Successful Multidisciplinary Management of Foot Pain With Orgasm: A Case Report.

INTRODUCTION: There is very little literature on referred pain syndromes with orgasm. Referred foot pain with orgasm is rare and evidence based diagnosis and management is not defined. Dysorgasmia is a pain condition that can severely affect sexual health and quality of life. AIM: To add to the understanding and scant literature on referred orgasmic pain with pelvic floor and myofascial etiology. METHODS: A 34-year-old cis-female presented to a Physiotherapist, Sexual Medicine Physician, and Sex Therapist with a rare case of new insidious onset right foot pain with orgasm. RESULTS: Femoral nerve entrapment was diagnosed at the level of the inguinal ligament, referring pain to the right terminal sensory branch of the saphenous nerve along the medial aspect of the foot. Physiotherapy management resolved the patient's pain, while medical assessment was important to rule out numerous potential pathologies and to facilitate multidisciplinary management. Psychological therapy via sex therapy was integral in the highly successful and improved sexual outcome for this patient and her husband. CONCLUSION: This case report details the successful multi-disciplinary assessment and management of a rare dysorgasmia and the importance of addressing sexual sequelae to add to the small amount of literature on difficult referred pain syndromes during sexual arousal and orgasm. Meddings K , Klein C, Elliott S, Successful Multidisciplinary Management of Foot Pain With Orgasm: A Case Report. Sex Med 2022;10:100499.

Effects of carrier agents on powder properties, stability of carotenoids, and encapsulation efficiency of goldenberry (Physalis peruviana L.) powder produced by co-current spray drying.

Maltodextrin, modified starch, inulin, alginate, gum arabic, and combinations thereof were used as carrier agents for spray drying of carotenoid-rich goldenberry (Physalis peruviana L.) juice and compared to cellobiose as an alternative carrier. Powders were analyzed with respect to particle size and morphology, yield, moisture content, cold water solubility, suspension stability, hygroscopicity, carotenoid encapsulation efficiency, and carotenoid retention during storage. A high initial carotenoid concentration after spray drying, a high encapsulation efficiency of 77.2%, and a slow carotenoid degradation kinetics favored the high carotenoid content of the cellobiose powder at the end of the storage. Cellobiose might protect the carotenoids from degradation processes by light exposure, high temperature, and oxygen due to a tighter particle crust and larger particle sizes. Therefore, cellobiose may be considered a potential carrier agent for the encapsulation of carotenoid-rich fruit juices.

Women's Postpartum Sexual Health Program: A Collaborative and Integrated Approach to Restoring Sexual Health in the Postpartum Period.

The postpartum period presents unique challenges to couples' relationships and sexuality, yet these factors are often left unaddressed by health care providers. The Women's Postpartum Sexual Health Program (WPSHP), a four-session, group- and couples-based program delivered by an interdisciplinary care team at a family practice center, was designed specifically to address common concerns among postpartum women and their partners. The interrelated, biopsychosocial aspects of women's sexuality in the postpartum period are summarized, followed by a detailed description of the WPSHP content and structure. This information is intended to serve as a practical resource for implementation and adaptation of the WPSHP across different practice settings.

A treatment-oriented typology of self-identified hypersexuality referrals.

Men and women have been seeking professional assistance to help control hypersexual urges and behaviors since the nineteenth century. Despite that the literature emphasizes that cases of hypersexuality are highly diverse with regard to clinical presentation and comorbid features, the major models for understanding and treating hypersexuality employ a "one size fits all" approach. That is, rather than identify which problematic behaviors might respond best to which interventions, existing approaches presume or assert without evidence that all cases of hypersexuality (however termed or defined) represent the same underlying problem and merit the same approach to intervention. The present article instead provides a typology of hypersexuality referrals that links individual clinical profiles or symptom clusters to individual treatment suggestions. Case vignettes are provided to illustrate the most common profiles of hypersexuality referral that presented to a large, hospital-based sexual behaviors clinic, including: (1) Paraphilic Hypersexuality, (2) Avoidant Masturbation, (3) Chronic Adultery, (4) Sexual Guilt, (5) the Designated Patient, and (6) better accounted for as a symptom of another condition.

Perceived prevalence and definitions of sexual dysfunction as predictors of sexual function and satisfaction.

Evidence for the influence of sexual beliefs on sexual functioning and satisfaction has mainly emanated from clinical lore. Empirical investigations on this topic remain sparse. This study investigated whether beliefs regarding prevalence and definitions of male and female sexual dysfunctions predicted sexual function and satisfaction in a sample of 131 undergraduate students. Results indicated that higher perceived prevalence of male and female sexual dysfunctions was predictive of lower sexual functioning and poorer sexual satisfaction in women. For the male participants, none of the examined sexual beliefs emerged as significant predictors of their sexual functioning or satisfaction. Surprisingly, it was also found that participants estimated the prevalence of female sexual dysfunctions to be higher than male sexual dysfunctions, while defining male sexual dysfunctions more broadly than female sexual dysfunctions. Possible mechanisms for the findings are provided.

Circulating endocannabinoid concentrations and sexual arousal in women.

INTRODUCTION: Several lines of evidence point to the potential role of the endocannabinoid system in female sexual functioning. These include results from studies describing the subjective effects of exogenous cannabinoids on sexual functioning in humans and the observable effects of exogenous cannabinoids on sexual functioning in other species, as well as results from studies investigating the location of cannabinoid receptors in the brain and periphery, and the effects of cannabinoid receptor activation on neurotransmitters implicated in sexual functioning. While these lines of research suggest a role for the endocannabinoid system in female sexual functioning, no studies investigating the relationship between concentrations of endogenous cannabinoids (i.e., arachidonoylethanolamide [AEA] and 2-arachidonoylglycerol [2-AG]) and sexual functioning have been conducted in any species. AIM: To measure circulating endocannabinoid concentrations in relation to subjective and physiological indices of sexual arousal in women (N = 21). METHODS: Serum endocannabinoid (AEA and 2-AG) concentrations were measured immediately prior to, and immediately following, viewing of neutral (control) and erotic (experimental) film stimuli in a repeated measures design. Physiological sexual arousal was measured via vaginal photoplethysmography. Subjective sexual arousal was measured both continuously and noncontinuously. Pearson's correlations were used to investigate the relationships between endocannabinoid concentrations and sexual arousal. MAIN OUTCOME MEASURES: Changes in AEA and 2-AG concentrations from pre- to post-film and in relation to physiological and subjective indices of sexual arousal. RESULTS: Results revealed a significant relationship between endocannabinoid concentrations and female sexual arousal, whereby increases in both physiological and subjective indices of sexual arousal were significantly associated with decreases in AEA, and increases in subjective indices of sexual arousal were significantly associated with decreases in 2-AG. CONCLUSIONS: These findings support the hypothesis that the endocannabinoid system is involved in female sexual functioning, with implications for furthering understanding of the biological mechanisms underlying female sexual functioning.

Impact of 4-methylbenzylidene camphor, daidzein, and estrogen on intact and osteotomized bone in osteopenic rats.

The study investigated the influence of 4-methylbenzylidene camphor (4-MBC), daidzein, and estradiol-17ß-benzoate (E(2)) on either intact or osteotomized cancellous bone in ovariectomized (Ovx) rats. Three-month old Ovx rats were fed with soy-free (SF) diet over 8 weeks; thereafter, bilateral transverse metaphyseal osteotomy of tibia was performed and rats were divided into groups: rats fed with SF diet and SF diet supplemented with 4-MBC (200 mg), daidzein (50 mg), or E(2) (0.4 mg) per kilogram body weight. After 5 or 10 weeks, computed tomographical, biomechanical, histological, and ashing analyses were performed in lumbar spine and tibia of 12 rats from each group. 4-MBC and E(2) improved bone parameters in lumbar spine and tibia, were not favorable for osteotomy healing, and decreased serum osteocalcin level. However, daidzein improved bone parameters to a lesser extent and facilitated osteotomy healing. For lumbar spine, the bone mineral density was 338±9, 346±5, 361±6, and 360±5 mg/cm(3) in SF, daidzein, 4-MBC, and E(2), respectively, after 10 weeks. For tibia, the yield load was 98±5, 114±3, 90±2, and 52±4 N in SF, daidzein, 4-MBC, and E(2), respectively, after 10 weeks. Serum daidzein was 54±6 ng/ml in daidzein group and equol was not detected. Alp and Igf1 genes were down-regulated in callus after daidzein and E(2) compared with 4-MBC (week 5). The response of bone tissue and serum markers of bone metabolism could be ordered: daidzein<4-MBC

Posttraumatic Stress Disorder (PTSD) and Disorders of Extreme Stress (DESNOS) symptoms following prostitution and childhood abuse.

With the participation of 46 prostituted women in Korea, this study investigates the relationship between prostitution experiences, a history of childhood sexual abuse (CSA), and symptoms of posttraumatic stress disorder (PTSD) and disorders of extreme stress not otherwise specified (DESNOS). Prostituted women showed higher levels of PTSD and DESNOS symptoms compared to a control group. Women who had experienced both CSA by a significant other and prostitution showed the highest levels of traumatic stress. However, posttraumatic reexperiencing and avoidance and identity, relational, and affect regulation problems were significant for prostitution experiences even when the effects of CSA were controlled.

Sexual functioning in transsexuals following hormone therapy and genital surgery: a review.

INTRODUCTION: Sexual function following genital sexual reassignment surgery (SRS) is an important outcome for many transsexuals, affecting the choice of surgical technique, satisfaction with surgery, and quality of life. However, compared to other outcome measures, little clinical and research attention has been given to sexual functioning following SRS. AIM: To discuss the potential impact of cross-sex hormone therapy and SRS on sexual function and to summarize the published empirical research on postsurgical sexual functioning in male-to-female (MtF) and female-to-male (FtM) transsexuals. METHODS: Cross-sex hormone therapy and SRS techniques are outlined, the potential roles of cross-sex hormone therapy and SRS on sexual function are discussed, and peer-reviewed literature published in English on postoperative sexual functioning in MtF and FtM transsexuals is reviewed. MAIN OUTCOME MEASURES: Sexual desire, sexual arousal, and ability to achieve orgasm following SRS. RESULTS: Contrary to early views, transsexualism does not appear to be associated with a hyposexual condition. In MtF transsexuals, rates of hypoactive sexual desire disorder (HSDD) are similar to those found in the general female population. In FtM transsexuals, sexual desire appears unequivocally to increase following SRS. Studies with MtF transsexuals have revealed not only vasocongestion, but also the secretion of fluid during sexual arousal. Research on sexual arousal in FtM transsexuals is sorely lacking, but at least one study indicates increased arousal following SRS. The most substantial literature on sexual functioning in postoperative transsexuals pertains to orgasm, with most reports indicating moderate to high rates of orgasmic functioning in both MtF and FtM transsexuals. CONCLUSIONS: Based on the available literature, transsexuals appear to have adequate sexual functioning and/or high rates of sexual satisfaction following SRS. Further research is required to understand fully the effects of varying types and dosages of cross-sex hormone therapies and particular SRS techniques on sexual functioning.

Laboratory-induced hyperventilation differentiates female sexual arousal disorder subtypes.

The effects of heightened sympathetic nervous system (SNS) activity via laboratory-induced hyperventilation (LIH) on subjective and physiological sexual arousal were examined in a heterogeneous group of women with Sexual Arousal Disorder (SAD; n = 60), as well as across subtypes of SAD, in comparison to a control group of women without sexual difficulties (n = 42). Participants took part in 2 min of rapid breathing, a technique previously found to increase SNS activity, immediately prior to viewing erotic stimuli. Physiological arousal (i.e., vaginal pulse amplitude; VPA) was measured via the vaginal photoplethysmograph and subjective arousal was measured via self-report questionnaires. LIH differentiated women with SAD from those in the control group, with LIH increasing VPA in the latter, but having no significant effect in the heterogeneous SAD group. However, among subtypes of SAD, LIH differentiated women with genital (n = 16) and subjective (n = 16) subtypes of SAD from women with combined SAD (n = 28) and women without sexual difficulties. Specifically, women in the control group and those with combined SAD had a significant increase in VPA whereas women with genital or subjective SAD had a significant decrease in VPA following LIH. There was no significant effect of LIH on any self-report measure of sexual arousal following erotic stimuli. Implications of the results for the conceptualization, diagnosis, and treatment of SAD are discussed.

Rape myth acceptance in men who completed the prostitution offender program of British Columbia.

In an effort to characterize the attitudes and characteristics of men who solicit sex, this study investigated rape myth acceptance as assessed by a modification of Burt's Rape Myth Acceptance Scale. The participants were all men who took part in the Prostitution Offender Program of British Columbia after being arrested for attempting to solicit sex from an undercover police officer. Relationships between endorsement of rape myths, other attitudes, sexual behavior, and demographic variables were examined. Results reveal that age, education, use of pornography, ideal frequency of intercourse, and believing that purchasing sex is a problem are all negatively correlated with rape myth acceptance. Positive correlations were found between rape myth acceptance and sexual conservatism, sexual violence/coercion, and social desirability. Results are discussed in terms of the association between rape myth acceptance and the violence frequently perpetrated against those working in the sex trade.

Psychophysiological and subjective sexual arousal to visual sexual stimuli in new women.

Conflicting data exist regarding the sexual arousal patterns of post-operative male-to-female (MTF) women with Gender Identity Disorder. The purpose of this study was to examine objective and subjective aspects of the sexual arousal response using a vaginal photoplethysmograph. Fifteen MTF women viewed neutral and erotic audiovisual film segments while their blood flow patterns were monitored. Subjective measures of affect and sexual arousal were taken before and immediately after the films. There was a significant increase in self-reported subjective arousal, perceived genital arousal, perceived autonomic arousal, and positive affect; however, movement artefacts interfered with our assessment of the genital arousal response. MTF women reported both low levels of pain and low levels of awareness of the vaginal probe during testing. These data are discussed in the context of differences in pelvic musculature between natal and new women and have implications for future studies that aim to measure sexual arousal objectively in MTF women.