Orgasmic Latency and Related Parameters in Women During Partnered and Masturbatory Sex.

INTRODUCTION: Orgasmic latency (OL) during partnered sex (POL) and OL during masturbatory sex (MOL) in women with and without orgasmic difficulty have received minimal attention. AIM: To ascertain POL and MOL both overall and more specifically in women with and without difficulty reaching orgasm and to explore interrelationships between masturbatory and partnered latencies and sexual satisfaction. METHODS: Participants for this study were 2,304 women drawn from community-based samples in the United States and Hungary who completed an investigator-derived questionnaire regarding their sexual history and response, including items related to frequency of masturbation and partnered sex, sexual desire, sexual arousal, orgasmic response, OL, distress, partner distress, and sexual satisfaction. MAIN OUTCOME MEASURE: Self-reported OL and related orgasmic parameters during masturbation and partnered sex in women with and without difficulty reaching orgasm were assessed. RESULTS: POL were longer than those during MOL. Women experiencing difficulty reaching orgasm showed even longer latencies during partnered sex but comparable latencies during masturbation. Covariates related to POL included age, overall relationship quality, masturbation frequency, MOL, and level of distress about not reaching orgasm. CLINICAL IMPLICATIONS: POL in women are substantially longer than men's, suggesting the potential need for an increased repertoire of stimulatory behaviors to increase the woman's arousal. STRENGTH AND LIMITATIONS: The study was well powered and drew from a multi-national population. However, specific types of sexual stimulation during partnered and masturbatory sex were not included in this analysis. CONCLUSION: MOL for women and POL differ significantly, with latencies during partnered sex being substantially longer than masturbation, although women reporting the greatest difficulty reaching orgasm have the longest latencies and are likely to find masturbation more satisfying than women who do not. Rowland DL, Sullivan SL, Hevesi K, et al. Orgasmic Latency and Related Parameters in Women During Partnered and Masturbatory Sex. J Sex Med 2018;15:1463-1471.

Weaker masturbatory erection may be a sign of early cardiovascular risk associated with erectile dysfunction in young men without sexual intercourse.

INTRODUCTION: Although increasing evidences emphasize the importance of early cardiovascular evaluation in men with erectile dysfunction (ED) of unexplained aetiology, impaired masturbation-induced erections in young men are usually overlooked and habitually presumed to be psychological origin. AIMS: To evaluate the young men presenting weaker masturbatory erection with no sexual intercourse (WME-NS) and verify if this cohort have early cardiovascular risks associated with ED. METHODS: Male subjects aged 18-40 years with WME-NS were screened by analyzing detailed sexual intercourse and masturbatory history. The age-matched ED and non-ED population were identified by using International Index of Erectile Function-5 (IIEF-5). All subjects with acute and/or chronic diseases (including diagnosed hypertension and diabetes) and long-term pharmacotherapy were excluded. Nocturnal penile tumescence and rigidity (NPTR), systemic vascular parameters and biochemical indicators related to metabolism were assessed. MAIN OUTCOME MEASURES: Comparison analysis and logistic regression analysis were conducted among WME-NS, ED and non-ED population. RESULTS: In total, 78 WME-NS cases (mean 28.99 ± 5.92 years), 179 ED cases (mean 30.69 ± 5.21 years) and 43 non-ED cases (mean 28.65 ± 4.30 years) were screened for analysis. Compared with non-ED group, WME-NS group had higher prevalence of early ED risk factors including endothelial dysfunction, insulin resistance, high level of glycosylated serum protein and abnormal NPTR. Multivariable-adjusted logistic regression analysis showed endothelia dysfunction (odds ratio: 8.83 vs. 17.11, both P < 0.001) was the independent risk factor for both WME-NS and ED. CONCLUSIONS: Weaker masturbatory erection may be a sign of early cardiovascular risk associated with ED in young men without sexual intercourse. More studies are warranted to elucidate the clinical benefits by targeting these formulated strategies.

Effects of chemical castration on sex offenders in relation to the kinetics of serum testosterone recovery: implications for dosing schedule.

INTRODUCTION: A growing number of countries are adopting chemical castration as treatment and penalty for sex offenders. AIM: The aim of this study is to evaluate the outcome of chemical castration of sexual offenders with a focus on the kinetics of serum testosterone (T) recovery. METHODS: This prospective analysis included 56 sex offenders imprisoned for sexual offenses at the National Forensic Hospital. Thirty-eight and 18 patients who received 3 and 6 months of leuprolide acetate injections were assigned to group A and group B, respectively. MAIN OUTCOME MEASURES: To evaluate treatment efficacy according treatment duration, psychobehavioral assessments and serum T levels were serially measured during the on-cycle and the following observational 12-month off-cycle. RESULTS: Chemical castration and the associated decrease in serum T levels reduced the frequency and intensity of sexual thoughts in 76% and 71% of group A patients and in 78% and 72% of group B patients, respectively. Reductions in masturbation frequency were observed in 74% of group A and 83% of group B patients. The median Wilson's Sex Fantasy Questionnaire (SFQ) scores were also significantly reduced in both groups. In group A, an upsurge of serum T to the flare level was observed during the first 2 months of the off-cycle, accompanied by an intense sexual drive and fantasy. In group B, serum T gradually recovered to the baseline level and continued to upsurge beyond baseline levels during the observational period. SFQ scores of group A returned to pretreatment levels following the observational period; however, SFQ scores of group B remained suppressed. Lack of objective assessments for psychobehavioral outcomes was a limitation. CONCLUSIONS: The efficacy of chemical castration varied according to the treatment duration. Regarding the kinetics of serum T recovery, maintaining at least 6 months of treatment warranted stable control of an excessive sexual drive following treatment cessation.

Greater resting heart rate variability is associated with orgasms through penile-vaginal intercourse, but not with orgasms from other sources.

INTRODUCTION: Resting heart rate variability (HRV), a marker of parasympathetic activity, is a predictor of health and longevity. Better erectile function is associated with greater resting HRV (assessed by high frequency power [HF]), and in both sexes, penile-vaginal intercourse (PVI) is the only sexual behavior consistently associated with indices of better physical and mental health, including greater resting HRV (assessed by standard deviation [SD] of heart rate [HR]). AIMS: To examine the hypotheses that greater frequency of orgasms attained through PVI (for women, without additional simultaneous clitoral stimulation; vaginal orgasm) are associated with greater resting HRV. A differential hypothesis is that HRV measures will be unrelated to orgasmic frequency from noncoital sexual activities. METHODS: Coitally experienced men and women (N = 143) had their heart rate measured for 5 minutes and reported the frequency of various sexual behaviors and corresponding orgasms in a recent representative month. MAIN OUTCOME MEASURES: Partial correlations and analyses of covariance controlling for social desirability responding were used to examine the associations of sexual activities with time and frequency domains of HRV. RESULTS: For men, greater resting SD of HR was associated with greater PVI orgasm frequency. For women, greater resting SD of HR was associated with any vaginal orgasm. These findings remained after controlling for cohabitation. Sexual activities were unrelated to HF. Lifetime number of PVI partners was unrelated to SD of HR and HF. CONCLUSIONS: Findings are discussed in the context of orgasms through PVI enhancing HRV, and greater parasympathetic tone favoring the capacity to engage in PVI, and in the case of women, to reach vaginal orgasm. The possibility of healthier people having greater resting HRV and more frequent orgasms through specifically PVI is also considered.

[Human orgasm from the physiological perspective--part II]. / Orgazm czlowieka z perspektywy fizjologicznej--czesc II.

In contrast to the male orgasm, female orgasm is characterized by high variability and diversity, not only in the general population, but also during the life. Women experience sexual pleasure on many levels: physical, emotional, spiritual and intellectual. Sexual functioning of women and men is determined by many factors. A strong correlation between the state of subjective arousal and genital response (erection) is typical for men. In the case of women important role played: emotions, cognitive interpretation of the situation, age, self-esteem and previous sexual experiences. Among women experience orgasm during intercourse or masturbation is not a goal in itself. Modern approach to the phenomenon of orgasm and sexual education of women, make absence of orgasm as a failure. It becomes a source of low self-esteem, less self-confidence or sense of lack of attractiveness.

Sexual functioning in transsexuals following hormone therapy and genital surgery: a review.

INTRODUCTION: Sexual function following genital sexual reassignment surgery (SRS) is an important outcome for many transsexuals, affecting the choice of surgical technique, satisfaction with surgery, and quality of life. However, compared to other outcome measures, little clinical and research attention has been given to sexual functioning following SRS. AIM: To discuss the potential impact of cross-sex hormone therapy and SRS on sexual function and to summarize the published empirical research on postsurgical sexual functioning in male-to-female (MtF) and female-to-male (FtM) transsexuals. METHODS: Cross-sex hormone therapy and SRS techniques are outlined, the potential roles of cross-sex hormone therapy and SRS on sexual function are discussed, and peer-reviewed literature published in English on postoperative sexual functioning in MtF and FtM transsexuals is reviewed. MAIN OUTCOME MEASURES: Sexual desire, sexual arousal, and ability to achieve orgasm following SRS. RESULTS: Contrary to early views, transsexualism does not appear to be associated with a hyposexual condition. In MtF transsexuals, rates of hypoactive sexual desire disorder (HSDD) are similar to those found in the general female population. In FtM transsexuals, sexual desire appears unequivocally to increase following SRS. Studies with MtF transsexuals have revealed not only vasocongestion, but also the secretion of fluid during sexual arousal. Research on sexual arousal in FtM transsexuals is sorely lacking, but at least one study indicates increased arousal following SRS. The most substantial literature on sexual functioning in postoperative transsexuals pertains to orgasm, with most reports indicating moderate to high rates of orgasmic functioning in both MtF and FtM transsexuals. CONCLUSIONS: Based on the available literature, transsexuals appear to have adequate sexual functioning and/or high rates of sexual satisfaction following SRS. Further research is required to understand fully the effects of varying types and dosages of cross-sex hormone therapies and particular SRS techniques on sexual functioning.

Sexsomnia in an Adolescent.

ABSTRACT: Sexsomnia has been reported and is well described in 115 prior cases in the literature. There have been associations with other sleep disorders serving as triggers for confusional arousals, thereby worsening sexsomnia episodes. We present a case of an adolescent boy with a history of resected and treated pineoblastoma who later developed sexsomnia marked by multiple episodes of masturbatory events per night. He had additional suspicions of obstructive sleep apnea. Polysomnography confirmed severe obstructive sleep apnea and captured multiple episodes of sexsomnia from both REM and NREM sleep. The patient also had daytime symptoms of severe anxiety and hypersomnia that required pharmacological intervention, cognitive behavioral techniques, and hypnosis. The patient showed improvement with hypnosis along with a multimodal approach to the treatment of sexsomnia.

Bilateral testicular pain due to masturbation interruptus.

A case is reported of a young man with apparent idiopathic pain in the testicles, inguinal regions, and perineum. An unusual cause and mechanism were found. A personality of antisex attitudes with a sense of guilt and sex-suppressive tendencies was observed. These were the underlying but indirect factors in the causation of pain exposed only on inquiry into his personal habits; otherwise the pain most likely would have been labelled as "functional" or psychologic.

Epileptic fits or infantile masturbation?

Two infants, one girl, 5 months old, and one boy, 6 months old, presented with rhythmic and sustained motor activities of a stereotyped nature accompanied by moaning and grunting, facial flushing and altered awareness. The episodes occurred frequently and were initially believed to be epileptic. Normal electroencephalograms during the fits, lack of response to antiepileptic medication given to one child and careful reviewing of videotape recordings, enabled us eventually to diagnose the 'seizure-like' episodes as masturbatory activity.

Semen finger print.

A correlation between testosterone (T) and dihydrotestosterone (DHT) exists in seminal plasma. These androgens play a role in sperm maturation. The T/DHT ratio is different from one person to the other, due to the heterogenicity of seminal plasma which stems for the most part from the male accessory sex glands, the prostate and seminal vesicles, and also from the 'epididymo-testicular unit'. This ratio is useful in identifying the person's semen. Consequently, the steroid values from assailant semen or accused persons and semen on the victim's clothes are of cardinal importance in matching. The results reported include data on the validation of this technique as a tool for semen identification. Coital and masturbated semen were correlated, and consecutive coital semen were also analysed. It may be concluded that the T/DHT value is specific for each person.

Sexual asphyxiophilia (Koczwarism) in women and the biological phenomenon of female ejaculation.

Life threatening eroticizing behavior, asphyxiophilia (sexual asphyxia) is practiced in women, as in men, in order to heighten sexual excitement and to achieve orgasm, which is in some women accompanied by expulsions of fluid (ejaculation) from the urethra. The relatively easily achieved orgasm induced by the mechanism of asphyxia is hypothesized to be the common reason for repetitive deviant asphyxiophilic behavior. Moreover, in women of the ejaculatory type (female ejaculators), the desire to induce ejaculatory orgasm by asphyxia may also come into play as this kind of orgasm is usually assessed as sensation of greater delight than orgasm without ejaculation.

De virginibus puerisque: the function of the human foreskin considered from an evolutionary perspective.

The functional significance of the human male foreskin is considered in evolutionary terms. It is postulated that there is a lifetime's reproductive advantage in delaying the age of first coitus, and hence of first childbirth, for some years after puberty, until the parents are better established as providers. Phimosis and preputial adhesions are common in human males because they have selective advantage, tending to impede and therefore delay the onset of sexual activity. The physical signs of female virginity have an analogous function, and have been selected for in the same way. This hypothesis also provides a consistent explanation for the worldwide tradition of circumcision and for the common practice of masturbation by human males.

Do all orgasms feel alike? Evaluating a two-dimensional model of the orgasm experience across gender and sexual context.

The characteristics common to all human orgasm experiences and potential gender and contextual factors affecting these experiences were investigated in two studies. A two-dimensional descriptive model of the orgasm experience was evaluated by testing hypotheses concerning (a) fit of the model to adjective-ratings data describing male and female orgasm experiences, and (b) sexual context effects on the importance of model components. In the first model-evaluation study, 888 university students (523 women) provided adjective ratings to convey orgasm experiences attained through both solitary masturbation and sex with a partner. In a cross-validation study, 798 university students (503 women) provided similar ratings to convey orgasm experiences attained either through solitary masturbation or through sex with a partner. Overall, findings supported the utility of a two-dimensional model of the orgasm experience, an adjective-rating approach in comparing male and female orgasm, and the importance of examining sexual context effects on the orgasm experience.

Prostatodynia in United Nations peacekeeping forces in Haiti.

Prostatodynia is a clinical entity associated with voiding symptoms and pelvic pain suggestive of prostatitis but with a normal prostate examination and without evidence of inflammation or infection in expressed prostatic secretions. The problem tends to be chronic and is vexing in its management. Although thought to be a common condition, prevalence data are generally lacking. From June to October 1995, the U.S. Army's 86th Combat Support Hospital provided medical support to a multinational United Nations peacekeeping force in Haiti. Patients diagnosed with prostatodynia were more common (13 cases) than men with other urologic problems (urolithiasis, 6 cases; urinary tract infection, 6 cases; scrotal abscess/mass, 2 cases; epididymitis, 1 case). Patients tended to be young (mean age 29.8), had multiple visits, failed to respond to multiple courses of antibiotics for presumed "prostatitis," and denied recent sexual relations. Some patients reported having had similar symptoms on prolonged separation from their spouses in the past that resolved with resumption of normal intercourse. Masturbation, however, had no impact on symptoms and was painful in some individuals. Terazosin, an alpha-antagonist, and stress-reduction therapy led to improvement in some patients' symptoms. A discussion of these retrospective findings in light of what is known about the possible etiologies and treatment of prostatodynia is presented. Prostatodynia appears to be a common problem in deployed troops and can lead to frequent use of medical services. Physicians supporting long deployments need to be aware of this entity.

Sexual behaviour, a stress factor affecting ovulation and cycle length.

The hormonal profile and clinical picture of women, mean age 21 years, with aberrant anovulatory cycles, lasting from 35-65 days were presented. Although all subjects had orgasmic experiences by automanipulation, and 4 had sporadic sex with men, the fact of not having regular heterosexual relationship, acts as an emotional stress, with resulting higher PRL and urinary catecholamine level, as compared to an age-matched control group of 14 women, having regular 1-2 weekly coitus. Sexual behaviour affects cycle length and ovulation, having no effect on estradiol level. Menstrual disorders and aberrant long cycles, resulting from absence of or sporadic sexual encounters should not be treated. They are a temporary phenomenon, which disappears after establishment of normal heterosexual life-style.

PIP: Ovulation assessed by urinary LH, prolactin, estradiol and urinary catecholamine were measured in 12 women not in union, and compared to those of 14 controls in union, to see whether lack of regular heterosexual sex, considered a stress, affects menstrual cycles in women. The subjects were orgasmic women aged 17-28 with secondary amenorrhea that had been treated with progestins. The controls had regular menstrual cycles and sex 1-2 times/week. 10 of the 12 study subjects were anovulatory, in contrast with all 14 controls. The study group had higher serum prolactin, 15.64ng/ml vs. 10.56 in controls (p0.05); higher urinary catecholamine, 52.2mg/24 hours vs 30.75 in controls, (p0.001). There was no difference in estradiol. Amenorrhea caused by the stress of sporadic or no sexual activity can be treated, but usually will resolve with change of life style.

Masturbation mimicking seizure in an infant.

A 3.5-month-old boy was referred to our hospital with the diagnosis of infantile spasm. His developmental milestones and physical examination were normal. During the follow-up we recorded about six to nine attacks a day and the duration of attacks was changed between 15 seconds-1.5 minutes. During the episodic attacks he was flushed and had tonic posturing associated with crossing of thighs, without loss of consciousness and his eye movements were normal. Routine and long-term electroencephalogram (EEG) were normal during attack. The patient was diagnosed as masturbation according to the clinical and EEG findings. In conclusion, we would like to stress that masturbation should also be considered in infants who were admitted with complaint of seizure, and aside from EEG monitoring a detailed history and careful observation are very important factors in differential diagnosis of these two different conditions.

Orgasm and women's waist circumference.

OBJECTIVE: Given that adiposity is related to poorer female sexual function, among many other health problems, the present study aimed at testing the hypothesis that larger waist circumference, an index of subcutaneous and abdominal fat mass, is associated with lack of specifically vaginal orgasm. Study design One hundred and twenty Portuguese women of reproductive age had their waist measured and reported their past month frequency of penile-vaginal intercourse (PVI), vaginal orgasm, orgasm from clitoral masturbation during PVI, non-coital partnered sex (in the absence of same-day PVI), non-coital partnered sex orgasm (regardless of same-day PVI), masturbation, and masturbation orgasm. RESULTS: In both simple and partial correlations (controlling for age, social desirability responding, relationship status, and cohabitation status), larger waist circumference was associated with lack of any vaginal orgasm and with having masturbated in the past month. In a multiple regression, larger waist circumference was independently predicted by lesser frequency of vaginal orgasm, greater frequency of masturbation, and older age. CONCLUSION: Abdominal fat mass appears to be adversely associated with lesser capacity for vaginal orgasm, but not for orgasms from other sexual activities. Results are discussed in the context of vaginal orgasm being relatively more contingent on situations of increased fitness in both partners.