Sexual Function and Problematic Use of Smartphones and Social Networking Sites.

BACKGROUND: The use of social networking sites (SNS) sometimes acquires an addictive-like quality, often referred to as problematic use of SNS. This condition overlaps with problematic (addictive-like) use of smartphones, as the latter are commonly used for online social networking in addition to other activities that may gain addictive-like qualities. There is ample evidence that problematic use of smartphones and SNS is associated with poorer mental health, but research on associations with sexual function is scarce. AIM: To examine if sexual difficulties are related to problematic use of SNS and smartphones. METHODS: Data from 4 studies conducted in Portugal between October 2019 and December 2021 (analyzed for the first time) were collapsed, resulting in 946 women and 235 men providing data on sexual function and problematic use of smartphones, and in 536 women and 194 men providing data on sexual function and problematic use of SNS. Female sexual function was assessed with the Female Sexual Function Index and the Female Sexual Distress Scale - Revised (FSDS-R). Male sexual function was assessed by the International Index of Erectile Function. Problematic smartphone use was measured by the Smartphone Addiction Scale - Short Version (SAS-SV). Problematic use of SNS was measured by the Internet Addiction Scale (IAT) specifically adapted to online social networking. OUTCOMES: Participants rated their symptoms of problematic use of smartphones and SNS, as well as their sexual function. RESULTS: In women, problematic use of SNS correlated with lower sexual arousal (r = -0.22), difficulties lubricating (r = -0.13), difficulties having orgasms (r = -0.20), sexual dissatisfaction (r = -0.23), coital pain (r = -0.19), and greater sexual distress (r = 0.33). In men, problematic use of SNS correlated with lower erectile function (r = -0.26), lower desire (r = -0.17), intercourse dissatisfaction (r = -0.20), overall sexual dissatisfaction (r = -0.30), and more difficulties having orgasms (r = -0.20). For both sexes, correlations between sexual function and problematic smartphone use were in the same direction, but were generally weaker and, in most cases, become nonsignificant after controlling for problematic use of SNS. CLINICAL IMPLICATIONS: Addictive-like use of SNS might be a risk factor for sexual difficulties. STRENGTHS & LIMITATIONS: This study is innovative and well-powered to uncover associations between poorer sexual function and addictive-like use of new technologies. The lack of representativeness of the sample warrants caution. CONCLUSIONS: Problematic (addictive-like) use of SNS was associated with male and female sexual difficulties. This corroborates previous research. Fuzeiro V., Martins C., Gonçalves C, et al. Sexual Function and Problematic Use of Smartphones and Social Networking Sites. J Sex Med 2022;19:1303-1308.

Heart Rate Variability and Erectile Function in Younger Men: A Pilot Study.

Erectile dysfunction (ED) in younger men is an increasing concern. In middle aged and older men, ED was related to lower resting heart rate variability (HRV), but research in younger men is lacking. The present study examined, in a nonclinical sample of 105 men between 18 and 39 years, the association of ED with several parameters of resting HRV. Scores of the 5-item version of the International Index of Erectile Function (IIEF-5) below 22 were considered as indicating ED. Eighteen men (17.1%) reported ED (mild in 16, mild to moderate in 2). Welch's tests revealed that ED was associated with lower low-frequency power (LF), lower high-frequency power (HF), lower standard deviation of interbeat intervals, and lower standard deviation of the heart rate, which is influenced by both sympathetic and parasympathetic activity. After removing outliers, ED was unrelated to HF. In younger men, erections might be facilitated by a combination of higher parasympathetic tone and relatively higher sympathetic tone in the heart, as indicated by LF and greater standard deviation of the heart rate, a largely overlooked parameter in HRV research.

Marine-Derived Penicillium purpurogenum Reduces Tumor Size and Ameliorates Inflammation in an Erlich Mice Model.

BACKGROUND: This study addresses the antitumoral properties of Penicillium purpurogenum isolated from a polluted lagoon in Northeastern Brazil. METHODS: Ethyl Acetate Extracellular Extract (EAE) was used. The metabolites were studied using direct infusion mass spectrometry. The solid Ehrlich tumor model was used for antitumor activity. Female Swiss mice were divided into groups (n = 10/group) as follows: The negative control (CTL-), treated with a phosphate buffered solution; the positive control (CTL+), treated with cyclophosphamide (25 mg/kg); extract treatments at doses of 4, 20, and 100 mg/kg; animals without tumors or treatments (Sham); and animals without tumors treated with an intermediate dose (EAE20). All treatments were performed intraperitoneally, daily, for 15 days. Subsequently, the animals were euthanized, and the tumor, lymphoid organs, and serum were used for immunological, histological, and biochemical parameter evaluations. RESULTS: The extract was rich in meroterpenoids. All doses significantly reduced tumor size, and the 20 and 100 mg/kg doses reduced tumor-associated inflammation and tumor necrosis. The extract also reduced the cellular infiltration of lymphoid organs and circulating TNF-α levels. The extract did not induce weight loss or renal and hepatic toxic changes. CONCLUSIONS: These results indicate that P. purpurogenum exhibits immunomodulatory and antitumor properties in vivo. Thus, fungal fermentation is a valid biotechnological approach to the production of antitumor agents.

Rationalization is a suboptimal defense mechanism associated with clinical and forensic problems.

Cushman argues that "rationalization is rational." We show that there is reasonable empirical clinical and forensic psychological evidence to support viewing rationalization as a quite suboptimal defense mechanism. Rationalization has been found to be associated not only with poorer emotional development, but also with a broad range of antisocial behavior, including not only shoplifting, but also pedophilia and murder.

Interoceptive Awareness, Alexithymia, and Sexual Function.

Research in women suggests a relation between sexual difficulties and lower interoceptive awareness, the conscious perception of internal bodily states. Lower interoceptive awareness is theoretically linked to greater alexithymia, which has been related to sexual dysfunctions. Hence, we examined the relations of interoceptive awareness and alexithymia with several dimensions of sexual functioning in a nonclinical sample of both sexes. Methods: Three hundred forty Portuguese (228 women, 112 men) completed the Toronto Alexithymia Scale (TAS-20) and the Multidimensional Assessment of Interoceptive Awareness (MAIA). Women additionally completed the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R). Men additionally completed the International Index of Erectile Function (IIEF) and one question on difficulties delaying ejaculation. Greater alexithymia correlated with lesser interoceptive awareness. For women, greater alexithymia and lesser interoceptive awareness correlated with lesser arousal, lesser lubrication, more orgasm difficulties, more dissatisfaction, more pain, and more sexual distress. Higher female desire correlated with greater interoceptive awareness, but was unrelated to alexithymia. In men, lesser interoceptive awareness correlated with more difficulties delaying ejaculation, and greater alexithymia correlated with more erectile difficulties. The present investigation corroborates that awareness of emotions and internal bodily states is important for sexual functioning.

Human Papillomavirus and Coronary Artery Disease in Climacteric Women: Is There an Association?

BACKGROUND: Cardiovascular diseases are leading causes of death worldwide. Recent studies suggest that infection by some viruses, including the human papillomavirus (HPV), may increase the risk of developing atheromatous lesions on coronary arteries. However, there is a lack of data regarding the possible association between HPV infection and coronary artery disease (CAD) in women. OBJECTIVE: To investigate whether HPV infection is associated with the occurrence of CAD among climacteric women. METHODS: The presence of CAD and cervical HPV DNA was investigated in 52 climacteric women. Social and demographic variables and metabolic profiles were also investigated. RESULTS: Among 27 women with CAD, 16 were positive for HPV, whereas 11 were negative. The presence of cervical HPV was strongly associated with CAD, after adjusting for demographic variables, health and sexual behaviors, comorbidities, and known cardiovascular risk factors. HPV-positive women showed a greater likelihood of having CAD (odds ratio [OR] = 3.74; 95% confidence interval [CI]: 1.16 to 11.96) as compared with HPV-negative women, particularly those infected with high-risk HPV types (OR = 4.90; 95% CI: 1.26 to 19.08). CONCLUSION: These results support the hypothesis that HPV infection might be associated with CAD among climacteric women, though further studies are needed to investigate the mechanisms involved.

The Cyclooxigenase-2 Inhibitor Parecoxib Prevents Epidermal Dysplasia in HPV16-Transgenic Mice: Efficacy and Safety Observations.

Carcinogenesis induced by high-risk human papillomavirus (HPV) involves inflammatory phenomena, partially mediated by cyclooxigenase-2. In pre-clinical models of HPV-induced cancer, cyclooxygenase-2 inhibitors have shown significant efficacy, but also considerable toxicity. This study addresses the chemopreventive effect and hepatic toxicity of a specific cyclooxigensase-2 inhibitor, parecoxib, in HPV16-transgenic mice. Forty-three 20 weeks-old female mice were divided into four groups: I (HPV16-/-, n = 10, parecoxib-treated); II (HPV16-/- n = 11, untreated); III (HPV16+/-, n = 11, parecoxib-treated) and IV (HPV16+/-, n = 11, untreated). Parecoxib (5.0 mg/kg once daily) or vehicle was administered intraperitoneally for 22 consecutive days. Skin lesions were classified histologically. Toxicological endpoints included genotoxic parameters, hepatic oxidative stress, transaminases and histology. Parecoxib completely prevented the onset of epidermal dysplasia in HPV16+/- treated animals (0% versus 64% in HPV16+/- untreated, p = 0.027). Parecoxib decreases lipid peroxidation (LPO) and superoxide dismutase (SOD) activity and increases the GSH:GSSG ratio in HPV16+/- treated animals meaning that oxidative stress is lower. Parecoxib increased genotoxic stress parameters in wild-type and HPV16-transgenic mice, but didn't modify histological or biochemical hepatic parameters. These results indicate that parecoxib has chemopreventive effects against HPV16-induced lesions while maintaining an acceptable toxicological profile in this model.

Problematic internet use and feelings of loneliness.

Objectives: Internet addiction or problematic internet use (PIU) has been related to feelings of loneliness and social networking. Research suggests that online communication may cause loneliness. We examined if the association between PIU and loneliness is independent of lack of social support, as indicated by lack of a committed romantic relationship, poor family functioning, and lack of time to interact face-to-face due to time online. Methods: Portuguese adolescents and young adults (N = 548: 16-26 years) completed the Generalized Problematic Internet Use Scale-2, the UCLA Loneliness Scale, and the general functioning subscale of the McMaster Family Assessment Device. They also reported if they had a committed romantic relationship, and if being online did not leave them time to be with partner, spend with family and socialise face-to-face with friends. Results: Social networking was reported as among the main preferences by 90.6% of the females and 88.6% of the males. Perceived loneliness was associated with PIU independently of age and indicators of social support. Conclusions: Evolution created neurophysiological mechanisms to recognize satisfying social relationships based on sensory information and bodily feedback present in face-to-face interactions. These are greatly absent in online communication. Hence, online communication likely engenders feelings of loneliness. Keypoints Problematic internet use (PIU) has been related to loneliness and social networking. Online communication was shown to increase loneliness. Lack of romantic relationships did not explain the association of PIU with loneliness. Poorer family environment did not explain the association of PIU with loneliness. Lack of face-to-face interactions due to time online also did not explain it. Lack of adequate sensory cues and bodily feedback in online contacts might facilitate it.

Self-Transcendence, Sexual Desire, and Sexual Frequency.

Self-forgetfulness is a facet of self-transcendence characterized by tendency to experience altered states of consciousness. We examined associations of self-forgetfulness with sexual desire and frequency. Two hundred sixty-one Portuguese men and women completed the self-forgetfulness subscale of the Temperament and Character Inventory-Revised, a measure of openness to experience, and a questionnaire on desired and actual frequency of vaginal intercourse, noncoital sex, and masturbation in the past month. In simple and partial correlations controlling for openness to experience and relationship status, women's self-forgetfulness correlated with desired frequency of intercourse and noncoital sex. For men, self-forgetfulness correlated with actual frequency of intercourse and noncoital sex.

Smoking is unrelated to female sexual function.

BACKGROUND: Previous research shows that smoking status is unrelated to female sexual difficulties. However, degree of nicotine dependence has not been measured, and the assessment of sexual functioning has not specified penile-vaginal intercourse (henceforth, intercourse), which is more clearly impaired by sexual difficulties than other sexual behaviors. OBJECTIVES: To test if smoking status is associated with poorer female sexual function during intercourse, and if nicotine dependence rather than smoking status is related to poorer female sexual function. METHODS: During 2012, 129 Portuguese community women reported their smoking status, and completed the Fagerström Test for Nicotine Dependence, the Female Sexual Function Index (FSFI), and an adaptation of the FSFI to assess sexual functioning specifically during intercourse, as well as the desire thereof. RESULTS: Smokers reported higher desire for intercourse and were more likely to have actually engaged in it in the past 4 weeks. Among the coitally active women in the preceding 4 weeks, nicotine dependence correlated with lower desire for intercourse. Smoking status and nicotine dependence were unrelated to arousal, lubrication, orgasm, satisfaction, pain. CONCLUSIONS: The findings are consistent with many studies that fail to demonstrate an increased risk of sexual difficulties among female smokers. However, nicotine dependence, rather than smoking status per se, might be associated with lower libido. The results suggest the possibility of an inverse U-shaped relationship between smoking and libido with a moderate use of tobacco being associated with higher sexual desire.

Silence between words: Is solitude important for relatedness?

Chronic loneliness is a risk factor for physical and health problems, in part due to dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system. In contrast, temporary moments of positive solitude (passing good times alone and not feeling lonely) appear to have positive effects on mental health, social life, and creativity, and seems to be a buffer against loneliness. Herein, three ways of how solitude may have positive effects on health and relatedness are discussed, namely effects on enhancement of mind-wandering, interoceptive awareness, and spirituality. Solitude may facilitate (1) activation of the default mode network (DMN) underlying mind-wandering including daydreaming about other people; (2) activation of brain areas supporting interoceptive awareness; (3) deactivation of prefrontal cortex, or deactivation and decreased connectivity of the DMN, giving raise to susceptibility to spiritual experiences. The capacity to handle and enjoy solitude is a developmental process that may be difficult for many persons. Craving for social connections and external stimulation with digital technologies (e.g., internet, smartphones, social media) might be interfering with the development of the capacity for solitude and thereby increasing loneliness; this might be partly due to impaired interoceptive awareness and impaired functional mind-wandering (common in solitude). Congruently, overuse of digital technologies was associated with reduced activity, and reduced gray matter volume and density, in brain areas supporting interoceptive awareness, as well as with decreased connectivity of the DMN supporting creative insights. Solitude has been a relatively dismissed topic in neuroscience and health sciences, but a growing number of studies is highlighting its importance for well-being.

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

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

Women who prefer longer penises are more likely to have vaginal orgasms (but not clitoral orgasms): implications for an evolutionary theory of vaginal orgasm.

INTRODUCTION: Research indicates that (i) women's orgasm during penile-vaginal intercourse (PVI) is influenced by fitness-related male partner characteristics, (ii) penis size is important for many women, and (iii) preference for a longer penis is associated with greater vaginal orgasm consistency (triggered by PVI without concurrent clitoral masturbation). AIMS: To test the hypothesis that vaginal orgasm frequency is associated with women's reporting that a longer than average penis is more likely to provoke their PVI orgasm. METHOD: Three hundred twenty-three women reported in an online survey their past month frequency of various sexual behaviors (including PVI, vaginal orgasm, and clitoral orgasm), the effects of a longer than average penis on likelihood of orgasm from PVI, and the importance they attributed to PVI and to noncoital sex. MAIN OUTCOME MEASURES: Univariate analyses of covariance with dependent variables being frequencies of various sexual behaviors and types of orgasm and with independent variable being women reporting vs. not reporting that a longer than average penis is important for their orgasm from PVI. RESULTS: Likelihood of orgasm with a longer penis was related to greater vaginal orgasm frequency but unrelated to frequencies of other sexual behaviors, including clitoral orgasm. In binary logistic regression, likelihood of orgasm with a longer penis was related to greater importance attributed to PVI and lesser importance attributed to noncoital sex. CONCLUSIONS: Women who prefer deeper penile-vaginal stimulation are more likely to have vaginal orgasm, consistent with vaginal orgasm evolving as part of a female mate choice system favoring somewhat larger than average penises. Future research could extend the findings by overcoming limitations related to more precise measurement of penis length (to the pubis and pressed close to the pubic bone) and girth, and large representative samples. Future experimental research might assess to what extent different penis sizes influence women's satisfaction and likelihood of vaginal orgasm.

Prevalence of visual snow and relation to attentional absorption.

Visual snow is a condition of unclear prevalence characterized by tiny flickering dots throughout the entire visual field. It appears to result from visual cortex hyperactivity and possibly correlates with propensity to be engrossed in sensory and imaginary experiences (absorption). The prevalence and correlates of visual snow, and emotional reactions to it, were explored in the general Portuguese population with three studies with online surveys. In Study 1, 564 participants were shown an animated graphic simulation of visual snow and asked to rate how frequently they have similar percepts on a scale anchored by 0% and 100% of their waking time. They also reported their degree of distress and fascination resulting from visual snow. Absorption was measured with the Modified Tellegen Absorption Scale. 44% of respondents reported they see visual snow at least 10% of the time, and 20% reported seeing it between 80% and 100% of the time. Similar to findings in clinical samples, the frequency of visual snow correlated with tinnitus frequency and entoptic phenomena, but not with ophthalmologic problems. It was confirmed that visual snow is related to absorption. Although distress caused by visual snow was generally absent or minimal in our samples, a substantial minority (28%) reported moderate to high levels of distress. High fascination with visual snow was reported by 9%. In Studies 2 and 3, visual snow was measured by means of verbal descriptions without graphic simulation ("visual field full of tiny dots of light" and "world seen with many dots of light", respectively). The results were similar to those in Study 1, but seeing visual snow 80%-100% of the time was less frequent (6.5% in Study 2 and 3.6% in Study 3). Visual snow has been insufficiently investigated. More research is needed to uncover underlying neurophysiological mechanisms and psychological and behavioral correlates.

Vaginal orgasm is more prevalent among women with a prominent tubercle of the upper lip.

INTRODUCTION: Recent studies have uncovered multiple markers of vaginal orgasm history (unblocked pelvic movement during walking, less use of immature psychological defense mechanisms, greater urethrovaginal space). Other markers (perhaps of prenatal origin) even without obvious mechanistic roles in vaginal orgasm might exist, and a clinical observation led to the novel hypothesis that a prominent tubercle of the upper lip is such a marker. AIMS: To examine the hypothesis that a prominent tubercle of the upper lip is associated specifically with greater likelihood of experiencing vaginal orgasm (orgasm elicited by penile-vaginal intercourse [PVI] without concurrent masturbation). METHODS: Women (N = 258, predominantly Scottish) completed an online survey reporting their frequencies of various sexual activities and corresponding orgasms, age, and the prominence of the tubercle of their upper lip. Social desirability response bias was also assessed. MAIN OUTCOME MEASURES: Multivariate associations of lip tubercle prominence with vaginal orgasm (ever and past month consistency) and with orgasm by other means. RESULTS.: A prominent and sharply raised lip tubercle was associated with greater odds (odds ratio = 12.3) of ever having a vaginal orgasm, and also with greater past month vaginal orgasm consistency (an effect driven by the women who never had a vaginal orgasm), than less prominent lip tubercle categories. Lip tubercle was not associated with social desirability responding, or with orgasm triggered by masturbation during PVI, solitary or partner clitoral or vaginal masturbation, vibrator, or cunnilingus. CONCLUSIONS: The results are discussed in light of the unique nature of vaginal orgasm and the possibility of prenatal developmental influences.

The power of Dionysus-Effects of red wine on consciousness in a naturalistic setting.

There is lack of research on effects of red wine on consciousness when drank in wine bars designed to enhance the pleasurableness of the wine drinking experience. Effects of a moderate dose of red wine (≈ 40.98 g of ethanol) on consciousness were examined in a naturalistic study taking place in a wine bar located in one of the most touristic areas of Lisbon, Portugal. One hundred two participants drank in one of three conditions: alone, in dyad, or in groups up to six people. Red wine increased pleasure and arousal, decreased the awareness of time, slowed the subjective passage of time, increased the attentional focus on the present moment, decreased body awareness, slowed thought speed, turned imagination more vivid, and made the environment become more fascinating. Red wine increased insightfulness and originality of thoughts, increased sensations of oneness with the environment, spiritual feelings, all-encompassing love, and profound peace. All changes in consciousness occurred regardless of volunteers drinking alone, in dyad or in group. Men and women did not report different changes in consciousness. Older age correlated with greater increases in pleasure. Younger age correlated with greater increases in fascination with the environment of the wine bar. Drinking wine in a contemporaneous Western environment designed to enhance the pleasurableness of the wine drinking experience may trigger changes in consciousness commonly associated with mystical-type states.

Prayer as a pain intervention: protocol of a systematic review of randomised controlled trials.

BACKGROUND: Pain is a universal experience and the most common reason for seeking healthcare. Inadequate pain management negatively impacts numerous aspects of patient health. Multidisciplinary treatment programmes, including psychosocial interventions, are more useful for pain management than purely biomedical treatment alone. Recently, researchers showed increasing interest in understanding the role of spirituality/religiosity and spiritual/religious practices on pain experience, with engagement in religious practices, such as prayer, showing to positively impact pain experience in religious individuals. This systematic review will seek to summarise and integrate the existing findings from randomised controlled trials assessing the effects of prayer and prayer-based interventions on pain experience. METHODS: The systematic review procedures and its report will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Electronic searches in nine databases (Web of Science Core Collection, MEDLINE, SCIELO Citation Index, PubMed, Cochrane Central Register of Controlled Clinical Trial, PsycINFO, Scopus, LILACS and Open-SIGLE) will be performed to identify randomised controlled trials of prayer-based interventions. Two independent researchers will assess studies for inclusion and extract data from each paper. Risk of bias assessment will be assessed independently by two reviewers based on the Consolidated Standards of Reporting Trials statement. Qualitative synthesis of the body of research will be conducted using a narrative summary synthesis method. Meta-analysis will be limited to studies reporting on the same primary outcome. Formal searches are planned to start in June 2021. The final report is anticipated to be completed by September 2021. DISCUSSION: Findings will be useful to (1) understand the condition of our knowledge in this field and (2) provide evidence for prayer effectiveness in reducing pain intensity and pain-related stress and increasing pain tolerance in adults experiencing acute or chronic pain. PROSPERO REGISTRATION NUMBER: CRD42020221733.

Is There a Role for Sex Hormone Receptors in Head-and-neck Cancer? Links with HPV Infection and Prognosis.

BACKGROUND/AIM: Head-and-neck squamous cell carcinoma (HNSCC) is the fifth most common cancer in the world and human papillomavirus (HPV) is an important risk factor for this neoplasm. Recent studies showed an association between sex hormone receptors and pathogenesis and/or prognosis in patients with HNSCC. The aim of this study was to clarify the expression patterns of sex hormone receptors in HPV-positive and HPV-negative HNSCC and their associations with tumour biopathology and biological behaviour. MATERIALS AND METHODS: Scientific literature indexed in PubMed about sex hormone receptors in HNSCC was retrieved and critically analyzed, to obtain an overview of expression patterns and their possible implications for tumour biopathology and prognosis. RESULTS: Sex hormone receptors were more frequently detected in oropharyngeal tumours compared with HNSCC from other locations. ERα was associated with HPV-positive tumours. The androgen and progesterone receptors were associated with poor patient prognosis. Estrogen receptor alpha (ERα) is implicated in the biopathology of HNSCC in different ways, by promoting DNA hypermutation and facilitating HPV integration thus contributing to an immunogenic phenotype, but also by cooperating with the epithelial growth factor receptor (EGFR) to promote resistance to therapy. CONCLUSION: The expression of sex hormone receptors may be of prognostic value in specific tumour subgroups, but the use of hormonal therapies for HNSCC is still not in close sight.

Immature defense mechanisms are associated with lesser vaginal orgasm consistency and greater alcohol consumption before sex.

INTRODUCTION: Disturbances of emotional and physical awareness can impair female sexual function. Previous research revealed that immature psychological defense mechanisms (impairing emotional awareness) are associated specifically with impaired vaginal orgasm (orgasm triggered solely by penile-vaginal stimulation). Alcohol consumed before sex (ACBS) might impair vaginal orgasm or lead to avoiding the opportunity for it, but research examining immature defenses, ACBS, and specific sexual behaviors has been lacking. AIM: To test the hypothesis that greater use of immature defenses and greater ACBS are inversely associated with vaginal orgasm consistency, but unrelated or positively correlated with greater frequency of other sexual behaviors. METHODS: Three hundred twenty-three coitally experienced women (predominantly Scottish) responded to an online survey reporting their frequency of various sexual activities (and corresponding orgasms) and their ACBS, and completed the Defense Style Questionnaire DSQ-40. MAIN OUTCOME MEASURES: Univariate and multivariate correlations of immature defenses, ACBS, and various sexual behaviors. RESULTS: Both immature defenses and ACBS were associated with less vaginal orgasm consistency, but unrelated or positively correlated with frequency of other sexual behaviors (including clitoral masturbation during penile-vaginal intercourse). Immature defenses were associated with more ACBS. Immature defenses explained the association between ACBS and both lack of vaginal orgasm and greater frequency of other sexual behaviors. CONCLUSIONS: The results provide further evidence that difficulty in having a vaginal orgasm is associated with immature defenses (and associated disturbances of sensibility), among other indicators of poorer health and relatedness. ACBS might impair vaginal orgasm or increase the likelihood of choosing other sexual activities, but this effect might be somewhat contingent on immature defenses. Based on various empirical studies, we call for examination of the possibility that lack of vaginal orgasm (given an adequate man) should qualify as a female sexual dysfunction.