Development and psychometric evaluation of the sexual satisfaction questionnaire for postmenopausal women (PWSSQ): an exploratory mixed method study protocol.

BACKGROUND: The concept of sexual satisfaction in menopausal women is very different from that in premenopausal women, and this difference is due to aging and physical, hormonal, cultural, and psychological changes. Therefore, the first step in discovering methods for assessing sexual satisfaction in postmenopausal women is to develop a measurement instrument. This study was conducted to develop and evaluate the psychometric properties of a sexual satisfaction instrument for postmenopausal women. METHODS: The current study is an exploratory-sequential mixed-methods research project that will be divided into two parts: qualitative and quantitative. Aligned with the primary objective of the research, which is to elucidate the concept of sexual satisfaction in postmenopausal women, the hybrid concept analysis model developed by Schwartz and Kim will be employed. This model comprises three key phases: the theoretical phase, the fieldwork phase, and the final analytical phase. Those who met the inclusion criteria and exhibited maximum variance in terms of age, educational level, employment status, and menopausal duration were recruited. The conventional content analysis will be carried out following the steps proposed by Graneheim and Lundman. Second, in the quantitative phase, the psychometric properties of the instrument were evaluated, including the content, face and construct validity and reliability via internal consistency and stability. The psychometric properties described in the COSMIN checklist will be utilized for designing the instrument. DISCUSSION: A valid and reliable scale for evaluating the sexual satisfaction of postmenopausal women should be developed, and educational content should be designed to improve the sexual satisfaction of this group of women.

Menopause is a natural event that is accompanied by numerous physical and psychological changes that create a complex period in the life of postmenopausal women. Sexual satisfaction is a component related to human sexuality and is known as the last stage of the sexual response cycle. Sexual satisfaction is defined as the emotional response resulting from the mental evaluation of positive and negative things in a sexual relationship. Sexual satisfaction is one of the important factors of satisfaction in married life. People who have sexual satisfaction have a significantly better quality of life than those who do not have sexual satisfaction. The concept of sexual satisfaction in menopausal women is very different from that in premenopausal women, and this difference is due to aging and physical, hormonal, cultural, and psychological changes. Sexual satisfaction is important for researchers for two reasons. First, sexual satisfaction provides a mechanism through which to assess a relationship partner's performance. Second, sexual satisfaction is a predictor of other aspects of the relationship, such as marital quality and stability. To discuss feelings and discover methods for achieving sexual satisfaction in postmenopausal women, it is necessary to understand the factors affecting sexual satisfaction and dissatisfaction in this group. The existing tools in the field of women's sexual satisfaction are not designed for this age group (menopausal women) and do not have the necessary comprehensiveness and adequacy to assess sexual satisfaction in menopausal women. Therefore, this study will be conducted to develop and evaluate the psychometric properties of the sexual satisfaction of postmenopausal women.

Update on cannabis in human sexuality.

RATIONALE: Sexuality is a central aspect of being human that encompasses many facets. Cannabis, a widely used psychoactive substance, has been associated with various effects on sexuality. The relationship between cannabis and sexuality is complex and multifaceted, involving physiological, psychological, and social factors. OBJECTIVES: This review aims to provide an overview of the current literature on the effects of cannabis on several sexual functions, including sexual desire, arousal, orgasm, and sexual satisfaction. It also discusses the potential mechanisms underlying these effects, as well as the impact of dose and frequency of use. RESULTS: This review has revealed a complex relationship between cannabis dosage and its influence on sexuality. It appears that the frequency of cannabis use in humans has been associated with the frequency of sexual activities. Individuals who use cannabis more frequently tend to report higher levels of sexual activity. Moreover, there is a notable gender difference in how cannabis affects sexuality. In addition, we found lower doses of cannabis to be linked to heightened sexual desire and enjoyment, whereas higher doses may lead to a decrease in sexual desire and performance. CONCLUSIONS: Overall, the association between cannabis and sexuality is complex and warrants further research to better understand the psychological and neurological mechanisms that underlie the effect of cannabis on these sexuality functions and its implications for sexual health. To advance in this endeavor, a crucial step is establishing a precise measurement of dosage in human studies.

Quality of Life Evaluation after Partial Penile Amputation for Penile Cancer.

BACKGROUND: Penile cancer is most prevalent in developing countries. Both the physiological and psychological consequences for the patient are critical. These consequences result from both the cancer diagnosis and the treatment's effects. OBJECTIVE: The objective of this study was to evaluate the quality of life (QoL) of patients who have undergone partial penile amputation in terms of general well-being, sexual function, and urinary function. MATERIALS AND METHODS: This retrospective observational study included 32 patients who underwent partial penile amputation. The european organisation for research and treatment of cancer core quality of life questionnaire (EORTC QLQ C-30) questionnaire was completed postoperatively. Erectile function and satisfaction were assessed retrospectively after partial penile amputation using the International Index of Erectile Function-15. RESULTS: The mean age of the patients was 54.03 ± 16.02 years. The mean scores for erectile function, orgasm, sexual desire, satisfaction, and overall satisfaction were 16.28 ± 10.83, 7.50 ± 3.30, 5.72 ± 3.35, 8.84 ± 4.77, and 9.12 ± 0.83 preoperatively, and 14.03 ± 8.61, 6.88 ± 2.97, 5.72 ± 3.35, 7.94 ± 4.09, and 7.81 ± 1.00 postoperatively. Mean erectile function, orgasm, satisfaction, and overall satisfaction were significantly decreased postoperatively compared with preoperatively. Erectile function and overall satisfaction improved more in younger years from the preoperative to the postoperative period, whereas they improved less in older years. CONCLUSION: Although partial penile amputation for penile cancer provides adequate local disease management, appropriate counseling is crucial, especially when the QoL concerns general well-being, sexual function, and urinary function.

Résumé Contexte:Le cancer du pénis est plus répandu dans les pays en développement. Les conséquences physiologiques et psychologiques pour le patient sont cruciales. Ces conséquences résultent à la fois du diagnostic de cancer et des effets du traitement.Objectif:L'objectif de cette étude était d'évaluer la qualité de vie (QdV) des patients ayant subi une amputation partielle du pénis en termes de bien­être général, de fonction sexuelle et de fonction urinaire.Matériels et méthodes:Cette étude observationnelle rétrospective a inclus 32 patients ayant subi une amputation partielle du pénis. Le questionnaire de base sur la qualité de vie de l'organisation européenne pour la recherche et le traitement du cancer (EORTC QLQ C­30) a été complété en postopératoire. La fonction érectile et la satisfaction ont été évaluées rétrospectivement après une amputation partielle du pénis à l'aide de l'indice international de la fonction érectile­15.Résultats:L'âge moyen des patients était de 54,03 ± 16,02 ans. Les scores moyens pour la fonction érectile, l'orgasme, le désir sexuel, la satisfaction et la satisfaction globale étaient de 16,28 ± 10,83, 7,50 ± 3,30, 5,72 ± 3,35, 8,84 ± 4,77 et 9,12 ± 0,83 en préopératoire, et de 14,03 ± 8,61, 6,88 ± 2,97, 5,72. ± 3,35, 7,94 ± 4,09 et 7,81 ± 1,00 en postopératoire. La fonction érectile moyenne, l'orgasme, la satisfaction et la satisfaction globale étaient significativement diminués en postopératoire par rapport au préopératoire. La fonction érectile et la satisfaction globale se sont améliorées davantage dans les années plus jeunes, de la période préopératoire à la période postopératoire, alors qu'elles se sont moins améliorées dans les années plus âgées.Conclusion:Bien que l'amputation partielle du pénis pour le cancer du pénis permette une prise en charge locale adéquate de la maladie, un conseil approprié est crucial, en particulier lorsque la qualité de vie concerne le bien­être général, la fonction sexuelle et la fonction urinaire.

Sexual satisfaction of postmenopausal women: An integrative review.

A prerequisite for interventions for sexual satisfaction in postmenopausal women is a clear, objective measurement of the concept. Despite the large number of studies on the sexual satisfaction of postmenopausal women, there is no clear definition of sexual satisfaction in menopause. This study was conducted to investigate the concept of sexual satisfaction in postmenopausal women. The present study was carried out using an integrated review of data obtained from secondary sources, utilizing Whittemore and Knafl's method of bibliographic search. A literature search was performed without any data limitations in journals and international databases. The primary inclusion criterion was relevance to sexual satisfaction in postmenopausal women. The full texts of all these articles were evaluated using the checklists of the MMAT and PRISMA. Data were analyzed using MAXQDA 10 software using a constant comparison method. Meaning units were identified and coded. The codes were classified into subgroups and categories according to the characteristics, antecedents, and consequences of sexual satisfaction in postmenopausal women. During the integrative review of the 62 articles and three books, 580 codes about sexual satisfaction in menopause were extracted. The codes were grouped into three main attributes, five main antecedents, and three main consequences of sexual satisfaction in postmenopausal women. Four attributes, symptoms, or components were identified for the concept. These attributes were as follows: Change in sexual objective and subjective dimensions of sexual satisfaction after menopause, conditional sexual consent, change in behavior, and sexual function. These dimensions distinguish sexual satisfaction in menopause from other conditions. The concept of sexual satisfaction in menopause is a subjective (emotional interaction) and objective (physical interaction) experience that is conditioned by the fulfillment of expectations and the reconstruction of sexual relations while also being influenced by the change in sexual capacity during menopause.

[Sexual functional outcomes of vaginal dilation therapy for MRKH syndrome: a prospective study].

Objectives: To report the sexual functional outcomes of vaginal dilation therapy in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome patients. Methods: From March 2020 to February 2023, 97 MRKH syndrome patients performed vaginal dilation therapy with guidance from Peking Union Medical College Hospital, and 45 of them engaged in penetrative intercourse and were included in this prospective cohort study. The Chinese version of female sexual function index (FSFI) was used to assess sexual function. Functional success was defined as FSFI>23.45. Forty age-matched healthy women were selected as controls. Kaplan-Meier survival analysis was used to calculate the median time to success. Pearson correlation analysis was used to explore the relationship between neovagina length and sexual function. Complications were collected using follow-up questionnaires. Results: The functional success rate of vaginal dilation therapy was 89% (40/45) with a median time to success of 4.3 months (95%CI: 3.0-6.1 months). Compared to controls, MRKH syndrome patients had significantly lower scores in the orgasm domain (4.72±1.01 vs 4.09±1.20; P=0.013) and pain domain (5.03±0.96 vs 4.26±0.83; P<0.001). However, there were no significant differences in the FSFI total score (26.77±2.70 vs 26.70±2.33; P=0.912), arousal domain (4.43±0.77 vs 4.56±0.63; P=0.422) and satisfaction domain (4.88±0.98 vs 4.65±0.86; P=0.269) between MRKH syndrome patients and controls. MRKH syndrome patients had significantly higher scores in the desire domain (3.33±0.85 vs 3.95±0.73; P<0.001) and lubrication domain (4.37±0.56 vs 5.20±0.67; P<0.001). The prevalence of sexual dysfunction in MRKH patients was non-inferior to controls: low desire [3% (1/40) vs 23% (9/40); P=0.007], arousal disorder [3% (1/40) vs 3% (1/40); P>0.999], lubrication disorder [5% (2/40) vs 25% (10/40); P=0.012], orgasm disorder [40% (16/40) vs 20% (8/40); P=0.051], sexual pain [30% (12/40) vs 15% (6/40); P=0.108]. Conclusions: MRKH syndrome patients undergoing non-invasive vaginal dilation therapy could achieve satisfactory sexual life. Given its high functional success rate and slight complication, vaginal dilation therapy should be recommended as the first-line option, reducing the need for unnecessary surgeries.

Relationship between the frequency and duration of masturbation and the sexual health literacy and sexual function of women in western Turkey: a cross-sectional study.

BACKGROUND: Although sexual life and its knowledge are still taboo in many cultures, especially for women, it can negatively affect women's sexual health. AIM: The aim of this study was to examine the relationship between the frequency and duration of masturbation and the sexual health literacy among young Muslim women of reproductive age between 18 and 25 years living in western Turkey. METHODS: The cross-sectional descriptive study was conducted with 921 young women in western Turkey between March and December 2023. Participants were included in the study per the snowball method. The data consisted of attitudes, beliefs, and behaviors regarding masturbation, sexual life, and sexual health literacy. Data were obtained on an online platform and analyzed with SPSS (version 24; IBM). Difference, correlation, and regression analyses were performed. The significance level for statistical analyses was accepted as P < .05. OUTCOMES: The outcomes of the study are the attitudes, beliefs, and behaviors regarding masturbation, orgasm, sexual health literacy, and sexual function in women. RESULTS: The participants were young Muslim women aged 21.00 ± 1.89 years (mean ± SD). The frequency of masturbation was 5.06 ± 2.03 times per month, and the duration was 3.47 ± 1.77 minutes per day. Masturbation frequency and duration were significantly associated with sexual health literacy and sexual function (P < .001). According to regression analysis, sexual function increased and sexual health literacy increased as masturbation frequency and duration increased (P < .001). CLINICAL IMPLICATIONS: This study presents results on the current situation regarding the sexual health literacy and sexual lives in women from different geographies and cultures, and it serves as a source for future studies on areas that need to be improved. STRENGTHS AND LIMITATIONS: The limitation of the study is that it was conducted only with Muslim and Turkish women who use smartphones and are sexually active, so it cannot be generalized to all women. The strengths of the study are that it was conducted with a sample of 921 women, it was based on self-report and addressed many dimensions related to masturbation and female sexuality, and the results were reached through exploratory analysis. CONCLUSION: The study found that the higher the duration and frequency of masturbation in young women, the better their sexual function and higher their sexual literacy.

The Effectiveness of Online Sensate Focus Exercises in Enhancing Sexual Function and Intimacy Among Chinese Heterosexual Couples: A Randomized Controlled Trial.

We investigated the effectiveness of online Sensate Focus exercises, delivered online as a series of 11 animation videos, in improving participants' sexual functioning and enhancing intimacy, relationship and sexual satisfaction. We studied 35 Chinese heterosexual couples, assessed them at pretest, post-test, and a three-month follow-up. Compared to the waitlist control group, the experimental group showed improvement in orgasm in women, and this was maintained at follow-up. Also, for those with a lower function at pretest, the intervention was possibly effective in improving erectile function among men, as well as overall sexual function and pain among women. These improvements were maintained at follow-up as well. Findings from the current study suggest that online Sensate Focus intervention has potential in treating sexual dysfunction of Chinese heterosexual couples. It may also serve as the first part of a stepped care approach or be integrated with other medication or cognitive behavioral therapy treatment.

Problematic pornography use and novel patterns of escalating use: A cross-sectional network analysis with two independent samples.

Modern internet pornography allows users to harness sexual novelty in numerous ways, which can be used to overcome desensitisation through increasing volume of use (quantitative tolerance), progressing to more stimulating genres (qualitative escalation), skipping between stimuli (tab-jumping), delaying orgasm ('edging'), and engaging in pornographic binges. However, existing research has not yet evaluated how these potentially reciprocal consumption patterns relate to problematic pornography use (PPU). To this end, we recruited two independent samples of male pornography users (N1 = 1,356, Mage = 36.86, SD = 11.26; N2 = 944, Mage = 38.69, SD = 12.26) and examined the relationships between these behavioural dimensions and self-reported difficulties in controlling one's pornography use. Data were analysed through the network analysis approach (using Gaussian graphical models). As hypothesised, i) quantitative tolerance was centrally placed within the overall network, and ii) acted as a statistical bridge node between other patterns of pornography use (e.g., pornographic binges), and all measured facets of PPU. Our results are consistent with other emerging literature suggesting that tolerance, pornographic binges, tab-jumping, and edging behaviours as relevant features ofPPU, and that upscaling overall usage may connect broader patterns of use with problematic engagement. Clinical and theoretical implications, as well as future research directions, are discussed.

Personal genital satisfaction is associated with differences in perception of male and female sexual anatomy and function.

BACKGROUND: Prior studies primarily of men correlated low personal genital satisfaction (PGS) with decreased sexual activity; however, the association between PGS and genital anatomy perceptions is unknown, and there is a paucity of studies examining women. AIM: We assessed the relationship between genital satisfaction, survey respondent sexual activity, and perceptions of anatomy and function. METHODS: A 54-item REDCap survey was distributed to any-gendered volunteers ≥18 years of age through ResearchMatch from January to March 2023. Responses were split into (1) high PGS and (2) low PGS. Analysis was performed using chi-square tests on survey responses and a Mann Whitney U test on median satisfaction level. OUTCOMES: Outcomes were genital anatomy perceptions, sexual activity, and respondents' PGS. RESULTS: Of the 649 respondents who started the survey, 560 (86.3%) completed it. Median PGS was 7 of 10, forming subgroups of high (≥7 of 10) satisfaction (n = 317 of 560 [56.6%]) and low (<7 of 10) satisfaction (n = 243 of 560 [43.4%]). The mean age was 45.8 ± 16.8 years, and demographics were notable for 72.1% women (n = 404 of 560), 83.2% White (n = 466 of 560), 47.9% married (n = 268 of 560), and 75.5% bachelor's degree holders (n = 423 of 560). Comparing high- and low-PGS groups, more low-PGS respondents felt normal flaccid penis length to be <2 inches (11.1% vs 5.1%; P = .008). High-PGS respondents more often responded that it is normal for women to have orgasms over half the time (20.8% vs 13.2%; P = .0002) or to identify as being sexually active (81.1% vs 71.6%; P = .008). Women were more likely than men to report larger normal testicle sizes as 60.1 to 90 mL (24.5% vs 10.3%; P < .0001), whereas more men felt that normal testicle size was 7 to 15 mL (26.3% vs 11.4%; P < .0001). Orgasm length perceptions also differed: more women felt female orgasm length was 2.6 to 5 seconds (36.6% vs 16.7%; P < .0001), and more men believed female orgasms to be longer, at 7.6 to 10 seconds (29.5% vs 17.3%; P = .002), 10.1 to 12.5 seconds (11.5% vs 5.2%; P = .0008), and >12.5 seconds (12.2% vs 5.7%; P = .009). Respondents' views on their genitalia differed by gender, with women more likely to feel that their genitals are normal compared with men (89.4% vs 75.0%; P < .0001). CLINICAL IMPLICATIONS: PGS may be a useful screening tool given its association with sexual activity. STRENGTHS AND LIMITATIONS: Our large-scale survey assesses public perceptions of genital anatomy and function. Limitations include a lack of gender nonbinary perceptions. CONCLUSION: Gender and PGS interact with perceptions of male anatomy and female sexual activity, and the frequency of sexual activity was higher among high-PGS respondents; however, the direction of these interactions remains unclear and requires future causal analysis.

Social Perceptions of Masculinity and Sexual Esteem Are Impacted by Viagra Use, Testosterone, and Sexual Performance.

Sexual behaviors play a role in the social construction of masculinity. Moreover, this stereotype has been capitalized upon by pharmaceutical companies, as well as those that sell products not approved by the U.S. Food and Drug Administration, for purposes of marketing sexual medicines. Stereotypical notions of masculinity, however, also emphasize the importance of self-reliance, which may cause some to look unfavorably upon the use of sexual medicine. Consistent with this notion, a male target was viewed as more masculine when his female partner consistently reached orgasm, unless he had no history of erectile dysfunction (ED), but was taking Viagra anyway (Experiment 1; N = 522). In addition, when his partner consistently reached orgasm, ratings of his sexual esteem were also lower if he used Viagra than if he did not, but only if he had no history of ED. In Experiment 2 (N = 711), although there was no effect of a male target's use of testosterone, social perception of his masculinity and sexual esteem increased as his "natural" levels of testosterone increased. In addition, exploratory analysis revealed that if the male target had low (but not normal or high) "natural" levels of testosterone, ratings of his masculinity were higher if his female partner consistently had an orgasm, which suggests that female orgasm served to "rescue" masculinity. Because expectations about drugs drive their use, it is important to address preconceived notions about the use of sexual medicines for purposes of enhancing masculinity and sexual esteem, as the social perception of their use is much more complex.

What happens to orgasmic function after surgical benign prostate hypertrophy (BPH) treatments?

INTRODUCTION: The increasing number of subjects with benign prostate obstruction (BPO) has become a worldwide concern. The sexual problem after benign prostate enlargement (BPE) surgery that has received the most attention in the literature is ejaculation disorder. However, there appears to be a change in orgasmic sensation independent of ejaculation retention. The objective of our study is to explore the influence of BPE surgery on orgasmic function. METHODS: We evaluated the prospective, multicenter clinical data of 104 patients undergoing BPE surgery who reported maintaining sexual activity from January 2016 to November 2020. The endpoint of this study was to decipher the percentage of patients with an orgasm disorder as assessed by the difference between pre-and-postoperative question 10 of the IIEF 15 questionnaire. RESULTS: Orgasm function was stable, improved, and degraded in 34% (n=35), 30% (n=31), and 36% (n=38) respectively. A deterioration in orgasm was statistically significant in men who maintained quality ejaculation with retained force preoperatively and a high IIEF15 scale values preoperative of orgasmic function, overall and intercourse patient satisfaction. CONCLUSION: To enable the patient to maintain a satisfying and healthy sex life after any BPE surgery, urologist physicians should know the prevalence of orgasmic side effects after surgical treatment to provide appropriate counseling to patients. LEVEL OF EVIDENCE: Grade 4.

Sexual Self-Esteem and Orgasm Consistency: Exploring the Unique Roles of Body Image and Genital Image.

We explored the unique roles that body and genital image play in behavior-specific orgasm consistency, beyond overall sexual self-esteem. US adults (N = 599; 64% women) completed questionnaires online. Hierarchical regression analyses predicted orgasm consistency during receptive oral sex and penile-vaginal intercourse (PVI) with additional clitoral stimulation (WAS) and with no additional clitoral stimulation (NAS) for the woman. Body image, genital image, and gender were entered in later steps to assess model improvement above sexual self-esteem. Models accounted for age, sexual and racial minority identities, and current relationship status. Results indicated that genital image improved all models and predicted higher orgasm consistency across all behaviors for men and women. For orgasm during receptive oral sex and PVI-NAS, sexual self-esteem was no longer significant once genital image was included. Genital image was a stronger predictor of women's versus men's orgasm during PVI-NAS; no significant gender differences were found for oral sex and PVI-WAS. Body image was not significant in any models, contrary to expectations, suggesting role overlap with sexual self-esteem. Genital image appears to play a unique role in sexual pleasure beyond overall sexual self-esteem and body image.

Sexual satisfaction and its predictors in patients with advanced cancer and their family caregivers in six European countries: Baseline data from the DIAdIC study.

OBJECTIVE: To identify predictors of sexual satisfaction in patients with advanced cancer and their family caregivers. METHODS: Cross-sectional study using baseline survey data from a randomized controlled trial in six European countries. Patients with advanced cancer and their family caregiver completed measures on sexual satisfaction (one item from Functional Assessment of Cancer Therapy - General questionnaire for patients and Caregiver Quality of Life Index-Cancer scale for family caregivers) and health-related characteristics. Multivariable linear regressions were performed for all predictors (identified based on literature) with sexual satisfaction as dependent variable. RESULTS: The sample comprised 431 patient-family caregiver dyads. Patients with prostate or gynecological cancer reported lower sexual satisfaction (respectively B = -0.267 95% CI: -1.674, -0.594 and B = -0.196, 95% CI -2.103, -0.452). Higher emotional (B = 0.278, 95% CI 0.024, 0.057) physical (B = 0.305, 95% CI 0.012, 0.025) and social functioning (B = 0.151, 95% CI 0.001, 0.013), global health (B = 0.356, 95% CI 0.007, 0.013) and social wellbeing (B = 0.161, 95% CI 0.013, 0.082) among patients were associated with higher sexual satisfaction. Among family caregivers, sexual satisfaction was lower with increased age (B = -0.142, 95% CI -0.022, -0.004). Higher emotional functioning (B = 0.027, 95% CI 0.011, 0.043) and quality of life (B = 0.165, 95% CI -0.165, 0.716) were associated with higher sexual satisfaction in family caregivers. CONCLUSIONS: The results underscore that sexual wellbeing of patients and family caregivers is related to health related factors in physical, emotional, and social domains. Patients and family caregivers could benefit from a dyadic approach to address sexual wellbeing.

Victim Sexual Arousal During Nonconsensual Sex: A Scoping Review.

Sexual arousal in male and female victims during nonconsensual sex is an understudied phenomenon with many potential psychological, clinical, and legal implications for survivors. The aim of this scoping review was to assess the literature to determine whether we could estimate the frequency and circumstances of physiological sexual arousal (e.g., erection, lubrication, ejaculation, orgasm) among victims during nonconsensual sex. Six reference database and hand searches led to the screening of 13,894 articles and other reports. Eight articles and one book published between 1977 and 2019 included relevant data from 136 male survivors and 250 female survivors. Results confirmed that physiological sexual arousal (only genital responses were mentioned) can occur in both male and female victims during nonconsensual sex. The frequency of these responses could not be determined because of the widely different methodologies used. In addition, it was not possible to determine the circumstances in which victim sexual arousal was more likely to occur although some were inferred. The results of the scoping review highlight that physiological sexual arousal during nonconsensual sex does occur for victims but has not been studied systematically. There is a clear need to properly assess the type, circumstances, consequences, and frequency of sexual arousal during nonconsensual sex in large and diverse populations of male and female survivors.

Punto G: enfoque anatómico y seguridad del paciente / G-spot: anatomical approach and patient safety

Se investiga la región uretro-vaginal (pared posterior de la uretra ­ pared anterior de la vagina), en el área que corresponde a la descripción del "punto G", con el fin de colaborar a la discusión respecto de si existe una estructura morfológica que lo identifique. Se destaca una mayor y ocasional distribución venosa en esta zona, que puede explicar el fenómeno fisiológico descrito por Gräfenberg. Para los ginecólogos, urólogos y sexólogos, el conocimiento de la anatomía funcional de esa región tiene importancia para tratar las disfunciones orgásmicas además de la incontinencia urinaria. Esta situación controvertida influye en el marco actual de la seguridad del paciente

The urethro-vaginal region (posterior wall of the urethra ­ anterior wall of the vagina) is investigated, in the area that corresponds to the description of the "G-spot", in order to contribute to the discussion regarding whether there is a morphological structure that identifies it. A greater and occasional venous distribution in this area stands out, which may explain the physiological phenomenon described by Gräfenberg. For gynecologists, urologists and sexologists, knowledge of the functional anatomy of that region is important to treat orgasmic dysfunctions in addition to urinary incontinence. This controversial situation influences the current framework of patient safety

The relationship between female orgasmic disorder, attention-deficit/hyperactivity disorder, and depression in Dominican women.

BACKGROUND: Female orgasmic disorder is listed in the DSM-5 and is defined as the persistent or recurrent inability to have an orgasm. Many depressed women may experience sexual dysfunction, including female orgasmic disorder. AIM: The study sought to analyze the relationship between depressive disorders and attention-deficit/hyperactivity disorder (ADHD) and their influence on the development of female orgasmic disorder. METHODS: A total of 221 Dominican women participated in this case-control study. The case group consisted of 107 women diagnosed with female orgasmic disorder, while the control group consisted of 114 women without any sexual dysfunction. OUTCOMES: The diagnosis of ADHD was obtained from the participants' medical records, previously conducted using the DSM-5-TR criteria. The Beck Depression Inventory II was used to assess the severity of depressive symptoms in both groups. RESULTS: There was a significant relationship between female orgasmic disorder and ADHD and depression. The results of multiple logistic regression indicated that the highest risk of female orgasmic disorder was observed in women with ADHD (odds ratio [OR], 4.91; 95% confidence interval [CI], 2.46-9.20; P < .001), women with severe depression (OR, 2.50; 95% CI, 1.08-6.96; P = .04), and women who had sexual intercourse that focused on penetration (OR, 2.02; 95% CI, 1.03-3.98; P = .04). CLINICAL IMPLICATIONS: These findings may have important implications for the prevention and treatment of sexual disorders in women. STRENGTHS AND LIMITATIONS: This design selected all diagnosed cases of female orgasmic disorder and did not select a specific subgroup. However, some limitations must be considered. This study was conducted in a single clinic, although it should be noted that it is the main clinic for the treatment of sexual dysfunction in the country. A further limitation could be that this type of study design does not allow for statements about causality to be made. CONCLUSION: There is an increased risk of female orgasmic disorder in women with ADHD, with severe depression, and who engage in penetrative sex.

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.

Investigating the role of the pelvic floor muscles in sexual function and sexual response: a systematic review and meta-analysis.

INTRODUCTION: The pelvic floor muscles (PFMs) have been suggested to play a key role in sexual function and response in women. However, syntheses of the evidence thus far have been limited to interventional studies in women with pelvic pain or pelvic floor disorders, and these studies have failed to fully capture the involvement of the PFMs in a broader population. AIM: We sought to appraise the evidence regarding the role of the PFMs in sexual function/response in women without pelvic pain or pelvic floor disorders. More specifically, we examined the following: (1) effects of treatment modalities targeting the PFMs on sexual function/response, (2) associations between PFM function and sexual function/response, and (3) differences in PFM function between women with and those without sexual dysfunction. METHODS: We searched for all available studies in eight electronic databases. We included interventional studies evaluating the effects of PFM modalities on sexual outcomes, as well as observational studies investigating the association between PFM function and sexual outcomes or the differences in PFM function in women with and those without sexual dysfunction. The quality of each study was assessed using the Mixed Methods Appraisal Tool. Estimates were pooled using random-effects meta-analyses whenever possible, or a narrative synthesis of the results was provided. MAIN OUTCOMES: The main outcomes were sexual function (based on a questionnaire)/sexual response (based on physiological test), and PFM function (assessment of the PFM parameters such as strength and tone based on various methods). RESULTS: A total of 33 studies were selected, including 14 interventional and 19 observational studies, most of which (31/33) were deemed of moderate or high quality. Ten out of 14 interventional studies in women with and without sexual dysfunctions showed that PFM modalities had a significant effect on sexual function. Regarding the observational studies, a meta-analysis revealed a significant moderate association between PFM strength and sexual function (r = 0.41; 95% CI, 0.08-066). Of the 7 observational studies performed to assess sexual response, all showed that the PFMs were involved in arousal or orgasm. Conflicting results were found in the 3 studies that evaluated differences in PFM function in women with and those without sexual dysfunction. CLINICAL IMPLICATIONS: Our results highlight the contribution of the PFMs in sexual function/response. STRENGTHS AND LIMITATIONS: One strength of this review is the inclusion of a broad range of study designs and outcomes, allowing a thorough synthesis of evidence. However, interpretations of these data should consider risk of bias in the studies, small sample sizes, and the absence of control/comparison groups. CONCLUSION: The findings of this review support the involvement of the PFMs in sexual function/response in women without pelvic pain or pelvic dysfunction. Well-designed studies should be performed to further investigate PFM modalities as part of the management of sexual dysfunction.

Female orgasm, reproduction and couple relationships.

A deficit or problematic achievement of female orgasm is often classified as a sexual disorder that creates complications in the sex life of couples. This assumption is generally accepted, even though vaginal anorgasmia is an accepted statistical norm and non-coital methods of generating female orgasm are not as easy as they are for men. Female orgasms manifest themselves in different ways; they are variable and can be dependent on a number of variable factors. Some theories suggest a high degree of correlation between the capacity for orgasmic experience, sexual attitudes and behaviour, but also with reproductive potential or the stability of the given couple's relationship. Female orgasm is often seen as a discriminatory mechanism influencing attitudes towards sexuality or even as a kind of fertility catalyst. There is no consensus on the importance of female orgasm. The results of some relevant studies refute theories about the female orgasm's positive influence on adaptive functions of the couple's relationship, as well as its influence on fertility. The orgasm in women is most likely an evolutionary by-product of its male variant, since the clitoris and penis have an identical embryonic basis of development. Female anorgasmia should not be considered an unquestioned diagnosis, let alone a psychiatric construct leading to a paradigm in which anorgasmia is categorically the cause of frustration or other problems.

SEEG study of a rare male temporal lobe epilepsy with orgasmic aura originating from the right amygdala.

As a primitive driving force for biological reproduction, sexual behavior (and its associated mechanisms) is extremely complex, and orgasm plays an essential role. The limbic system plays a very important role in regulating human sexual behavior. However, it is not clear which components of the limbic system are related to orgasm sensation. We studied a rare case of spontaneous orgasmic aura in a male patient with temporal lobe epilepsy. Stereoelectroencephalography (SEEG) revealed that the right amygdala was the origin of orgasmic aura. Surgical removal of the medial temporal lobe, including the right amygdala, completely eliminated the patient's seizures. This study demonstrates the critical role of the amygdala in human male orgasm.