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Results for “Sexual Dysfunction, Physiological”

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PubMed2006

A cross-national study of subjective sexual well-being among older women and men: findings from the Global Study of Sexual Attitudes and Behaviors.

Subjective sexual well-being refers to the cognitive and emotional evaluation of an individual's sexuality. This study examined subjective sexual well-being, explored its various aspects, examined predictors across different cultures, and investigated its possible associations with overall happiness and selected correlates, including sexual dysfunction. Data were drawn from the Global Study of Sexual Attitudes and Behaviors, a survey of 27,500 men and women aged 40-80 years in 29 countries. The cross-national variation of four aspects of sexual well-being (the emotional and physical satisfaction of sexual relationships, satisfaction with sexual health or function, and the importance of sex in one's life) was explored using cluster analysis, and relationships among sexual well-being, general happiness, and various correlates were examined using ordinary least squares regression and ordered logistic regression. Results from the cluster analysis identified three clusters: a gender-equal regime and two male-centered regimes. Despite this cultural variation, the predictors of subjective sexual well-being were found to be largely consistent across world regions.

Adult↗
PubMed2006

Diminished sexual activity, interest, and feelings of attractiveness among HIV-infected women in two eras of the AIDS epidemic.

Despite the high prevalence of sexual inactivity, decreased sexual desire, and poor sexual satisfaction documented among HIV-infected individuals, women's experiences of sexuality following HIV-infection and their reasons for these sexual changes remain little examined. Further, the potential effects of the availability of highly active antiretroviral therapy (HAART) medications on their sexuality have not been explored among women living with HIV/AIDS. To examine these issues, focused interviews were conducted with two samples of women living with HIV/AIDS: one before the advent of HAART and a second matched sample interviewed after HAART became widely available. Women in both the pre-HAART and HAART eras frequently discussed decreased sexual activity, a loss of sexual interest, and a diminished sense of sexual attractiveness following their HIV infection. In addition, they reported a number of reasons for why they had discontinued sexual activity or were no longer interested in sex, including anxiety about HIV transmission, a loss of freedom and spontaneity during sex, fears of emotional hurt, not wanting the hassle of sexual relationships, a loss of sexual interest, and a diminished sense of sexual attractiveness. However, the types of changes in their sexuality women described, nor the reasons offered for these changes, did not differ between women in the pre-HAART and HAART eras. The findings suggest that therapeutic intervention may be needed by some HIV-infected women to overcome difficulties in resuming healthy sexual relationships following their HIV diagnosis and offer insights into the potential content of such intervention efforts.

Adult↗
PubMed2006

Emotions during sexual activity: differences between sexually functional and dysfunctional men and women.

The present study investigated the differences in emotional response to automatic thoughts presented during sexual activity between sexually functional and dysfunctional men and women. A total of 376 participants (160 women and 120 men without sexual problems and 47 women and 49 men with a DSM-IV-TR diagnosis of sexual dysfunction) completed the Sexual Modes Questionnaire (SMQ male and female versions; P. J. Nobre & J. Pinto-Gouveia, 2000) and measures of sexual functioning: The International Index of Sexual Function (IIEF; R. C. Rosen et al., 1997), and The Female Sexual Function Index (FSFI; R. C. Rosen et al., 2000). The SMQ is a combined measure constituted by three interdependent subscales: Automatic Thought subscale (AT), Emotional Response subscale (ER), and Sexual Response subscale (SR). Emotions were assessed by the ER subscale, where participants endorsed emotional reactions (worry, sadness, disillusion, fear, guilt, shame, anger, hurt, pleasure, satisfaction) to a list of automatic thoughts (AT subscale) that may occur during sexual activity. Results showed that both men and women with sexual dysfunction had significantly less positive emotional reactions to automatic thoughts during sexual activity. Sexually dysfunctional men had significantly more emotions of sadness, disillusion, and fear, and less pleasure and satisfaction, compared to men without sexual problems. Women with sexual dysfunction had significantly less pleasure and satisfaction, and more sadness, disillusion, guilt, and anger. Findings were congruent with recent studies indicating that emotions related to depressed affect (sadness, disillusion, lack of pleasure) as opposed to negative emotions (mostly related to anxiety) were stronger correlates of sexual dysfunction.

Adult↗
PubMed2006

Sexual and relationship functioning in men with chronic prostatitis/chronic pelvic pain syndrome and their partners.

This study compared the sexual and relationship functioning of 38 male patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) to that of their female partners, and of both the men and women in these couples to those in 37 control couples. Male sexual function was also examined as a predictor of partner sexual function. In comparison to control males, the men with CP/CPPS reported significantly more sexual dysfunction and symptoms of depression. Furthermore, symptoms of depression mediated the relationship between some aspects of sexual function and male participant status as a patient or control. However, men with CP/CPPS did not report significantly decreased sexual satisfaction or relationship functioning compared to controls. Partners of men with CP/CPPS reported significantly more pain upon intercourse, vaginismus, and depressive symptoms when compared to control females. In addition, patients with CP/CPPS and their partners did not differ significantly from each other with regard to sexual functioning and satisfaction, relationship functioning, and symptoms of depression. Patient sexual functioning significantly predicted female partner sexual functioning. This study was the first to evaluate partners of men with CP/CPPS. Patients and partners in this study reported lower levels of sexual functioning in some domains, yet were comparable to control couples on measures of satisfaction and relationship functioning. Furthermore, the sexual and relationship functioning of patients and partners was significantly associated. The results of this study have implications for the assessment and management of CP/CPPS and for future research in this area.

Adult↗
PubMed2007

The impact of sexual coercion on psychological, physical, and sexual well-being in a representative sample of Australian women.

It is well established that, compared to other women, women who have been forced or frightened into unwanted sexual activity have poorer psychological, physical, and sexual health. However, it is not clear whether particular experiences of sexual coercion, such as younger age when coerced or number of times coerced, are more likely to lead to poorer health status. This study of a representative sample of Australian women aged 16-59 years was designed to examine such associations. Of the 9134 women recruited for the study, 885 (21%) had been sexually coerced, which was defined as being forced or frightened into unwanted sexual activity. This study showed that any experience of sexual coercion was associated with poorer psychological, physical, and sexual health. The data revealed no consistent associations between health status and particular characteristics of sexual coercion, such as the age when women were coerced, the number of times they had been coerced, or the time since being coerced. Two of the few significant findings were that women who had been coerced more than once reported significantly greater psychosocial distress, and that women first coerced when aged 13-16 reported poorer physical well-being than women first coerced at younger or older ages. There was no significant association between whether women had consulted a psychologist or other professional counselor and better health status. The absence of consistent associations between health status and particular characteristics of sexual coercion indicates a need for care and support services for all women who have been sexually coerced.

Adolescent↗
PubMed2005

Evaluation of the role of pudendal nerve integrity in female sexual function using noninvasive techniques.

OBJECTIVE: Using quantitative sensory testing and a validated questionnaire, we investigated the role of pudendal nerve integrity in sexual function among women. STUDY DESIGN: Participants completed the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ). Vibratory and pressure thresholds were measured at the S2 dermatome reflecting pudendal nerve distribution. RESULTS: A total of 56 women enrolled; 29 (51.8%) were asymptomatic and 27 (48.2%) had 1 or more forms of female sexual dysfunction (total sexual dysfunction) including: desire disorder 16.1%, arousal disorder 26.8%, orgasmic disorder 25%, and pain disorder 12.5%. Age, parity, menopausal status, and body mass index were similar between groups. PISQ scores were lower in symptomatic subjects compared with controls (P < .001). Decreased tactile sensation was found at the clitoris for women with total sexual dysfunction, desire disorder, and arousal disorder. Women with arousal disorder also had decreased tactile sensation at the perineum. CONCLUSION: Pudendal nerve integrity may play a role in female sexual dysfunction.

Adult↗
PubMed2005

Sexuality.

This article reviews changes in sexual function in middle-aged women and discusses how these changes relate to aging, hormone alterations, and psychosocial and physical factors. A Medline search of population-based studies that measured sexual function, menopausal status and/or hormone levels was conducted. Longitudinal findings are from the Melbourne Women's Midlife Health Project, a population-based sample of 438 Australian-born white women, aged 45 to 55 years, who were menstruating at baseline. Annual assessments included hormone levels and the Short Personal Experiences Questionnaire. Few of the population-based studies of the menopausal transition measured sexual function or hormones. Aging and the length of the woman's relationship with her partner are associated with decline in sexual function. An additional decrement in sexual function occurs in midlife associated with menopause. Findings from the Melbourne Women's Midlife Health Project using structural equation modeling, found the most important factors influencing a woman's sexual function are prior level of sexual function; losing or gaining a sexual partner; feelings toward a partner; and estradiol level. When psychosocial and lifestyle status were added to the model, mood was the only additional variable affecting sexual function. There is a decline in all aspects of female sexual function with age. A further incremental decline in most aspects of sexual function occurs as women pass through the menopausal transition and is related to decreasing estradiol levels. Other factors such as prior sexual function and partner issues have larger effects on women's sexual function than do hormonal factors.

Aging↗
PubMed2006

Altered sexual health and quality of life in women prior to hematopoietic cell transplantation.

The purpose of this cross-sectional descriptive study is to define sexual dysfunction and menopausal symptoms in women following cytotoxic or immunosuppressive medication for the treatment of malignant or life-threatening hematolymphoid diseases. These women were preparing to undergo hematopoietic cell transplantation (HCT) as the next step in their treatment plan. It is assumed that sexual dysfunction and symptoms of premature menopause are more pronounced post-HCT due to the intensity of the preparative regimen on the hypothalamic-pituitary-gonadal axis. This study included 48 pre-menopausal women and 28 spouses/partners. Data were collected using five self-report instruments (demographic and medical, the Female Sexual Function Index, the Menopause-specific Quality of Life, the Psychosocial Adaptation to Illness Scale, and a global quality of life score). The main research variables were female sexual functioning, symptoms of menopause, and quality of life. The findings indicate that 73% of women report decreased libido and 48% report dissatisfaction with their overall sex life. Hot flashes, the most common symptom of menopause are reported by 46% and 27% report the hot flashes moderate to severe in intensity. Vaginal dryness was reported by 35% with 23% reporting the vaginal dryness to be moderate to severe. The mean quality of life (QOL) score in women was 69+/-25 with a range of 2-100 (on a scale of 0-100 with 100 being an excellent QOL). The findings indicate that women treated with standard dose chemotherapy and immunosuppressive therapy for malignant and life-threatening hematolymphoid diseases experience alterations in sexual health and symptoms of premature menopause. The results show that the desire, arousal, and orgasm phase of the sexual response cycle are altered. Additionally, nearly half of the women are experiencing hot flashes, the most common symptom of menopause and over a third report vaginal dryness. There are statistically significant correlations between altered sexual health, menopausal symptoms, and QOL scores.

Adaptation, Psychological↗
PubMed2006

Psychobiologic correlates of the metabolic syndrome and associated sexual dysfunction.

OBJECTIVES: The association of low testosterone level and erectile dysfunction (ED) with metabolic syndrome (MS) is receiving increasing attention. The present study determined the psychobiologic characteristics of sexual dysfunction (SD) associated with MS (as defined by the National Cholesterol Education Program's Adult Treatment Panel III criteria) in a series of 803 consecutive male outpatients. METHODS: Several hormonal, biochemical, and instrumental (penile Doppler ultrasound [PDU]) parameters were studied, along with general psychopathology scores (Middlesex Hospital Questionnaire modified [MHQ]). The Structured Interview on Erectile Dysfunction (SIEDY) was also applied. RESULTS: Among the 236 patients (29.4%) diagnosed as having a MS, 96.5% reported ED, 39.6% hypoactive sexual desire (HSD), 22.7% premature ejaculation, and 4.8% delayed ejaculation. Patients with MS were characterised by greater subjective (as assessed by SIEDY) and objective (as assessed by PDU) ED and by greater somatised anxiety than the rest of the sample. The prevalence of overt hypogonadism (total testosterone <8 nM) was significantly higher in patients with MS. Among MS components, waist circumference and hyperglycaemia were the best predictors of hypogonadism. Hypogonadal patients with MS showed higher gonadotropin and lower free testosterone levels, suggesting a primary hypogonadism. Among patients with MS, hypogonadism was present in 11.9% and 3.8% in the rest of the sample (p<0.0001) and was associated with typical hypogonadism-related symptoms, such as hypoactive sexual desire, low frequency of sexual intercourse, and depressive symptoms. CONCLUSIONS: Our data suggest that MS is associated with a more severe ED and induces somatisation. Furthermore, MS is associated with a higher prevalence of hypogonadism in patients with SD. The presence of hypogonadism can further exacerbate the MS-associated sexual dysfunction, adding the typical hypogonadism-related symptoms (including HSD, 66.7%). Recognising MS associated with hypogonadism is important for both sexual and general health and its serious potential associated risks.

Adult↗
PubMed2006

Sexual functioning and congenital heart disease: Something to worry about?

BACKGROUND: Although sexual problems in cardiac patients are receiving increasing attention, research on sexual functioning of patients with congenital heart disease is very scarce. Therefore, this study investigated sexual functioning in adults with congenital heart disease and compared this with that of matched, healthy control subjects. METHODS: A descriptive, comparative study was conducted, in which 441 adults with congenital heart disease were matched to 441 healthy counterparts, according to age, gender, and marital status. The sample consisted of 53.5% males. Median age was 24 years. Disease-specific determinants of quality of life were assessed using the CHD-TAAQOL. This 77-item instrument includes five items referring to sexual problems. For each item, both the perceived frequency and the associated distress were scored. RESULTS: Sexual problems were perceived by 10% to 20% of the patients. When these problems occurred, they were distressing in 67% to 88% of the patients. Female patients reported significantly more often 'not enjoying having sex', 'being insecure about having sex', and 'not being aroused while having sex', and experienced more distress at 'being insecure about having sex' than male patients. Congenital heart disease patients reported significantly fewer 'not enjoying having sex' and 'worrying about your sex life' than healthy counterparts, but experienced more distress at 'worrying about your sex life'. CONCLUSION: In this study, we found that only a minority of adults with congenital heart disease reported sexual problems. This suggests that sexual functioning in this group of patients is not as problematic as in some other cardiac populations.

Adolescent↗
PubMed2005

Clitoral therapy device for treatment of sexual dysfunction in irradiated cervical cancer patients.

PURPOSE: The purpose of this pilot study was to evaluate the efficacy of the clitoral therapy device (Eros Therapy) in alleviating sexual dysfunction in irradiated cervical cancer patients. METHODS AND MATERIALS: Eligible patients had a history of cervical cancer treated with radiotherapy and self-reported sexual dysfunction of sexual arousal and/or orgasmic disorders. Patients used the noninvasive, nonpharmacologic clitoral therapy device using a hand-held, battery-powered vacuum to cause clitoral engorgement four times weekly for 3 months during foreplay and self-stimulation. Study instruments included the Female Sexual Function Index, Derogatis Interview for Sexual Functioning, and Dyadic Adjustment Scale. The outcome evaluation was performed at 3 months. RESULTS: Between 2001 and 2002, 15 women were enrolled and 13 completed the study. The median patient age and radiotherapy-enrollment interval was 43.5 years and 2 years, respectively. At baseline, all patients reported symptoms of sexual arousal and/or orgasmic disorders, and some also had sexual desire and pain disorders. At 3 months, statistically significant improvements were seen in all domains tested, including sexual desire, arousal, lubrication, orgasm, sexual satisfaction, and reduced pain. The median Female Sexual Function Index total score increased from 17 to 29.4 (maximal score, 36; p <0.001). The median Derogatis Interview for Sexual Functioning total raw score increased from 46 to 95 (maximal score, 118; p <0.001). At baseline, the Derogatis Interview for Sexual Functioning total T-score corresponded to the bottom 10th percentile of normal sexual functioning. At 3 months, the total T-score placed the patients at the normalcy cutoff. Gynecologic examinations revealed improved mucosal color and moisture and vaginal elasticity and decreased bleeding and ulceration. CONCLUSION: Our results from this pilot study suggest that the clitoral therapy device may alleviate sexual dysfunction in irradiated cervical cancer patients. A randomized, controlled trial is warranted to assess the full benefits of this approach.

Adult↗
PubMed2006

Sexual and psychological symptoms in the climacteric years.

OBJECTIVES: To provide epidemiological data about psychological and sexual functioning during menopausal transition in a large Italian non-clinical sample, and to investigate their correlation with life events. METHODS: The study design was a cross-sectional postal survey of a menopausal sample of women recruited from the General Registry Office in Ferrara's province. The sample was composed of four thousand and seventy-three women; they were sent a questionnaire designed on the basis of the Women's Health Questionnaire (WHQ). Together with the WHQ, the subjects filled out a personal file to define social status, cultural level, family's characteristics, recent menstrual cycles, gynaecological history and operations, drug assumption, life events in the last year, and lifetime depression. RESULTS: One thousand three hundred and forty-five women provided usable questionnaires. Factor analysis resulted in eight clusters: somatic symptoms, depressive symptoms, depressed mood with anxiety symptoms, cognitive difficulties, anxiety, sexual functioning, vasomotor symptoms and sleep problems. Mood and sexual function were impaired through the menopausal transition, with depressive and sexual symptoms being higher in the post-menopausal group compared to the pre-menopausal one. Therefore, the correlation between the two was greater in the pre- and peri-menopausal period. CONCLUSION: Depressive and sexual symptoms presented greater severity in the post-menopausal group. Both clusters of symptoms were strongly associated with life events. The parallel course of the two clusters could be related with a common pathoplastic action of life events, both on sexual symptoms and on depressive symptoms, occurring right at the time that a woman has to face the transition into menopause.

Anxiety↗
PubMed2006

Female androgen insufficiency.

FAI, seen commonly and often caused by aging and ovarian dysfunction, still presents a challenge to clinicians because of some unresolved and unattended aspects of the condition, including standardized diagnosis and management. Although the use of androgens in women who have FAI has been shown to be effective, there are no FDA approved androgen preparations available at this time for women. Large scale, long-term, controlled trials focusing on establishment of valid and standardized diagnosis and treatment options are needed.

Adrenal Glands↗
PubMed2005

Infertility: a label of choice in the case of sexually dysfunctional couples.

OBJECTIVES: In Indian society infertility and sexual dysfunction are stigmatized characteristics. The aim of the study was to explore which label couples who have both complaints, prefer to describe their situation, and whether gender differ occur in this preference. METHODS: A total of 40 couples - all clients of the reproductive health clinic of the King Edward Memorial Hospital in Pune because of problems with infertility and sexual dysfunction - participated in this study. Data were collected by means of interviews. RESULTS: The findings show that sexual activity decreased as the number of childless years increased. However, the interspouse-relationship gets stronger and more supportive. The couples never revealed their sexual dysfunction to others. When the husband was sexually dysfunctional, the couples preferred to label their situation as 'infertility' in order to avoid stigma. CONCLUSION: Issues that are related to sexual dysfunction, sexual behavior, inter-spouse relationship and communication are important aspects into the reality of an infertile couple's life. PRACTICE IMPLICATION: In planning the treatment clinicians should give more attention to the specific cultural context of these aspects.

Adaptation, Psychological↗