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1.
Cell ; 163(3): 533, 2015 Oct 22.
Article in English | MEDLINE | ID: mdl-26496594

ABSTRACT

Flibanserin acts at cortical, limbic, hypothalamic, and brainstem nuclei to inhibit serotonin release by binding to 5-HT1A autoreceptors and block postsynaptic action of serotonin at 5-HT2A receptors. This gradually disinhibits the turnover of other monoamines like dopamine and noradrenaline that are critical for sexual desire.


Subject(s)
Benzimidazoles/therapeutic use , Serotonin Antagonists/therapeutic use , Sexual Dysfunctions, Psychological/drug therapy , Brain/metabolism , Humans , Receptors, Serotonin/metabolism , Sexual Dysfunctions, Psychological/metabolism
2.
CA Cancer J Clin ; 71(3): 250-263, 2021 05.
Article in English | MEDLINE | ID: mdl-33283888

ABSTRACT

Sexual function is a vital aspect of quality of life among adolescent and young adult (AYA) (ages 15-39 years) cancer survivors. Sexual function encompasses physical, psychosocial, and developmental factors that contribute to sexual health, all of which may be negatively impacted by cancer and treatment. However, limited information is available to inform the care of AYA cancer survivors in this regard. This scoping review, conducted by the Children's Oncology Group AYA Oncology Discipline Committee, summarizes available literature regarding sexual function among AYA cancer survivors, including relevant psychosexual aspects of romantic relationships and body image. Results suggest that, overall, AYA cancer survivors experience a substantial burden of sexual dysfunction. Both physical and psychosocial sequelae influence survivors' sexual health. Interventions to support sexual health and psychosexual adjustment after cancer treatment are needed. Collaborations between the Children's Oncology Group and adult-focused cooperative groups within the National Cancer Institute's National Clinical Trials Network are warranted to advance prospective assessment of sexual dysfunction and test interventions to improve sexual health among AYA cancer survivors.


Subject(s)
Cancer Survivors/psychology , Interpersonal Relations , Sexual Dysfunction, Physiological/epidemiology , Sexual Dysfunctions, Psychological/epidemiology , Sexual Health , Adolescent , Adult , Body Image/psychology , Humans , Orgasm , Prevalence , Quality of Life , Sexual Arousal , Sexual Dysfunction, Physiological/physiopathology , Sexual Dysfunction, Physiological/psychology , Sexual Dysfunctions, Psychological/physiopathology , Sexual Dysfunctions, Psychological/psychology , Young Adult
3.
J Sex Med ; 21(4): 288-293, 2024 Mar 28.
Article in English | MEDLINE | ID: mdl-38441520

ABSTRACT

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.


Subject(s)
Sexual Dysfunction, Physiological , Sexual Dysfunctions, Psychological , Female , Humans , Adult , Middle Aged , Adolescent , Young Adult , Aged , Male , Testosterone , Sexual Dysfunctions, Psychological/drug therapy , Sexual Dysfunctions, Psychological/epidemiology , Sexual Dysfunctions, Psychological/diagnosis , Sexual Dysfunction, Physiological/chemically induced , Premenopause , Estrogens/therapeutic use , Libido
4.
J Sex Med ; 21(6): 539-547, 2024 May 28.
Article in English | MEDLINE | ID: mdl-38582607

ABSTRACT

BACKGROUND: Models depicting sexual desire as responsive to sexual arousal may be particularly apt for women experiencing arousal or desire difficulties, and the degree to which arousal triggers desire may depend on the relationship context and desire target and timing-yet, these associations have not been directly tested among women with and without sexual interest/arousal disorder (SIAD). AIM: To assess the role of SIAD status and relationship satisfaction in the associations between genital arousal and 4 types of responsive desire. METHODS: One hundred women (n = 27 meeting diagnostic criteria for SIAD) in romantic relationships with men viewed a sexual film (pleasurable intimate depiction of oral sex and penile-vaginal intercourse) while their genital arousal was recorded via vaginal photoplethysmography (n = 63) or thermal imaging of the labia (n = 37). Partner and solitary desire was assessed immediately before and after the film (immediate desire) and 3 days later (delayed desire). OUTCOMES: Outcomes consisted of genital response (z scored by method) and associations between genital response and responsive sexual desire. RESULTS: The key difference between women with and without SIAD was not in their ability to experience genital arousal but in how their genital responses translated to responsive sexual desire. Women with SIAD actually exhibited greater genital arousal than unaffected women. Associations between genital arousal and desire were significant only for women with SIAD and depended on relationship satisfaction and desire type. For women with SIAD with low relationship satisfaction, higher arousal predicted lower immediate desire for a partner; for those with high relationship satisfaction, arousal was either positively related (vaginal photoplethysmography) or unrelated (thermal imaging of the labia) to immediate desire for a partner. Associations with other desire types were not significant. CLINICAL IMPLICATIONS: Patterns of genital arousal and partner-specific responsive desire among women affected with SIAD were indicative of an avoidance model in response to heightened genital arousal, unless relationship satisfaction was high; attending to genital arousal sensations could be a means of triggering sexual desire for women with SIAD who are satisfied in their relationships. STRENGTHS AND LIMITATIONS: This is one of the first sexual psychophysiologic studies to connect relationship factors to patterns of sexual response. The differing arousal assessment procedures and lack of official diagnosis may have attenuated results. The homogeneous sample and in-person session requirement limit generalizability. CONCLUSION: When compared with unaffected women, women affected by SIAD may exhibit stronger arousal responses with sufficiently incentivized sexual stimuli, and the connection between their genital arousal and responsive desire for their partners may be stronger and more dependent on relationship context.


Subject(s)
Libido , Photoplethysmography , Sexual Arousal , Sexual Dysfunctions, Psychological , Humans , Female , Adult , Libido/physiology , Sexual Dysfunctions, Psychological/physiopathology , Sexual Dysfunctions, Psychological/psychology , Vagina/physiopathology , Young Adult , Personal Satisfaction , Sexual Partners/psychology , Sexual Behavior/physiology , Sexual Behavior/psychology
5.
J Sex Med ; 21(2): 129-144, 2024 Jan 30.
Article in English | MEDLINE | ID: mdl-38055615

ABSTRACT

BACKGROUND: Research suggests that COVID-19 impairs sexual function in men, but little is known about the impact of COVID-19 (or long COVID) on sexual function in women. AIM: We sought to compare the sexual function of cisgender women who had never had COVID-19, who had COVID-19 but not long COVID, and who had long COVID, and assessed whether long COVID symptoms and/or emotional distress mediate the relationship between COVID-19 history and sexual function. METHODS: In total, 2329 adult cisgender women were recruited online as study participants. Half of these women reported having had COVID-19, and the other half reported never having had COVID-19. Of those who had COVID-19, 25% (n = 170) reported having long COVID. We compared the mean Female Sexual Function Index (FSFI) scores by using t-tests for each of the primary comparison categories (never COVID vs COVID and only COVID vs long COVID). Four path models were used to test the hypotheses that (1) long COVID symptoms or (2) depression, anxiety, and/or stress assessed with the subscales of the 21-item Depression, Anxiety, and Stress Scale (DASS-21) mediated the relationship between COVID-19 and sexual function. OUTCOMES: Sexual function was measured with the FSFI, long COVID symptoms were assessed using the Centers for Disease Control working symptom set, and emotional distress was measured with the DASS-21. RESULTS: In total, 1313 participants provided data suitable for analysis. The never-COVID group (n = 645, 49.1%) had higher scores on the Desire, Arousal, Lubrication, and Satisfaction subscales of the FSFI (mean [M] [SD] FSFI total Mnever COVID = 27.98 [4.84] vs MCOVID = 27.05 [5.21]) than the combined only-COVID (n = 498, 37.9%) and long-COVID (n = 170, 12.9%) groups. The FSFI subscale scores were significantly higher in the only-COVID group than in the long-COVID group for the Arousal, Lubrication, and Orgasm and lower for the Pain subscales and higher for overall sexual function (FSFI total Monly COVID = 27.49 [5.00] vs Mlong COVID = 25.77 [5.61]. None of the proposed mediation models had adequate model fit. CLINICAL IMPLICATIONS: Clinicians treating cisgender women who have COVID-19 should consider proactively discussing sexual function with their patients and offering available resources. STRENGTHS AND LIMITATIONS: In this study we used a large and diverse sample, but this sample did not include transgender or gender-diverse persons. This study was also correlational; as such, causal conclusions cannot be drawn. Further, the mechanism of action remains unexplained. CONCLUSIONS: The study findings suggest the following: (1) COVID-19 infection is associated with impaired sexual function in cisgender women, and (2) that women with long COVID experienced incrementally more impaired sexual function than women with COVID-19 who did not develop long COVID.


Subject(s)
COVID-19 , Sexual Dysfunction, Physiological , Sexual Dysfunctions, Psychological , Adult , Male , Female , Humans , Post-Acute COVID-19 Syndrome , Surveys and Questionnaires , COVID-19/complications , Sexual Dysfunction, Physiological/epidemiology , Sexual Dysfunction, Physiological/etiology , Sexual Dysfunction, Physiological/psychology , Orgasm , Sexual Behavior/psychology , Sexual Dysfunctions, Psychological/epidemiology , Sexual Dysfunctions, Psychological/etiology , Sexual Dysfunctions, Psychological/diagnosis
6.
J Sex Med ; 21(5): 452-463, 2024 Apr 30.
Article in English | MEDLINE | ID: mdl-38465848

ABSTRACT

BACKGROUND: Sexual difficulties and vaginal pain are common following treatment for breast cancer. AIM: The goal of this study was to evaluate an online mindfulness-based group sex therapy vs an online supportive sex education group therapy to address these sexual difficulties. METHODS: Breast cancer survivors (n = 118) were randomized to 1 of the 2 arms; 116 provided informed consent and completed the time 1 assessment. Treatment included 8 weekly 2-hour online group sessions. Those randomized to the mindfulness group completed daily mindfulness exercises, and those in the comparison arm read and completed exercises pertaining to sex education. OUTCOMES: Assessments were repeated at posttreatment and 6 months after the completion of the group. RESULTS: There was a main effect of treatment on primary endpoints of sexual desire, sexual distress, and vaginal pain, with all outcomes showing significant improvements, with no differential impact by treatment arm. Secondary endpoints of interoceptive awareness, mindfulness, and rumination about sex also significantly improved with both treatments, with no group-by-time interaction. CONCLUSION: Both mindfulness-based sex therapy and supportive sex education delivered in group format online are effective for improving many facets of sexual function, vaginal pain, rumination, mindfulness, and interoceptive awareness in breast cancer survivors. STRENGTHS AND LIMITATIONS: We used a randomized methodology. Future studies should seek to diversify participants. CLINICAL IMPLICATIONS: These findings highlight the need to offer similar treatments to more breast cancer survivors immediately after and in the years following cancer treatment as a means of improving survivorship quality of life.


Subject(s)
Breast Neoplasms , Cancer Survivors , Mindfulness , Psychotherapy, Group , Sex Education , Sexual Dysfunction, Physiological , Humans , Mindfulness/methods , Female , Breast Neoplasms/complications , Breast Neoplasms/psychology , Cancer Survivors/psychology , Middle Aged , Sexual Dysfunction, Physiological/therapy , Sexual Dysfunction, Physiological/etiology , Sexual Dysfunction, Physiological/psychology , Psychotherapy, Group/methods , Sex Education/methods , Adult , Sexual Dysfunctions, Psychological/therapy , Sexual Dysfunctions, Psychological/psychology , Sexual Dysfunctions, Psychological/etiology , Internet-Based Intervention
7.
J Geriatr Psychiatry Neurol ; 37(4): 263-271, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38156788

ABSTRACT

INTRODUCTION: The psychological and behavioral symptoms of dementia are frequently observed in clinical practice, and those related to sexuality are particularly challenging. However, few studies have evaluated the prevalence or factors associated with hypersexuality in patients with dementia. OBJECTIVES: This study aims to determine the prevalence of hypersexuality in patients with dementia, describe associated factors, and qualitatively report the most common presentations and treatments. METHODS: This retrospective cross-sectional study collected data from semi-structured charts of dementia patients who were followed up at a secondary care reference center between 2015 and 2019. Results: Of 552 total patients, 52 (9.3%) were hypersexual, which was associated with male sex (P < .000; OR 2.95, 95% CI 1.73-5.01), frontotemporal dementia (P < .007), alcohol use (P < .015; OR 2.35, 95% CI 1.16-4.73) and tobacco use (P < .000; OR 2.88, 95% CI 1.61-5.13). CONCLUSIONS: Although our findings were similar to the literature, their significant variability reflects the limited and low quality of the available evidence and a lack of standardization regarding terminology, definitions, and diagnostic criteria for hypersexuality.


Subject(s)
Dementia , Humans , Male , Cross-Sectional Studies , Retrospective Studies , Female , Aged , Prevalence , Dementia/epidemiology , Aged, 80 and over , Sexual Dysfunctions, Psychological/epidemiology , Sexual Dysfunctions, Psychological/psychology , Middle Aged , Frontotemporal Dementia/epidemiology , Frontotemporal Dementia/psychology , Sexual Behavior/psychology , Sex Factors
8.
Neurourol Urodyn ; 43(4): 977-990, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38501372

ABSTRACT

OBJECTIVE: To determine the burden and identify correlates of female sexual dysfunction (FSD) among women with prediabetes (PreD) and type 2 diabetes (T2D) enrolled in the Diabetes Prevention Program (DPP) Outcomes Study (DPPOS). METHODS: The DPPOS visit included the Female Sexual Function Index (FSFI) to determine sexual function. Of 1464 participants, 1320 (90%) completed the (FSFI) and 426 were sexually active. A backward selection multivariable logistic regression model estimated the odds of FSD for sociodemographic, clinical, and diabetes-related covariates. RESULTS: One hundred and eighty-five (43%) had a score of ≤26.55 and met the criteria for FSD. After adjustment for DPP treatment and age, urinary incontinence (UI) (odds ratio [OR] = 1.91, 95% confidence interval [CI] = 1.15-3.17) and hysterectomy (OR = 1.89, 95% CI = 1.01-3.53) were associated with increased odds of FSD. Increased body mass index was protective for FSD (OR = 0.93 per kg/m2, 95% CI = 0.89-0.96). Michigan Neuropathy Screening Instrument-based peripheral neuropathy (mean±SD scores 1.1±1.3 vs. 0.9±1.1, p < 0.0001) and Electrocardiogram (ECG)-based autonomic dysfunction measures (mean ± SD heart rate levels 64.3 ± 6.8 vs. 65.6 ± 10.2, p = 0.008) were associated with FSD. There were no differences in diabetes rates between women who did (66.5%) and did not (66%) have (p = 0.7). CONCLUSIONS: FSD is prevalent in women with PreD and T2D. Our findings suggest that FSD is associated with neuropathic complications commonly observed in PreD and T2D.


Subject(s)
Diabetes Mellitus, Type 2 , Sexual Dysfunction, Physiological , Sexual Dysfunctions, Psychological , Humans , Female , Diabetes Mellitus, Type 2/complications , Prevalence , Surveys and Questionnaires , Sexual Dysfunctions, Psychological/epidemiology
9.
J Sex Marital Ther ; 50(5): 607-626, 2024.
Article in English | MEDLINE | ID: mdl-38650453

ABSTRACT

With growing interest in developing digital health tools for treating sexual dysfunction, this pilot study aimed to determine feasibility and gather preliminary efficacy data of a self-led online mindfulness intervention in comparison to an online psychoeducational intervention for women's low sexual desire in a community sample (N = 57). After a four-week intervention, participants showed overall improvements on sexual functioning, orgasm, sexual self-pleasure, sexual self-image, and sexual distress, in both treatment arms. Majority completed assigned homework and felt the intervention enhanced their sexual well-being. This study supports the feasibility of a self-led online mindfulness intervention that could help inform future programs.


Subject(s)
Libido , Mindfulness , Sexual Dysfunctions, Psychological , Humans , Female , Mindfulness/methods , Adult , Sexual Dysfunctions, Psychological/therapy , Sexual Dysfunctions, Psychological/psychology , Pilot Projects , Middle Aged , Internet-Based Intervention
10.
J Sex Marital Ther ; 50(4): 542-553, 2024.
Article in English | MEDLINE | ID: mdl-38482856

ABSTRACT

Hypoactive sexual desire dysfunction (HSDD) is prevalent among women. This retrospective cohort study aimed to verify the results of the strategies used by Gynecologists and Obstetricians (Ob-gyn) residents in the management of female HSDD. For this, we conducted a data collection of patient medical records of women with HSDD from the Human Sexuality Studies outpatient clinic of the Human Reproduction Center, Department of Gynecology and Obstetrics of FMRP-USP, from 2005 to 2019. Among the 437 women included, 361 (82.6%) answered the question concerning the effect of the protocol to which they were submitted, whereas 234 (64.8%) reported improvements in sexual desire. The univariate model showed that patients without chronic pelvic pain were 19.0% less likely to report improvements in HSDD than those with chronic pelvic pain (p = 0.03). Patients without depression and without orgasmic dysfunction were, respectively 32% and 23% more likely to show improvements in their HSDD than those who had depression or orgasmic dysfunction (respectively p = 0.001, p = 0.008). However, the multivariate model did not identify any associations. The assistance regarding HSDD by the Ob-gyn resident in training to deal with female sexual complaints may be effective in improving sexual complaints.


Subject(s)
Sexual Dysfunctions, Psychological , Sexual Health , Humans , Female , Sexual Dysfunctions, Psychological/therapy , Adult , Retrospective Studies , Women's Health , Gynecology , Middle Aged , Libido , Sexual Dysfunction, Physiological/therapy , Obstetrics , Pelvic Pain/therapy
11.
J Sex Marital Ther ; 50(1): 105-120, 2024.
Article in English | MEDLINE | ID: mdl-37771315

ABSTRACT

Sexual aversion disorder (SAD) is a chronic condition that impacts sexual and psychological well-being. However, the relevance of SAD as a discrete disorder remains highly debated. This study aimed to clarify the status of SAD as either a distinct disorder or a trans-diagnostic symptom shared among sexual dysfunctions. This cross-sectional study used a latent class analysis approach among a Canadian community sample (n = 1,363) to identify how patterns of SAD symptoms (i.e., sexual fear, disgust, and avoidance) emerge across different spheres of sexual functioning (i.e., desire and arousal, erection or lubrication, genito-pelvic pain, and orgasm) and examine sociodemographic and psychosexual correlates of the identified classes. Examination of fit indices suggested four classes: Sexually functional, Impaired desire and responsiveness, Sexual aversion, and Comorbid sexual dysfunctions. Sexual aversion class members were more likely to be single, had experienced sexual assault in adulthood, and report lower levels of sexual satisfaction and psychological well-being, compared to Sexually functional class members. Results suggest that SAD is a distinct clinical syndrome, while its symptoms may co-occur with other sexual dysfunctions. To ensure that the needs of people with SAD are met with tailored treatment options, future nosography might consider reclassifying SAD as a specific disorder.


Subject(s)
Sexual Dysfunction, Physiological , Sexual Dysfunctions, Psychological , Humans , Cross-Sectional Studies , Latent Class Analysis , Canada/epidemiology , Sexual Dysfunctions, Psychological/diagnosis , Sexual Dysfunctions, Psychological/psychology , Sexual Behavior/psychology , Sexual Dysfunction, Physiological/diagnosis , Sexual Dysfunction, Physiological/psychology , Surveys and Questionnaires
12.
J Sex Marital Ther ; 50(1): 94-104, 2024.
Article in English | MEDLINE | ID: mdl-37787027

ABSTRACT

Several questionnaires have been developed to evaluate female sexual dysfunction (FSD) and sexual health problems. However, there is a lack of validated versions of these questionnaires in Arabic. One of the most used instruments is the female version of The Sexual Dysfunctional Beliefs Questionnaire (SDBQ). The current study aimed to validate an Arabic version of the SDBQ. The Arabic version of SDBQ-Female was incorporated into an online questionnaire using and distributed among Jordanian Facebook groups and women-only groups. Factor analysis was performed to investigate evidence for the validity of the questionnaire. 530 females (mean age 30 years, SD = 9) completed the questionnaire. Principal component analysis produced the final model composed of 24 items distributed across four factors: Sexual Desire & Pleasure, Affection Primacy, Sexual Conservatism and Age-Related Beliefs. Confirmatory factor analysis was conducted, and fit indices were acceptable (CMIN/DF = 2.52, GFI = 0.91, AGFI = 0.89, CFI = 0.90, SRMR = 0.05 and RMSEA = 0.05). Income level and marital status both influenced FSD beliefs, with higher scores associated with higher income and being single. The Arabic version of the SDBQ-female demonstrated evidence of validity and reliability. Additional research is necessary to explore beliefs related to FSD within an Arabic context.


This study provides evidence for the validity and reliability of an Arabic questionnaire for assessing female sexual dysfunction (FSD) among Jordanian women recruited through Facebook. Women's income level and marital status influenced their FSD beliefs. Further research is needed to explore these beliefs in an Arabic context.


Subject(s)
Sexual Dysfunction, Physiological , Sexual Dysfunctions, Psychological , Humans , Female , Adult , Sexual Dysfunctions, Psychological/diagnosis , Reproducibility of Results , Sexual Dysfunction, Physiological/diagnosis , Surveys and Questionnaires , Factor Analysis, Statistical , Psychometrics
13.
J Sex Marital Ther ; 50(5): 595-606, 2024.
Article in English | MEDLINE | ID: mdl-38685854

ABSTRACT

Unwanted sexual contact (USC) is common in women, and may contribute to sexual dysfunction via avoidance coping techniques. Mindfulness-based treatments, which directly challenge avoidance, have been shown to be effective in treating sexual dysfunction, however, it is not yet clear whether there are differences in trait mindfulness between women with and without a history of USC. We used data from four previous studies and compared trait mindfulness on the Five Facet Mindfulness Questionnaire (FFMQ) in women with and without a history of USC. There were no significant differences between the USC and no-USC groups on total FFMQ score, nor on most individual domain scores; however, significant group differences were found on observe and acting with awareness subscales. We speculate on the possible meaning of the USC group having higher observe scores and lower acting with awareness scores compared to the no-USC group.


Subject(s)
Mindfulness , Humans , Female , Adult , Surveys and Questionnaires , Young Adult , Sexual Behavior/psychology , Sexual Partners/psychology , Sexual Dysfunctions, Psychological/psychology , Sexual Dysfunctions, Psychological/therapy , Middle Aged , Adaptation, Psychological
14.
J Sex Marital Ther ; 50(5): 627-637, 2024.
Article in English | MEDLINE | ID: mdl-38651313

ABSTRACT

Not all women experiencing pelvic floor complaints and sexual function problems seek help in pelvic physical therapy practice. Decisions to seek help can result from explicit and implicit cognitive processes. Having found some explicit predictive factors for receiving help in this setting, this study examines possible complementary implicit associations between sexual function problems and pursuing help that might also be predictive. The Pursuing Help for Sexual Problems Implicit Association Test (PHSP-IAT) was specially developed for this purpose. The instrument's reliability and validity were evaluated. High reliability was found (Spearman's Rho = .95). Convergent and divergent validity analyses resulted in low and non-significant correlations between the PHSP-IAT and the chosen self-report measures. The PHSP-IAT was predictive for receiving help in pelvic physical therapy practice. Further research is necessary to determine the PHSP-IAT's validity and its predictive value in other healthcare settings.


Subject(s)
Psychometrics , Sexual Dysfunction, Physiological , Humans , Female , Reproducibility of Results , Sexual Dysfunction, Physiological/psychology , Sexual Dysfunction, Physiological/therapy , Adult , Middle Aged , Sexual Dysfunctions, Psychological/psychology , Sexual Dysfunctions, Psychological/therapy , Pelvic Floor Disorders/psychology , Surveys and Questionnaires/standards , Patient Acceptance of Health Care/psychology , Physical Therapy Modalities
15.
J Sex Marital Ther ; 50(4): 439-455, 2024.
Article in English | MEDLINE | ID: mdl-38288968

ABSTRACT

Psoriasis is a chronic disease, involving skin and joints, characterized by inflamed lesions. Psoriasis negatively impacts the patients' quality of life due to the physical, emotional, and social burden that accompanies this condition. Also, psoriasis is associated with a number of psychiatric comorbidities, including sexual dysfunctions. The present study investigates the variables associated with sexual functioning in psoriasis patients. One-hundred-three psoriasis patients and 101 matched control subjects took part in the present study. Each participant completed five self-report measures investigating the presence of depression, anxiety and stress symptoms, body image, quality of life, and sexual experience. Our results show that differences in sexual activity, but not in sexual functioning, emerged between groups. In men with psoriasis, more sexual difficulties were associated with more negative automatic thoughts about sexuality. In women, more sexual difficulties were associated with more negative automatic thoughts; anxiety, depression, and stress; severity of symptoms; comorbid disease; age; quality of life. Our findings expand the current knowledge about sexual functioning in psoriasis and shed light on specific cognitive, psychological, and demographic variables associated with sexual impairment in men and women with psoriasis.


Subject(s)
Body Dissatisfaction , Psoriasis , Quality of Life , Sexual Dysfunctions, Psychological , Humans , Male , Psoriasis/psychology , Psoriasis/complications , Female , Adult , Middle Aged , Quality of Life/psychology , Sexual Dysfunctions, Psychological/psychology , Body Dissatisfaction/psychology , Sexual Behavior/psychology , Sexual Dysfunction, Physiological/psychology , Depression/psychology , Anxiety/psychology , Body Image/psychology
16.
Arch Sex Behav ; 53(3): 1075-1089, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38114871

ABSTRACT

Hypoactive sexual desire disorder (HSDD) in men, characterized by chronically low sexual desire, is associated with poor sexual well-being, such as lower sexual satisfaction and higher sexual distress. Additionally, despite their low desire, men with HSDD often report wanting sexual intimacy and validation within their sexual lives/relationships. Studies that apply self-determination theory to sexual relationships demonstrate that adopting more autonomous (e.g., engaging in sex for its inherent pleasure) and less controlled (e.g., engaging in sex for some external reward or consequence) motives for engaging in sex is associated with greater sexual well-being for both members of the couple. Given that autonomous motivation in relationships is associated with intimacy and sexual satisfaction, and lower sexual distress, having sex for autonomous reasons may allow men with HSDD and their partners to feel more sexually intimate despite their lower sexual desire, whereas having sex for controlled reasons may hinder sexual intimacy and satisfaction and augment sexual distress. In this dyadic cross-sectional study, we examined the associations between types of sexual motivation and sexual intimacy, sexual satisfaction, and sexual distress for men with HSDD and their partners (n = 64 couples). Men with HSDD who reported having sex for more autonomous reasons reported more sexual satisfaction and both partners reported more sexual intimacy. Men with HSDD who had sex for more controlled reasons had partners who felt less sexual intimacy and satisfaction, and both partners were more sexually distressed. Promoting autonomous sexual motivation and decreasing controlled motivation may help couples navigating HSDD to feel closer in their relationship, more sexually satisfied, and less sexually distressed.


Subject(s)
Motivation , Sexual Dysfunctions, Psychological , Male , Humans , Orgasm , Cross-Sectional Studies , Sexual Behavior , Sexual Partners , Libido
17.
Arch Sex Behav ; 53(6): 2141-2158, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38594464

ABSTRACT

Problematic sexual arousal (PSA) is an umbrella term to describe a range of clinical presentations related to excessive sexual thinking (e.g., sexual preoccupation) and sexual behavior (e.g., hypersexuality). Although such concepts are known to affect sexual recidivism among individuals convicted of sexual offences, PSA is not routinely or directly targeted in offending behavior programs in England and Wales. However, in recent years, there have been moves to incorporate pharmacological interventions for addressing this among people with sexual offence histories. Although some work to understand the experiences of those taking SSRI medication for this purpose has emerged, little is known about the experiences of service users taking anti-androgen medication. In this study, we interviewed all individuals in prison taking anti-androgens for the treatment of problematic sexual arousal following convictions for sexual offences in England at the time of data collection (N = 10). Using a phenomenologically oriented thematic analysis, we established themes pertaining to "Differing needs: Motivations for treatment," "Medication as a risk management strategy," and how the medication helped the men in their pursuit of "Discovering a 'new me'." This work contributes important knowledge to inform the development of ethical and effective prescribing of anti-androgen medication with this population and offer recommendations for both future research and the development of clinical practice.


Subject(s)
Androgen Antagonists , Sex Offenses , Humans , Male , Adult , Androgen Antagonists/therapeutic use , England , Sex Offenses/psychology , Middle Aged , Sexual Arousal , Sexual Behavior/psychology , Sexual Dysfunctions, Psychological/psychology , Sexual Dysfunctions, Psychological/drug therapy , Prisoners/psychology , Criminals/psychology
18.
Arch Sex Behav ; 53(6): 2277-2290, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38589743

ABSTRACT

Among the multiple controversies surrounding hypersexuality is the important issue of whether it constitutes a univocal construct. Although an initial study supported its homogeneity, more resent research has identified two separate subcomponents-problematic sexuality and sexual drive. The present survey study addressed this issue in a sample that included both in-person tested college students (n = 69) and online respondents (n = 339). A factor analysis of scales attempting to capture the indicators of each subcomponent of hypersexuality yielded two correlated, but separate factors. Whereas Problematic Sexuality (PS) comprised scales measuring sexual compulsivity, using sex as a coping mechanism, and the negative consequences of sexual behavior, Sexual Drive (SD) was defined by frequent sexual activity, preoccupation with sexual fantasies, a predilection for impersonal sexual behavior, and facile sexual arousal. These two subcomponents of hypersexuality were found to covary with different types of impulsivity, further supporting their discrimination and providing external validation for their differentiation. Contrary to a priori hypotheses, however, PS correlated highly with Callous/Manipulative/Risk-Taking as well as with a predicted Affective Instability/Behavioral Disinhibition factor, suggesting that PS may constitute an equifinality of separate developmental trajectories for those high on both subtypes of hypersexuality.


Subject(s)
Impulsive Behavior , Sexual Behavior , Humans , Male , Female , Sexual Behavior/psychology , Adult , Surveys and Questionnaires , Adolescent , Young Adult , Sexual Dysfunctions, Psychological/psychology , Factor Analysis, Statistical , Compulsive Behavior/psychology , Students/psychology
19.
Acta Derm Venereol ; 104: adv35107, 2024 Jun 11.
Article in English | MEDLINE | ID: mdl-38860625

ABSTRACT

Atopic dermatitis is a prevalent skin condition that affects up to 17% of adult population. It can lead to itching, pain, and other symptoms such as sleep disturbance, anxiety, and depression. Due to its high prevalence and limiting symptoms, atopic dermatitis often has a great impact on patients' quality of life but there is scarce information regarding how atopic dermatitis affects women's sexual health and reproductive desires. The purpose of this article was to assess the impact of atopic dermatitis on sexual function and reproductive wishes in women. A cross-sectional study was conducted from February to March 2022. A total of 102 women with atopic dermatitis were recruited through online questionnaires sent through the Spanish Atopic Dermatitis Association; 68.6% of the patients acknowledged impairment in sexual function, especially those with more severe disease and those with genital and gluteal involvement. In addition, 51% of the women considered that atopic dermatitis may have an influence on their gestational desire, particularly those with gluteal involvement. In conclusion, atopic dermatitis has a great impact on sexual function and reproductive desires in women.


Subject(s)
Dermatitis, Atopic , Quality of Life , Sexual Dysfunction, Physiological , Humans , Female , Dermatitis, Atopic/psychology , Dermatitis, Atopic/epidemiology , Adult , Cross-Sectional Studies , Sexual Dysfunction, Physiological/psychology , Sexual Dysfunction, Physiological/epidemiology , Sexual Dysfunction, Physiological/physiopathology , Middle Aged , Young Adult , Sexual Dysfunctions, Psychological/psychology , Sexual Dysfunctions, Psychological/epidemiology , Surveys and Questionnaires , Sexual Behavior , Libido , Severity of Illness Index , Sexual Health
20.
BMC Psychiatry ; 24(1): 358, 2024 May 14.
Article in English | MEDLINE | ID: mdl-38745327

ABSTRACT

BACKGROUND: While some evidence suggests that l-arginine may improve sexual function and alleviate depression, it has not been investigated in women with depression to assess both its effects on the depression and sexual function concurrently. METHODS: Patients who had received a diagnosis of major depressive disorder, as determined by predetermined inclusion and exclusion criteria, were enrolled in this triple-blind clinical trial. Patients were divided into two groups: group A, received L-arginine 1 gram twice daily, and group B, received a placebo for four weeks. They were evaluated at baseline, after four and eight weeks with the Hamilton Depression Rating Scale (HDRS), and Rosen's questionnaire or Female Sexual Function Index (FSFI). RESULTS: A decrease in the severity of depression was observed in all patients, which was determined due to Hamilton's questionnaire (P-value < 0.001). During the time in group A, FSFI increased. Based on the FSFI questionnaire, they had improvement in some domains, including the lubrication index and orgasm index, which significantly changed in the eighth week compared to the baseline (P-value < 0.05). However, these two indicators did not change statistically significantly compared to the placebo group. CONCLUSION: L-arginine supplementation can improve sexual function, particularly lubrication and orgasm, and mood in women with depression, with minimal side effects observed. Additional research is necessary to validate these results by examining the effects of higher dosages, extended durations, and larger populations of depressed patients. TRIAL REGISTRATION: Iranian Registry of Clinical Trial: IRCT20100127003210N26.


Subject(s)
Arginine , Depressive Disorder, Major , Humans , Female , Depressive Disorder, Major/drug therapy , Arginine/therapeutic use , Adult , Sexual Dysfunction, Physiological/drug therapy , Middle Aged , Sexual Dysfunctions, Psychological/drug therapy , Double-Blind Method , Treatment Outcome , Sexual Behavior/drug effects
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