behavior decreased and dyadic sexual behavior increased among participants without a live-in romantic partner.

Conclusions

Our findings reveal differential impacts of COVID-19 related stress on sexual outcomes.

Interventions to Improve Sexual Health in Women Living with and Surviving Cancer: Review and Recommendations

Sexual health concerns, both physical and psychological, are common and represent an unmet need among women with and surviving cancer. Sexual challenges and conditions negatively impact body image, satisfaction, relationships, well-being, and quality of life, yet are widely reported to be under-recognized and undertreated. To guide clinical care and future research on sexual function in women with cancer, we performed a scoping review of interventions for sexual health concerns, including sexual function, body image, genitourinary symptoms, and hot flashes. Relevant publications between 2005 and 2020 were identified by searching PubMed with a combination of medical subject headings and keywords. Articles were included if they focused on the aforementioned topics, were primary research publications, and included female cancer survivors. Studies focusing on women receiving hormone therapy for breast cancer were also included. A total of 91 investigations conducted in the US and abroad were reviewed. Most commonly, interventions included a component of psychoeducation, although pharmacologic, exercise, and other approaches have been evaluated. Many studies have focused on survivors of breast or gynecologic cancer, among other sampling and methodological limitations. These limitations underscore the need for more work on this vital survivorship issue. Recommendations for future research in this area are also offered.

Associations of Intimacy, Partner Responsiveness, and Attachment-Related Emotional Needs With Sexual Desire

In this online cross-sectional survey study in a large community sample we investigated the associations between attachment-related relational needs, partner responsiveness, intimacy, and sexual desire, using structural equation modeling. Participants were heterosexual and non-heterosexual women and men. Intimacy and partner responsiveness correlated positively with sexual desire in all subsamples. Anxious attachment-related relational needs correlated positively with sexual desire. Avoidant attachment-related relational needs correlated negatively with sexual desire. Anxious and avoidant attachment-related needs, however, did not moderate the association between intimacy and sexual desire. Individuals with problems of low sexual desire may benefit from an emphasis in sex therapy on ways to increase (perceptions of) intimacy.

Differences in the Gut Microbiome of Women With and Without Hypoactive Sexual Desire Disorder: Case Control Study

Background

The gut microbiome is receiving considerable attention as a potentially modifiable risk factor and therapeutic target for numerous mental and neurological diseases.

Objective

This study aimed to explore and assess the difference in the composition of gut microbes and fecal metabolites between women with hypoactive sexual desire disorder (HSDD) and healthy controls.

Methods

We employed an online recruitment method to enroll “hard-to-reach” HSDD populations. After a stringent diagnostic and exclusion process based on DSM-IV criteria, fecal samples collected from 24 women with HSDD and 22 age-matched, healthy controls underwent microbiome analysis using 16S ribosomal RNA gene sequencing and metabolome analysis using untargeted liquid chromatography–mass spectrometry.

Results

We found a decreased abundance of Ruminococcaceae and increased abundance of Bifidobacterium and Lactobacillus among women with HSDD. Fecal samples from women with HSDD showed significantly altered metabolic signatures compared with healthy controls. The abundance of Bifidobacterium, Lactobacillus, and several fecal metabolites correlated negatively with the sexual desire score, while the number of Ruminococcaceae correlated positively with the sexual desire score in all subjects.

Conclusions

Our analysis of fecal samples from women with HSDD and healthy controls identified significantly different gut microbes and metabolic signatures. These preliminary findings could be useful for developing strategies to adjust the level of human sexual desire by modifying gut microbiota.

Trial Registration

Chinese Clinical Trial Registry ChiCTR1800020321; http://www.chictr.org.cn/showproj.aspx?proj=34267

Situational and Dispositional Determinants of College Men's Perception of Women's Sexual Desire and Consent to Sex: A Factorial Vignette Analysis

Sexual victimization of women by men on college campuses is a growing societal concern, with research identifying a host of situational and characterological factors that may predict men's likelihood to engage in sexual misconduct. In the present study, we examined the relative contribution and potential interplay of these various determinants on college men's perceptions of women's sexual desire and consent in hypothetical dating scenarios depicting a sexual interaction. We found that the men (N = 145) in this sample (a) conflated sexual desire with consent, (b) varied their appraisals of consent and desire depending on whether and how the woman in the vignette communicated consent or refusal, (c) perceived higher levels of consent if the man in the vignette had intercourse with the woman previously and as a function of escalating sexual intimacy in the ongoing interaction, (d) endorsed higher levels of perceived desire and consent across situations if they more strongly held rape-supportive attitudes, and (e) moderated their association between situational factors and perceptions of a woman's sexual intentions based on their endorsement of rape myths and a hypermasculine ideology. We conclude that efforts to prevent sexual violence among college students may benefit from being modeled on our findings that some men are likelier to infer consent regardless of the situation, that specific situational factors can foster misperceptions of consent across men in general, and that certain individuals in particular situations may pose the greatest risk for sexual misconduct.

Clinical features of and couple's attitudes towards premature ejaculation: a multicenter cross-sectional study

INTRODUCTION

The current study aimed to investigate the clinical features of and couple's attitudes towards premature ejaculation (PE).

METHODS

Qualified patients were continuously enrolled from 15 medical centers in different regions of China. Patient data were collected from March 1 2017 to July 31 2017. All men were assessed by the Premature Ejaculation Diagnostic Tool (PEDT) and Intravaginal Ejaculation Latency Time (IELT). Besides, sexual desire, force of ejaculation, and the five-item International Index of Erectile Function (IIEF-5) score were recorded. The couple's attitudes towards PE were evaluated by a self-designed questionnaire.

RESULTS

In total, 1033 males diagnosed with PE and their sexual partners and 3176 males without PE were enrolled. The mean PEDT and IELT scores of the patients with PE were 14.38 ± 3.68 and 1.59 ± 0.85, respectively. IIEF-5, sexual desire, and force of ejaculation significantly decreased in patients with PE. Among the 1033 couples, 44.3%, 21.39%, and 33.98% of the couples were seeking PE because of the dissatisfaction of the males, the females or both partners, respectively. In terms of the males who were dissatisfied with PE, 49.51% and 17.86% complained of short IELT and inability to control ejaculation. In terms of the females dissatisfied with PE, 41.61%, 19.93%, 21.68%, and 14.51% complained of arousal difficulty, weak sexual desire, failing to have organism and poor relationship, respectively.

CONCLUSIONS

PE has a negative impact on erectile function, sexual desire, and force of ejaculation. Sexual partners play important roles in the medical procedures for addressing PE.

Psychological Treatment of Low Sexual Desire in Women: Protocol for a Randomized, Waitlist-Controlled Trial of Internet-Based Cognitive Behavioral and Mindfulness-Based Treatments

BACKGROUND

Psychological therapies are effective treatments for hypoactive sexual desire dysfunction (HSDD; formerly hypoactive sexual desire disorder), a common sexual dysfunction among women. Access to evidence-based treatments, however, remains difficult. Internet-based interventions are effective for a variety of psychological disorders and may be a promising means to close the treatment gap for HSDD.

OBJECTIVE

This article describes the treatment protocol and study design of a randomized controlled trial, aiming to study the efficacy of cognitive behavioral and mindfulness-based interventions delivered via the internet for women with HSDD to a waitlist control group. Outcomes are sexual desire (primary) and sexual distress (secondary). Additional variables (eg, depression, mindfulness, rumination) will be assessed as potential moderators or mediators of treatment success.

METHODS

A cognitive behavioral and a mindfulness-based self-help intervention for HSDD will be provided online. Overall, 266 women with HSDD will be recruited and assigned either to one of the intervention groups, or to a waitlist control group (2:2:1). Outcome data will be assessed at baseline, at 12 weeks, and at 6 and 12 months after randomization. Intention-to-treat and completer analyses will be conducted.

RESULTS

We expect improvements in sexual desire and sexuality-related distress in both intervention groups compared to the waitlist control. Recruitment has begun in January 2019 and is expected to be completed in August 2021. Results will be published in 2022.

CONCLUSIONS

This study aims to contribute to the improvement and dissemination of psychological treatments for women with HSDD and to clarify whether cognitive behavioral and/or mindfulness-based treatments for HSDD are feasible and effective when delivered via the internet.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03780751; https://clinicaltrials.gov/ct2/show/NCT03780751.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/20326.

Vitamin E and ginseng supplementation to enhance female sexual function: a randomized, double-blind, placebo-controlled, clinical trial

Female sexual disorders (FSD) are a spectrum of disorders common among women, especially in their middle age, which can reduce the female quality of life substantially. We aimed to evaluate the effects of a combined vitamin E and ginseng supplement on amelioration of female sexual dysfunction. In a 6-week, double-blind, randomized, placebo-controlled clinical trial, participants, suffering from sexual dysfunction based on the female sexual function index (FSFI) questionnaire, were randomly allocated to receive the supplement (100 IU vitamin E, 67 mg Korean ginseng, and 40 mg Siberian ginseng) or placebo daily. The primary outcome in our trial was the change in the FSFI total score. Sixty-nine participants were enrolled, but only 31 in each group completed the trial. Changes in the FSFI total score and its domain scores were significant during the trial course within each group. However, the supplement only ameliorated desire and satisfaction domains superior to the placebo. In case of the total score and other domains, the changes were insignificantly different between the treatment groups. Although our study could not find additional benefits for the vitamin E and ginseng supplement over placebo in enhancing sexual function overall, the supplement worked better in enhancing sexual desire and satisfaction.

Creating and Validating the DESEA Questionnaire for Men and Women

In clinical practice, it is essential to be able to identify hypoactive sexual desire disorder (HSDD), with its different severity levels and assess the influence the subject’s relationship has on the issue. In order to do this, questionnaires are needed that comprise appropriate psychometric properties. We analyzed the psychometric properties and factorial structure of the Sexual Desire and Aversion (DESEA) questionnaire that evaluates sexual desire and interpersonal stress (relationship problems) in male and female couples. A pilot study was conducted with a group of 1583 people. Finally, it included 20,424 Spanish speakers who answered the questionnaire via an online link. The requirements for factor analysis were verified followed by the exploratory and confirmatory factor analysis. The Cronbach’s alpha coefficient calculated the reliability of the test scores at 0.834 in the pilot group and 0.889 in the final group. A 3-factor factorial design explains the 62.08% variance. The KMO (Kaiser-Meyer-Olkin) test (p = 0.904), Bartlett’s test of sphericity (126,115.3; p = 0.000010) and the matrix determinant (0.0020770) verified the appropriateness of the factor analysis. The results show that the DESEA questionnaire is a reliable and valid instrument for evaluating desire and interpersonal stress, both in women and men, in clinical and research contexts.

Sexual function changes attributed to hormonal contraception use - a qualitative study of women experiencing negative effects

Objective: To increase the understanding of women who experience negative effects on sexual function when using hormonal contraception.Methods: We performed 24 in-depth interviews with women who had previously experienced negative sexual function effects while using hormonal contraceptives. The thematic analysis method was used.Results: 'After experience comes insight', 'Lubrication and desire go hand in hand', 'Mental wellbeing comes before desire' and 'The contraceptive counsellor potentially facilitates insight and decision-making' were the main themes found in the study.Conclusions: This selected group of women described lubrication difficulties and decreased sexual desire associated with both contraceptive use and the menstrual cycle. Contraceptive use became easier with age and with better understanding. The contraceptive counsellor could facilitate the process. Further choice between hormonal or non-hormonal contraceptive methods depended primarily on experienced adverse effects on mood, and secondarily on sexual function, weighed against the advantages or disadvantages experienced during the person's own menstrual cycle.

Extradyadic Behaviors and Gender: How Do They Relate With Sexual Desire, Relationship Quality, and Attractiveness

Recent years have seen an increasing number of studies on relationship extradyadic behaviors (Pinto and Arantes, 2016; Pazhoohi et al., 2017; Silva et al., 2017; Fisher, 2018). However, much is still to learn about the impact of these extradyadic behaviors on subsequent relationships that an individual may have. Our main goal was to study the association between past extradyadic behaviors – inflicted and suffered – and current relationship quality, sexual desire and attractiveness. Specifically, we aimed to: (i) Understand if past extradyadic behaviors are related to current relationship quality, sexual desire, and self-perceived and partner’s attractiveness; (ii) Identify possible gender differences in these variables. For that, 364 participants (251 females and 113 males) were recruited through personal and institutional e-mails, online social networks (e.g., Facebook), and the website of the Evolutionary Psychology Group from the University of Minho. All participants completed a demographic and relationship questionnaire, followed by questions related to extradyadic behaviors and self-perceived attractiveness, the Perceived Relationship Quality Components (PRQC) Inventory, the Sex Drive Scale (SDQ), and the Importance of Partner’s Physical Attractiveness Scale (IPPAS). For those currently involved in a relationship, results suggested that extradyadic behaviors (both suffered or inflicted) are linked with current low relationship quality and high sexual desire in the present. In addition, individuals who perceived themselves as being more attractive tended to have a higher sexual desire and higher relationship quality. Overall, men reported higher levels of extradyadic behaviors and sexual desire, gave more importance to physical attractiveness, and perceived their current relationship as having less quality than women. These results add to the literature by focusing on different variables that play an important role in romantic relationships, and have important implications.

Sexual Desire among Veterans Receiving Prolonged Exposure Therapy for PTSD: Does Successful PTSD Treatment Also Yield Improvements in Sexual Desire?

Objective: People with posttraumatic stress disorder (PTSD) commonly report difficulties with sexual desire and other aspects of sexual functioning, but it is currently unknown if people who respond to psychotherapy for PTSD also report improvements in sexual desire. Method: One hundred and eighty-seven veterans with PTSD received prolonged exposure (PE) therapy at two outpatient PTSD specialty clinics and completed measures of PTSD symptoms (the PTSD Checklist - Military Version) and sexual desire (item 21 of the Beck Depression Inventory - Second Edition) repeatedly throughout the course of treatment. Results: The results of a conditional generalized mixed ordinal regression model showed a significant interaction between weeks in treatment and PTSD treatment response in predicting change in sexual desire across the course of treatment. Specifically, PTSD treatment responders reported improvement in sexual desire over the course of treatment, whereas nonresponders did not show changes in sexual desire over time. However, the effect of PTSD treatment response was no longer significant when accounting for severity of depression at the start of treatment. Participants reporting more severe depression at the start of treatment reported less improvement in sexual desire, regardless of PTSD symptom response. Conclusions: People with PTSD who respond to PE also report improvements in sexual desire over time, indicating that response to PE is associated with improved sexual desire, but the effect is complicated by the presence of co-occurring depression symptomatology.

Interactions between inflammation and female sexual desire and arousal function

PURPOSE OF REVIEW

To describe the current state of research on interactions between inflammation and female sexual function.

RECENT FINDINGS

Inflammation may interfere with female sexual desire and arousal via direct (neural) and indirect (endocrine, vascular, social/behavioral) pathways. There are significant sex differences in the effect of inflammation on sexual function, arising from different evolutionary selection pressures on regulation of reproduction. A variety of inflammation-related conditions are associated with risk of female sexual dysfunction, including cardiovascular disease, metabolic syndrome, and chronic pain.

SUMMARY

Clinical implications include the need for routine assessment for sexual dysfunction in patients with inflammation-related conditions, the potential for anti-inflammatory diets to improve sexual desire and arousal function, and consideration of chronic inflammation as moderator of sexual effects of hormonal treatments. Although the evidence points to a role for inflammation in the development and maintenance of female sexual dysfunction, the precise nature of these associations remains unclear.

Sexuality in Ageing Male: Review of Pathophysiology and Treatment Strategies for Various Male Sexual Dysfunctions

Sexual function among older men is often thought to decrease as part of normal ageing biology despite the fact that sexuality remains an important issue in the elderly. Sexual dysfunction in the aged male is likely multifactorial in nature, with the development and/or progression of medical comorbidities often resulting in decline in male sexual function and poor treatment response. At present, sexual dysfunction in the ageing male is poorly investigated and understood, and current treatment strategies aim at improving sexual desire and erectile function with limited data on ejaculatory and orgasmic dysfunctions. In addition, men are often reticent to seek help for health concerns including sexual dysfunction. The following article provides a narrative review of strategies to address various aspects of sexual dysfunction in the ageing male. Clinicians need to be educated to be sensitive when discussing sexuality issues among older men and to present practical solutions that take into account individual and cultural differences.

Contribution of sexual desire and motives to the compulsive use of cybersex

BACKGROUND AND AIMS

Cybersex is increasingly associated with concerns about compulsive use. The aim of this study was to assess the roles of motives and sexual desire in the compulsive use of cybersex.

METHODS

The sample consisted of 306 cybersex users (150 men and 156 women). The participants were assessed using the Compulsive Internet Use Scale (CIUS) adapted for cybersex, the Cybersex Motives Questionnaire (enhancement, coping, and social motives), and the Sexual Desire Inventory-2 (dyadic and solitary sexual desire).

RESULTS

For both genders, coping motive was associated with CIUS score. For women, an additional association with social motives was found whereas an association with sexual desire was found for men.

CONCLUSION

The study showed gender differences in the contributors to sex-related CIUS scores.

Aromatization Is Not Required for the Facilitation of Appetitive Sexual Behaviors in Ovariectomized Rats Treated With Estradiol and Testosterone

Testosterone can be safely and effectively administered to estrogen-treated post-menopausal women experiencing hypoactive sexual desire. However, in the United States and Canada, although it is often administered off-label, testosterone co-administered with estradiol is not a federally approved treatment for sexual arousal/desire disorder, partly because its mechanism is poorly understood. One possible mechanism involves the aromatization of testosterone to estradiol. In an animal model, the administration of testosterone propionate (TP) given in combination with estradiol benzoate (EB) significantly increases sexually appetitive behaviors (i.e., solicitations and hops/darts) in ovariectomized (OVX) Long-Evans rats, compared to those treated with EB-alone. The goal of current study was to test whether blocking aromatization of testosterone to estradiol would disrupt the facilitation of sexual behaviors in OVX Long-Evans rats, and to determine group differences in Fos immunoreactivity within brain regions involved in sexual motivation and reward. Groups of sexually experienced OVX Long-Evans rats were treated with EB alone, EB+TP, or EB+TP and the aromatase inhibitor Fadrozole (EB+TP+FAD). Females treated with EB+TP+FAD displayed significantly more hops and darts, solicitations and lordosis magnitudes when compared to EB-alone females. Furthermore, TP, administered with or without FAD, induced the activation of Fos-immunoreactivity in brain areas implicated in sexual motivation and reward including the medial preoptic area, ventrolateral division of the ventromedial nucleus of the hypothalamus, the nucleus accumbens core, and the prefrontal cortex. These results suggest that aromatization may not be necessary for TP to enhance female sexual behavior and that EB+TP may act via androgenic pathways to increase the sensitivity of response to male-related cues, to induce female sexual desire.

Prevalence and Risk Factors of Stress Urinary Incontinence Among Perimenopausal Women and Its Influence on Daily Life in Women with Sexual Desire Problem

The prevalence of, and related factors to, stress urinary incontinence (SUI) among perimenopausal Chinese women and its impact on daily life among those women with sexual desire problem in Hubei province were investigated. In this study, 1519 perimenopausal women aged 40 to 65 years were selected from three urban communities in the Wuhan area, and two impoverished, mountainous communities in Hubei province, and followed from April to October 2014. Detailed information about demographic characteristics, menstruation, pregnancy, sexual life and chronic diseases was collected. A cross-sectional survey was carried out following information collection by Chi-square test and multiple logistic regression analysis. Univariate and multivariate logistic regression analysis demonstrated that the potential factors associated with developing SUI were old age (OR=3.4, 95% CI: 1.92-6.04), vaginal delivery (OR=0.623, 95% CI: 0.45-0.87), low income (OR=0.063, 95% CI: 0.40-0.92), atrophic vaginitis (OR=1.4, 95% CI: 1.03-1.80), pelvic organ prolapse (OR=2.81, 95% CI: 1.36-5.80), chronic pelvic pain (OR=2.17, 95% CI: 1.90-4.03), constipation (OR=1.44, 95% CI: 1.07-1.93) and incontinence of feces (OR=3.32, 95% CI: 2.03-5.43). Moreover, the ratio of SUI (33.2%) was higher than the ratio of urgency urinary incontinence (24.1%) or the ratio of mixed urinary incontinence (17.4%), and SUI had a greater impact on daily life among women with decreased sexual desire. In conclusion, SUI is a common disorder affecting over one third of the women surveyed, and has a severe impact on the daily life of perimenopausal women with declined sexual desire. Age, mode of delivery, and monthly income are major risk factors involved in the development of SUI.

Brief Report: Sexual Wellbeing in Heterosexual, Mostly Heterosexual, and Bisexually Attracted Men and Women

OBJECTIVE

To assess differences in sexual wellbeing among men and women with exclusively heterosexual, mostly heterosexual, and bisexual attractions.

METHOD

An anonymous online survey in a convenience sample of 597 young adults (394 women, 203 men; average age = 20.04) assessed patterns of sexual attraction, desire, sexual functioning, and sexual satisfaction using validated questionnaires.

RESULTS

Individuals with mostly heterosexual attractions reported significantly higher solitary sexual desire than exclusively heterosexual individuals (women: d = 0.64; men: d = 0.68). Partnered sexual desire did not differ between groups. Women with exclusively heterosexual attractions reported significantly higher sexual functioning and satisfaction than either mostly heterosexual or bisexually attracted women (functioning: d = 0.29; satisfaction: d = 0.47). Men with mostly heterosexual attractions reported significantly lower sexual functioning than either exclusively heterosexual or bisexually attracted men (d = 0.40).

CONCLUSIONS

There were significant differences between exclusively vs. mostly heterosexual individuals in several aspects of sexual wellbeing, supporting the assertion that mostly heterosexual may constitute a distinct orientation. Taken together with prior research showing higher rates of sexual dysfunction in bisexual women, these findings highlight sexual health disparities among nonmonosexual women. Efforts to support the sexual wellbeing of sexual minority individuals should include consideration of mostly heterosexual individuals, as this population may have unique sexual health needs.