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PubMed1997

Sexual development in patients treated for cryptorchidism.

An analysis of sexual development was carried out in adult patients treated in childhood for cryptorchidism. Forty-seven healthy men served as a control group. The cryptorchid patients had been treated between the ages of 10 months to 13 years and their ages ranged from 16 to 30 years at follow-up. The onset of puberty, and sexual development, were within normal limits in all patients, although spermarche occurred somewhat later in the patients than in the controls. In addition, the patients were on average slightly less sexually active than the controls. Neither age at the time of treatment nor the method of treatment correlated with current sexual activity. The patients with larger testes were, however, sexually more active. Both treatment age and the method of treatment, whether hormonal or surgical, should be selected on the basis of fertility prognosis.

Adolescent↗
PubMed2000

Induced abortion and psychosexuality.

Little information exists on the impact of induced abortion on psychosexuality. Negative psychological effects and psychiatric complications due to termination of pregnancy seem to be rare. The objective of this study was to review the impact of induced abortion on sexuality and couple relationships. A systematic search of the literature was performed. Studies had to report a quantitative or qualitative evaluation of sexuality after pregnancy termination. Four studies were included. In the one prospective study using a control group, no difference in sexual functioning between groups after 1 year was reported. In the remaining observational studies, sexual dysfunction was reported in up to 30% of women after termination. Women undergoing abortion had significantly more conflicts in their partnerships. This was similar in all studies. Separation occurred in about one-quarter of all couples. Some studies report sexual dysfunction after termination of pregnancy. In about half of the couples separated after termination, abortion seemed not to have led to the separation. Psychological factors, together with relationship problems, might have played a role in failed contraception. The impact of induced abortion on sexuality needs to be studied in greater detail with rigorous methodology to draw firm conclusions.

Abortion, Induced↗
PubMed2001

Sexuality, partner relations and contraceptive practice after termination of pregnancy.

The aim of this study was to determine the impact of termination of pregnancy (TOP) on women's sexual well-being, the couple and contraceptive practice. In a prospective qualitative and quantitative study, 103 women undergoing induced abortion by vacuum aspiration were interviewed before the abortion and 6 months later. The interview was performed by means of a questionnaire including open and closed questions, and two psychological tests (Locke-Wallace and Horowitz). After TOP, the majority of women did not report changes in their sexual behavior and satisfaction. Eighteen per cent of women reported a decrease in sexual desire and 17% reported orgasmic disorders. About one-third of women described psychosomatic symptoms, but a minority were traumatized by the event. Ninety-eight per cent of the women were informed about, and had practiced, contraception in the past; 69% had actually used some kind of contraception during the menstrual cycle that had resulted in pregnancy (31% had had unprotected intercourse). Six months later, 83% practiced contraception, and only 17% did not. Fourteen out of 84 couples separated after TOP (one in six). Six months after TOP, the large majority of women interviewed seemed able to cope with TOP. A minority presented some persisting sexual dysfunction and/or some psychosomatic symptoms.

Abortion, Induced↗
PubMedDate not supplied

Erectile and ejaculatory function of males with spinal cord injury.

The object of the study was to investigate the frequency of physiological sexual dysfunction in a population of men with spinal cord injury (SCI). A questionnaire-based survey of admissions during 1980-84 was undertaken at a regional spinal cord injury rehabilitation unit. Male patients aged 20-63 years with complete or incomplete tetraplegia or paraplegia living in their own homes were included in the study; 43 complied with inclusion criteria, and 38 answered the questionnaire. Ninety-five per cent of the patients stated that they could obtain an erection, 61% on a purely reflex basis; 66% stated that erection was sufficient for coitus, and 45% that they could obtain ejaculation/emission. More patients with incomplete than complete lesions reported ability to obtain ejaculation/emission. Significantly, more of the patients aged below 30 years reported erection sufficient for coitus (p less than 0.05). Forty-five per cent of the patients experienced complications of sexual activity, mainly in the form of bladder dysfunction and pain or spasms. In conclusion, SCI is usually accompanied by considerable sexual dysfunction, but most patients are still capable of functioning sexually. Thus, in the rehabilitation process after SCI, sexual counselling and information may be valuable.

Adult↗
PubMed1999

Factors affecting sexual functioning of women in the mid-life years.

OBJECTIVE: To model the interaction of hormones, symptoms and psychosocial factors on women's sexuality during the menopausal transition. DESIGN AND METHODS: A prospective, observational study was carried out of a community-based sample of 438 Australian-born women aged 45-55 years at baseline. The study comprised six annual assessments in the women's own homes utilizing a core questionnaire, with rating scales for well-being and daily hassles, and a Personal Experiences Questionnaire as a measure of sexual functioning. Levels of follicle stimulating hormone (FSH), estradiol and inhibin were measured annually. Statistical analysis was performed by structural equation modelling. RESULTS: The retention rate was 90% (final sample size after exclusions, n = 354). The normal fit index for the global model obtained was 0.92. There is a significant direct effect of menopausal status on vaginal dryness/dyspareunia, and an indirect effect on sexual responsivity via a direct effect of menopausal status on symptoms, which then affect well-being. Menopausal status reflects hormonal status. Feelings for the partner and the partner's sexual problems have direct effects on different aspects of sexual functioning. Other social variables such as paid work, interpersonal stress, daily hassles and educational level affect sexual functioning indirectly via effects on symptoms and well-being. CONCLUSIONS: Psychosocial factors, symptoms and the menopausal transition affect women's sexual functioning during the mid-life years.

Aging↗
PubMed2002

Sexuality and quality of life after hematopoietic stem cell transplantation.

BACKGROUND: The quality of sexuality is significantly affected by physical changes following hematopoietic stem cell transplantation (HSCT) and the dissatisfied and/or dysfunctional sexuality may cause deterioration in the quality of life (QOL). METHODS: With two models of questionnaires, we interviewed thirty-eight patients who remained in the disease-free status after HSCT and had sex partners, to assess: 1) the changes in sexuality, 2) QOL in physical, psychological, social and spiritual domains and 3) the correlation between sexuality and QOL. RESULTS: The common physical changes that may affect sexuality in women were secondary amenorrhea (69.2%), loss of sexual interest (53.8%), diminished vaginal secretion (50%), menopausal syndrome (34.6%), dyspareunia (30.8%) and failure to orgasm (23.1%), while men complained of impotence (41.7%) and difficulty in ejaculation (16.7%). For sexuality, satisfaction of sexual activity, attainment of orgasm and frequency of intercourse decreased significantly after HSCT as compared with the pre-transplant levels. A score measuring, QOL after HSCT marked 5.91 on a full score of 10; social domain ranked the lowest (5.01) while physical domain the highest (6.70). Among the items of sexuality, only sexual desire was significantly correlated with QOL; satisfaction, orgasm and frequency were not significantly correlated with QOL. CONCLUSION: Although sexuality is affected by the physical changes following HSCT, we should not overlook the psychological and social effects on the sexuality of post-transplant patients. Therefore, educational and counseling programs are very important to restore and improve their sexuality.

Adult↗
PubMed1997

[The background factors influencing loss of sexual intercourse after transurethral resection of the prostate (TUR-P)--A study using the Sapporo Medical University-Questionnaire].

BACKGROUND: Sexual dysfunction after transurethral resection of the prostate (TUR-P) depends on multiple factors including preoperative erectile function itself. Using the Sapporo Medical University-questionnaire, we analyzed background factors contributing to loss of sexual intercourse after the operation. PATIENTS AND METHODS: We sent the self-administered questionnaires to 1,000 patients who had received TUR-P. Answers to questions were ranked as scores. Multiple regression analysis was used to identify factors significant for loss intercourse after TUR-P. RESULTS: The response rate was 63.5%. Patient with incomplete answers and those having diseases affecting voiding or sexual function and antiandrogen medication were excluded from the study. Leaving 536 patients for the final analysis. Scores for sexual desire and erectile function in the patients who received TUR-P were lower than those of age-matched healthy males. When we divided the patients according to frequency of sexual intercourse before and after TUR-P, there was distinct differences in age, scores for sensory disturbance, depression, the cooperative value of the sexual partner, sexual desire, erectile function, nocturia, residual sensation and urgency between those maintaining sexual intercourse and those having lost it. Multiple regression analysis using these factors indicated that the scores of erectile function was the most significant determinant for maintaining sexual intercourse after TUR-P in patients aged from 50 to 69 years, followed by the cooperative value of the sexual partner, residual sensation and sensory disturbance. In those 70 old and older, the score for erectile function was the most significant determinant, followed by the cooperative value of sexual partner. CONCLUSION: Our results suggest that, irrespective of age, the cooperation of the patient's sexual partner as well as erectile function significantly influence the maintenance of sexual intercourse after TUR-P. In addition, voiding condition and psychological status after TUR-P may affect the maintenance of sexual intercourse in patients in their fifties and sixties.

Aged↗
PubMedDate not supplied

Body image of women with rheumatoid arthritis.

OBJECTIVE: Physical disabilities generally cause severe disturbances in a patient's body image perception. The aim of the present study was to investigate different aspects of body image, including sexual dissatisfaction, in women with rheumatoid arthritis (RA) in relation to their subjective impression of handicap. METHODS: Forty women with RA were investigated using a series of instruments: Strauss and Appelt's questionnaire for assessing one's body (1), the body perception scale of Paulus (2), and an interview focusing on appearance, worries about health and sickness, and sexual dissatisfaction. In addition, clinical parameters and the subjective extent of morning stiffness were documented, and patients with a high degree of morning stiffness were compared to patients with a low degree of morning stiffness. RESULTS: In contrast to patients with a low degree of morning stiffness, patients with a high degree of morning stiffness worried significantly more about their bodies (p < or = 0.05) and reported significantly more problems in sexuality (p < or = 0.05). CONCLUSION: Our results suggest that morning stiffness plays a very important role in how severely a woman feels herself to be handicapped. Severely handicapped women have to deal with anxieties about health and have sexual problems. Physicians should not shy away from addressing these issues and in severe cases psychological therapy should be initiated.

Adaptation, Psychological↗
PubMed2000

The high prevalence of sexual concerns among women seeking routine gynecological care.

BACKGROUND: Sexuality is an important part of health, quality of life, and general wellbeing. Studies indicate that less than half of patients' sexual concerns are known by their physicians, and physicians are unaware of how common these sexual concerns are in their practices. Our objective was to determine the prevalence and type of sexual concerns among women seeking routine gynecological care. METHODS: We mailed the survey in waves. Of 1480 women seeking routine gynecological care from the departments of Family Practice and Obstetrics and Gynecology at Madigan Army Medical Center between August 1992 and January 1993, 964 responded. The main outcome measures were self-reported sexual concerns and their experiences with discussing these concerns with a physician. RESULTS: A A total of 98.8% of the women we surveyed reported one or more sexual concerns. The most frequently reported concerns were lack of interest (87.2%), difficulty with orgasm (83.3%), inadequate lubrication (74.7%), dyspareunia (71.7%), body image concerns (68.5%), unmet sexual needs (67.2%), and needing information about sexual issues (63.4%). More than half reported concerns about physical or sexual abuse, and more than 40% reported sexual coercion at some point in their lives. CONCLUSIONS: Our results suggest that sexual health concerns are prevalent for women seeking routine gynecological care. Sexual health inquiry should be a regular and important part of health care maintenance.

Adolescent↗
PubMed2000

Behavioural and clinical findings in couples where the man presents with erectile disorder: a retrospective study.

Relevant data were extracted from the case records of a consecutive series of 128 men (median age 57 years) who presented with erectile disorder and whose partners (median age 54 years) attended on the first or second consultation. The case records included responses to questionnaires addressing issues relating to sexual behaviour, used routinely in the clinic. Of these partners, 123 agreed to be clinically examined, including pelvic examination. The duration of erectile disorder ranged from less than one year to 40 years. Only about 10% of couples had experienced sexual kissing and/or caressing in the four weeks before presentation. Almost half the couples had not experienced any sexual activity for about 2.5 years. While 83.7% of men considered intercourse to be important to themselves, only 20.2% of the women rated intercourse somewhat or very important. Clinical evidence of urogenital atrophy was present in 33.3% of women over the age of 46 years. Three women had a vaginismic response to examination in the clinic and one of these women reported long term vaginismus pre-dating the onset of her partner's erectile disorder. One case of malignant ovarian tumour was identified. The observations from this study demonstrate the need to involve the partner in the assessment process of men presenting with erectile disorder.

Adult↗
PubMed2001

Measurement of vaginal and minor labial oxygen tension for the evaluation of female sexual function.

PURPOSE: Female sexual dysfunction is a new, rapidly expanding area of sexual medicine. Female sexual arousal disorder may, in part, be due to decreased pelvic blood flow. Therefore, we developed a simple noninvasive reproducible technique to measure vaginal and minor labial blood flow. MATERIALS AND METHODS: The study included 12 healthy young women able to have orgasm through self-stimulation. Observations at orgasm were recorded in the 12 subjects after self-stimulation. Measurements were obtained intravaginally and on the minor labia using a modified Clark oxygen electrode to obtain partial oxygen pressure (pO(2)). RESULTS: Mean basal vaginal value was 3.8 +/- 0.9 mm Hg and mean basal pO(2) on the minor labia was 18.3 +/- 3.7 mm. Hg. As soon as self-stimulation was initiated an increase in oxygen tension occurred and continued during sexual stimulation. Just before orgasm a further increase was noted with peak values measured immediately after the orgasm began (pO(2) 28.6 +/- 3.1 mm Hg intravaginally and 47.3 +/- 4.1 labial). Labial pO(2) measurement decreased relatively rapidly soon after orgasm. The time to return to basal vaginal values after orgasm varied from 20 to 30 minutes. CONCLUSIONS: Previously, changes in female sexual arousal responses have been difficult to evaluate and quantify clinically. We developed a simple noninvasive reproducible technique to measure vaginal and minor labial blood flow. Age based and cycle dependent normograms now can be produced for vaginal and labial blood flow using this method.

Adult↗
PubMed1975

[Anaphrodisia in gilts and sows(author's transl)].

The economy of pig breeding and rearing farms is determined mainly by the fertility of the animals. Anaphrodisia causes a considerable disturbance of the fertility. This has a direct effect on the number of litters born per sow per year and thus on the economic results. On the basis of several years of experience at the research station and the production unit of Varkensonderzoekcentrum Nieuw-Dalland the clinical symptoms in gilts and sows are described. Gilts should normally have come into oestrus at the age of about 8 months, and on a well-managed farm about 80% of the sows should come into oestrus within 10 days of weaning, provided that weaning takes place at 5 to 6 weeks. Different forms of anaphrodisia are described, based on the findings of post mortem examinations. These show that in 65-75% of the anaphrodisiac animals the ovaries were insufficiently active. In 20% of the animals that had not shown signs of oestrus, ovulation had in fact taken place. The causes of anaphrodisia must be sought in a disturbance of the hypothalamo-hypophysial ovarian system, in which genetic and health factors play an important role, besides housing and management (insluding feeding). A good keeping of records of sows is indispensable in the solving of the anaphrodisia problem on farms, and this hinges also on an analysis of the farm management and on the power of observation of the farmer. Finally, hormonal therapy is discussed, a distinction being made between breeding and rearing farms.

Age Factors↗