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PubMed1994

The sexual attitudes, behavior, and relationships of women with histrionic personality disorder.

To examine the sexual attitudes, behaviors, and intimate relationships of individuals with histrionic personality disorder, this study compared a sample of women with histrionic personality disorders to an adequately matched sample of women without personality disorders (aged 24-31 years) using various measures. As compared to the control group, women with histrionic personality were found to have significantly lower sexual assertiveness, greater erotophobic attitudes toward sex, lower self-esteem, and greater marital dissatisfaction. Women in the histrionic group were also found to evidence significantly greater sexual preoccupation, lower sexual desire, more sexual boredom, greater orgasmic dysfunction, and were more likely to enter into an extramarital affair than their counterparts. Despite these findings, a higher sexual esteem was noted among the histrionic group. This pattern of sexual behavior noted among histrionic women appears consistent with those behaviors exhibited in sexual narcissism. These findings and treatment considerations are explored.

Adult↗
PubMed1995

Prescribed masturbation in sex therapy: a critique.

The goal of this paper is to show from an interactional or systemic perspective how intimacy may be damaged through traditional sex therapy approaches. This is in opposition to stated claims by sex therapists, who have, since the pioneering work of Masters and Johnson, sought to improve intimacy by removing the impediment of poor sexual response. Prescribed masturbation in sex therapy is identified as particularly problematic in its potential for iatrogenic effects. These potentials are demonstrated from a relational perspective and from a functional perspective. Prescribed masturbation, intended to narrow the focus of attention from the "distraction" of a partner's response, may actually serve to further damage the openness and trust necessary for truly rewarding sexual expression. Difficulties in a relationship that preclude the trust necessary for open sexual interaction ought to be addressed before any sexual activity is prescribed. If clinicians' work circumvents the interactional component of the dysfunction, they may be guilty of colluding with clients in protecting them from intimacy. Recommended alternatives for clinicians are offered.

Behavior, Addictive↗
PubMed1977

Sex counseling of the elderly.

A sympathetic, nonjudgmental approach may reveal sexual dissatisfactions to be the basis of vague complaints about health, opening the way to counseling, changes in drug regimens, and referrals that can greatly improve quality of life.

Aged↗
PubMed2000

Sexuality among older women.

The population of the world is living longer. Currently, the average life expectancy is 78.9 and 72 years of age for women and men, respectively. By the year 2030, it is estimated that elderly people will make up approximately 17% of the total United States population. Our responsibility as physicians is, therefore, very clear. The care of this population must provide an acceptable quality of life and allow elderly people to enjoy living. This is where the question of sexuality plays an important part. Hormonal transition encompasses decreased levels of estrogen and testosterone, the latter being associated with decreased sexual libido, sensitivity, and response. Additional genitourinary effects associated with menopause include atrophic changes in the vagina, vulva, urethra, and neck of the bladder. Vaginal atrophy and diminished vaginal lubrication interfere mechanically with sexual comfort and pleasure. In addition to hormonal changes with aging, disease and associated medications may also negatively affect sexuality. Determining the impact of medications, both alone and in combination with others, on quality of life must be considered when providing comprehensive care for elderly patients.

Adolescent↗
PubMed1992

Sexual dysfunction in cancer patients.

As a result of the convergence of increased numbers of cancer survivors, heightened awareness of quality of life issues and improved methods of treatment with sex therapy, the problem of sexual dysfunction after cancer treatment is receiving increased attention. In this article, the recent literature is reviewed by tumor site, including breast, bladder, colorectal, gynecologic, testicular, prostate, and other malignancies. Limitations and advances in the available literature are discussed, and recommendations for future research and clinical work are made.

Adolescent↗
PubMed2001

Sexual difficulties of chronic pain patients.

OBJECTIVE: Description of the specific physical and psychological problems associated with sexual activity in patients with chronic pain. DESIGN: Self-completion questionnaire on extent and nature of sexual difficulties related to pain; data on psychological and physical function in respondents; personal and medical data for respondents and nonrespondents. PATIENTS: Three hundred twenty-seven patients with chronic pain in inpatient and outpatient pain programs; 237 (72%) completed the questionnaire. MEASURES: Extent of general and specific sexual problems; anxiety and depression (Hospital Anxiety and Depression Scale [HAD]); pain self-efficacy; pain-related disability (Sickness Impact Profile); drug use. RESULTS: Respondents were younger and had less depressed mood than nonrespondents, but there were no other major differences. Seventy-three percent of respondents had pain-related difficulty with sexual activity; most had several, in various combinations of problems with arousal, position, exacerbating pain, low confidence, performance worries, and relationship problems. All except position difficulties were associated with less frequent sexual activity. There were few differences between men and women, and only weak relations emerged between specific problems and mood and disability. CONCLUSIONS: There is a high prevalence of sexual difficulties in patients with chronic pain attending treatment, nearly double that of a general UK survey. These difficulties are not simply related to mood or disability. The range of problems and patients' expressed preferences for help suggest that multidisciplinary intervention is required.

Adult↗
PubMed2000

Intimacy and sexuality for the woman with breast cancer.

Human sexuality is more than sexual function. It is an ever-changing lived experience affecting the manner in which we view ourselves and our bodies. Most health professionals fail to address sexuality in the clinical setting and feel more comfortable focusing on treatment outcomes, such as the management of treatment side effects, than in addressing issues related to sexual behavior. Perhaps this is because many health professionals are uncomfortable about initiating a topic regarding a person's sexuality, or because they are unsure of their knowledge relating to changes in a person's sexuality after the management of cancer. Cultural issues in our society, such as the myth that older women with breast cancer are no longer interested in sexuality and intimacy, and the presumption that issues of survival overshadow sexuality, provide barriers to open communication about sexuality in women with breast cancer. Sexuality in the patient with breast cancer needs to be addressed by the nurse irrespective of the woman's age, partnership, and disease status. Knowledge related to changes in a woman's sexuality and intimacy after the management of breast cancer are explored, and strategies are provided for the nurse to use in communicating openly about sexuality in the clinical setting.

Adaptation, Psychological↗
PubMed1999

Sexual dysfunction of persons after traumatic brain injury: perceptions of professionals.

The purpose of this paper was to study the perceptions of professionals in the field of rehabilitation in Israel concerning sexual dysfunction of persons after traumatic brain injury. Thirty professionals filled out an open-ended questionnaire that focused on problems of sexual functioning, dyadic and social relationships, and suggestions for the most appropriate interventions for these problems. The results indicated that for persons with TBI, the physical changes were not identified as the primary obstacle preventing persons after TBI from achieving sexual satisfaction, but rather the cognitive and emotional sequelae of TBI. A number of possible intervention techniques were also suggested.

Brain Injuries↗
PubMedDate not supplied

Is there an association between menopause status and sexual functioning?

OBJECTIVE: The purpose of this study was to address whether: (1) there is an association between menopause status and various aspects of sexual functioning, and (2) the relative contributions of menopause status and other variables to various aspects of sexual functioning. DESIGN: Analyses are based on 200 women from the Massachusetts Women's Health Study II, a population-based sample of women transitioning through the menopause who were not HRT users, who had not had a surgical menopause, and who had partners. The women were classified as pre-, peri-, or postmenopausal according to menstrual cycle characteristics. Estradiol, estrone, and follicle-stimulating hormone were also measured. Sexual functioning was measured in terms of satisfaction, desire, frequency of sexual intercourse, belief that interest declines with age, arousal compared with a younger age, difficulty reaching orgasm, and pain. Predictor variables included sociodemographics, health, vasomotor symptoms, psychological variables, partner variables, and lifestyle behaviors. RESULTS: Menopause status was significantly related to lower sexual desire, a belief that interest in sexual activity declines with age, and women's reports of decreased arousal compared with when in their 40s. Menopause status was unrelated to other aspects of sexual functioning in either unadjusted or multiple regression analyses. In analyses in which log estradiol (E2) was included in addition to menopause status, log E2 was only related to pain. In multiple regression analyses, other factors such as health, marital status (or new partner), mental health, and smoking had a greater impact on women's sexual functioning than menopause status. CONCLUSIONS: Menopause status, but not E2, is related to some, but not all, aspects of sexual functioning. This may be due to menopause per se or other factors associated with menopause and aging (e.g., increased sexual dysfunction among aging men). Menopause status has a smaller impact on sexual functioning than health or other factors.

Aging↗
PubMedDate not supplied

Sexuality and the person with a stoma: implications for comprehensive WOC nursing practice.

Pelvic surgery for bladder, colon, prostate, and gynecologic cancers or disease amelioration can affect sexual health and functioning for the long-term or short-term. A person with a permanent diversion is likely to experience longer term adjustment challenges and may suffer from serious sexual dysfunction. Wound, ostomy, and continence nurses caring for the whole person must consider this in their overall care plan. Being prepared with specific information and practical interventions can assist in this endeavor. This article targets sexuality issues for a person with an ostomy and provides suggestions for comprehensive nursing interventions.

Enterostomy↗
PubMed2006

Assessment of sexual functions after spinal cord injury in Indian patients.

This study assessed the interacting physical, psychological and social aspects of sexuality among 86 males and 14 females with spinal cord injury (SCI). Data collection involved the use of a 42-item study-specific questionnaire designed to determine different aspects of sexuality. Subjects were rated, after interview, on a scale according to an integrated index of sexual function (IISF). It was observed that patients scoring higher on this index were sexually more active and showed positive sexual adjustments. A higher incidence of complications of SCI, partner dissatisfaction, less partner co-operation, lower self-esteem and social taboos were factors responsible for less sexual activity in our patients. The present study suggests that there is a strong need for improved treatment of the medical complications of SCI, sexual counselling, literature, information and peer support in this country. We are of the opinion that the IISF can be utilized in rehabilitation settings to examine the interplay of the various complex factors in sexual rehabilitation post-SCI.

Adult↗
PubMed1992

Multiple sclerosis: will it come between us? Sexual concerns of clients and their partners.

Multiple sclerosis (MS), an unpredictable neurologic disease, is sometimes called the crippler of young adults. This crippling effect often involves sexual functioning. Sexuality is an issue that is frequently difficult for clients, their partners and health care providers to discuss. To address this difficulty, a teaching pamphlet entitled, MS ... Will it Come Between Us? was produced. Open communication and creativity are helpful in dealing with problems frequently encountered by clients with MS: fatigue, impotence, decreased vaginal lubrication, bladder and bowel dysfunction. The pamphlet helps clients with these issues as well as the basics of sexuality as a whole.

Adaptation, Psychological↗
PubMed2004

The female partner's satisfaction with sildenafil citrate treatment of erectile dysfunction.

BACKGROUND: Data on female partners' satisfaction are scarce, although there have been many articles on patient satisfaction after sildenafil citrate treatment. The aim of this study was to evaluate the satisfaction of female partners of patients receiving sildenafil citrate for their erectile dysfunction (ED) and to assess the female partners' sexual function. METHODS: Ninety-eight patients with ED were treated. Their female partners were asked to answer a questionnaire we have prepared to evaluate the efficacy of treatment, sexual satisfaction and changes in quality of life. It also included a question about female sexual function. From the results, the relationship between their female partner's satisfaction and efficacy of treatment, as well as female sexual function, were assessed. RESULTS: Thirty (31%) questionnaires were returned to us for analysis. Effectiveness of the treatment was acknowledged by 90% of the partners. An improvement in their partner's quality of life was noticed by 60% of the women. The majority (66.7%) of the female partners were satisfied with sildenafil citrate treatment and 20% were disappointed. Moreover, 20% of the female partners were concerned about adverse events. Regarding female sexual function, some form of sexual dysfunction affected 46.7% of the women. Furthermore, a significant number (P = 0.0230) of the female partners disappointed with the treatment had some kind of sexual dysfunction. CONCLUSIONS: The results indicated that female partners reported relatively high levels of treatment satisfaction. Female partners' sexual function and anxiety regarding adverse events should be evaluated when their satisfaction with sildenafil citrate treatment is poor despite an improvement of erectile function.

Adult↗