Links between Aggressive Sexual Fantasies and Sexual Coercion: A Replication and Extension of a Multifactorial Model.

Current research indicates that aggressive sexual fantasies (ASF) are related to sexual aggression, above and beyond other risk factors for this behavior. There have, however, rarely been explicitly considered in multifactor models aiming to explain sexual aggression. One exception is the multifactorial Revised Confluence Model of Sexual Aggression that was replicated in two samples of male individuals who were convicted of sexual offenses and a small sample of men from the general population and evidenced a high relevance of ASF, respectively. There were, however, no further attempts to replicate the model in larger samples from the general population. We, therefore, used a subsample from the Finnish Genetics of Sexuality and Aggression project including 3269 men (age: M = 26.17 years, SD = 4.76) to do so. Cross-sectional latent structural equation models corroborated previous research and the assumption that ASF are a central component in multifactor models that aim to explain sexual aggression: ASF and antisocial behavior/aggression were equally important associates of sexual coercion when also considering adverse childhood experiences, hypersexuality, and callous-unemotional traits. Additionally, ASF mediated the links between hypersexuality, callous-unemotional traits, as well as childhood sexual abuse and sexual coercion. These links held stable when entering further risk factors, that is, distorted perceptions, rape-supportive attitudes, and violent pornography consumption into the model. Contrasting assumptions, alcohol consumption and antisocial behavior/aggression did not interact. These results illustrate the potential importance of ASF for sexual aggression. They indicate that ASF require consideration by research on sexual aggression as well as in the treatment and risk assessment of sexual perpetrators.

Genetic and Environmental Influences on Sexual Orientation: Moderation by Childhood Gender Nonconformity and Early-Life Adversity.

Existing evidence indicates genetic and non-genetic influences on sexual orientation; however, the possibility of gene-environment interplay has not been previously formally tested despite theories indicating this. Using a Finnish twin cohort, this study investigated whether childhood gender nonconformity and early-life adversities independently moderated individual differences in sexual orientation and childhood gender nonconformity, the relationship between them, and the etiological bases of the proposed moderation effects. Sexual orientation, childhood gender nonconformity, and early-life adversities were assessed using standard questionnaires. Structural equation twin model fitting was carried out using OpenMx. Childhood gender nonconformity was significantly associated with reduced phenotypic variance in sexual orientation (ß = - 0.14, 95% CI - 0.27, - 0.01). A breakdown of the underlying influences of this moderation effect showed that this was mostly due to moderation of individual-specific environmental influences which significantly decreased as childhood gender nonconformity increased (ßE = - 0.38; 95% CI - 0.52, - 0.001) while additive genetic influences were not significantly moderated (ßA = 0.05; 95% CI - 0.30, 0.27). We also observed that the relationship between sexual orientation and childhood gender nonconformity was stronger at higher levels of childhood gender nonconformity (ß = 0.10, 95% CI 0.05, 0.14); however, significance of the underlying genetic and environmental influences on this relationship could not be established in this sample. The findings indicate that beyond a correlation of their genetic and individual-specific environmental influences, childhood gender nonconformity is further significantly associated with reduced individual-specific influences on sexual orientation.

A Qualitative Content Analysis of Perceived Individual and Relational Consequences of Sexual Compliance and Their Contributors.

Sexual compliance (i.e., consensually engaging in sex despite a lack of desire for it) is common in committed intimate relationships, but the consequences of compliance for the well-being of the individual and the relationship are poorly understood. We investigated the perceived consequences of sexual compliance and perceptions of factors contributing to negative/positive consequences by applying qualitative content analysis to free-text retrospective survey responses from 107 (mostly) Finnish adults. We identified five themes of personal consequences (emotions and mood, sexual experience, sexual desire, pressure and violations, and physical pain), four of relational consequences (relationship satisfaction, partner's response, relationship interaction, and value alignment), and nine of possible factors contributing to negative/positive consequences (communication, self-esteem, motives for sex, relationship factors, agency and self-knowledge, mental health and stress, psychological flexibility, societal norms, and past negative experiences). Perceived consequences varied widely across individuals, both in terms of whether any positive or negative consequences were experienced and whether compliance was perceived as improving or worsening specific domains of well-being. We discuss the themes identified in relation to previous theories of sexuality and intimate relationships and offer hypotheses that can be tested in future quantitative studies.

Bidirectional Causal Associations Between Same-Sex Attraction and Psychological Distress: Testing Moderation and Mediation Effects.

Only one study has examined bidirectional causality between sexual minority status (having same-sex attraction) and psychological distress. We combined twin and genomic data from 8700 to 9700 participants in the UK Twins Early Development Study cohort at ≈21 years to replicate and extend these bidirectional causal effects using separate unidirectional Mendelian Randomization-Direction of Causation models. We further modified these models to separately investigate sex differences, moderation by childhood factors (retrospectively-assessed early-life adversity and prospectively-assessed childhood gender nonconformity), and mediation by victimization. All analyses were carried out in OpenMx in R. Same-sex attraction causally influenced psychological distress with significant reverse causation (beta = 0.19 and 0.17; 95% CIs = 0.09, 0.29 and 0.08, 0.25 respectively) and no significant sex differences. The same-sex attraction → psychological distress causal path was partly mediated by victimization (12.5%) while the reverse causal path was attenuated by higher childhood gender nonconformity (moderation coefficient = -0.09, 95% CI: -0.13, -0.04).

Actual and Desired Masturbation Frequency, Sexual Distress, and Their Correlates.

We investigated the prevalence of problematic masturbation using different criteria. We also investigated if masturbation-related distress was associated with sexual abuse history, family attitudes towards sexuality during childhood, and depression and anxiety symptoms. Here, 12,271 Finnish men and women completed a survey reporting masturbation frequency, desired masturbation frequency, sexual distress, childhood sexual abuse, sex-positive family background, as well as depression and anxiety symptoms. Among both sexes, those whose masturbation frequency did not match with desired frequency experienced more sexual distress. Different conceptualizations of problematic masturbation resulted in different proportions of individuals categorized as having it (i.e., 8.3% of men and 2.7% of women experienced self-perceived problematic masturbation, that is masturbating more than they desired and experiencing sexual distress; 2% of men and 0.6% of women masturbated more frequently than average and meanwhile experienced self-perceived problematic masturbation; 6.3% of men and 2.1% of women masturbated less frequently than average but still experienced self-perceived problematic masturbation). Moreover, among both sexes, self-perceived problematic masturbation was positively associated with childhood sexual abuse, depression, and anxiety, while negatively associated with a sex-positive family background. Our results point to the complexity of defining problematic masturbation. Causes of sexual distress related to masturbation need to be carefully examined case by case to choose an appropriate clinical approach.

Causal Influences of Same-Sex Attraction on Psychological Distress and Risky Sexual Behaviors: Evidence for Bidirectional Effects.

Although health disparities among same-sex attracted compared to heterosexual individuals are typically explained by minority stress, there is limited evidence for a causal effect. This study investigated whether same-sex attraction was causally associated with psychological distress and risky sexual behavior using sociosexual behavior as a proxy. The sample comprised monozygotic and dizygotic twins and their non-twin siblings (n = 2036, 3780 and 2356, respectively) genotyped and assessed for same-sex attraction, psychological distress (anxiety and depressive symptoms), and risky sexual behavior. Causal influences were investigated with same-sex attraction as the predictor and psychological distress and risky sexual behavior as the outcomes in two separate Mendelian Randomization-Direction of Causation (MRDoC) models using OpenMx in R. The MRDoC model improves on the Mendelian Randomization and Direction of Causation twin models by allowing analyses of variables with similar genetic architectures, incorporating polygenic scores as instrumental variables and specifying pleiotropy and residual covariance. There were significant causal influences flowing from same-sex attraction to psychological distress and risky sexual behavior (standardized coefficients = 0.13 and 0.16; 95% CIs 0.03-0.23 and 0.08-0.25, respectively). Further analyses also demonstrated causal influences flowing from psychological distress and risky sexual behavior toward same-sex attraction. Causal influences from same-sex attraction to psychological distress and risky sexual behavior may reflect minority stress, which reinforces ongoing measures to minimize social disparities. Causal influences flowing in the opposite direction may reflect rejection sensitivity, stigma-inducing outcomes of risky sexual behavior, and recall bias; however, further research is required to specifically investigate these processes.

Does Sexual Desire Fluctuate More Among Women than Men?

There is a lay assumption that women's sexual desire varies substantially over time, whereas men's is stable. This assumption is mirrored in prominent theories of desire, which posit that women are more variable than men in the extent to which they desire sex, and that women's sexual desire is more contextually sensitive than men's. We tested this assumption across three longitudinal studies. Study 1 assessed desire at 3 time points spanning 13 years (Nobservations = 5562), and Studies 2 and 3 (Nobservations = 11,282) assessed desire moment-to-moment over 7 days. When desire was measured over years, women were more variable in their sexual desire than men (Study 1). However, we found a different pattern of results when desire was measured over the short term. In Studies 2 and 3, we found no significant differences in women's and men's desire variability. The extent to which desire varied as a function of affective states (e.g., happiness) and relationship-oriented states (e.g., partner closeness) was similar for women and men, with some exceptions; women's desire was more negatively associated with tiredness and anger in Study 2. These data qualify existing assumptions about sex differences in sexual desire variability.

µ-opioid receptor availability is associated with sex drive in human males.

The endogenous mu-opioid receptor (MOR) system modulates a multitude of social and reward-related functions, and exogenous opiates also influence sex drive in humans and animals. Sex drive shows substantial variation across humans, and it is possible that individual differences in MOR availability underlie interindividual of variation in human sex drive. We measured healthy male subjects' (n = 52) brain's MOR availability with positron emission tomography (PET) using an agonist radioligand, [11C]carfentanil, that has high affinity for MORs. Sex drive was measured using self-reports of engaging in sexual behaviour (sex with partner and masturbating). Bayesian hierarchical regression analysis revealed that sex drive was positively associated with MOR availability in cortical and subcortical areas, notably in caudate nucleus, hippocampus, and cingulate cortices. These results were replicated in full-volume GLM analysis. These widespread effects are in line with high spatial autocorrelation in MOR expression in human brain. Complementary voxel-based morphometry analysis (n = 108) of anatomical MR images provided limited evidence for positive association between sex drive and cortical density in the midcingulate cortex. We conclude that endogenous MOR tone is associated with individual differences in sex drive in human males.

An Exploratory Network Analysis of Sexual and Relationship Satisfaction Comparing Partnered Cisgendered Men and Women.

BACKGROUND: Sexual and relationship satisfaction are intimately connected and share many predictors. AIM: The aim of the present study is to disentangle the relationship between sexual and relationship satisfaction, by exploring the connections to other relevant correlates. METHODS: Regularized mixed graphical model networks were estimated separately for men and women, which were compared using the network comparison test. In addition, strength centrality and community structure were explored. OUTCOME: The partial correlation structure between sexual satisfaction, relationship satisfaction and their correlates. RESULTS: The associations between variables measuring sexual and relationship satisfaction and related constructs did not differ significantly between partnered, cisgendered men and women. Sexual and relationship satisfaction were associated with sexual pleasure, sexual distress, and sexual communication for both men and women. Sexual satisfaction was the most central variable in the network for men (strength = 1.1), while sexual desire was the most central variable for women (strength = 1.1). Frequency of sexual activity was a central variable for both men and women (strength men = 1.0, strength women = 1.1). The community analysis showed similar communities of variables for men and women, except that frequency of sexual activity consistently belonged to the same community as sexual and relationship satisfaction for men, but not as consistently for women. CLINICAL TRANSLATION: The results have clinical implication in sex and couples therapy, as they increase the knowledge on sexual and relationship satisfaction. STRENGTHS & LIMITATIONS: A strength of the study is the population-based dataset, and a limitation is that inferences of causality cannot be made due to the cross-sectional study design. CONCLUSION: The present study suggests that men and women are largely similar when comparing constructs related to sexual and relationship satisfaction. Nickull S, Källström M, Jern P. An Exploratory Network Analysis of Sexual and Relationship Satisfaction Comparing Partnered Cisgendered Men and Women. J Sex Med 2022;19:711-718.

Sex, Drugs, and Genes: Illuminating the Moral Condemnation of Recreational Drugs.

Over the past decade, evolutionary psychologists have proposed that many moral stances function to promote self-interests. At the same time, behavioral geneticists have demonstrated that many moral stances have genetic bases. We integrated these perspectives by examining how moral condemnation of recreational drug use relates to sexual strategy (i.e., being more vs. less open to sex outside of a committed relationship) in a sample of Finnish twins and siblings (N = 8,118). Twin modeling suggested that genetic factors accounted for 53%, 46%, and 41% of the variance in drug condemnation, sociosexuality, and sexual-disgust sensitivity, respectively. Further, approximately 75% of the phenotypic covariance between drug condemnation and sexual strategy was accounted for by genes, and there was substantial overlap in the genetic effects underlying both drug condemnation and sexual strategy (rg = .41). Results are consistent with the proposal that some moral sentiments are calibrated to promote strategic sexual interests, which arise partially via genetic factors.

Erectile Dysfunction in Young Men: Testosterone, Androgenic Polymorphisms, and Comorbidity With Premature Ejaculation Symptoms.

BACKGROUND: The association between erectile dysfunction (ED), free testosterone (T), and androgenic genetic polymorphisms is still unclear. As most studies in the field have focused on older (>40 y.o.) men, data from young men is scarce. In addition, the clinically observed comorbidity between ED and premature ejaculation (PE) has not been explained. AIM: The aim of the present study was 3-fold: to assess in a sample of young men (1) the association between ED and T; (2) the role of androgenic genetic polymorphisms in the aforementioned association; and (3) comorbidity between ED and PE symptoms. METHODS: Statistical analyses were performed on a population-based sample of 2,302 Finnish men, (Mage = 26.8 years). Hormone samples were available from 317 men, and genotype information was available from a minimum of 1,144 men depending on genetic locus. For twin analyses, the sample contained 533 male individuals from opposite-sex fraternal twin pairs, 491 identical male individuals (110 complete pairs), 493 male individuals from male fraternal twin pairs (92 complete pairs), and 658 siblings of twins. OUTCOMES: The main outcome measure includes association between levels of salivary T and ED, main effects of the androgen-related genetic polymorphisms on ED scores. Bivariate twin models of PE and ED were fitted to elucidate possible shared etiology. RESULTS: We found no significant association between T levels and ED and no significant main effects of the androgenic genetic polymorphisms on ED. We found no evidence suggesting that any of the genetic polymorphisms would moderate the association between T and ED symptoms. We found shared unique environmental influences between PE and ED (rE = .28). CLINICAL TRANSLATION: Obtained data suggest that ED has T-independent causes and that any comorbidity between PE and ED is not explained by a set of genes affecting both phenotypes. STRENGTHS & LIMITATIONS: First, the sample size for both parts of the study was relatively small, which may make some statistical analyses underpowered. Furthermore, as the sample was a population-based sample of relatively young men, the number of clinically relevant ED cases was low. Second, some concerns about T derived from saliva exist because saliva sampling comes with increased risks of error particularly because saliva samples are more vulnerable to contamination. CONCLUSION: We found no significant association between free T levels, androgenic genetic polymorphisms, and ED in the younger age cohort. Twin analysis suggested a common nonshared environmental component in PE and ED. Zhuravleva1 ZD, Johansson A, Jern P. Erectile Dysfunction in Young Men: Testosterone, Androgenic Polymorphisms, and Comorbidity With Premature Ejaculation Symptoms. J Sex Med 2021;18:265-274.

Is the association between childhood maltreatment and aggressive behavior mediated by hostile attribution bias in women? A discordant twin and sibling study.

Understanding the mechanisms behind aggressive behavior (AGG) is vital so that effective prevention and intervention strategies can be developed. Maltreated children are hypothesized to be prone to social information processing biases, such as hostile attribution bias (HAB), which, in turn, may increase the likelihood of behaving aggressively. The first aim of the present study was to replicate findings regarding associations between childhood maltreatment (CM), HAB, and aggression in a population-based sample of Finnish female twins and their sisters (N = 2,167). However, these associations might not be causal but instead confounded by familial factors, shared between the variables. The second aim was, thus, to test the associations when potential confounding by familial (genetic or common environmental) effects were controlled for using a multilevel discordant twin and sibling design within (a) 379 pairs of twins (npairs = 239) or siblings (npairs = 140), and (b) within the 131 monozygotic (MZ) twin pairs. Consistent with previous studies, HAB mediated the association between CM and AGG when familial confounding was uncontrolled. No support was found for the mediation when controlling for familial confounding. Between-pair associations were found between CM and AGG, and between CM and HAB. In addition, within-pair associations were found between HAB and AGG, and between CM and AGG, however, these were nonsignificant in the discordant MZ analysis, offering the most stringent control of familial confounding. The results indicate the necessity of taking familial confounding into account when investigating the development of AGG.

Do women's Relationship Satisfaction and Sexual Functioning Vary as a Function of Their Male Partners' Premature Ejaculation Symptoms?

The present study investigated how women's sexual functioning and relationship satisfaction are associated with their partner's premature ejaculation (PE) symptoms, and whether prevalence rates of PE differ when women report on their male partners compared to male self-report. The sample comprised of responses from 1,779 Finnish women (mean age 33.3 years) and a control group of 1,024 Finnish men. Women who reported that their male partners had symptoms of PE were less satisfied with their relationships, and reported lower levels of arousal, orgasm, satisfaction, lubrication, and pain, but not desire. Effect sizes of these associations were small. Men and women report similar base rates of PE, suggesting that on a population level prevalence estimates are remarkably similar irrespective of whether men report on PE symptoms themselves, or women report on their partners.

Mental Health Disparities Mediating Increased Risky Sexual Behavior in Sexual Minorities: A Twin Approach.

Increased risky sexual behavior in sexual minorities relative to heterosexual individuals may be partly explained by mental health disparities, and both factors may be further jointly influenced by common genetic and environmental factors. However, these relationships have not been previously investigated. The objectives of the present study were to investigate mental health disparities as a mediator of the relationship between sexual orientation and risky sexual behavior, controlling for genetic and environmental effects in this relationship and testing for sex differences. Participants included 5814 twins from a Finnish twin cohort. Specified latent factors included sexual orientation, mental health indicators, and risky sexual behavior. Twin models were fitted to the factor structure of the data whereby a Cholesky decomposition on the factors was compared to a mediation submodel using OpenMx. Sex differences were tested in the final model. Phenotypically, mental health disparities partially mediated the relationship between sexual orientation and increased risky sexual behavior, with comparable effects in males and females. However, while this indirect route from sexual orientation to risky sexual behavior mainly contained transmitted genetic effects in males, there was a significant proportion of transmitted shared environmental effects in females. This is the first study to demonstrate that the mediation relationships between sexual orientation, mental health disparities, and risky sexual behavior are not confounded by genetic and environmental factors. The significant sex differences need to be recognized in future research and intervention design to improve sexual health in sexual minorities.

Vibrator-Assisted Start-Stop Exercises Improve Premature Ejaculation Symptoms: A Randomized Controlled Trial.

Premature ejaculation (PE) is associated with decreased quality of life, lower confidence and self-esteem, and higher levels of depression, anxiety, and interpersonal difficulties. Here we investigated the effectiveness of vibrator-assisted start-stop exercises for treatment of PE, and whether the treatment effect could be enhanced by an additional psychobehavioral intervention. Fifty participants with a mean age of 41.7 years were included and randomized into two treatment groups and a waiting list control group. Participants were instructed to perform start-stop exercises while stimulating the penis with a purpose-made vibrator, 3 times a week for 6 weeks. Additionally, participants in one of the treatment groups received additional psychoeducation and performed mindfulness meditation-based body scan exercises three times a week. Data were gathered through online questionnaires before and after treatment, as well as 3 and 6 months after treatment. The interventions reduced PE symptoms with large effect sizes (partial η2 = .20 across the three groups, d [95% CI] = 1.05 [.27, 1.82] and 1.07 [.32, 1.82] for treatment groups compared to waiting list control group). The additional psychobehavioral intervention did not further reduce PE symptoms, but did decrease PE-associated negative symptoms such as levels of sexual distress, anxiety, and depression. No side effects were reported. Vibrator-assisted start-stop exercises can be offered as an adequate treatment option for PE.

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

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

Preliminary Evidence for an Association Between Variants of the Catechol-O-Methyltransferase (COMT) Gene and Premature Ejaculation.

BACKGROUND: Studies have suggested that dopamine plays a role in the neurobiological mechanism that triggers ejaculation, leading scientists to hypothesize that dopamine-related genetic polymorphisms could contribute to symptoms of premature ejaculation (PE). AIM: To investigate associations between dopamine receptor and catechol-O-methyltransferase (COMT; an enzyme involved in the catabolism of dopamine) gene-linked polymorphisms and PE. METHODS: PE status in patient groups was determined by clinical diagnosis performed by a physician specializing in sexual medicine. Self-reported PE symptoms from a validated questionnaire also were reported. Saliva samples were collected from 149 patients with PE and 1,022 controls from a population-based sample. In total, we tested associations between PE and 11 single-nucleotide polymorphisms in the dopamine receptor D1, D2, and D3 genes and in the COMT gene. OUTCOMES: We found no associations between dopamine receptor gene polymorphisms and PE, but 2 COMT-linked loci (rs4680 and rs4818) had significant associations after correction for multiple testing. RESULTS: 1 COMT gene-linked locus that was associated with PE symptoms in the present study, rs4680, is a well-documented functional polymorphism that causes a valine-to-methionine substitution. The other polymorphism, rs4818, is in high linkage disequilibrium with the rs4680 locus, indicating that they capture the same effect. Surprisingly, the rs4680 variant that was statistically significantly more prevalent in the PE group (ie, the valine-encoding allele) has been associated with higher enzymatic activity and therefore lower synaptic dopamine levels. CLINICAL TRANSLATION: Drugs targeting the dopaminergic system could affect PE symptoms. STRENGTHS AND LIMITATIONS: No replication sample was available for the present study; thus, our findings should be interpreted with caution. Moreover, a limitation of our study is the small sample in the context of genetic association studies (although it should be mentioned that genetically informative samples with phenotypic information about PE symptoms are scarce, and most previous genetic association studies of PE have used samples of similar or smaller size). However, our results are plausible: we report an association between one of the most extensively studied and understood genetic polymorphisms in psychiatric research and PE, and our results are in line with the long-standing hypothesis that dopamine influences human ejaculatory function. CONCLUSIONS: We report an association between 2 COMT gene-linked loci and PE symptoms, but our results should be treated with caution until independently replicated. Jern P, Johansson A, Strohmaier J, et al. Preliminary Evidence for an Association Between Variants of the Catechol-O-Methyltransferase (COMT) Gene and Premature Ejaculation. J Sex Med 2017;14:1558-1565.

Nausea and Vomiting During Pregnancy is Highly Heritable.

Nausea and vomiting during pregnancy (NVP) affects about 70 % of all expectant mothers and commonly impacts their physical health and psychosocial functioning. The aim of this study was to estimate the heritability of the presence, duration and severity of NVP. The sample consisted of 1723 women (M age = 41.78, SD = 11.67) including twins in both complete and incomplete pairs and their sisters from two cohorts participating in the NVP Genetics Consortium. The sample comprised 159 monozygotic and 140 dizygotic complete twin pairs, and 69 twin-sister pairs. We applied an extended twin design using OpenMx and Mx for secondary analysis. Individual differences in NVP were best explained by additive genetic and unique environmental effects. Heritability estimates were 73 % (95 % CIs = 57-84 %) for presence, 51 % (95 % CIs = 36-63 %) for duration and 53 % (95 % CIs = 38-65 %) for severity of NVP. The genetic correlation between duration and severity was almost perfect. Our results show that genes play an important role in different aspects of NVP and justify the importance of searching for genetic variants.

Lifestyle Factors and Premature Ejaculation: Are Physical Exercise, Alcohol Consumption, and Body Mass Index Associated With Premature Ejaculation and Comorbid Erectile Problems?

INTRODUCTION: Premature ejaculation (PE) is a common sexual problem in men, but its etiology remains uncertain. Lifestyle factors have long been hypothesized to be associated with sexual problems in general and have been proposed as risk factors for PE. AIM: To explore associations among physical exercise, alcohol use, body mass index, PE, and erectile dysfunction. METHODS: A population-based sample of Finnish men and a sample of Finnish men diagnosed with PE were surveyed for statistical comparisons. Participants using selective serotonin reuptake inhibitors or other medications known to affect symptoms of PE were excluded from analyses. MAIN OUTCOME MEASURES: Self-report questionnaires: Multiple Indicators of Premature Ejaculation, International Index of Erectile Function-5, Alcohol Use Disorders Identification Test, and Godin Leisure-Time Exercise Questionnaire. RESULTS: The clinical sample reported lower levels of physical exercise (mean = 27.53, SD = 21.01, n = 69) than the population-based sample (mean = 34.68, SD = 22.82, n = 863, t930 = 2.52, P = .012), and the effect size was large (d = 0.85). There was a small negative correlation between levels of physical exercise and symptoms of PE (r = -0.09, P < .01, n = 863) in the population-based sample. The association between physical exercise and PE remained significant after controlling for effects of age, erectile dysfunction, alcohol use, and body mass index. CONCLUSION: If future studies show that the direction of causality of this association is such that physical activity alleviates PE symptoms, then including physical activity in PE treatment interventions could be a promising addition to treatment regimes.

Genetic variation of the growth hormone secretagogue receptor gene is associated with alcohol use disorders identification test scores and smoking.

The multifaceted gut-brain peptide ghrelin and its receptor (GHSR-1a) are implicated in mechanisms regulating not only the energy balance but also the reward circuitry. In our pre-clinical models, we have shown that ghrelin increases whereas GHSR-1a antagonists decrease alcohol consumption and the motivation to consume alcohol in rodents. Moreover, ghrelin signaling is required for the rewarding properties of addictive drugs including alcohol and nicotine in rodents. Given the hereditary component underlying addictive behaviors and disorders, we sought to investigate whether single nucleotide polymorphisms (SNPs) located in the pre-proghrelin gene (GHRL) and GHSR-1a gene (GHSR) are associated with alcohol use, measured by the alcohol use disorders identification test (AUDIT) and smoking. Two SNPs located in GHRL, rs4684677 (Gln90Leu) and rs696217 (Leu72Met), and one in GHSR, rs2948694, were genotyped in a subset (n = 4161) of a Finnish population-based cohort, the Genetics of Sexuality and Aggression project. The effect of these SNPs on AUDIT scores and smoking was investigated using linear and logistic regressions, respectively. We found that the minor allele of the rs2948694 SNP was nominally associated with higher AUDIT scores (P = 0.0204, recessive model) and smoking (P = 0.0002, dominant model). Furthermore, post hoc analyses showed that this risk allele was also associated with increased likelihood of having high level of alcohol problems as determined by AUDIT scores ≥ 16 (P = 0.0043, recessive model). These convergent findings lend further support for the hypothesized involvement of ghrelin signaling in addictive disorders.