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 and Erotic Fantasies Questionnaire: Validation of the Erotic Fantasy Inventory Scale (SDEF3) in Italian Adults.

BACKGROUND: Erotic fantasies are the most common sexual experiences and provide valuable clinical material for understanding individual and relational emotional dynamics. The primary objective of this study is to validate the Sexual Desire and Erotic Fantasies questionnaire (SDEF) Part 3-Inventory of Erotic Fantasies. This questionnaire was designed to be a sex-positive and inclusive measure of the content of erotic fantasies, accessible to individuals of all gender identities, sexual orientations, relationship/romantic status, and sexual behaviors. METHODS: The SDEF3 was completed by 1773 Italian participants (1105 women, 645 men, and 23 participants identifying as other genders). Two factorial structures were presented and discussed: a 20-dimension structure for clinical and explorative use and a 6-dimension structure for research purposes. RESULTS: The six-factor version was preferred due to its robust statistical properties and its ability to differentiate between sexually clinical and functional men and women, based on cut-off scores from the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). Differences in the frequency of themes in fantasies between gender and sexual orientation were reported and discussed. CONCLUSIONS: The current study indicates that the SDEF3 is a valuable and comprehensive measure for assessing various scenarios related to fantasizing activity. It has potential applications in both clinical practice and scientific research.

Sexual Satisfaction Mediates the Effects of the Quality of Dyadic Sexual Communication on the Degree of Perceived Sexual Desire Discrepancy.

Difficulties related to sexual desire discrepancy are among the most common complaints in people seeking help in therapy. The aims of the current study were to test a mediation model using a bootstrapping procedure where the quality of the dyadic sexual communication plays a key role in increasing or diminishing the degree of perceived sexual desire discrepancy through sexual satisfaction. An online survey was administered through social media to N = 369 participants involved in a romantic relationship, measuring the quality of dyadic sexual communication, sexual satisfaction, the degree of the perceived sexual desire discrepancy, and a series of relevant covariates. As expected, the mediation model showed that a better quality of dyadic sexual communication is related to a lower degree of perceived sexual desire discrepancy through increased sexual satisfaction (ß = -0.17, SE = 0.05, [95% CI = -0.27, -0.07]). The effect held over and above the effect of the relevant covariates. The theoretical and practical implications of the present study are discussed.

Italian Versions of the 12-Item Sexual Distress Scale (SDS) and the 5-Item Sexual Distress Scale-Short Form (SDS-SF): Psychometric Properties.

The study aimed to analyze the psychometric properties of the Italian versions of the 12-item Sexual Distress Scale (SDS) and the 5-item Sexual Distress Scale-Short Form (SDS-SF). A total sample of 2291 adults (1361 women, 930 men) participated through a web survey completing the SDS, the FSFI, the IIEF, the PANAS and the SCL-90-R. The results supported the adequacy of both the SDS and SDS-SF factor structures, good reliability (respectively, α = .96 and .92), discriminant validities and strong associations with satisfaction, fear, depression, and psychoticism. SDS and SDS-SF may facilitate the assessment of sexual distress for both clinical and research purposes.

Endometriosis and Sexual Functioning: How Much Do Cognitive and Psycho-Emotional Factors Matter?

Women with endometriosis often suffer from genito-pelvic pain. The objective of the present study was to analyze the relationship between cognitive and psycho-emotional factors and sexual functioning of women with endometriosis, comparing women with and without endometriosis. A total of 87 women with endometriosis (EG) and 100 women without endometriosis (CG) completed a socio-demographic questionnaire; the short-form of McGill Pain Questionnaire (SF-MPQ); the Female Sexual Functioning Index (FSFI); the Sexual Distress Scale (SDS); the Symptoms Checklist (SCL-90-R); the Toronto Alexithymia Scale (TAS-20); the Positive and Negative Affects Scale (PANAS); the Sexual Dysfunctional Belief Questionnaire (SDBQ); the Sexual Modes Questionnaire (SMQ); and the Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC). EG obtained worse scores than CG in SF-MPQ, Pain subscale of FSFI, and SDS. EG reached higher scores than CG on almost all scales of SCL-90-R and lower scores in the "Identifying Feelings" scale of TAS-20. Furthermore, EG reported more negative emotions toward sexuality than CG (PANAS) higher scores on the "Affection Primacy" scale of SDBQ and the "Helpless" sexual cognitive schema of QCSASC than CG. No significant differences were found in SMQ. Sexual health professionals should address psychological, emotional, and cognitive factors since they seem involved in patients' sexual experiences.

Sex in Chemsex: Sexual Response, Motivations, and Sober Sex in a Group of Italian Men Who Have Sex With Men With Sexualized Drug Use.

BACKGROUND: Most studies on chemsex focus on the health risks associated with the practice, whereas less attention has been paid to the perception of sexual gratification in men who have sex with men (MSM) who use these substances. AIM: The purpose of this study was to explore the effects of chemsex substances on sexual response, motivations to engage in chemsex and the relationship with sober sex. METHODS: Thirty-one Italian cisgender MSM involved in sexualized drug use were interviewed and transcripts were thematically analyzed. OUTCOMES: An ad hoc grid exploring sociodemographic data, chemsex sexual experience, motives, and relationships with sober sex was used during telephone-based interviews. RESULTS: Participants showed significant individual differences in how chems may affect their sexual experience. The most reported effects were an increase in sexual desire and subjective arousal, access to higher disinhibition, possible erection and ejaculation difficulties, significant extension of the sexual experience duration, and an intensified perception of intimacy and pleasure. All the positive outcomes of substances on sex creates a great curiosity around chemsex, which is among the primary motives to engage in chemsex for the first time. Over time, other motives may emerge, also connected to substance abuse and craving. Some men reported to be motivated by their partners and friends and to use chemsex to cope with depressive mood/anxiety symptoms, stress and sexual problems. Many differences were reported between chemsex and sober sex. Chemsex seems to embody the idea of transgressive and exciting sex, while sober sex is outlined as a more intimate encounter, that can be significantly affected by performance anxiety. CLINICAL TRANSLATION: These results offer some new perspectives that may add interesting information to the literature and be fundamental for future prevention and harm-reduction projects. STRENGTHS & LIMITATIONS: Although this study is based on a small group of Italian MSM and the interviews were not audio-recorded, transcripts were consistent with scientific literature that considers it important to pay attention to the positive links between sex and substance use. CONCLUSION: The promotion of safer sexual behavior should contemplate an in-depth discussion and recognition of both pleasurable and distressing aspects of chemsex sexual experience, its motivations over time and perceived differences with sober sex. Nimbi FM, Rosati F, Esposito RM, et al. Sex in Chemsex: Sexual Response, Motivations, and Sober Sex in a Group of Italian Men Who Have Sex With Men With Sexualized Drug Use. J Sex Med 2021;18:1955-1969.

Endometriosis-associated pain: a review of quality of life, sexual health and couple relationship.

INTRODUCTION: Endometriosis is a chronic gynecological disease that affects women's quality of life, sexuality, and relationship. Endometriosis-associated pain plays an essential role in well-being impairment. The present review aimed to analyze literature about endometriosis-associated pain and quality of life, sexual health, and quality of the relationship, assessing the role of the bio-psycho-social factors involved and the women's pain experience. EVIDENCE ACQUISITION: Bibliographic research of relevant articles published from 2015 to 2020 in PubMed, Google Scholar, Web of Science, Scopus, EBSCO, and Cochrane Library. EVIDENCE SYNTHESIS: Endometriosis is associated with impairing all women's quality of life domains, and pain appears to be the most influential variable. The pain mechanism is not simple and implies several biological, psychological, and social factors. Women's sexual health is also impaired, and patients report dyspareunia, sexual dysfunctions, dissatisfaction, and distress. Partners' sexual well-being is compromised as well. Endometriosis negatively influences relationship quality, and the illness burden affects both couple members. CONCLUSIONS: A multidisciplinary team using a couple-centered and a biopsychosocial approach is crucial to provide appropriate treatment for endometriosis-associated pain. A better comprehension of all bio-psycho-social aspects implicated in women's well-being and pain experience needs more research.

Hypersexuality and Trauma: a mediation and moderation model from psychopathology to problematic sexual behavior.

INTRODUCTION: . Hypersexuality is a clinical condition regarding the psychopathology of sexual behavior. In this study, we aimed to investigate the role of trauma, through the post-traumatic stress-disorder (PTSD), depression, shame and guilt on the hypersexual behavior. METHODS: . Through an online platform, a convenience sample of 1025 subjects was recruited (females: n=731; 71.3%; males: 294; 28.7%; age: 29.62±10.90). Recruited subjects compiled a psychometric protocol composed by the Hypersexual Behavior Inventory (HBI) to assess hypersexuality, the International Trauma Questionnaire (ITQ) for PTSD, the Patient Health Questionnaire (PHQ-9) to evaluate depression and the State Shame and Guilt Scale (SSGS) for shame and guilt. Then a mediation/moderation model was performed for the data analysis. RESULTS: . There was a statistically significant direct effect of post-traumatic symptoms (ITQTotal) on hypersexual behavior (HBTotal). Furthermore, indirect effects were also statistically significant, providing support to the hypothesis that depression and guilt would be serial mediators of trauma-hypersexual behavior relations. The paths through depression and guilt have been found to be the most significant with moderate and high indirect effects on hypersexuality. Moreover, male gender, as covariate variable, is a relevant risk factor for hypersexual behavior. CONCLUSION: . We found the relationship between hypersexuality and trauma describing a possible etiological pathway mainly involving depression, shame and guilt. Hypersexuality can be considered as a reactive form of a major affective psychopathology representing a tip of the iceberg hiding the real issues of a suffering personality. Clinicians and researchers should therefore consider hypersexual behavior in the light of a symptomatic manifestation of a major psychopathology involving the affective aspects of personality.

Can Physical and/or Sexual Abuse Play a Role in the Female Choice of a Partner? A Cross-Sectional, Correlational Pilot Study.

The present study aims to evaluate the relationship in women between a history of physical/sexual abuse and the preferences regarding the choice of a partner for a short/long-term relationship in terms of male facial dimorphism, and to assess their sexual functioning. We enrolled 48 abused women and 60 non-abused women. Facial preferences were evaluated with the Morphing test. Sexual functioning was measured with the Female Sexual Function Index (FSFI). Regarding the choice for a short-term partner, abused and non-abused women did not show any differences, and both groups chose a less masculine male face. On the other hand, regarding the choice for a long-term partner, abused women showed a preference for an average male face, whilst non-abused women preferred a less masculine face. The sexual functioning of abused women was found significantly dysfunctional in all domains of the FSFI. These data, generated from a small but highly selected cohort, demonstrated that physical/sexual abuse may be associated with a more rational and conscious choice of a male partner for a long-term relationship, but not with an instinctive one, as the choice of an occasional partner. In addition, the sexual functioning of abused women appears to be compromised by the traumatic experience.

Chemsex in Italy: Experiences of Men Who Have Sex With Men Consuming Illicit Drugs to Enhance and Prolong Their Sexual Activity.

BACKGROUND: Chemsex is a novel phenomenon referring to the consumption of illicit drugs to facilitate, enhance, and prolong the sexual experience in men who have sex with men (MSM). AIM: The present study aims to investigate contexts, patterns of substance use, first chemsex experience, and harm reduction in a group of MSM practicing chemsex in Italy. METHODS: Thirty MSM involved in chemsex activities were interviewed between February and July 2019. OUTCOMES: The interviews were conducted using an ad hoc grid exploring general characteristics of Italian chemsex, patterns of substance use, first chemsex experience, and harm reduction opinions. RESULTS: Chemsex in Italy showed important peculiarities and patterns because of sociocultural background. Chemsex was mainly reported in private venues within couple and group sexual activities. Most participants attended chemsex sessions about 1-2 times per month often concurring with men-only club events. Freebase cocaine emerged among the most relevant substances consumed together with gamma-hydroxybutyrate/gamma-butyrolactone, crystal methamphetamine, and mephedrone. A rare use of injected substances compared with other European Union countries was shown. Given the high prevalence of erectile problems, a large use of phosphodiesterase type 5 inhibitors was reported, and noncoital sexual activities were usually preferred (eg, oral sex, fist fucking). The first chemsex experiences were usually accessed by geolocation-based dating apps and sexual partners and were generally described as positive experiences, with some negative consequences at the end of the session (dysphoric mental states, guilt, craving). Taking part in international gay events seems to favor the first experience of chemsex for some participants. Moreover, some MSM practiced chemsex only abroad or in other cities in Italy so as not to be recognized as chem users in their daily environment. CLINICAL TRANSLATION: Implications for ad hoc harm reduction programs are discussed. STRENGTHS & LIMITATIONS: Despite the methodological limitations due to participants' number and the absence of interviews audio recording, results highlighted some relevant characteristics of chemsex in Italy, such as freebase cocaine use, attitudes regarding slamming, geographical movements, and secrecy. CONCLUSION: The results revealed a need for greater scientific and public attention on chemsex to act with the most specific and effective prevention and harm reduction tools. Nimbi FM, Rosati F, Esposito RM, et al. Chemsex in Italy: Experiences of Men Who Have Sex With Men Consuming Illicit Drugs to Enhance and Prolong Their Sexual Activity. J Sex Med 2020;17:1875-1884.

Genital Pain and Sexual Functioning: Effects on Sexual Experience, Psychological Health, and Quality of Life.

BACKGROUND: Genital pain (GP) is a common symptom in women of reproductive age. The prevalence of GP is difficult to gauge as it has been underreported by both patients and clinicians and neglected in clinical studies despite wide recognition of the adverse effects to women's health. AIM: The purpose of the present study was 3-fold: (i) to explore the self-reported presence and perception of GP and its association with sexual functioning, sexual distress, emotions, psychopathology, and quality of life (QoL); (ii) to explore if, controlling for the pain effect, women with Female Sexual Function Index (FSFI) scores indicating sexual dysfunction also reported worse outcomes regarding sexual distress, emotions, psychological health, and QoL than GP women with higher FSFI scores; and (iii) to evaluate the effects of GP duration, comparing women with GP with shorter (<6 months) duration of symptoms with women with longer (≥6 months) duration of symptom of GP on sexual functioning, distress, emotions, psychopathology and QoL. METHODS: A total of 1,034 women (age ranges between 18 and 40 years) from the Italian general population completed a web survey on sexual health. OUTCOMES: 6 self-report questionnaires exploring different biopsychosocial factors were assessed: the FSFI, the Female Sexual Distress Scale, the Positive and Negative Affect Schedule, the Short Form McGill Pain Questionnaire adapted for GP, the Short Form 36, and the Symptom Check List-90-Revised. RESULTS: Women who reported GP (n = 319) indicated generally lower sexual function than women without GP (n = 648; P = .036). They reported a higher level of sexual distress (P < .001), more negative emotions related to sexual experiences (P = .001), lower scores in all QoL domains (P < .001), and higher levels of psychopathological symptoms (P < .001). Controlling for pain effects, women whose FSFI scores indicated sexual dysfunction (n = 150) reported higher rates of sexual distress than women whose FSFI scores indicated normal sexual function (n = 169; P < .001). The scores also indicated fewer positive (P < .001) and more negative emotions (P < .001) related to sexuality, lower QoL (P < .001) and significantly higher psychological burden (P < .001). Moreover, women experiencing GP for ≥6 months reported significantly lower means on the FSFI total score (P < .05; especially in the desire, satisfaction, and pain domains), distress (P < .001), and emotions (P < .05) than women experiencing GP duration <6 months. No significant differences were found on the QoL and the psychopathological symptoms. CLINICAL IMPLICATIONS: GP is significantly pervasive, but a high percentage of sexual problems and related emotional suffering is overlooked. Raising awareness about this issue is critical, both among clinicians and the general public. STRENGTHS & LIMITATIONS: The present study highlighted important characteristics of GP from a community sample; the results indicate problems related to pain experiences and their repercussions on sexual, psychological, affective health, and QoL. Major limitations are related to the use of self-report measures via a web-based study. CONCLUSION: The results provide evidence of a lack of awareness regarding pain experiences as they relate to sexual functioning in women; clinicians would be advised to more fully investigate sexual functioning and psychosocial variables associated with GP during routine consultation beginning with the first onset of the symptoms. Nimbi FM, Rossi V, Tripodi F, et al. Genital Pain and Sexual Functioning: Effects on Sexual Experience, Psychological Health, and Quality of Life. J Sex Med 2020; 17:771-783.

Sexological Aspects Related to Tinder Use: A Comprehensive Review of the Literature.

INTRODUCTION: Tinder is the most popular and used meeting application for dating. However, its impact on sexual behavior and sexual health has not yet been thoroughly investigated. OBJECTIVES: To review the current empirical knowledge on the sexual health and sexual behavior effects related to Tinder use. METHODS: A literature review was conducted based on empirical studies published in the last 5 years. A computerized search was performed to identify all relevant studies in PubMed and Google Scholar. The following search terms were used: "Tinder" AND "Sexuality" OR "Tinder" AND "Sexual Behavior" OR "Tinder" AND "Sexual Dysfunctions" OR "Tinder" AND "Sexual Health." 34 articles fully satisfied the established criteria. RESULTS: We found sociosexuality, that is, sexual activities outside a committed relationship, to be the main predictor for casual sex in the Tinder users. The sexual aims appeared gender-influenced: men used Tinder mostly for casual sex compared with women. With respect to other dating apps, it has been also found that the Tinder use is less related to the risk of sexually transmitted infections. However, specific personality traits related to dark personality (ie, the association of Machiavellianism, narcissism, and psychopathy) were more frequently reported among male Tinder users. CONCLUSION: Existing literature concerning Tinder use shows the advantages and disadvantages of this dating technology. Casual sex might be a risk for sexual health, but Tinder users have also been committed to romantic relationships. Moreover, some pathological aspects of personality characterize some Tinder users. From an evolutionary perspective, sociosexuality partially explains the reasons of the Tinder user's interest for casual sex. Finally, this review highlights the need of further studies on Tinder as a new, pivotal virtual place to promote sex education and sexual health. Ciocca G, Robilotta A, Fontanesi L, et al. Sexological Aspects Related to Tinder Use: A Comprehensive Review of the Literature. Sex Med Rev 2020;8:367-378.

Male Sexual Desire: An Overview of Biological, Psychological, Sexual, Relational, and Cultural Factors Influencing Desire.

INTRODUCTION: The literature showed the need for a better understanding of the male sexual response, which has historically been considered as simpler and more mechanistic compared with that in women. AIM: To examine the literature on biopsychosocial factors associated with the level of sexual desire in men and discuss some interesting directions for future research. METHODS: A systematic literature review was conducted. MAIN OUTCOME MEASURES: 169 articles published in Google Scholar, Web of Science, Scopus, EBSCO, and Cochrane Library about male sexual desire and related biopsychosocial factors. RESULTS: We found a lack of multidimensional studies on male sexual desire. Most existing research has focused on hypoactive sexual desire disorder in coupled heterosexual men. Biological factors play important roles in the level of sexual desire, but they are insufficient to explain the male sexual response. Psychological, relational, and sexual factors (eg depression, anxiety, emotions, attraction, conflicts, communication, sexual functioning, distress, satisfaction) are involved in the development/maintenance of lack of sexual interest in men. Cultural influence is also relevant, with cognitive factors linked to gender roles and sexual scripts of masculinity identified as important predictors of low sexual desire. CONCLUSION: Male sexual desire is characterized by an interplay among biological, psychological, sexual, relational, and cultural elements. This interplay merits further study to better understand how sexual desire works and how treatments for low sexual interest could be improved. Nimbi FM,Tripodi F, Rossi R, et al. Male Sexual Desire: An Overview of Biological, Psychological, Sexual, Relational, and Cultural Factors Influencing Desire. Sex Med Rev 2020;8:59-91.

Attachment Style, Sexual Orientation, and Biological Sex in their Relationships With Gender Role.

INTRODUCTION: Masculinity and femininity constitute the gender role construct into the general concept of sexual identity. AIM: To investigate the relationships of attachment style, sexual orientation and biological sex with the gender role. METHODS: A convenience sample of 344 subjects (females = 207; males = 137) was recruited. MAIN OUTCOME MEASURES: The Attachment Style Questionnaire (ASQ), the Kinsey Scale, and the Bem Sex Role Inventory assessed, respectively, attachment styles, sexual orientation, and masculinity/femininity was administered. RESULTS: Regression analysis revealed that the confidence scale of the ASQ (secure attachment) and relationship as secondary scale of ASQ (insecure/dismissing attachment) have a predictive role toward a higher score of masculinity (ß = 0.201; P = .000 and ß = 0.208; P = .000, respectively), whereas the need of approval scale of the ASQ (insecure/fearful-preoccupied attachment) shows a reverse association on it (ß = -0.228; P = .001). Moreover, to be a male is predictive for masculinity (ß = 0.196; P = .000). Also, femininity is predicted by the confidence (ß = 0.173; P = .002) and the need of approval (ß = 0.151; P = .03) scales of ASQ. Instead, the relationship as secondary scale of ASQ is negatively related to femininity (ß = -0.198; P = .0001). No association between non-heterosexual orientation and gender role was found. CLINICAL IMPLICATIONS: A better knowledge of links between relational patterns and gender roles for assessment and anamnesis phases in sexual medicine. STRENGTHS & LIMITATIONS: This is the first study considering sexual orientation and biological sex in the relationship between attachment styles and gender role. The main limitation is the use of self-reported psychometric tests. CONCLUSION: Our data indicate that a secure attachment is related to both masculinity and femininity. On the contrary, different and reverse aspects of insecure attachment style characterize masculinity and femininity. Masculinity is mostly linked to insecure/dismissing attachment, whereas femininity is linked to insecure/fearful-preoccupied attachment. Moreover, although being male is a further element in support of masculinity, sexual orientation is not associated with gender role. Ciocca G, Zauri S, Limoncin E, et al. Attachment Style, Sexual Orientation, and Biological Sex in their Relationships with Gender Role. Sex Med. 2019;8:76-83.

A Biopsychosocial Model for the Counseling of Hormonal Contraceptives: A Review of the Psychological, Relational, Sexual, and Cultural Elements Involved in the Choice of Contraceptive Method.

INTRODUCTION: Hormonal contraceptives are among the most popular contraceptives used by women worldwide. Long-term adherence may vary significantly among users because of fear of side effects, unhealthy habits, and lack of knowledge, despite their proven effectiveness. AIM: To analyze the psychological, relational, sexual, and cultural factors associated with choice and use of hormonal contraceptives. We highlight the importance of a biopsychosocial approach to contraceptive counseling. METHODS: A systematic literature review was conducted in September 2018. MAIN OUTCOME MEASURES: 99 articles published in Google Scholar, Web of Science, Scopus, EBSCO, and the Cochrane Library about counseling to hormonal contraception and related biopsychosocial factors were reviewed. RESULTS: In the current work, we have analyzed a broad range of factors involved in the contraceptive choice among psychological, relational, sexual, and cultural spheres under the umbrella of the biopsychosocial model. The literature has highlighted that counseling provided by a specialized health care professional may help women in selecting a contraceptive method that best suits their personal needs and lifestyles, maximizing compliance and well-being. CONCLUSION: The importance of psychological, relational, sexual and cultural aspects involved in the selection of a contraceptive should be acknowledged by health care professionals and addressed during individualized counseling to ensure that the option selected and offered is tailored to the personal preferences, lifestyle, and practices of each woman. Nimbi FM, Rossi R, Tripodi F, et al. A Biopsychosocial Model for the Counseling of Hormonal Contraceptives: A Review of the Psychological, Relational, Sexual, and Cultural Elements Involved in the Choice of Contraceptive Method. Sex Med Rev 2019;7:587-596.

[Smartphone applications : useful for sex education, counselling and therapy ?] / Applications pour smartphones - Peuvent-elles être utiles pour l'éducation sexuelle, le counseling et la thérapie ?

In recent years, the number of smartphone users has exploded worldwide and downloads of applications for these phones have increased significantly. The purpose of this article is to present a review of the literature on the use of smartphone applications to improve sexual health, suggesting how they can be used in sex education, counselling and therapy ; the use of smartphone applications to provide sexual health information, particularly to younger populations, could increase awareness of risky sexual behaviours before first sexual intercourse. This article could help sexologists use smartphone applications to facilitate their work. It is very important that clinicians have specific knowledge of online sexual issues, otherwise they may be vulnerable to stereotypes and judgments.

Ces dernières années, le nombre d'utilisateurs de smartphones a explosé dans le monde entier et les téléchargements d'applications pour ces téléphones ont considérablement augmenté. Le but de cet article est de présenter une revue de la littérature sur l'utilisation des applications des téléphones intelligents pour améliorer la santé sexuelle, suggérant comment elles peuvent être utilisées dans l'éducation sexuelle, le counseling et la thérapie. Cet article pourrait aider les sexologues à utiliser les applications des téléphones intelligents pour faciliter leur travail. Il est très important que les cliniciens aient une connaissance spécifique des questions sexuelles en ligne, sinon ils peuvent être vulnérables aux stéréotypes et aux jugements.

Are Role and Gender Related to Sexual Function and Satisfaction in Men and Women Practicing BDSM?

BACKGROUND: Published studies show good psychological health of people involved in bondage-discipline, dominance-submission, and sadism-masochism (BDSM) activities; nevertheless, there are few studies on characteristics related to gender, role in the BDSM scene, sexual functioning, and satisfaction among BDSM practitioners. AIM: The aim of this study was to explore gender and role differences, prevalence of sexual complaints, related distress, and sexual satisfaction in BDSM participants compared with the general population. METHODS: A group of 266 Italian consensual BDSM participants (141 men and 125 women) were recruited with a snowball sampling technique. An anonymous protocol, including self-reported ad hoc and validated questionnaires, was used. The control group was composed of 100 men and 100 women who were not significantly different from the BDSM group for the sociodemographic data and were randomly extracted from an Italian database on sexual functioning of the general population. MAIN OUTCOME MEASURES: Self-reported demographic factors, including favorite and most frequent BDSM practices, the Sexual Complaint Screener, and the Sexual Satisfaction Scale, were completed by the participants. RESULTS: The mean age of the BDSM group was 41.42 ± 9.61 years old (range 18-74). Data showed a varied outlook of practices, fantasies, rules, and roles. With regard to concerns about BDSM activities (fantasies and behaviors), participants reported a very low self-declared degree of distress. The dominant and switch groups appear to be more satisfied and less concerned about sexuality than the general population and the submissive group. Role in the BDSM scene was the only significant predictor of sexual satisfaction, showing a medium effect size. CLINICAL IMPLICATIONS: Results from this study could be helpful to inform sexual health care professionals and to reduce the stigma related to the BDSM population. STRENGTHS & LIMITATIONS: In general, this study may help to describe better some characteristics related to gender, role, sexual preferences, function, and satisfaction. The main limitation regards the sampling method, which does not allow us to consider the group as representative of BDSM participants in general. CONCLUSION: Data showed a varied outlook of practices, fantasies, rules, and roles in both BDSM men and women. BDSM participants (especially dominant and switch groups) appear to be more satisfied and less concerned about sexuality than the general population. This is an attempt to increase the attention of researchers and health care professionals to this important topic and to improve the care provided to people with specific preferences and behaviors. Botta D, Nimbi FM, Tripodi F, et al. Are Role and Gender Related to Sexual Function and Satisfaction in Men and Women Practicing BDSM? J Sex Med 2019;16:463-473.

Which psychosocial variables affect drive the most? Analysis of sexual desire in a group of Italian men.

Literature lacks wide studies on variables affecting sexual desire in men. Aim of this study was to explore the role of some psychosocial variables such as quality of life, sexual function, distress, sexual satisfaction, psychological symptoms, emotions, alexithymia, couple adjustment, sexism, dysfunctional beliefs, cognitive schemas, and modes. A self-administered survey reached 450 heterosexual Italian men (age 31.36 ± 10.73). Results showed "orgasmic function", "lack of erotic thoughts", "erection concerns thoughts", "hostile sexism", and "positive affect" as the main sexual desire predictors. "Depression", "premature ejaculation severity", "sexual distress", "sexual conservatism", and "helpless" predicted in minor manner sexual desire levels. Analyzed variables could represent key factors in the assessment and therapy of sexual desire problems.

Testing a Conceptual Model for Men's Sexual Desire Referring to Automatic Thoughts, Emotions, Sexual Function, and Sexism.

INTRODUCTION: Literature lacks biopsychosocial models of men's sexuality. Regarding sexual desire, Carvalho and Nobre (J Sex Med 2011;8:754-763.) presented a cognitive-affective model including age, medical factors, dyadic adjustment, psychopathology, restrictive attitudes toward sexual activity, erection concerns, lack of erotic thoughts (LET), sadness, and shame as predictors. In particular, automatic thoughts were highlighted as the main predictors of sexual desire in men. AIM: To test a conceptual model (confronting full and partial mediation) considering the interrelated role of automatic thoughts, emotional factors, sexual function, and sexism in influencing the levels of men's sexual desire. METHODS: Selected variables were the best predictors of men's sexual desire in a previous study on 450 heterosexual Italian men (age 31.36 ± 10.73 years). Path diagrams were built including "orgasmic function," "LET," "erection concerns thoughts" (ECT), "hostile sexism," and "positive affect" as predictors of sexual desire. The 2 versions of the model were designed as a "partial" and a "full mediation" from automatic thoughts toward desire. ECT and LET were selected as main predictors, with direct paths going from ECT to positive affect and sexual desire, and from LET to positive affect, orgasmic function, and sexual desire. Direct paths were also drawn from emotions and orgasm to sexual desire. Moreover, in the partial mediation model, part of ECT and LET effect was mediated by emotions and orgasm, and part directly influenced sexual desire. Hostile sexism and sociodemographic variables were considered as exogenous variables influencing sexual desire. Path analyses were performed through structural equation modeling approach. MAIN OUTCOME MEASURE: Results from 4 standardized questionnaires and sociodemographic information were considered for this study: International Index of Erectile Function, Positive and Negative Affect Schedule, Ambivalent Sexism Inventory, and Sexual Modes Questionnaire. RESULTS: Results showed a satisfactory data fit for both versions, but the partial mediation model was retained (χ2 = 35.312, degree of freedom = 34, P = .406; goodness of fit = .987; normed fit index = .945; comparative fit index = .998; root mean square error of approximation = .009 [95% CI .000-.036]). All the endogenous paths and hostile sexism were found to be significant. CLINICAL IMPLICATIONS: The model selected could suggest the need to operate under an biopsychosocial approach, considering cognitive, emotional, and sexual aspects all together to elicit an effective arise of sexual desire level. STRENGTH & LIMITATIONS: The study can claim a good methodology and the proposal of an interesting model, even if the results should be carefully interpreted due to the use of no representative sample, self-report measures, and the limited number of variables involved. CONCLUSION: Our findings suggest that cognitive, emotional, sexual functioning, and cultural variables interplay affecting men's sexual interest. Nimbi FM, Tripodi F, Rossi R, et al. Testing a Conceptual Model for Men's Sexual Desire Referring to Automatic Thoughts, Emotions, Sexual Function, and Sexism. J Sex Med 2018;15:1518-1526.