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Secondary orgasmic dysfunction. II. Case study.

The treatment of a case of secondary orgasmic dysfunction is described. In this case, a direct behavioral retraining program was employed to increase the couple's repertoire of effective sexual behaviors. An extinction and successive approximation procedure was used to transfer ortasmic responsiveness from solitary masturbation to heterosexual coitus. Since other data have indicated that nonsexual marriage problems contribute to the maintenance of secondary orgasmic dysfunction, a direct, confrontive intervention into the marital relationship was made concurrent with the sexual retraining program. Outcome data are presented to illustrate the effectiveness of the reatment procedures.

Adult

Effects of group systematic desensitization on female orgasmic dysfunction.

This study investigated the impact of group systematic desensitization (SD) on varied aspects of sexual functioning in primary and secondary nonorgasmic women. After serving as their own controls, 22 women (eight primary, 14 secondary) received 15 sessions of group SD using four common hierarchies of sexual scenes. The measures were administered to each subject and her regular sex partner at each of the testing periods. Significant positive treatment effects were found on measures of general and specific sexual adjustment and in extracoital orgasmic frequency. Treatment also enhanced sexual communication among subjects and their partners, increased the females' acceptance of their mates as being satisfactory sexual partners, and increased the females' self-acceptance as sexual beings. All but one of the treatment effects (degree of pleasure experienced during extracoital stimulation) were maintained at the 6-week follow-up. Secondary subjects reported significantly greater pleasure from coital and extracoital stimulation and significantly increased frequency of orgasm in response to extracoital stimulation than primary subjects. Primary and secondary subjects did not differ in their evaluation of the experiment. The need for controlled comparative treatment investigations is stressed.

Adult

Response of women with primary orgasmic dysfunction to audiovisual education.

Of 17 women ages 19 to 38 with primary orgasmic dysfunction, 7 achieved orgasm within a week after viewing an audiovisual sex education program, a statistically significant change (p less than .02). No other intervention (educational, behavioral, psychotherapeutic) occurred between the audiovisual session and later inquiry about subsequent sexual response. These results suggest that explicit sex education can help remedy sexual dysfunction in a significant number of women and that further investigation is needed.

Adult

Does the CAT technique enhance female orgasm?

The following is a report of The Human Sexuality Program of the New York Hospital-Cornell Medical Center to personally replicate Edward W. Eichel's claims that his Coital Alignment Technique (CAT) enhances and increases female coital orgasms and mutual orgasms. We failed to replicate these claims. However, it was the consensus of the group that within the context of sex therapy, the CAT technique may have merit in certain clinical situations, and as such deserves to be further evaluated.

Coitus

Behavioural treatment of orgasmic dysfunction: a controlled study.

Twenty-two anorgasmic women received 20 sessions of a multiple-technique behavioural therapy. The design included blind ratings by two independent assessors, multiple assessment instruments, and a waiting list control group. Treatment was significantly better than no treatment in terms of: (1) the percentage of patients experiencing orgasm during at least 50 per cent of sexual relations; (2) the percentage of women reporting satisfactory sexual relations at least 50 per cent of the time; (3) patients' ratings of positive reactions to various sexual behaviours; and (4) assessors' global clinical ratings. Significant improvement was also noted on the MMPI, IPAT, and Symptom Check List. Improvement was maintained at a follow-up average 9 months later. These results support the impression that a behavioural approach offers much promise in treating female orgasmic dysfunction.

Adult

[Time factors and trends in the onset of the menarche, sex maturation and experience of orgasm in a questionnaire administered to 971 women in Vojvodina].

A questionnaire and interview of 971 women aged 15-80 years or more from three Voivodina communes (Becej, Veternik, Mali Idos) have supplied the following information: the arithmetic mean of the age of women during menarche is 13.459 +/- 1.523 years, the median being 13.872 years. Menarche appears earlier in the town (13.334 +/- 1.373) than in villages (13.668 +/- 1.61). The arithmetic mean of menarche recedes towards younger age groups (y = 12.90 +/- 0.106; r = 0.890, p less than 0.01), so that below 20 years is 1.4 years, and this is more pronounced in the town than on villages. The arithmetic mean of the age of women at sexarche (the first sexual intercourse) is 19.088 +/- 2.495 years, and the median is 18.964. The interval between the arithmetic mean of menarche and sexarche is 5.6 years, smaller in the urban (5.0) than in the rural environment (6.4). Sexarche recedes towards younger age groups (y = 18.136 +/- 0.130; r = 0.540), more intensively than the acceleration of menarche. In the course of their sexual life, 16.4% of women rarely experienced orgasm, 11.2% never did. The experience of orgasm "rarely" or "never" is statistically significantly more frequent in women over 40 years of life in relation to younger women (X2 = 6.893, p less than 0.01).

Adult

Self-perceived differences in the female orgasmic response.

This investigation was concerned with perceived differences between orgasms experienced via masturbation, petting, and sexual intercourse and the relationship of such differences, if any, to sexual satisfaction. An anonymous questionnaire was distributed to registered nurses in fifteen states concerning sexual attitudes, sexual behavior and the female sexual response. Although 76% of these respondents reported perceived differences between orgasms experienced via masturbation, petting, and sexual intercourse, no differences were found between respondent groups for either physiological or psychological sexual satisfaction. Several other variables were identified which affected perceived levels of sexual satisfaction. A clear understanding of these findings should be helpful in counseling patients with sexual problems.

Adult

Electroencephalographic laterality changes during human sexual orgasm.

Left and right parietal EEGs were recorded while seven subjects experienced sexual climax through self-stimulation. EEG data were quantified by continuous cumulated measurements of the integrated areas of EEG recording during successive 1-sec epochs. In eight out of 12 experiments, this measure revealed a statistically significant change in laterality. Controlled replications with two of the original subjects obviated the possibility that two potential sources of artifact (hand used for masturbation and gross body movements) accounted for the changes. While previous research has focused on vasomotor and myotonic indices of sexual response, this study demonstrates the significance of brain phenomena in sexual orgasm.

Adult

Orgasmic frequency and plasma testosterone levels in normal human males.

Twenty males participated in a 2-month study examining the relationship between 8 a.m. plasma testosterone levels and orgasmic frequency. Within subjects, higher levels of testosterone are associated with periods of sexual activity. Over subjects, however, the direction of the relationship is reversed. Mean testosterone levels were higher for sexually less active individuals.

Adult

Nocturnal orgasm in college women: its relation to dreams and anxiety associated with sexual factors.

Ss (N = 774 female undergraduates) were administered a structured questionnaire and an anxiety scale. It was found that women do experience nocturnal orgasms during sleep. Chi-square analysis revealed that a differential exists between academic levels with senior experiencing states of sexual excitement more than freshmen, sophomores, and juniors. Sexual excitement during sleeping hours and a high degree of anxiety were positively related.

Adult

Primary orgasmic dysfunction: essential treatment components.

In an attempt to determine the essential components of a successful treatment regime for primary orgasmic dysfunction, the principle treatment approaches are reviewed to elucidate the similarities in different programs which have reported similar outcome data. It is concluded that the systematic desensitization studies, the masturbatory training approaches, and the Reproductive Biology Research Foundation series are all effective treatment procedures. It appears that all three approaches employ graduated exposure to sexual stimuli plus some form of directive psychotherapy emphasizing interpersonal skills acquisition. These may be the essential treatment components.

Female

Psychiatric drugs and inhibited female orgasm.

The available evidence concerning sexual side effects of psychiatric drugs suggests that inhibited female orgasm may be associated with the use of hetereocyclic antidepressants, monoamine oxidase inhibitors, benzodiazepines, and neuroleptics. Possible mechanisms of action including anticholinergic, alpha adrenergic blockade, and serotonergic effects are discussed.

Antidepressive Agents

The effect on erection and orgasm of cystectomy, prostatectomy and vesiculectomy for cancer of the bladder: a clinical and electromyographic study.

Forty-three men who had been subjected to cystectomy and concomitant prostatectomy, vesiculectomy and urethrectomy were interviewed about their pre-operative and post-operative sexual activities at a mean of 3 (range 1 to 8) years after operation. Twenty-eight of the 38 men (74%) who had been sexually active continued to have some form of sexual activity, 21 of them achieving orgasm. Only 3 men had penile erection; 2 of them had been subjected to prostatectomy and 1 to prostatic resection. One of these men treated by prostatectomy had also had urethrectomy. Electromyographic registration from the striated external urethral sphincter, the bulbocavernosus muscle and the levator ani muscle showed normal duration of muscular contractions and length of interval between contractions after operation. The pattern of impulses during organs did not differ from that of normal men.

Adult

Fluoxetine and orgasmic sexual experiences.

The purpose of this article to describe a unique potential side effect of fluoxetine. A case report of a patient with post stroke depression treated with fluoxetine is presented. Fluoxetine was associated temporally with frequent short episodes of sexual excitement described by the patient as feeling like an orgasm. The relationship was dose dependent. Serotonergic medications, like fluoxetine, may induce sexual stimulation as a side effect. The mechanism for this effect is unclear but patients with organic brain disease may be at higher risk for this complication.

Aged

The role of serotonin in sexual dysfunction: fluoxetine-associated orgasm dysfunction.

Iatrogenic sexual dysfunction has been associated with many pharmacologic agents. The authors report 6 cases of orgasm dysfunction associated with the use of fluorxetine in 77 depressed outpatients. Fluoxetine is a novel antidepressant known to block the reuptake of serotonin with little effect on other neurotransmitter systems. Because fluoxetine has a specific mechanism of action, it serves as a useful model to hypothesize about potential mechanisms of drug-induced sexual dysfunction. The possible effects of serotonin on central, spinal, and peripheral anatomical areas are discussed in relation to drug-induced sexual dysfunction.

Adult

Inhibited female orgasm resulting from psychotropic drugs. A five-year, updated, clinical review.

As of 1989, the psychotropic drugs that have been reported to inhibit female orgasm include antipsychotic agents (thioridazine, trifluoperazine and fluphenazine), the combination drug perphenazine/amitriptyline, antidepressants (phenelzine, isocarboxazid, tranylcypromine, amoxapine, clomipramine, imipramine, nortriptyline and desipramine) and anxiolytic agents (diazepam, flurazepam and alprazolam). The management of psychotropic-drug-induced female anorgasmia includes discontinuation of the offending drug, reduction of the dosage level, a wait for spontaneous remission while the patient remains on the agent and substitution of another medication. The use of bethanechol chloride and cyproheptadine has been successful in resolving anorgasmia while patients continue to receive antidepressants.

Female