Which Came First, the Money or the Sex? Bidirectional, Indirect Associations between Financial Management Behaviors and Sexual Satisfaction among Newlywed Couples.

Scholars have established connections between how married couples navigate their finances and their sexual relationship. For example, financial management behaviors are associated with sexual satisfaction among newlywed couples. However, we know very little about the direction of the association between financial management behaviors and sexual satisfaction. Understanding which might predict the other, or if there might be a bidirectional association between the two, could provide information on where to intervene to help newlywed couples with financial or sexual obstacles in their marriage. With three waves of dyadic data (N = 1,205 U.S. newlywed couples), we used structural equation modeling to examine the bidirectional, indirect associations between husbands' and wives' financial management behaviors and their own sexual satisfaction through their own marital satisfaction. Overall, we found that financial management behaviors indirectly predicted changes in sexual satisfaction through marital satisfaction for both husbands and wives. We also found limited evidence that husbands' sexual satisfaction indirectly predicted changes in their own financial management behaviors through their own marital satisfaction. Additionally, these indirect associations differed by gender. Partner effects, however, were largely non-significant. Implications of these findings for those who help newlywed couples with their sexual relationships are discussed.

The self-assessment of genital anatomy, sexual function, and genital sensation (SAGASF-M) questionnaire in a Belgian Dutch-speaking male population: A validating study.

INTRODUCTION: Penile and genital surgery for congenital or acquired conditions is daily practice in reconstructive urology. These procedures, which carry the risk of disrupting nerves and blood vessels, may impair the genital sensation, and affect the capacity for sexual pleasure. Self-reported tools are needed to systematically assess the male genitalia before and after reconstructive surgeries in terms of genital sensation and sexual experience. AIM: This study validated the Dutch translation of the "self-assessment of genital anatomy and sexual functioning in male" (SAGASF-M) questionnaire and investigated the perceptions of healthy men regarding their genital anatomy and sensory function. METHODS: Eight hundred and eight sexually active men with a median age of 39 years (18-79 years) and no history of genital procedures other than circumcision filled out an online version of the questionnaire. Twenty-four participants were randomly recruited to confirm the responses of the "self-assessment of genital anatomy and sexual functioning in male" questionnaire by a clinical evaluation. MAIN OUTCOME MEASURES: The "self-assessment of genital anatomy and sexual functioning in male" questionnaire comprises of multiple-choice questions and clarifying illustrations asking men to rate their genital appearance, overall sexual sensitivity, and pain perception as well as the intensity and the effort to reach orgasm. Prespecified regions of the glans, penile shaft, scrotum, perineum, and anus are evaluated through this questionnaire. RESULTS: Only slight variability in anatomical ratings was observed. Overall discrimination between different genital areas in terms of genital sensation was significant. The bottom of the glans or frenular area was rated the highest contributor to "sexual pleasure," followed by the other regions of the glans and shaft. The same distribution was found for "orgasm intensity" and "orgasm effort." The anal region was generally rated the lowest. "Discomfort/pain" was rated lower than any of the other sensory function indicators and the top of the glans and anal region were rated most likely to perceive this unpleasant sensation. Participants reported significantly more sexual pleasure and intense orgasms when stimulated by a sexual partner than self-stimulation. Homosexual and bisexual men reported a higher contribution of the perineal and anal regions in sexual pleasure and orgasm. No significant difference between circumcised and uncircumcised individuals regarding overall genital sensation could be found. CONCLUSION: The Dutch translation of the SAGASF-M questionnaire is a valuable and reliable tool for self-assessment of genital anatomy and sensation, providing a site-specific attribution of a patient's perceived sexual function. Further prospective research with this questionnaire could aid in the patient-centered improvement of genital surgery.

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)

Comparison Between the Effect of the Information-Motivation-Behavioral (IMB) Model and Psychoeducational Counseling on Sexual Satisfaction and Contraception Method Used Under the Coercion of the Spouse in Iranian Women: A Randomized, Clinical Trial / Comparação entre o efeito do modelo Informação-Motivação-Comportamental (IMB) e o aconselhamento psicoeducacional sobre a satisfação sexual e o método contraceptivo usado sob coerção do cônjuge em mulheres iranianas: um ensaio clínico randomizado

Abstract Objective Women play an essential role in maintaining the family's health, and family planning is part of women's and families' health. The couple's mutual understanding of family planning methods is essential in selecting contraception. Acceptance of and satisfaction with different contraception methods can impact sexual satisfaction. The present study aimed to compare the effect of the information-motivation-behavioral (IMB) model and psychoeducational counseling on sexual satisfaction and contraception methods of women referring to health centers in Kerman. Methods This trial was conducted on 81 women aged 18 to 45, in Kerman health centers, from 2021 to 2022. Participants were randomly divided into 3 groups of 27 people (control, psychoeducational counseling, and IMB method). Three online counseling sessions were held for the psychoeducational group, and four were held for the IMB group. The control group received routine care. The IBM SPSS Statistics for Windows, version 22 (IBM Corp. Armonk, NY, USA) was used for data analysis using nonparametric Friedman and Kruskal-Wallis tests. Results The mean age of participants was 32.59 ± 7.04, and the majority of them had university degrees and were homemakers. The mean sexual satisfaction score significantly increased immediately after the intervention and 1 month later in the 2 interventional groups (p< 0.0). Changes in contraception methods after intervention were significant in the psychoeducational group (p= 0.0) Conclusion The results indicate the positive impact of psychological counseling on women's sexual satisfaction and contraception method. The IMB method also impacted men's sexual satisfaction but did not lead to any changes in the contraceptive method.

Resumo Objetivo A mulher desempenha um papel essencial na manutenção da saúde da família, e o planejamento familiar faz parte da saúde da mulher e da família. A compreensão mútua do casal sobre os métodos de planejamento familiar é essencial na seleção da contracepção. A aceitação e a satisfação com os diferentes métodos contraceptivos podem afetar a satisfação sexual. O presente estudo teve como objetivo comparar o efeito do modelo informação-motivação-comportamental (IMB) e aconselhamento psicoeducacional sobre a satisfação sexual e métodos contraceptivos de mulheres encaminhadas para centros de saúde em Kerman. Métodos Este estudo foi realizado em 81 mulheres de 18 a 45 anos, nos centros de saúde de Kerman, de 2021 a 2022. As participantes foram divididas aleatoriamente em 3 grupos de 27 pessoas (controle, aconselhamento psicoeducacional e método IMB). Foram realizadas três sessões de aconselhamento online para o grupo psicoeducativo e quatro para o grupo IMB. O grupo de controle recebeu cuidados de rotina. OIBM SPSS Statistics for Windows, versão 22 (IBM Corp. Armonk, NY, EUA) foi utilizado para a análise dos dados por meio dos testes não paramétricos de Friedman e Kruskal-Wallis. Resultados A média de idade das participantes foi de 32,59 ± 7,04, sendo que a maioria delas possuía nível superior e eram donas de casa. A pontuação média de satisfação sexual aumentou significativamente imediatamente após a intervenção e 1 mês depois nos 2 grupos de intervenção (p <0,0). As mudanças nos métodos contraceptivos após a intervenção foram significativas no grupo psicoeducativo (p = 0,0) Conclusão Os resultados indicam o impacto positivo do acompanhamento psicológico na satisfação sexual das mulheres e no método contraceptivo. O método IMB também impactou a satisfação sexual dos homens, mas não levou a nenhuma mudança no método contraceptivo.

Assessment of Sexual Dysfunction in Cervical Cancer Patients after Different Treatment Modality: A Systematic Review.

Background and Objectives: Cervical cancer is a leading cause of mortality among women. Chemo-radiation followed by interventional radiotherapy (IRT) is the standard of care for stage IB-IVA FIGO. Several studies have shown that image-guided adaptive IRT resulted in excellent local and pelvic control, but it is associated with vaginal toxicity and intercourse problems. The purpose of this review is to evaluate the dysfunctions of the sexual sphere in patients with cervical cancer undergoing different cervix cancer treatments. Materials and Methods: We performed a comprehensive literature search using Pub med, Scopus and Cochrane to identify all the full articles evaluating the dysfunctions of the sexual sphere. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. Results: One thousand three hundred fifty-six women included in five studies published from 2016 to 2022 were analyzed. The median age was 50 years (range 46-56 years). The median follow-up was 12 months (range 0-60). Cervical cancer diagnosis and treatment (radiotherapy, chemotherapy and surgery) negatively affected sexual intercourse. Sexual symptoms such as fibrosis, strictures, decreased elasticity and depth and mucosal atrophy promote sexual dysfunction by causing frigidity, lack of lubrication, arousal, orgasm and libido and dyspareunia. Conclusions: Physical, physiological and social factors all contribute to the modification of the sexual sphere. Cervical cancer survivors who were irradiated have lower sexual and vaginal function than the normal population. Although there are cures for reducing discomfort, effective communication about sexual dysfunctions following treatment is essential.

Sleep and sexual satisfaction in couples with matched and mismatched chronotypes: A dyadic cross-sectional study.

Chronotype can be defined as an overt expression of circadian rhythmicity in an individual that dictates tendencies towards being a morning or evening person - also referred to as 'morningness' or 'eveningness.' Chronotypes generally impact preferred bed and wake times, in addition to a range of personal and social factors. This study examined how matching/mismatching chronotypes within relationships impact sexual satisfaction and sleep quality. A sample of 32 couples (52% females, 38.3 ± 11.7 years) each completed an online survey that assessed chronotype (reduced Morningness Eveningness Questionnaire), sleep (Pittsburgh Sleep Quality Index), and sexual satisfaction (Index of Sexual Satisfaction). Partner surveys were matched to identify whether chronotypes were matching or mismatching. Couples with matched chronotypes reported greater sexual satisfaction than those with mismatched chronotypes, F(1, 58) = 19.57, p < .001. Matched couples also reported better sleep quality than couples whose chronotypes were mismatched, F(1,62) = 48.02, p < .001. The individual chronotype did not seem to impact on sleep quality or sexual satisfaction. To improve sleep quality and sexual satisfaction, strategies (e.g., circadian phase advance or delay) could be used to increase circadian alignment between members of a couple.

[Assessment of quality of sexual life in women after breast cancer treatment: about 100 cases]. / Evaluation de la sexualité chez des femmes atteintes d'un cancer du sein après traitement: à propos de 100 cas.

Breast cancer is the most common neoplastic disease in women. Several treatment strategies are used: chemotherapy, radiotherapy, surgery and hormone therapy. Each of these treatments may affect sexual health of patients in the short or long term. The purpose of our study is to assess the quality of sexual life in women after breast cancer treatment. We made a quantitative descriptive estimate of 100 sexual active patients followed up for non-metastatic breast cancer, met during their consultations with a gynaecologist at the Farhat Hached hospital in Sousse. Data collection was carried out using an information sheet and two validated scales: RSS (relation Ship and sexual) and BESAA (Body EsteemScale for adolescents and Adults) to assess the quality of sexual life and body image. The average age of patients was 53.8 years. About half of patients (48%) had impaired sexuality due to the disease. The frequency of intercourse, sexual desire and the ability to reach orgasm were decreased in 65. 45, and 54 patients, respectively. The overall score for the three body image dimensions was 49.4. Women aged between 35 and 39 years were significantly more afraid of sexual intercourse (p=0.002) and less of sexual frequency (p=0.004). Adequate and enhanced training focused on the management of women with cancer and their sexual problems and multidisciplinary approach can improve women's psychological status.

The effect of endometriosis on sexual function as assessed with the Female Sexual Function Index: systematic review and meta-analysis.

AIM: To systematically compare sexual function between non-treated women with and without endometriosis. METHODS: A systematic review was performed on PubMed/Medline, Scopus, EMBASE, Web of Science and Cochrane Library databases searching studies that analyzed sexual function (assessed with the 19-item Female Sexual Function Index [FSFI]), and dyspareunia, chronic pelvic pain and dysmenorrhea (assessed with a visual analogue scale [VAS]) in women with and with endometriosis. RESULTS: In 4 studies, non-treated women with endometriosis presented a higher risk of female sexual dysfunction (mean total FSFI score ≤ 26.55; OR = 2.38; 95% confidence interval [CI] = 1.12, 5.04). Although mean total FSFI scores were not significantly different between women with and without endometriosis (mean difference [MD] = -2.15; 95% CI -4.96, 0.67); all FSFI domain scores were significantly lower in women with endometriosis (n = 4 studies): desire (MD = -0.43; 95% CI -0.57, -0.19); arousal (MD = -0.66; 95% CI -1.15, -0.17); lubrication (MD = -0.41; 95% CI -0.79, -0.02); orgasm (MD = -0.40; 95% CI -0.73, -0.06); satisfaction (MD = -0.45; 95% CI -0.72, -0.18); and pain (MD = -1.03; 95% CI -1.34, -0.72). Women with endometriosis displayed differences (more severity) in terms of VAS scores (2 studies) for dyspareunia (MD = 1.88; 95% CI 0.38, 3.37) and chronic pelvic pain (MD = 2.92; 95% CI 1.26, 4.58); but not for dysmenorrhea. CONCLUSION: Non-treated women with endometriosis displayed altered sexual function as evidenced by lower scores in all FSFI domains, and severity of dyspareunia and chronic pelvic pain.

[Assessment of the impact of pulmonary rehabilitation on sexual activity in patients with chronic obstructive pulmonary disease]. / Evaluación del impacto sobre la actividad sexual de un programa de rehabilitación pulmonar para pacientes con enfermedad pulmonar obstructiva crónica.

BACKGROUND AND OBJECTIVE: Chronic obstructive pulmonary disease (COPD) affects life quality, and also sexual activity. Pulmonary rehabilitation (PR) is a helpful treatment in COPD patients. The aim of this study is to assess sexual activity on COPD patients, and the effect of PR over it. PATIENTS AND METHODS: Single cohort prospective study over male COPD candidates to PR. Clinical, respiratory and biochemical assessment (FSH, LH, T, and progesterone) was performed. Patients were asked to fill baseline International Index of Erectile Function (IIEF) questionnaire, and 6 months after PR. A descriptive initial analysis compared respiratory values between patients with and without sexual activity. Changes in IIEF results were assessed after PR, and satisfaction with treatment using Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). RESULTS: Between 2014 and 2016, 62 male COPD patients enlisted. Mean age: 66.5 years (SD 7.2). 52 Ex-smokers. 10 declared being sexually active (16.1%). No hormonal levels alterations. No significant differences on respiratory parameters between sexually active and non-active patients (FEV1, 6-minutes walking test, number of exacerbations, CAT score). Baseline mean IIEF values: Erectile function 8, orgasmic function 4, sexual desire 5.6, intercourse satisfaction 5.3, and overall satisfaction 4.5. After PR, significant increase in mean IIEF value: 6.1 (CI95% 1.9-10.3). Improvement was found in all domains, with statistical significance on intercourse satisfaction 0.9 (CI95% 0.2-1.6). Moderate satisfaction with treatment was achieved according to EDITS. CONCLUSIONS: Only a low percentage of COPD males included in PR is sexually active. No pulmonary differences were found between sexually active and non-active patients. PR improves sexual function, particularly intercourse satisfaction domain.

Translation and cross-cultural adaptation of the Arizona Sexual Scale (ASEX) into Portuguese / Tradução e adaptação transcultural da Arizona Sexual Scale (ASEX) para a língua portuguesa

Abstract Introduction Sexual dysfunction is common in individuals with psychiatric disorders and under psychotropic medication such as antidepressants and antipsychotics. Several scales have been developed to assess sexual function in these patients. The Arizona Sexual Scale (ASEX) is a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. We describe the translation and cross-cultural adaptation of the ASEX into the Portuguese language, with the goal of contributing to the assessment of sexual function in Portuguese-speaking psychiatric patients under treatment with psychotropic drugs. Methods The translation and cross-cultural adaptation process thoroughly followed the steps recommended by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), namely: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing, finalization, proofreading, and final version. Results The process was successfully completed and no major differences were found between the translation, reconciliation and back-translation phases, with only small adjustments being made. Conclusion The translation of the ASEX was completed successfully, following international reference guidelines. The use of these guidelines is a guarantee of a Portuguese version that is qualitatively and semantically equivalent to the original scale. This availability of this new scale version will enable studies evaluating the sexual function of Portuguese-speaking psychiatric patients. Future studies may assess the validity of the scale for Portuguese-speaking populations.

Resumo Introdução A disfunção sexual é comum em indivíduos com doenças psiquiátricas e sob o uso de medicações como antidepressivos e antipsicóticos. Várias escalas foram desenvolvidas para avaliar a função sexual desses doentes. A Arizona Sexual Scale (ASEX) é uma escala de cinco itens de avaliação que quantifica desejo sexual, excitação, lubrificação vaginal/ereção peniana, capacidade para atingir o orgasmo e satisfação com o orgasmo. Este artigo descreve o processo de tradução e adaptação transcultural da escala ASEX para a língua portuguesa, com o objetivo de contribuir para a avaliação da função sexual dos doentes medicados com fármacos psicotrópicos nos vários países onde se utiliza essa língua. Métodos A tradução e a adaptação transcultural seguiram de forma detalhada os passos recomendados pelo grupo de trabalho da International Society for Pharmacoeconomics and Outcomes Research (ISPOR), nomeadamente: preparação, tradução inicial, reconciliação, retroversão, revisão da retroversão, harmonização, teste cognitivo, revisão do teste cognitivo, finalização, leitura final e versão final. Resultados O processo foi completado com sucesso, e não foram observadas diferenças grandes entre as fases de tradução, reconciliação e retroversão, tendo sido feitos apenas pequenos ajustes. Conclusão A tradução da escala ASEX foi bem-sucedida, seguindo orientações internacionais de referência. A aplicação dessas orientações é a garantia de uma versão em língua portuguesa que é qualitativa e semanticamente equivalente à versão original da escala. A existência desta nova versão da escala permitirá estudos que avaliem a função sexual dos doentes em países nos quais se fale a língua portuguesa. Estudos futuros poderão atestar a validade da escala para essas populações.

Translation and cross-cultural adaptation of the Arizona Sexual Scale (ASEX) into Portuguese.

INTRODUCTION: Sexual dysfunction is common in individuals with psychiatric disorders and under psychotropic medication such as antidepressants and antipsychotics. Several scales have been developed to assess sexual function in these patients. The Arizona Sexual Scale (ASEX) is a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. We describe the translation and cross-cultural adaptation of the ASEX into the Portuguese language, with the goal of contributing to the assessment of sexual function in Portuguese-speaking psychiatric patients under treatment with psychotropic drugs. METHODS: The translation and cross-cultural adaptation process thoroughly followed the steps recommended by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), namely: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing, finalization, proofreading, and final version. RESULTS: The process was successfully completed and no major differences were found between the translation, reconciliation and back-translation phases, with only small adjustments being made. CONCLUSION: The translation of the ASEX was completed successfully, following international reference guidelines. The use of these guidelines is a guarantee of a Portuguese version that is qualitatively and semantically equivalent to the original scale. This availability of this new scale version will enable studies evaluating the sexual function of Portuguese-speaking psychiatric patients. Future studies may assess the validity of the scale for Portuguese-speaking populations.

First assessment of the validity of the only diagnostic criteria for postorgasmic illness syndrome (POIS).

Postorgasmic illness syndrome (POIS) is a rare condition that affects men and about which little is known. According to Waldinger and colleagues, men with POIS fulfill three or more of five preliminary diagnostic criteria regarding symptoms, time to onset, setting, duration, and spontaneous disappearance. We conducted a self-report study to assess, for the first time, the validity of these criteria. One hundred and twenty-seven men with self-reported POIS have completed the survey, making this the largest study of such men to date. Almost all respondents fulfill a majority of the criteria for POIS; a large minority fulfills all five criteria. Almost all respondents always experience symptoms after ejaculating in at least one ejaculatory setting (sex, masturbation, or nocturnal emission), though only a small majority fulfill the criterion that symptoms occur after all ejaculations because a large minority always experience symptoms in one setting but not always in another. The most common symptom cluster from the criteria, involving fatigue, irritation, and concentration difficulties, is always experienced by 80% of respondents. Median symptom severity is 8 on a 0-10 scale. While almost all men with POIS fulfill a majority of the preliminary diagnostic criteria, there is room for refining some of the criteria.

Psoriasis and male sexuality.

Since sexual satisfaction is a key factor in quality-of-life scores, the aim of this review article is to examine current knowledge concerning the impact on male sexuality of psoriasis, particularly genital psoriasis. Risk factors for sexual dysfunction, and more specifically erectile dysfunction, demonstrated to date include severity of psoriasis, genital psoriasis, psoriatic arthritis, smoking, psychological disorders (anxiety-depression), cardiovascular comorbidities and side effects of psoriasis treatments. Studies evaluating the burden of genital psoriasis on male sexuality are contradictory: while the link between genital psoriasis and global sexual functioning has been clearly established in relation to question 9 of the DLQI, discrepancies exist between the scoring systems used concerning sexual satisfaction. Finally, psoriasis patients have expressed a wish to receive more care from their dermatologist in terms of their genital psoriasis and its impact on their sexual activity.

Nexplanon Subdermal Implant: Assessment of Sexual Profile, Metabolism, and Bleeding in a Cohort of Italian Women.

OBJECTIVES: To evaluate the impact on metabolism, bleeding, and sexual function of Nexplanon, a subdermal implant. STUDY DESIGN: We recruited women (n=101) receiving the Nexplanon implant at two university centers in Italy between 2011 and 2016 into this prospective, observational, multicenter research trial. Participants completed the Interview for Ratings of Sexual Function (IRSF) and the Female Sexual Function Index (FSFI) questionnaires before and 3 and 6 months after the implant was inserted. In addition, all blood parameters were assessed at these visits. All women were given a menstrual diary card and a pictorial blood assessment chart to record daily any vaginal bleeding. RESULTS: The studied metabolic parameters remained in the normal range, showing no alarming modifications: minimal statistical reductions (in aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglycerides, and activated partial thromboplastin time) and increases (in glucose and prothrombin activity) were observed. Changes in IRSF score over 6 months showed a significant increase in pleasure, personal initiative, orgasm, intensity of orgasm, and satisfaction, and a significant decrease in anxiety and discomfort. Mean Body Mass Index decreased, and the weekly frequency of sexual intercourse increased. CONCLUSIONS: Nexplanon showed not only a lower metabolic and bleeding impact, but also important positive effects on sexual function. It expands the range of possibilities for women, 38 and couples, in the modern concepts of sexual and reproductive wellbeing.

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.

Significado de la sexualidad y el orgasmo en un grupo de mujeres profesionales / Meaning of Sexuality and Orgasm in Professional Women

Introducción La salud sexual se considera uno de los elementos de bienestar y salud general en el ser humano. Múltiples estudios asocian calidad de vida y salud corporal con la actividad sexual. Objetivo Comprender el significado de la sexualidad y el orgasmo en un grupo de mujeres profesionales. Materiales y Métodos Se realizó una investigación cualitativa con enfoque etnográfico, en la que participaron 15 mujeres profesionales con vínculo a la vida universitaria. La edad del grupo fue entre 26­58 años. Se utilizó una entrevista estructurada que permitió conocer y describir sus prácticas de sexualidad. La investigación está inscrita y aprobada en el Sistema Universitario de la Universidad de Antioquia. Resultados Las 15 entrevistadas manifestaron tener vida sexual activa y expresaron los siguientes ejes temáticos: La sexualidad significó la construcción y el reconocimiento del sí mismo para refinar el encuentro con el otro; es un espacio de relacionamiento que requiere del entendimiento mutuo, no limitado a lo coital; compartir las creencias, valores y rituales con sus parejas da una estabilidad que se traduce en una sexualidad sana. El sexo en pareja es un ejercicio de relación que genera alegría, placer y ganas de vivir. La sexualidad significa un encuentro permanente con el otro, donde la convivencia, la armonía, la posibilidad de crecer, es lo que se prodiga, como deseo y pasión; ese vínculo de pareja es un tipo de conexión que no se equipara con otras relaciones. La sexualidad es parte de la salud, es algo natural e indispensable en la vida de las personas. El orgasmo es definido como un momento de supremo placer liberador de energía, que produce éxtasis, un momento culmen donde parece juntarse la vida y la muerte. No es el fin último, ni es tan satisfactorio como el vínculo que se genera en los encuentros; el orgasmo no lo es todo y no siempre se vive con la misma intensidad. Conclusión Para las mujeres entrevistadas sexualidad implica salud, bienestar y encuentro con el otro. El orgasmo no es una condición indispensable para gozar la actividad sexual.

Introduction Sexual health is considered one of the elements of wellbeing and general health in the human being. Multiple studies associate quality of life and bodily health with sexual activity. Objective Understand the meaning of sexuality and orgasm in professional women. Materials and Methods A qualitative research with ethnographic approach was designed, in which 15 professional women with links to university life participated. The age of the group was between 26­58 years. A structured interview was used which enabled them to know and describe their sexuality practices.. The research is registered and approved in the University System of the University of Antioquia. Results The 15 interviewees had active sex life and expressed the following thematic axes: Sexuality meant the construction and recognition of the self to refine the encounter with the other; is a space of relationship that requires mutual understanding, which is not limited to the coital; sharing beliefs, values and rituals with their partners gives stability that translates into a healthy sexuality. Sex as a couple is an exercise in relationship that generates joy, pleasure, energy and the desire to live. Sexuality means a permanent encounter with the other, where coexistence, harmony, the possibility of growing, is what is lavished, as desire and passion; this link is a type of connection that is not equated with other relationships. Sexuality is part of health, is something natural and indispensable in the lives of people, which is altered by desires and concerns. Eroticism has an emotional and emotional component that makes pleasure possible. The orgasm is defined by the participants as a moment of supreme energy-releasing pleasure, which produces ecstasy, a culminating moment where life and death seem to gather together, a sensation of maximum fullness, of climax. Orgasm is not the ultimate goal, nor is it as satisfying as the bond generated in encounters; orgasm is not everything and not always lived with the same intensity. Conclusion For women interviewed sexuality implies health, well-being and encounter with the other. Orgasm is not an indispensable condition to enjoy sexual activity.

The Significance of the Female Orgasm: A Nationally Representative, Dyadic Study of Newlyweds' Orgasm Experience.

BACKGROUND: Self-reported orgasm, perception of partner's orgasm, and misperception of partner's orgasm have each been correlated with individual sexual and relationship satisfaction, but these associations have rarely included dyadic data, have not fully accounted for potentially confounding variables such as sexual communication, and have never been simultaneously studied with a nationally representative sample. AIM: To provide a more complete picture of how the orgasmic experience within the heterosexual couple influences individual and partner sexual and relationship satisfaction. METHODS: Using a nationally representative dyadic sample of 1,683 newlywed heterosexual couples, a structural equation model was estimated to test associations between husband and wife self-reported orgasm frequency, husband and wife report of the other partner's orgasm frequency, and husband and wife misperception of their partner's orgasm frequency, as correlates of relationship and sexual satisfaction. OUTCOMES: Both husband and wife completed the Couples Satisfaction Index to assess their own relationship satisfaction, and completed a sexual satisfaction instrument designed for the CREATE study. RESULTS: 87% of husbands and 49% of wives reported consistently experiencing orgasm. 43% of husbands misperceived how often their wives experienced orgasm. The final structural equation model, including sexual communication, explained moderate amounts of variance in wives' and husbands' relationship satisfaction, and a high level of variance for wives' and husbands' sexual satisfaction. Wives' relationship satisfaction was positively associated with wives' and husbands' sexual communication. Wives' sexual satisfaction was positively associated with self-reported orgasm frequency, and both wives' and husbands' sexual communication. Husbands' relationship satisfaction was positively associated with husbands' and wives' sexual communication. Husbands' sexual satisfaction was positively associated with husbands' perception of wives' orgasm frequency, and both husbands' and wives' sexual communication. CLINICAL TRANSLATION: When counseling couples, clinicians should give particular attention to the wife's orgasm experiences, to potentially help both husbands and wives have higher sexual satisfaction. STRENGTHS & LIMITATIONS: Strengths of this study include the use of a nationally representative sample and dyadic data. Limitations include cross-sectional data, and the assessment of sexual experiences only in newlywed couples. CONCLUSION: Wives' orgasm (wives' self-report of frequency and husbands' perception of frequency) has a unique positive association with sexual satisfaction, even after taking into account other aspects of the orgasm experience and sexual communication. Leonhardt ND, Willoughby BJ, Busby DM, et al. The Significance of the Female Orgasm: A Nationally Representative, Dyadic Study of Newlyweds' Orgasm Experience. J Sex Med 2018;15:1140-1148.

A Longitudinal Assessment of Associations Between Women's Tendency to Pretend Orgasm, Orgasm Function, and Intercourse-Related Pain in Different Partner Relationship Constellations.

The aim of the present study was to investigate how women's tendency to pretend orgasm during intercourse is associated with orgasm function and intercourse-related pain, using a longitudinal design where temporal stability and possible causal relationships could be modeled. The study sample consisted of 1421 Finnish women who had participated in large-scale population-based data collections conducted at two time points 7 years apart. Pretending orgasm was assessed for the past 4 weeks, and orgasm function and pain were assessed using the Female Sexual Function Index for the past 4 weeks. Associations were also computed separately in three groups of women based on relationship status. Pretending orgasm was considerably variable over time, with 34% of the women having pretended orgasm a few times or more at least at one time point, and 11% having done so at both time points. Initial bivariate correlations revealed associations between pretending orgasm and orgasm problems within and across time, whereas associations with pain were more ambiguous. However, we found no support in the path model for the leading hypotheses that pretending orgasms would predict pain or orgasm problems over a long period of time, or that pain or orgasm problems would predict pretending orgasm. The strongest predictor of future pretending in our model was previous pretending (R 2 = .14). Relationship status did not seem to affect pretending orgasm in any major way.

Prospective controlled assessment of men's sexual function changes following Holmium laser enucleation of the prostate for treatment of benign prostate hyperplasia.

OBJECTIVES: To assess how much Holmium laser enucleation of the prostate (HoLEP) is detrimental on men sexuality. METHODS: Between January and December 2013, all patients presented for BPH surgery were assessed using IIEF-15 (international index of erectile function-15) and Ej-MSHQ (ejaculatory domain-male sexual health questionnaire). Changes in men's sexuality following HoLEP in relation to control procedure were prospectively assessed. Intervention group included legible consecutive patients treated by HoLEP. Control group included legible patients presented for diagnostic cystoscopy. Changes in IIEF-15, its subdomains and Ej-MSHQ scores were compared between HoLEP group and control. RESULTS: At one year 80 and 70 subjects were included for final analysis following HoLEP and control groups, respectively. Regardless of the baseline erectile function (EF/IIEF) score, there was an increase in EF score similar to control following HoLEP (P = 0.6). However, among subjects with normal preoperative EF (score >25), in comparison with control, there was similar decline in EF score following HoLEP (P = 0.07). Regarding the orgasm domain, there was a significant reduction in orgasm perception following HoLEP in relation to control (P = 0.01). Patients reported desire changes, intercourse satisfaction and overall satisfaction scores similar to control following HoLEP. Using Ej-MSHQ score, there was no statistically significant difference between HoLEP and control groups in percentage of subjects reporting ejaculatory dysfunction at baseline. However, at 12 months, there was statistically significant more ejaculatory dysfunction reporting following HoLEP. The most common ejaculatory abnormality was volume abnormality. Orgasm perception was significantly decreased among subjects with newly reported ejaculatory dysfunction (5.3 ± 1.4 vs. 8.6 ± 1.3, P = 0.001). CONCLUSIONS: Controlled short-term assessment of HoLEP showed potential negative impact on EF in patients with normal preoperative EF. Apart from orgasm perception, sexual function changes following HoLEP were similar to control. High prevalence of postoperative ejaculatory dysfunction following HoLEP remained notable finding.

Exploring the Optimal Erectile Function Domain Score Cutoff That Defines Sexual Satisfaction After Radical Prostatectomy.

INTRODUCTION: The International Index of Erectile Function (IIEF) is the gold standard validated instrument for defining erectile function (EF) and its response to treatment. The EF domain (EFD) contains six questions and is a sensitive and specific measurement of treatment-related changes in EF. The EFD score has been widely used as a primary assessment end point for clinical trials of EF recovery after radical prostatectomy (RP). Various EFD scores have been used to define functional erections. Recently, an EFD score of at least 22 has been used as a threshold in major post-RP penile rehabilitation studies. AIM: To define the EFD score that optimally defines "functional" erections after RP. METHODS: We assessed men 24 months after RP using the IIEF and specifically analyzed the scores of the EFD and intercourse satisfaction domain (ISD). MAIN OUTCOME MEASURES: We used two questions on satisfaction (score = 0-5) and enjoyment (score = 0-5) from the ISD to classify IS (score = 0-10). We tested the following intercourse satisfaction classifications: ISD score equal to 10, ISD score of at least 8, and a score of at least 4 for the ISD questions on satisfaction and enjoyment. We used the classification that produced the largest area under the curve (AUC) using a receiver operating characteristic (ROC) curve. Then, we used a three-step process to determine the optimal EFD score cutoff using sensitivity and specificity analysis. RESULTS: One hundred seventy-eight men had an average age at RP of 58 ± 7 years and a 24-month EFD score of 20 ± 9. Sixty-four percent had complete nerve-sparing surgery, 35% had partial nerve-sparing surgery, and 1% had the nerves fully resected. Thirty-three percent had laparoscopic RP and 67% had open RP. The ROC curves produced AUCs of 0.80 (ISD score = 10), 0.85 (ISD score ≥ 8), and 0.86 (ISD scores for satisfaction and enjoyment ≥ 4; P < .001 for all comparisons). Using the IS criterion of ISD scores for satisfaction and enjoyment of at least 4 (largest AUC), the sensitivity and specificity values were 0.89 and 0.66 for an ESD score equal to 22, 0.78 and 0.71 for a score equal to 23, 0.78 and 0.80 for a score equal to 24, 0.77 and 0.82 for a score equal to 25, and 0.73 and 0.85 for a score equal to 26. The scores of 24 and 25 met the criteria outlined in the first two steps of analysis. The score of 24 was selected as the cutoff using face valid judgment and the previous literature. CONCLUSION: These data support an EFD score of 24 as a valid cutoff defining "functional" erection in men with erectile dysfunction after RP. These data are important for clinicians in counseling patients and to researchers to define inclusion criteria and treatment end points for trials of erectile dysfunction after RP. Terrier JE, Muhall JP, Nelson CJ. Exploring the Optimal Erectile Function Domain Score Cutoff That Defines Sexual Satisfaction After Radical Prostatectomy. J Sex Med 2017;14:804-809.