Characteristics of systemic testosterone therapy for female hypoactive sexual desire disorder-a claims database analysis.

BACKGROUND: Testosterone therapy (TTh) is recommended for postmenopausal women with hypoactive sexual desire disorder (HSDD); however, there remain insufficient data to support use of TTh in premenopausal women with sexual dysfunction. AIM: In this study, we used a large national database to evaluate prescribing trends of TTh for women with HSDD. METHODS: We conducted a cohort analysis of information from electronic health records acquired from the data network TriNetX Diamond. The study cohort consisted of women 18-70 years of age with a diagnosis of HSDD. We analyzed trends of testosterone prescriptions, routes of testosterone administration, and coadministration of testosterone with estrogen. OUTCOMES: Despite an increase in rates of testosterone prescriptions for HSDD, there remains a high degree of variability in the duration of treatment, route of administration, and coadministration of estrogen with significant underprescription of testosterone. RESULTS: Our query of the TriNetX database led to the identification of 33 418 women diagnosed with HSDD at a mean age of 44.2 ± 10.8 years, among whom 850 (2.54%) women received a testosterone prescription. The testosterone prescriptions were highly variable with regard to duration and route of administration and coadministration with estrogen. For all patients until 2015, the prevalence of testosterone prescriptions for HSDD showed a positive quadratic relation was observed. Since 2015 a linear increase in prevalence was observed, with the highest rate of increase for patients aged 41-55 years. CLINICAL IMPLICATIONS: The findings of this study reveal a significant need for further research investigating the optimal use of TTh to enhance the sexual health of women with HSDD, and further studies on the long-term effects of testosterone use must be undertaken to ensure that patients have access to safe and effective treatment. STRENGTHS AND LIMITATIONS: Limitations to this study include patient de-identification and lack of availability of testosterone dosage data. However, this study also has many strengths, including being the first, to our knowledge, to characterize the prescribing trends of testosterone for women with HSDD. CONCLUSION: Testosterone therapy should be considered as a potential therapy for premenopausal female patients with HSDD. Further studies on the long-term effects of testosterone use must be undertaken to address disparities in the management of HSDD and to ensure patients can access treatment.

Testosterone replacement therapy: clinical considerations.

INTRODUCTION: As an increasingly popular therapeutic option, testosterone replacement therapy (TRT) has gained significant notoriety for its health benefits in indicated populations, such as those suffering from hypogonadism. AREAS COVERED: Benefits such as improved libido, muscle mass, cognition, and quality of life have led to widened public interest in testosterone as a health supplement. No therapy exists without side effects; testosterone replacement therapy has been associated with side effects such as an increased risk of polycythemia, benign prostate hypertrophy (BPH), prostate cancer, gynecomastia, testicular atrophy, and infertility. Testosterone replacement therapy is often accompanied by several prophylactic co-therapies aimed at reducing the prevalence of these side effects. Literature searches for sections on the clinical benefits and risks associated with TRT were performed to include clinical trials, meta-analyses, and systematic reviews from the last 10 years. EXPERT OPINION: Data from clinical studies over the last decade suggest that the benefits of this therapy outweigh the risks and result in overall increased quality of life and remission of symptoms related to hypogonadism. With this in mind, the authors of this review suggest that carefully designed clinical trials are warranted for the investigation of TRT in symptomatic age-related hypogonadism.

Androgen-based therapies in women.

Androgens play a key biological role in libido and sexual arousal in women, and knowledge about their complex role in other systems remains ambiguous and incomplete. This narrative review examines the role of endogenous androgens in women's health throughout the life span before focusing on evidence surrounding the use of androgen-based therapies to treat postmenopausal women. The role of testosterone as a therapeutic agent in women continues to attract controversy as approved preparations are rare, and use of off-label and compounded formulations is widespread. Despite this androgen therapy has been used for decades in oral, injectable, and transdermal formulations. Responses to androgen therapy have been demonstrated to improve aspects of female sexual dysfunction, notably hypoactive sexual desire disorder, in a dose related manner. Substantial research has also been conducted into the role of androgens in treating aspects of the genitourinary syndrome of menopause (GSM). Evidence for benefits beyond these is mixed and more research is required regarding long-term safety. However, It remains biologically plausible that androgens will be effective in treating hypoestrogenic symptoms related to menopause, either through direct physiological effects or following aromatization to estradiol throughout the body.

The effect of short-term increase of estradiol levels on sexual desire and orgasm frequency in women and men: A double-blind, randomized, placebo-controlled trial.

Estradiol (E2) has been implicated in sexual functioning in both sexes. E2 levels change distinctively over the menstrual cycle, peaking around ovulation. Data on short-term effects of fluctuating E2 levels on sexual desire are however sparse and mostly based on observational studies. To fill this gap, we ran a double-blind, randomized, placebo-controlled study (N = 126) to investigate the effects of a short-term increase in E2 on sexual desire and orgasm frequency in healthy, young men and women. Circulating E2 levels were elevated through estradiol valerate (E2V) administered over two consecutive days to simulate the rise in E2 levels around ovulation. E2V had no effect on orgasm frequency and only minor effects on sexual desire. On average, the administered E2V dampened change in sexual desire compared to untreated participants with comparable baseline sexual desire in such a way that sexual desire was slightly reduced even in those with higher baseline sexual desire. These findings suggest that short-term increases in E2 have little effect on sexual function and are unlikely to explain the increase in sexual desire around ovulation.

Point-of-care assessment of sexual concerns among young adult oncology active patients and survivors.

PURPOSE: Adolescent and young adult (AYA) oncology populations have unique sexual health concerns that deserve more attention. Our study aimed to describe sexual health and related concerns in young adults (YAs) to move toward integrating sexual health into routine care. METHODS: A total of 127 YAs (ages 19-39) in active treatment and survivorship from three outpatient oncology clinics provided demographic and clinical information. They completed versions of the NCCN Distress Thermometer and Problem List (AYA-POST; AYA-SPOST) developed specifically for AYAs as part of an ongoing needs assessment study. RESULTS: Over one quarter (27.6%) of the total sample (Mage = 31.96, SD = 5.33) - 31.9% in active treatment (n = 72) and 21.8% in survivorship (n = 55) - reported at least one sexual health concern (i.e., sexual concern, loss of libido (desire for sex), pain with sex, and unprotected sex). Those undergoing active treatment with sexual concerns had significantly higher distress than those without sexual concerns, whereas this pattern was nonsignificant for those in survivorship. Both genders often endorsed general sexual concerns and loss of libido. CONCLUSION: The current study adds to the important and burgeoning literature on sexual health concerns of YAs oncology populations. The prevalence of sexual concerns, differences between treatment status and between those with and without sexual concerns highlight the utility and need to embed screening that includes sexual health items at point of care. This can facilitate discussion of these sensitive and multifaceted needs throughout the cancer continuum.

Impact of female stress urinary incontinence and related treatments on the sexual function of male partners: a systematic review and meta-analysis.

BACKGROUND: No conclusions have been reached on whether female stress urinary incontinence (SUI) and related treatments affect male partners' sexual function. AIM: To assess the effects of female SUI and related treatments on male partners' sexual function. METHODS: A comprehensive search of the PubMed, Embase, Web of Science, Cochrane, and Scopus databases was performed up to September 6, 2022. Studies were included that investigated the effect of female SUI and related treatments on male partners' sexual function. OUTCOME: Male partners' sexual function. RESULTS: Of the 2294 citations identified, 18 studies with 1350 participants were included. Two studies assessed the effect of female SUI without treatment on male partners' sexual function, finding that partners had more erectile dysfunction, more sexual dissatisfaction, and less sexual frequency than partners of women without urinary incontinence. Seven studies directly assessed the effect of female SUI treatments on male partners' sexual function by surveying the male partners. Among these, 4 assessed transobturator suburethral tape (TOT) surgery; 1 assessed TOT and tension-free vaginal tape obturator surgery; and the remaining 2 assessed pulsed magnetic stimulation and laser treatment. Among the 4 TOT studies, 3 used the International Index of Erectile Function (IIEF). TOT surgery significantly improved the total IIEF score (mean difference [MD] = 9.74, P < .00001), along with erectile function (MD = 1.49, P < .00001), orgasmic function (MD = 0.35, P = .001), sexual desire (MD = 2.08, P < .00001), intercourse satisfaction (MD = 2.36, P < .00001), and overall satisfaction (MD = 3.46, P < .00001). However, the improvements in IIEF items may be of unclear clinical significance, as 4 points in the erectile function domain of the IIEF are typically defined as the minimal clinically important difference. In addition, 9 studies indirectly assessed the effect of female SUI surgery on male partners' sexual function by surveying patients with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire. The results demonstrated no significant differences in erectile function (MD = 0.08, P = .40) or premature ejaculation (MD = 0.07, P = .54). CLINICAL IMPLICATIONS: The effects of female SUI and related treatments on male partners' sexual function were summarized for the first time, providing a reference for future clinical practice and scientific research. STRENGTHS AND LIMITATIONS: A limited number of studies that used various scales met the standardized eligibility criteria. CONCLUSION: Female SUI may affect male partners' sexual function, and female patients' anti-incontinence surgery does not appear to have a clinically significant improvement on the sexual function of their partners.

Reversible control of reproduction in tom cats: medical options for manipulating libido and fertility.

BACKGROUND: There has been a growing interest in alternatives to surgery for controlling reproduction in tom cats, and the resultant medical options add to a practitioner's toolbox when handling these cases in clinical practice. It is important, however, that when suggesting these drugs, veterinarians have a good understanding of their mode of action, and their correct use and dosage. CLINICAL RELEVANCE: Breeders increasingly wish to be able to switch on/off the reproductive ability of their tom cats in a controlled manner. In addition, in small animal medicine, there has been concern from some academics, and a growing number of pet cat owners, about potential long-term effects of surgical sterilisation. Further, for some cats surgical castration may not be possible due to health conditions that mean anaesthesia is unsafe. In all of these scenarios, medical alternatives to surgery can prove useful. EQUIPMENT AND TECHNICAL SKILLS: No special equipment or technical skills are required. A good knowledge of the medical alternatives to surgical sterilisation for controlling reproduction in a tom, and making sure the patient is a suitable candidate, are, however, important for ensuring the cat's health during and after treatment and the owner's satisfaction. AUDIENCE: This review is aimed principally (but not exclusively) at veterinary practitioners working with cat breeders who seek a temporary arrest in their tom cat's reproduction. It may also help practitioners with clients who would like an alternative to surgery or with cats where anaesthesia for surgical castration is not possible. EVIDENCE BASE: Advances in reproductive feline medicine have resulted in improved knowledge of medical contraception. This review draws on scientific evidence-based papers that report on the mode of action, length of efficacy and potential side effects of different methods of medical contraception, as well as the authors' own clinical experience.

O impacto do uso de métodos contraceptivos orais na função sexual de mulheres em idade reprodutiva / The impact of the use of oral contraceptive methods on the sexual function of women of reproductive age

Objetivo: Investigar o impacto dos contraceptivos orais hormonais na função sexual de mulheres. Métodos: Estudo transversal realizado por meio do questionário traduzido e validado "Índice da Função Sexual Feminina", capaz de estimar o risco de disfunção sexual feminina. Dados sociodemográficos, ginecológicos, medicamentosos e outros foram avaliados e correlacionados estatisticamente a esse escore, estimando possíveis causas da disfunção sexual, com destaque para o uso de anticoncepcional oral. O estudo foi baseado em uma amostragem por conveniência, incluindo mulheres > 18 anos em idade reprodutiva, de 04/01/2021 a 04/01/2022, obedecendo aos critérios de inclusão e exclusão. Resultados: Participaram deste estudo 105 mulheres com média e desvio-padrão de idade de 23,4 ± 3,8 anos, predominantemente heterossexuais (84,0%) e bissexuais (13,2%). A maioria delas (93,4%) utiliza métodos contraceptivos, sendo esses anticoncepcional oral (45,3%), DIU hormonal (19,8%) e camisinha (17,0%). A composição hormonal mais utilizada foi levonorgestrel (26,4%) e etinilestradiol (25,5%). Oitenta por cento das mulheres são sexualmente ativas, 69,3% delas têm parceria fixa, 42,5% tinham relações quase sempre e 33,0% referiam que as relações sexuais eram sempre satisfatórias. Houve boa adequação da amostra (0,865) e significância estatística (p < 0,0001). Utilizar ou não método contraceptivo apresentou diferença nos domínios desejo, satisfação e dor. Contudo, as questões do histórico sexual foram as que mais apresentaram relevância estatística em relação aos domínios. Conclusão: Apesar de outros estudos serem necessários para provar a hipótese de que os contraceptivos orais têm impacto negativo na função sexual feminina, é clara a importância de os profissionais de saúde já estarem cientes dessa possibilidade e saberem como abordá-la.

Objective: To investigate the impact of hormonal oral contraceptives on women's sexual function. Methods: Cross-sectional study carried out using the translated and validated questionnaire "Index of Female Sexual Function", capable of estimating the risk of female sexual dysfunction. Sociodemographic, gynecological, medication and other data were evaluated and statistically correlated to this score, estimating possible causes of sexual dysfunction, with emphasis on the use of oral contraceptives. The study was based on a convenience sample, including women > 18 years of reproductive age, from 01/04/2021 to 01/04/2022, following inclusion and exclusion criteria. Results: The study included 105 women with a mean and standard deviation of (23.4 ± 3.8) years old, predominantly heterosexual (84.0%) and bisexual (13.2%). Most of them (93.4%) use contraceptive methods, these being (45.3%) oral contraceptives, (19.8%) hormonal IUDs and (17.0%) condoms. The most used hormonal composition was levonorgestrel (26.4%) and ethinylestradiol (25.5%). Eighty percent of the women are sexually active, 69.3% of them have a steady partner, 42.5% almost always had sex and 33.0% said that sex was always satisfactory. There was good sample adequacy (0.865) and statistical significance (p < 0.0001). Using or not using a contraceptive method showed a difference in the desire, satisfaction and pain domains. However, sexual history questions were the ones that showed the most statistical relevance in relation to the domains. Conclusion: Although further studies are needed to prove the hypothesis that oral contraceptives have a negative impact on female sexual function, it is clear that health professionals are already aware of this possibility and know how to approach it.

Flaxseed oil modulates testicular biometrics, hormone, libido, antioxidant and semen profiles in endangered Teressa goat of Andaman and Nicobar Islands.

Teressa goat is a unique goat breed in Andaman and Nicobar Islands (ANI) of India. Effects of Flaxseed oil (FSO) supplementation in body weight (BW), scrotal circumference (SC), testicular volume (TV) and testicular weight (TW), endocrinological profiles, sex behavioural profiles (SBPs), oxidative stress markers and semen production and its quality profiles in rainy and dry summer season were studied in Teressa goat. Male goats (n = 12) of 3-4 years old were equally divided into control and treated groups. Treated animals received 25 mL FSO per day. Oral drenching of FSO was done in the morning before feeding the concentrate ration. Body weight, scrotal circumference, TV and TW were measured in bucks of FSO treated and untreated during rainy and dry summer seasons. Blood follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), cortisol and prolactin, total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT), glutathione (GSH) and malondialdehyde (MDA) were measured in bucks of FSO treated and untreated during rainy and dry summer seasons. Libido score (LS), mating ability score (MAS) and sex behavioural score (SBS) were estimated at time of semen collection in bucks of FSO treated and untreated during rainy and dry summer seasons. Semen samples (n = 100; 50 semen samples from each season; each 25 semen samples from control and treatment groups per season) were collected and analysed for semen quality profiles. One-way ANOVA (control rainy, control dry, treated rainy and treated dry) revealed that BW, SC, TV and TW, FSH, LH, testosterone, TSH, T3 and T4 were higher (P < 0.05) and cortisol and prolactin were lower (P < 0.05) in FSO treated bucks of rainy season followed by untreated bucks of rainy season, FSO treated bucks of dry summer season and were lower (P < 0.05) in untreated bucks of dry summer season. Similarly, TAC, CAT, SOD and GSH, LS, MAS and SBS, and volume, pH, sperm concentration, mass activity, total motility (TM), viability, acrosomal integrity (AcI), plasma membrane integrity (PMI) and nuclear integrity (NI) were higher (P < 0.05) and MDA and TSA were lower (P < 0.05) in FSO treated bucks of rainy season followed by FSO treated bucks of dry summer season, untreated bucks of rainy season and were lower (P < 0.05) in untreated bucks of dry summer season. The results of the present study indicated that the breeding bucks suffered physiological stress (higher cortisol), oxidative stress (higher MDA and deficiency of antioxidants), hormonal imbalance (higher prolactin and cortisol and deficiency of gonadotropins, gonadal hormone and thyroid hormones) and infertility due to poor libido and poor semen production and its quality profiles during dry summer season. Thus, dry summer was more stressful season compared to rainy season for the goat bucks. FSO supplementation mitigated these stresses and improved the scrotal and testicular biometrics, libido, antioxidants, hormones and semen quality profiles in Teressa goat bucks. The current study concluded that FSO effectively improved the hormones, libido, antioxidant profiles, and scrotal and testicular biometrics with cascading beneficial effects on semen quality profiles in Teressa goat bucks under humid tropical island ecosystem of Andaman and Nicobar Islands.

[Cross-sectional analysis of libido status and risk factors in male patients with chronic headache].

OBJECTIVE: Exploring the libido status of male chronic headache patients and analyzing its relationship with headache symptoms, sleep, anxiety, and depression, providing reference for the comprehensive treatment of male chronic headache. METHODS: 179 patients with chronic headache who visited the Third Affiliated Hospital of Qiqihar Medical College from January 2022 to February 2023 were selected. The male Self Rated Libido Scale , Visual Analog Scale for Pain, Migraine Disability Assessment Scale, Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder Scale-7, and Patient Health Questionnaire-9 were used to evaluate the libido status, headache severity, disability level, sleep quality, anxiety, and depression of the research subjects, respectively. RESULTS: Among 179 male chronic headache patients, 97 were chronic migraine (CM) patients and 82 were chronic tension type (CTT) patients, and 47 were screened for low libido. The influencing factors of libido in male chronic headache patients include age, smoking, frequency of exercise, course of disease, severity of pain, frequency of headache, disability score, sleep quality, anxiety and depression (all P<0.05). Compared with male CTT patients, male CM patients have higher pain severity, headache frequency, disability score, and anxiety score, while lower libido score (all P<0.05). The results of multivariate analysis showed that age, frequency of exercise, course of disease, severity of pain, frequency of headache, degree of disability, sleep quality, anxiety, and depression were the influencing factors for the decline of libido in male chronic headache patients. CONCLUSION: It is common for male chronic headache patients to experience decreased libido, with male chronic migraine (CM) patients exhibiting more severe reductions. Advanced age, decreased physical activity, longer disease duration, severe pain intensity, frequent headaches, higher disability levels, poor sleep, anxiety, and depression are risk factors for decreased libido in male chronic headache patients.

Educação sexual: dificuldades dos pais de jovens com síndrome de down / Sex education: difficulties for parents of young people with down syndrome / Educación sexual: dificultades para los padres de jóvenes con síndrome de down

Com este estudo buscou-se conhecer as dificuldades e barreiras de pais na educação sexual de jovens com Síndrome de Down, a partir de uma pesquisa descritiva e de natureza qualitativa, utilizando-se o conceito das representações sociais como referencial teórico-metodológico. O estudo foi conduzido em uma Organização Não Governamental (ONG), localizada em Recife (PE), após aprovação do Comitê de Ética e Pesquisa, sob parecer consubstanciado 3.558.587. A amostra do estudo envolveu 11 pais de jovens com Síndrome de Down com idades entre 15 e 24 anos. A coleta de dados foi realizada por meio de entrevistas semiestruturadas. A abordagem escolhida para a interpretação desses dados foi a análise de conteúdo proposta por Bardin. Pode-se elencar como principais dificuldades enfrentadas pelos pais ao conversarem com seus filhos sobre sexualidade: a infantilização do jovem com Síndrome de Down, julgando-o incapaz de experienciar tais fenômenos e compreender a orientação que pudesse ser repassada; o medo em ultrapassar etapas e, de repente, "estimular" o filho a viver sua sexualidade de maneira "precoce"; e o fato de os pais também terem recebido pouca ou nenhuma orientação sexual por parte de suas famílias. Diante das narrativas dos pais, é possível perceber que ainda são muitos os mitos, tabus e preconceitos que permeiam a sexualidade dos jovens com Síndrome de Down, demonstrando que os responsáveis estão despreparados para dar as devidas orientações.(AU)

This study sought to know the difficulties and barriers of parents in the sexual education of young people with Down Syndrome, from a descriptive, qualitative study, using the concept of social representations as a theoretical-methodological framework. The study was conducted in a Non-Governmental Organization (NGO), located in Recife (PE) after approval by the Ethics and Research Committee, under substantiated opinion 3,558,587. The study sample involved 11 parents of young people with Down Syndrome aged between 15 and 24 years. The data collection was carried out by using semi-structured interviews. The approach chosen for interpretation of these data was the content analysis proposed by Bardin. The main difficulties faced by parents in talking with their children about sexuality can be listed as: the infantilization of young persons with Down Syndrome, deeming them incapable of experiencing such phenomena and understanding the guidance that could be given; the fear of overshooting the stages and, suddenly, "stimulating" the child to live their sexuality in an "early" way; and the facts of the parents also having received little or no sexual guidance from their families. Given the parents' narratives, it is possible to realize that there are still many myths, taboos, and prejudices that permeate the sexuality of young people with Down Syndrome, demonstrating that parents were unprepared to provide the right guidance.(AU)

Este estudio buscó conocer las dificultades y barreras de los padres en la educación sexual de los jóvenes con síndrome de Down a partir de un estudio descriptivo, cualitativo, que utilizó el concepto de representaciones sociales como marco teórico-metodológico. La investigación se llevó a cabo en una Organización No Gubernamental (ONG), ubicada en la ciudad de Recife (Pernambuco, Brasil), después de la aprobación del Comité de Ética e Investigación, bajo la opinión fundamentada 3.558.587. La muestra del estudio incluyó a 11 padres de jóvenes con síndrome de Down con edades comprendidas entre 15 y 24 años. La recolección de datos se realizó mediante entrevista semiestructurada. El enfoque elegido para la interpretación de los datos fue el análisis de contenido propuesto por Bardin. Pueden enumerarse como las principales dificultades que enfrentan los padres para hablar sobre la sexualidad con sus hijos: la infantilización del joven con síndrome de Down, considerándolo incapaz de experimentar tales fenómenos y comprender la orientación que se le puede dar; el miedo de ir más allá de las etapas y, de repente, "estimular" al niño a vivir su sexualidad de una manera "temprana"; y el hecho de que los padres también habían recibido poca o ninguna orientación sexual de sus familias. Dadas las narraciones de los padres, es posible darse cuenta de que todavía hay muchos mitos, tabúes y prejuicios sobre la sexualidad de los jóvenes con síndrome de Down, lo que muestra que los padres no estaban preparados para brindarles este tipo de orientación.(AU)

Um capítulo esquecido na história da psicologia? sexualidades desviantes, psicopatologia e normalidade / A forgotten chapter in the history of psychology? deviant sexualities, psychopathology, and normality / ¿Un capítulo olvidado en la historia de la psicología? sexualidades desviadas, psicopatología y normalidad

Este artigo tem como objetivo produzir uma análise histórica sobre as intersecções entre Psicologia e sexualidade desviantes da norma no Brasil, de fins do século XIX a meados da década de 1980. Esta temporalidade foi escolhida por abarcar o surgimento das pesquisas científicas sobre sexualidade e desvios sexuais, a consolidação dos estudos psicológicos sobre a temática e o processo mais recente de despatologização da homossexualidade. Em termos teóricos e metodológicos, foram adotados os pressupostos da História Social da Psicologia e da historiografia das homossexualidades no Brasil. Desse modo, buscou-se compreender como as ideias, concepções e práticas psicológicas foram mudando ao longo do tempo, em conexão com as transformações socioculturais e políticas que ocorreram durante o século XX. Para isto, foram utilizadas fontes primárias e secundárias de pesquisa com vistas à produção de interpretações sobre as conexões entre as ideias, os atores e os eventos narrados. Argumenta-se, ao longo do artigo, que as ideias e práticas psicológicas estão intrinsecamente conectadas aos contextos socioculturais e políticos de seu tempo, sendo os movimentos dinâmicos e os conflitos presentes nesses contextos fatores determinantes para a sua constituição.(AU)

This article aims to produce a historical analysis of the intersections between Psychology and sexualities that deviate from the norm in Brazil, from the late 19th century to the mid-1980s. This period was chosen because it encompasses the emergence of scientific research on sexuality and sexual deviations, the consolidation of psychological studies on the subject and the most recent process of de-pathologization of homosexuality. Theoretically and methodologically, the assumptions of the Social History of Psychology and the historiography of homosexualities in Brazil were adopted. Therefore, we sought to understand how psychological ideas, conceptions and practices have changed over time, in connection with the sociocultural and political transformations that occurred throughout the 20th century. For this, primary and secondary sources of research were used to produce interpretations about the connections between the ideas, the actors and the narrated events. It is argued, throughout the article, that the psychological ideas and practices are intrinsically connected to the sociocultural and political contexts of their time, being the dynamic movements and conflicts present in these contexts determining factors for their constitution.(AU)

Este artículo tiene como objetivo realizar un análisis histórico de las intersecciones entre la Psicología y las sexualidades desviadas de la norma en Brasil desde finales del siglo XIX hasta mediados de la década de 1980. Esta temporalidad fue elegida por abarcar el surgimiento de las investigaciones científicas sobre sexualidad y desvíos sexuales, la consolidación de los estudios psicológicos sobre el tema y el más reciente proceso de despatologización de la homosexualidad. En el marco teórico y metodológico, se adoptaron los presupuestos de la Historia Social de la Psicología y de la historiografía de las homosexualidades en Brasil. De esta manera, se pretende comprender cómo las ideas, concepciones y prácticas psicológicas han cambiado a lo largo del tiempo, en conexión con las transformaciones socioculturales y políticas ocurridas durante el siglo XX. Para ello, se utilizaron las fuentes de investigación primarias y secundarias con miras a generar interpretaciones sobre las conexiones entre las ideas, los actores y los eventos narrados. Se argumenta, a lo largo de este artículo, que las ideas y las prácticas psicológicas están intrínsecamente conectadas a los contextos socioculturales y políticos de su tiempo, y los movimientos dinámicos y los conflictos presentes en estos contextos fueron los factores determinantes para su constitución.(AU)

Butler e a psicanálise: do fracasso das normas à estranheza do gozo / Butler and psychoanalysis: from the failure of norms to the uncanniness of jouissance / Butler y el psicoanálisis: del fracaso de las normas a la rareza del goce

O objetivo deste artigo é fazer avançar o debate entre a psicanálise e os estudos queer, em especial a partir da interlocução traçada por Judith Butler com os trabalhos de Freud e Lacan. Retomando o modo como Butler articula Foucault, Derrida e a psicanálise para pensar os problemas de gênero, evidenciamos que a teoria psicanalítica permite à filósofa situar, a partir de sua concepção da melancolia de gênero, os pontos de fracasso da norma em função da vida psíquica do poder. Ainda que a cisheterossexualidade normativa imponha um roteiro de identificações e escolhas de objeto a seus sujeitos, há uma imprevisibilidade na maneira pela qual cada um responderá às injunções normativas da cultura, o que aponta para uma falha das normas em determinar completamente a subjetividade. A melancolia de gênero se torna, assim, uma marca da importância da psicanálise no percurso de Butler. Em seguida, discutimos as interpelações da filósofa ao simbólico lacaniano, bem como as nuances progressivamente introduzidas em sua leitura da diferença sexual. Ao longo do percurso de Butler, a diferença sexual deixa de ser considerada uma teoria da heterossexualidade e passa a ser apresentada como um conceito-borda, uma fronteira vacilante, que tomamos aqui como um convite para produzirmos uma releitura não normativa da diferença sexual na psicanálise a partir da teoria lacaniana da sexuação. Finalmente, localizamos a estranheza do gozo e o caráter irredutível da sexualidade às normas sociais como um importante eixo partilhado entre Butler e a psicanálise.(AU)

The aim of this article is to branch out the debate between psychoanalysis and queer studies, focusing on the interlocution drawn by Judith Butler with the works of Freud and Lacan. Returning to the way Butler articulates Foucault, Derrida and psychoanalysis to think about gender trouble, we show that psychoanalytic theory allows the philosopher to situate, from her conception of gender melancholy, the points of failure of the norm in function of the psychic life of power. After all, even though normative cis-heterosexuality imposes a script of identifications and object-choices on its subjects, there is an unpredictability to the way in which each one will respond to the normative injunctions of culture, so that norms fail to fully determine subjectivity. Gender melancholy thus becomes a mark of the importance of psychoanalysis in Butler's path. Then, we discuss the philosopher's interpellations to the Lacanian symbolic order, as well as the nuances progressively introduced in her reading of sexual difference. Along Butler's path, sexual difference is no longer considered a theory of heterosexuality and is presented as a border-concept, a vacillating frontier, which we take here as an invitation to produce a non-normative rereading of sexual difference in psychoanalysis, resorting to the Lacanian theory of sexuation. Finally, we locate the uncanniness of jouissance and the irreducible character of sexuality to social norms as an important shared axis between Butler and psychoanalysis.(AU)

El objetivo de este artículo es hacer avanzar el debate entre el psicoanálisis y los estudios queer, enfatizando la interlocución trazada por Judith Butler con los trabajos de Freud y Lacan. Volviendo a la forma en que Butler articula a Foucault, Derrida y el psicoanálisis para pensar los problemas de género, mostramos que la teoría psicoanalítica permite a la filósofa ubicar, desde su concepción de la melancolía de género, los puntos de falla de la norma en función de la vida psíquica del poder. Aunque la cis-heterosexualidad normativa imponga identificaciones y elecciones de objeto a sus sujetos, hay una imprevisibilidad en la forma en que cada uno responderá a los mandatos normativos de la cultura, lo que apunta a un fracaso de las normas para determinar completamente la subjetividad. La melancolía de género se convierte, entonces, en una marca de la importancia del psicoanálisis en la trayectoria de Butler. En seguida, discutimos las interpelaciones de la filósofa a lo simbólico lacaniano, así como los matices progresivamente introducidos en su lectura de la diferencia sexual. A lo largo de la trayectoria de Butler, la diferencia sexual deja de ser considerada una teoría de la heterosexualidad y pasa a ser presentada como un concepto-borde, um límite vacilante, que tomamos aquí como una invitación para producirmos una relectura no normativa de la diferencia sexual en psicoanálisis a partir de la teoría lacaniana de la sexuación. Finalmente, ubicamos la rareza del goce y el carácter irreductible de la sexualidad a las normas sociales como un importante eje compartido entre Butler y el psicoanálisis.(AU)

Uma leitura teórico-clínica de uma análise: o fato clínico como operador metodológico / A theoretical-clinical reading of an analysis: the clinical fact as a methodological operator / Una lectura teórico-clinica del análisis: el hecho clínico como herramienta metodológica

O presente artigo é oriundo de pesquisa acadêmica que teve como objetivo estudar a clínica psicanalítica e seus efeitos por meio da apresentação de fragmentos de uma análise já encerrada. Para alcançar esse objetivo, utilizamos a ferramenta metodológica do fato clínico, articulando o material clínico com alguns pontos da teoria psicanalítica. Como resultado, apontamos que é possível fazer uma leitura teórico-clínica de uma experiência de análise sob a perspectiva dos movimentos discursivos, em especial do sujeito do inconsciente ($) e do objeto a, conforme apresentados na proposição dos Quatro Discursos de Lacan. Acreditamos que este estudo enfatiza a importância da especificidade da pesquisa em psicanálise em sua dimensão clínica e os possíveis efeitos produzidos por esse processo terapêutico. Dessa maneira, entendemos que a divulgação deste trabalho pode contribuir para a discussão da prática clínica entre colegas do campo psicanalítico e acadêmico, bem como para a difícil tarefa da apresentação do material clínico com a sustentação teórica necessária, a fim de fortalecermos a sempre fundamental transmissão da psicanálise.(AU)

This article comes from academic research that aimed to study the psychoanalytic clinic and its effects by presenting fragments of an analysis that has already ended. To achieve this goal, we used the methodological tool of the clinical fact, articulating the clinical material with some points of psychoanalytic theory. As a result, we point out that it is possible to make a theoretical-clinical reading of an analysis experience from the perspective of discursive movements, in particular, the subject of the unconscious ($) and of the object a, as presented in the proposition of Lacan's Four Discourses. We believe that this study emphasizes the importance of the specificity of research in psychoanalysis in its clinical dimension and the possible effects produced by this therapeutic process. In this way, we understand that the dissemination of this work can contribute to the discussion of clinical practice among colleagues in the psychoanalytic and academic fields, as well as to the difficult task of presenting clinical material with the necessary theoretical support, to strengthen the always fundamental transmission of psychoanalysis.(AU)

Este artículo surge de una investigación académica que pretendió estudiar la clínica psicoanalítica y sus efectos mediante la presentación de fragmentos de un análisis que ya terminó. Para lograr este objetivo, se utilizó la herramienta metodológica del hecho clínico articulando el material clínico con algunos puntos de la teoría psicoanalítica. El resultado permite señalar que es posible realizar una lectura teórico-clínica de una experiencia de análisis desde la perspectiva de los movimientos discursivos, en particular el sujeto del inconsciente ($) y el objeto a, como se presenta en la proposición de los cuatro discursos de Lacan. Este estudio enfatiza la importancia de la especificidad de la investigación en psicoanálisis en su dimensión clínica y los posibles efectos que produce este proceso terapéutico. De esta forma, la difusión de este trabajo puede contribuir a la discusión de la práctica clínica entre colegas del campo psicoanalítico y académico, así como a la difícil tarea de presentar material clínico con el soporte teórico necesario para fortalecer la siempre fundamental transmisión del psicoanálisis.(AU)

O sexo em psicanálise como ontologia negativa / El sexo en el psicoanálisis como ontología negativa / Sex in psychoanalysis as a negative ontology

RESUMO O objetivo deste artigo é defender a tese de que o sexo em psicanálise apresenta caráter ontologicamente negativo. Desde Freud, sabemos que sexo não se restringe a práticas específicas nem se aferra a objetos predeterminados - sexo é encarado como pulsional; sendo assim, perverso, polimorfo e infantil. Desta feita, trata-se de um objeto não positivado e que se manifesta em fenômenos negativos, como as formações do inconsciente - sexo, inconsciente e não saber estão intimamente associados. O impasse ontológico radical concernente ao sexo compõe os desenvolvimentos lacanianos referentes ao desejo e ao gozo. Ater-se à espécie de negatividade que lhe é própria permite extrair outras consequências do aforismo 'não há relação sexual' - para além da ideia de obstáculo ou impedimento, problematiza-se a face ontológica negativa da não relação, correspondente à ligação entre simbólico e real e que pode ser formalizada no matema S (Ⱥ). O artigo também põe em destaque incidências clínicas desta proposta - reconhecer a irredutibilidade ontológica da negação nos desvia das determinações positivas que sustentam normatizações identitárias em horizonte clínico.

RESUMEN El objetivo de este artículo es defender la tesis de que el sexo en el psicoanálisis tiene un carácter ontológicamente negativo. Desde Freud hemos sabido que el sexo no se limita a prácticas específicas, ni se aferra a objetos predeterminados: el sexo es visto como pulsional; así, perverso, polimorfo e infantil. Esta vez, es un objeto no positivo que se manifiesta en fenómenos negativos, como las formaciones del inconsciente: el sexo, el inconsciente y el no-saber están estrechamente asociados. El impasse ontológico radical sobre el sexo constituye el desarrollo lacaniano sobre el deseo y el goce. Cumplir con su propio tipo de negatividad nos permite extraer otras consecuencias del aforismo 'no hay relación sexual': más allá de la idea de obstáculo o impedimento, el aspecto ontológicamente negativo de la no-relación, correspondiente al vínculo entre lo simbólico y lo real, se problematiza. Este marco teórico se puede formalizar en el matema S (Ⱥ). El artículo también destaca las implicaciones clínicas de esta propuesta: reconocer la irreductibilidad ontológica de la negación nos desvía de las determinaciones positivas que sustentan las normas de identidad en el horizonte clínico.

ABSTRACT The purpose of this article was to defend the thesis that sex in psychoanalysis has an ontologically negative character. Since Freud, we have known that sex is not limited to specific practices or attached to predetermined objects - sex is seen as instinctual; therefore, perverse, polymorphous and childish. In this case, it is a non-positivized object that manifests itself in negative phenomena, such as the formations of the unconscious - sex, unconscious and not-knowing are intimately associated. The radical ontological impasse concerning sex makes up the Lacanian developments concerning desire and jouissance. Keeping to the negativity that is proper to it allows to draw other consequences from the aphorism 'there is no sexual relationship' - in addition to the idea of obstacle or impediment, the negative ontological face of non-relation is problematized, corresponding to the link between symbolic and real, which can be formalized in the matheme S (Ⱥ). The article also highlights clinical incidences of this proposal - recognizing that ontological irreducibility of negation diverts us from positive determinations that support identity norms in the clinical horizon.

Female sexual function in different phenotypes of polycystic ovarian syndrome: a comparative cross-sectional study.

Polycystic ovary syndrome (PCOS) coexisting mood disorders along with a combination of aesthetic manifestations may have a detrimental effect on women's sexual function. Hence, different phenotypes of PCOS have different clinical and biochemical signs and symptoms. The aim of this study was to compare women's sexual function (SF) in different phenotypes of PCOS. This cross-sectional study was conducted on 364 women who met the Rotterdam diagnostic criteria to compare different PCOS phenotypes (A = 95, B = 79, C = 95, and D = 95) and 100 non PCOS women in control group. All participants were invited to fill out the female sexual function index (FSFI). Significant differences were observed between the different phenotypes and control group in terms of the total score, sexual desire, arousal, lubrication, and satisfaction (P < 0.001); however, no significant differences were found between different phenotypes in terms of pain (P > 0.05) and orgasm (P > 0.05) but difference was significant between different phenotypes and control group. In addition, phenotype B had the lowest mean score of total FSFI (P < 0.05). The results indicated that women's SF is significantly different in different PCOS phenotypes. It is concluded that in order to solve the SF problems of women with PCOS, different treatment and care measures should be considered according to the relevant phenotype.

Ovarian hormones in relation to naturally cycling women's conception risk: Empirical evidence and implications for behavioral endocrinology.

A substantial body of literature has examined how women's psychology and behavior vary as a function of conception risk across the ovarian cycle. These effects are widely believed to be outcomes of hormonal regulation, in particular effects of estrogens (E) and progesterone (P). Increasingly, researchers have sought to test predictions about how psychological processes or behavior vary as a function of conception risk by examining associations with estrogen (e.g., estradiol) and progesterone levels. Yet issues regarding how best to assess these associations arise. Should hormone levels be log-transformed? Do hormone ratios best capture their joint effects? How important are hormone interactions? How should outliers be treated? Across two large datasets, we examined hormonal predictors of conception risk, estimated from day of a luteinizing hormone (LH) surge. Log-transformed E and P levels predicted conception risk better than raw E and P levels did. The raw E/P ratio was a relatively poor predictor, whereas the log-transformed ratio (ln[E/P]) was a relatively good predictor. E × P interactions were detected but weak. Outliers were frequent, especially in distributions of raw hormone levels. Hormone measures predicted two psychological outcomes in these datasets-sexual desire and preferences for strength and muscularity-in parallel to how strongly they predicted conception risk. These results give rise to several recommendations regarding treatment of hormone measures and their use in analyses.

Effects of Kisspeptin Administration in Women With Hypoactive Sexual Desire Disorder: A Randomized Clinical Trial.

Importance: Despite being the most common female sexual health complaint worldwide, current treatment options for hypoactive sexual desire disorder (HSDD) are limited in their safety and effectiveness. The hormone kisspeptin is a key endogenous activator of the reproductive hormonal axis with additional emerging roles in sexual and emotional behavior; however, its effects in women with HSDD are unknown. Objective: To test the hypothesis that kisspeptin enhances sexual and attraction brain processing in women with HSDD. Design, Setting, and Participants: This randomized clinical trial was double-masked and placebo controlled with a 2-way crossover. The trial was conducted in a university research setting in the UK from October 2020 to April 2021. Eligible participants were premenopausal women with HSDD. Functional neuroimaging, psychometric, and hormonal analyses were employed to investigate the effects of kisspeptin administration on brain processing, in response to erotic stimuli (erotic videos) and facial attraction (face images of varying attractiveness). Data were analyzed from May to December 2021. Interventions: A 75-minute intravenous infusion of kisspeptin-54 (1 nmol/kg/h) vs equivalent-rate placebo infusion. Main Outcomes and Measures: Blood oxygen level-dependent responses across the whole brain and regions of interest during kisspeptin vs placebo administration in response to erotic and facial attraction stimuli. Results: Of the 40 participants who were randomized, 32 women completed both kisspeptin and placebo visits, with a mean (SE) age of 29.2 (1.2) years. Kisspeptin administration resulted in modulations in sexual and facial attraction brain processing (deactivation of the left inferior frontal gyrus: Z max, 3.76; P = .01; activation of the right postcentral and supramarginal gyrus: Z max, 3.73; P < .001; deactivation of the right temporoparietal junction: Z max 4.08; P = .02). Furthermore, positive correlations were observed between kisspeptin-enhanced hippocampal activity in response to erotic videos, and baseline distress relating to sexual function (r = 0.469; P = .007). Kisspeptin's enhancement of posterior cingulate cortex activity in response to attractive male faces also correlated with reduced sexual aversion, providing additional functional significance (r = 0.476, P = .005). Kisspeptin was well-tolerated with no reported adverse effects. Conclusions and Relevance: These findings lay the foundations for clinical applications for kisspeptin in women with HSDD. Trial Registration: ISRCTN trial registry identifier: ISRCTN17271094.

Body image and sexual function in women with polycystic ovary syndrome: a case-control study.

OBJECTIVES: The study aimed to determine the impact of polycystic ovary syndrome on women's body image and sexual function. METHODS: In this case-control study, 97 women with polycystic ovary syndrome and 95 healthy women were interviewed in a hospital using the Personal Information Form, Body Image Scale, and Female Sexual Function Index. RESULTS: The total score of body image of women in the polycystic ovary syndrome group was found to be 132.11±19.44 and it was 133.35±21 in the control group; there was no statistically significant difference between them (p>0.05). In this study, 74.23% of the women with polycystic ovary syndrome (+) experienced sexual dysfunction. Sex drive, arousal, lubrication, orgasm, and averages of pain subscales and female sexual function index total score were found to be significantly lower in the polycystic ovary syndrome group than in the control group (p<0.05). CONCLUSION: The findings suggest a difference between women with polycystic ovary syndrome and healthy women in terms of sexual function, while body image was similar in both groups. Our data suggest that the polycystic ovary syndrome has a negative effect on the sexuality.

Climacteric status is associated with sexual dysfunction at the age of 46 years: a population-based study.

OBJECTIVE: Increasing age and menopausal transition increase the risk of sexual dysfunction. Sexual dysfunction is common in women experiencing menopause before the age of 40 years, whereas evidence on sexual function in women experiencing menopause in their mid-40s is scarce. We aimed to investigate sexual function in 46-year-old women in relation to their menopausal status. METHODS: This study cross-sectionally evaluated sexual function of women in a prospective population-based Northern Finland Birth Cohort 1966 (NFBC1966). A 46-year follow-up study of NFBC1966 included a broad questionnaire evaluating health, lifestyle, and life situation, as well as menstrual history and sexual function, and blood sampling analysis including follicle stimulating hormone and free androgen index (FAI). The participants were divided into two groups by their menopause status, defined by follicle-stimulating hormone and menstrual history. We performed logistic regression models in which parameters of sexual function were dependent factors and climacteric status, self-reported health, FAI, relationship status, smoking, and education level were independent variables. RESULTS: The study population included 2,661 women. In regression models, more advanced climacteric status was associated with higher frequency and difficulty level of low sexual desire and vaginal dryness (odds ratios with 95% confidence intervals: 2.80 [2.12-3.71], 3.22 [2.43-4.27], 3.83 [2.82-5.20], 3.75 [2.75-5.12], respectively), lower frequency of sexual thoughts (1.34 [1.02-1.75]), and higher frequency of problems with intercourse (2.35 [1.51-3.66]). Lower FAI and poorer health were associated with impaired sexual function. CONCLUSIONS: The current study suggests that women experiencing menopausal transition in their mid-40s are at risk of impaired sexual function.