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

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

Age-related changes in testicular histological structure, testosterone level, libido and semen traits in male Coturnix quail.

To investigate the effect of age in male quail on testicular weight and histology, sexual libido and semen characteristics, a study was performed on 100 quails at 10, 16, 22, 28 and 34 weeks of age. The body and testicular weights were significantly (p < .05) higher at 16 and 22 than at 28 weeks of age. The circumference and diameter of the seminiferous tubules were significantly (p < .05) higher at 28 and 34 than at 10 and 16 weeks of age. Histological evaluation of testicular slices revealed advanced and effective seminiferous tubes as early as 10 weeks, while spermatogenic activity peaked at 16 weeks of age. The highest semen volume, sperm motility and sperm concentration were observed at weeks of age and then decreased gradually with age. At the same time, the testosterone level and libido were significantly (p < .05) higher at 22 than at 10 weeks of age. Furthermore, the age was positive (p < .05), correlated to seminiferous tubule circumference and diameter, and negative (p < .05), correlated to sperm concentration. In conclusion, the age of quail markedly affected the testicular histological structure, libido, testosterone level and semen characteristics.

Auditory Cues Alter the Magnitude and Valence of Subjective Sexual Arousal and Desire Induced by an Erotic Video.

Although women and men rate their subjective arousal similarly in response to "female-centric" erotic videos, women rate their subjective arousal lower than men in response to "male-centric" videos, which often end with the male's ejaculation. This study asked whether ratings of subjective sexual arousal and desire using the Sexual Arousal and Desire Inventory (SADI) would be altered if this ending was present or absent, and whether including or excluding the accompanying soundtrack would influence the magnitude and direction of the responses. A total of 119 cis-gendered heterosexual undergraduates (59 women and 60 men) viewed an 11-min sexually explicit heterosexual video that ended with a 15-s ejaculation scene. Two versions of the video were created, one with the ejaculatory ending (E+) and one without (E-). Participants were assigned randomly to view one of the two versions with (S+) or without (S-) the accompanying soundtrack, after which they completed the state version of the SADI. Women and men found both sequences without sound less arousing on the Evaluative, Motivational, and Physiological subscales of the SADI relative to the S+ sequences. However, on the Negative/Aversive subscale, women found the E + S- sequence more negative than did men, whereas this difference was not found with sound. Thus, women and men were sensitive to the auditory content of sexually explicit videos, and scenes of sexual intercourse ending with explicit ejaculation increased the Evaluative and Motivational properties of subjective sexual arousal and desire. However, this occurred in women only when the auditory cues signaled a clear and gratifying sexual interaction.

Deepening Sexual Desire and Erotic Fantasies Research in the ACE Spectrum: Comparing the Experiences of Asexual, Demisexual, Gray-Asexual, and Questioning People.

Over the past 30 years, an increasing number of people have identified within the asexual (ACE) spectrum recognizing an absence/low/situational sexual attraction to individuals of any gender. The current study aims to deepen the knowledge of sexual desire, erotic fantasies, and related emotions within the ACE spectrum. A total of 1072 Italian volunteers were recruited to take part to the present study via social media. Data were collected from October 2021 to January 2022 using the Sexual Desire and Erotic Fantasies questionnaire and the Sexual Desire Inventory-2. Participants were divided into four groups: asexual, demisexual, gray-asexual, and questioning. Focusing on sexual desire, asexual people reported significantly lower scores than the other groups in all the dimensions except for "negative feelings to sexual desire," while demisexual participants showed the higher scores in all the domains except for "negative feelings to sexual desire." The questioning group reported the highest scores in the "negative feelings toward sexual desire" compared to the asexual and demisexual ones. The asexual group reported significantly lower scores than the other groups in fantasies frequency, fantasies importance, negative emotions, and sharing and experiencing. The demisexual group showed higher frequency of romantic fantasies than the asexual and gray-asexual ones. The results showed some specific patterns of desire and fantasies among the asexual, gray-asexual, demisexual, and questioning groups. These data may provide relevant material to clinicians working with asexual patients who need greater awareness about the diversity and heterogeneity of the sexual experience within the ACE spectrum.

Testosterone replacement therapy: clinical considerations.

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

Sexual counseling for female sexual interest/arousal disorders: a randomized controlled trial based on the "good enough sex" model.

BACKGROUND: Female sexual interest/arousal disorder (FSIAD) is the most common female sexual disorder with adverse effects on women's health and interpersonal relationships. AIM: This survey evaluated the effects of sexual counseling based on the "good enough sex" (GES) model on the sexual health variables of women with FSIAD. METHODS: A randomized clinical trial with a 1:1 allocation ratio was conducted among 80 women with FSIAD in Iran in 2021. Eligible participants were randomly assigned to group A (women) and group B (couples). Women attended 4 weekly online group sexual counseling sessions based on the GES model, each lasting 120 minutes. In group B, husbands participated in sessions 2 and 3. OUTCOMES: Women's sexual health parameters-including sexual desire, sexual satisfaction, sexual function, sexual distress, sexual communication, frequency of sexual intercourse, and dysfunctional beliefs-were evaluated before and 3 months after counseling. The significance threshold considered P < .007 due to Bonferroni correction. RESULTS: After the intervention, all sexual parameters except sexual dysfunctional beliefs showed significant improvement (P < .001) in both groups. During the follow-up period, the average scores for all sexual variables were slightly higher in group B vs group A. The between-group difference was significant only for frequency of sexual intercourse (P < .01). CLINICAL IMPLICATIONS: This study reaffirms the impact of the GES model as biopsychosocial therapy in managing female sexual problems. Considering men's reluctance to accompany their wives to sex clinics, counseling for women alone can play a significant role in solving sexual problems, especially in the case of FSIAD. Online sexual consultation offers cost and time savings, provides a secure space for discussing sensitive topics, and facilitates group program coordination. It ensures universal access to counseling, thereby addressing gender incompatibility issues. It is a powerful, interactive, and acceptable alternative to in-person visits, providing convenience and confidentiality for clients seeking sexual health support. STRENGTHS AND LIMITATIONS: The following were among the survey strengths: conducting a randomized controlled trial on women with FSIAD by applying an appropriate model and scales, involving spouses, and evaluating online group sexual counseling. However, the results of this study may not be generalizable to women without partners. CONCLUSION: The GES model, emphasizing intimacy and sexual dialogue, reduces unrealistic sexual expectations and improves women's sexual desire and overall health. Our results showed that instead of insisting on the physical presence of husbands in counseling sessions, clinicians should emphasize their emotional support and companionship during the treatment process.

The Role of Dyadic Sexual Desire Similarity in Predicting Sexual Behaviors in Cohabitating Couples: An Ecological Momentary Assessment Study.

Although researchers are increasingly paying attention to the dyadic nature of sexual desire and its relevance to sexual and relational outcomes, our understanding of how sexual desire operates on a couple level and how it may influence the occurrence of sexual activity in relationships remains limited. This study used ecological momentary assessments to explore to what extent similarity in levels of desire for sex with one's sexual partner, or dyadic sexual desire, was associated with sexual initiations, receptivity to one's partner's initiations, and partnered sexual activity, and how these associations were moderated by perceived partner support. Ninety-four cohabitating couples (M age = 26.30, SD = 7.60) provided six reports a day for 10 consecutive days. We used response surface analysis to examine the associations among both the degree and direction of (dis)similarity in partners' dyadic desire and each of the three outcome variables. Our results revealed that although partners tended to experience similar levels of desire on a moment-to-moment basis, similarity in desire levels was not associated with the three outcome variables. Rather, higher desire within couples predicted each partner's behavioral outcomes. At lower levels of perceived partner support, dyadic sexual desire was negatively associated with women's receptivity to sexual initiations by their partners, indicating high context-sensitivity of women's sexual responding. These findings offer new insights into the links between the similarity in partners' levels of dyadic desire and sexual behaviors in couples, suggesting the need for increased focus on maintaining desire and promoting perceived partner support in clinical practice.

Rose Colored Glasses: An Exploration of the Relationship between Sexual Nostalgia and Sexual Satisfaction.

Sexual satisfaction contributes significantly to one's quality of life and offers a variety of mental and physical health benefits. Consequently, numerous studies have examined ways to improve sexual satisfaction. However, no research has investigated how sexual nostalgia (i.e., "the sentimental longing for or wistful reflection on past sexual memories," p. 1539) with one's current partner impacts sexual satisfaction. Thus, this program of research was designed to develop the Sexual Nostalgia Inventory, assess the relationship between sexual nostalgia and sexual satisfaction, and to examine the moderating role of romantic attachment. The results of Study One (N = 227) indicated that the content of sexual memories can be conceptualized into one factor. The results from Study Two (N = 619) revealed that sexual nostalgia was positively related to sexual satisfaction and that romantic attachment moderated these relationships. In particular, the positive association between sexual nostalgia and satisfaction was greatest for those insecurely attached (i.e., those high in anxious and avoidant attachment). These findings have important implications for researchers looking to establish the causal link between nostalgia and satisfaction and clinicians working with couples experiencing low sexual desire and/or unmet sexual needs.

A 2-week high-intensity interval training intervention improves ejaculation control among men with premature ejaculation.

BACKGROUND: Premature ejaculation (PE), which leads to substantial distress in men and their partners, is a common male sexual dysfunction worldwide. However, there is still a lack of effective treatments without side effects. OBJECTIVES: We investigated the effect of high-intensity interval training (HIIT) on PE symptoms. MATERIALS AND METHODS: We recruited 92 Chinese men aged 18-36 to complete the experiment. There were 22 (13 in the control group; 9 in the HIIT group) men diagnosed with PE and 70 (41 in the control group; 29 in the HIIT group) men with normal ejaculatory function. In the HIIT group, participants completed HIIT exercises every morning for 14 days. Participants also completed surveys inquiring about demographic information, erectile function, PE symptoms, body image (including sexual body image), physical activity, and sexual desire. The heart rate was measured before and after each HIIT. In the control group, participants were instructed not to do HIIT, but other procedures were the same as in the HIIT group. RESULTS: Results indicated that the HIIT intervention alleviated PE symptoms in men with PE. In addition, in the HIIT group, men with PE who had a higher heart-rate increase during the HIIT intervention reported the greatest overall decrements in PE symptoms. In men with normal ejaculatory function, HIIT did not decrease PE symptoms. In addition, increments in the heart rate during the intervention were associated with more pronounced PE symptoms post-intervention in this group. Analyses of secondary outcome measures suggested that the HIIT intervention improved general and sexual body image satisfaction of men with PE compared to before the intervention. DISCUSSION AND CONCLUSION: In summary, HIIT intervention may reduce PE symptoms in men with PE. The heart-rate increase during the intervention may be a key factor influencing the effect of the HIIT intervention on PE symptoms.

Androgen-based therapies in women.

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

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

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

Adaptive Calibration of Dyadic Sexual Desire Is Sex Differentiated and Disrupted by Hormonal Contraceptives.

Adaptive calibration models suggest that features of people's childhood ecologies can shape their reproductive outcomes in adulthood. Given the importance of dyadic sexual desire (i.e., desire for sex with a partner) for relationships and reproduction, we examined the extent to which people's childhood ecologies-especially the unpredictability of those ecologies-adaptively calibrate such desire. Nevertheless, because female (versus male) sexual desire is presumed to be more sensitive to situational factors, and because hormonal contraceptives alter myriad aspects of female physiology that influence female sexual desire, we predicted that adaptive calibration of dyadic sexual desire would emerge more strongly for naturally cycling females (versus females who use hormonal contraceptives and versus males). In Study 1, a total of 630 participants (159 males, 203 naturally cycling females, and 268 females using hormonal contraceptives) completed questionnaires assessing the harshness and unpredictability of their childhood ecologies as well as their sexual desire. Consistent with predictions, childhood unpredictability (but not harshness) was positively associated with dyadic (but not solitary) sexual desire among naturally cycling females (but not among females using hormonal contraceptives nor among males). Study 2, which consisted of 736 females (307 naturally cycling females, 429 females using hormonal contraceptives), replicated this pattern of results for females. These findings add to a growing literature suggesting that the instability of people's early childhood ecologies can adaptively calibrate their adult reproductive motivations and behaviors, including their dyadic sexual desire. Not only is the current finding among the first to show that some adaptive calibration processes may be sex differentiated, it further highlights that hormonal contraceptives, which alter the evolved reproductive physiology of females, may disrupt adaptive calibration processes (though such disruption may not be inherently negative).

Sexual Compliance in Finnish Committed Relationships: Sexual Self-Control, Relationship Power, and Experienced Consequences.

We studied sexual compliance (i.e., consensual engagement in partnered sexual activity despite lack of sexual desire) in committed relationships using a large Finnish sample. First, we tested if previous theories on sexual self-control and partner sexual relationship power could be extended to a Finnish setting. As little is known about the personal and relational consequences of compliance, we also explored the experienced consequences and their association with the aforementioned aspects. The convenience survey sample (n = 1,496) included individuals who were or had recently been in committed intimate relationships. As 93% of the participants were women, our analyses focused on these (64.3% heterosexual, 24.5% bisexual, 11.3% other). Sixty-five percent of women reported having complied at least once in their current or most recent relationship. Women with lower sexual self-control and higher partner sexual relationship power reported more compliance, corroborating previous research. Lower age was uniquely associated with more compliance, whereas the association between more compliance and lower education diminished when including sexual self-control and partner sexual relationship power in the regression model. Experienced consequences of compliance varied greatly among women. However, roughly two-fifths reported only negative consequences for their well-being and relationships. Fewer approach motives, more avoidance motives, lower sexual self-control, and higher partner relationship control were associated with experiencing fewer positive consequences. Our results corroborate previous studies conducted in North America, suggesting that sexual compliance is common among women in committed relationships. We suggest careful consideration in instances of compliance, considering possible negative consequences.

What Does a Pregnancy Loss Mean for Sex? Comparing Sexual Well-Being Between Couples With and Without a Recent Loss.

It is unclear whether sexual well-being, which is an important part of individual and relational health, may be at risk for declines after a pregnancy loss given the limits of prior work. Accordingly, in a cross-sectional study, we used structural equation modeling to (1) compare sexual well-being levels-satisfaction, desire, function, distress, and frequency-of both partners in couples who had experienced a pregnancy loss in the past four months (N = 103 couples) to their counterparts in a control sample of couples with no history of pregnancy loss (N = 120 couples), and (2) compare sexual well-being levels of each member of a couple to one another. We found that gestational individuals and their partners in the pregnancy loss sample were less sexually satisfied than their control counterparts but did not differ in sexual desire, problems with sexual function, nor sexual frequency. Surprisingly, we found that partners of gestational individuals had less sexual distress than their control counterparts. In the pregnancy loss sample, gestational individuals had lower levels of sexual desire post-loss than their partners but did not differ in sexual satisfaction, problems with sexual function, nor sexual distress. Our results provide evidence that a recent pregnancy loss is associated with lower sexual satisfaction and greater differences between partners in sexual desire, which may be useful information for clinicians working with couples post-loss. Practitioners can share these findings with couples who may find it reassuring that we did not find many aspects of sexual well-being to be related to pregnancy loss at about three months post-loss.

Romantic Attachment and Sexual Desire: The Role of Desire Target.

Attachment insecurities are characterized by distinct approaches to intimacy and sex, yet their roles in sexual desire remain largely unexamined. Drawing from theories of attachment and behavioral motivation, the current study investigated the role of attachment insecurities in sexual desire and how that role differs by desire target. The Sexual Desire Inventory provided both a general dyadic desire measure and a measure differentiating between partner-specific desire and desire for an attractive potential sexual partner (attractive other desire). In a sample of 321 young adults (51% men), two structural equation models (SEMs) were compared, each with attachment predicting desire: a Dyadic Combined model and a Partner Type model. Models accounted for gender, relationship status, sexual identity, racial/ethnic identity, number of previous sexual partners, and measurement error. Preliminary confirmatory factor analyses indicated adequate factor loadings (>.40) for both desire measures, yet superior fit for the partner type measure. In the SEMs, the Partner Type model outperformed the Dyadic Combined model across all indices. Attachment avoidance predicted lower partner-specific desire, yet higher attractive other desire. Attachment anxiety predicted higher partner-specific desire, yet was unrelated to attractive other desire. Findings suggest the discomfort with intimacy characterized by attachment avoidance deters interest in sex with romantic partners, yet may enhance sexual interest in nonattachment figures. Several discrepant associations across desire measures indicate that distinguishing between desire targets is critical for fully understanding individual differences in desire. Partner-specific sexual desire may be a unique experience that should not be conflated with other forms of sexual desire.

What Women Want? The State of the Art regarding the Treatment of Young Women with Hypoactive Sexual Desire Disorder.

BACKGROUND: Hypoactive sexual desire disorder (HSDD) in premenopausal women involves biological, psychological, and social aspects. In the European Society for Sexual Medicine meeting in Rotterdam in February 2023, several leading experts in the field discussed the multifaceted nature of this disorder and the state of the art regarding treatment at a round table. This review reflects the information discussed at this event and further discusses current controversies. SUMMARY: HSDD is the most prevalent female-estimated sexual disorder reported by 28% of the 40% premenopausal women with sexual dysfunction. Flibanserin and bremelanotide are the only approved medications to treat HSDD in the USA, and none are approved in Europe. Lybrido, Lybridos, and Lorexys are under development. There are several psychological factors with impact in sexual desire, including depression and sexual abuse. Feminine sexual scripts, the pleasure gap, and structural inequalities also affect sexual desire. Evidence strongly supports the value of combining medical and psychological approaches in the treatment of HSDD, but there is ongoing controversy regarding the pharmacological treatment of young women with HSDD. However, some women seem open and would like to have access to drug treatment. KEY MESSAGES: The treatment of HSDD in young women requires a mixed treatment approach that addresses the disorder's complexity. Despite clinicians seeming to be divided between using pharmacological and/or psychosocial approaches, some women might respond better to one type of intervention over the others. This calls for the development of tools that assess the best approach for each person, including their will and informed choice.

Motivation When Desire Is Low: Associations Between Sexual Motivation and Sexual Intimacy, Sexual Satisfaction, and Sexual Distress for Men with Hypoactive Sexual Desire Disorder and Their Partners.

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.

Desexualization: An interesting problem in The Ego and the Id.

The sudden appearance of the term "desexualization" in The Ego and the Id is considered as a marker of the subtle, almost unnoticeable changes that occurred in Freud's thinking after 1920. The strict dichotomy between life and death drives posed a series of new problems that force Freud to invoke a "desexualized libido" in order to restore some fluidity in the psychic apparatus. But the mechanism of desexualization was difficult to describe and Freud seems to resort to a circular explanation. In the end, the restored dialectics between Eros and the death drive, thanks to desexualization, force Freud to invoke a split in the ego itself.

Measuring Sexual Motivation as a Trait Dimension: A multisample study of the Portuguese (European) Version of the Trait Sexual Motivation Questionnaire.

The current study aimed at translating and validating the TSMQ into Portuguese-European (TSMQ-PT) and to investigate its psychometric properties. Three online studies were conducted with independent samples collected between September 2020 and March 2022. Study 1 tested the exploratory factorial structure (N = 325; 206 women); Study 2 explored the confirmatory factorial structure and construct validity (N = 450; 230 women); and Study 3 examined the temporal stability of the TSMQ-PT (N = 30; 15 women). Participants completed the TSMQ-PT for all three studies. In study 2, further completed the Sexual Compulsivity Scale, the Sexual Sensation Seeking Scale, and the Sexual Desire Inventory. Data revealed that the TSMQ-PT yielded a four-structure model, (i.e., Sexually Oriented, Comparison with Others, Seeking for Sexual Encounters, and Importance of Sex) comprising 13 items, with seven additional items for assessing existence and number of sexual partners, and frequency of sexual behaviors. The TSMQ-PT achieved good internal consistency levels (McDonald's omega ranged from .71 to .89) and construct validity, and temporal stability over 10-11 months (values ranged from .80 to .87) supporting the trait-dimension of sexual motivation. Current findings support a brief, valid, and reliable self-report instrument for assessing sexual motivation in the Portuguese context.

Disciplining the disciplined: Making sense of the gender gap that lies at the core of puritanical morals.

Because suppression of sex has been and is at the core of puritanical morals, a proper account thereof would need to explain why suppression of sex has been largely directed towards the human female. Not only do the authors not account for this pattern, but their general model would seem to predict the reverse - that is, greater suppression/control of the male libido.