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PubMed2003

Relationship between obesity-related metabolic abnormalities and sexual function.

Obesity is increasing worldwide. In fact, within the next 20 years it is likely to become an epidemic condition. As obesity is characterized by a variety of severe co-morbidities, it imposes a tremendous burden to health care systems of western societies. Among these, although less recognised, there is also sexual dysfunction. This short review will first give some details about the prevalence of sexual dysfunction among obese people, and then focus on the role of obesity in the negative modulation of sexuality. In detail, it will be reported about the 3 possible mechanisms through which obese people may suffer from sexual dysfunction: a) insulin resistance and associated hormonal changes, b) dyslipidemia and related drugs, and c) psychological problems.

Humans↗
PubMed2003

Stress, sexual dysfunctions, and male infertility.

Involuntary childlessness is considered to be a chronic stressor for couples suffering from infertility. Stress itself may interfere with spermatogenesis and fertility rate. The long period of diagnostic and treatment procedures may also have a negative impact on the sex life of the infertile couple. In fact, we observed in such patients a higher frequency of male sexual disturbances expressed as erectile dysfunction, ejaculatory disorders, loss of libido and a decrease in the frequency of intercourse. We tried to partially overcome these sexual symptoms by administration of 50 mg of a type-V phosphodiesterase inhibitor (sildenafil) to two selected groups: patients collecting semen for artificial insemination and male partners of couples before post-coital testing. The results of this uncontrolled pilot study suggest that sildenafil is effective in increasing compliance of male patients facing infertile couple management procedures, and also in improving some sperm parameters, above all the number of sperm penetrating the cervical mucus.

Humans↗
PubMed2003

Role of testosterone in feminine sexuality.

Gonadal steroids play a crucial role in maintaining the anatomical and functional integrity of all the structures involved in feminine sexual response. While the role of estrogens on the activity of neuroendocrine circuitries and on the trophism of genital organs has been well established, the contribution of androgens to female physical and mental well-being is still a matter of debate. Recent studies reconsidered the sources, production rates, circulating concentrations and regulatory mechanism of the major androgen precursors and androgens in women throughout the reproductive life span, as well as the wide variety of actions at the target tissues. Collectively, these reports support the therapeutic use of androgens in women, mainly to cure sexual dysfunctions, one of the consequences of menopause.

Androgens↗
PubMed2003

The challenge of sexual medicine for women: overcoming cultural and educational limits and gender biases.

Women's sexuality is multifactorial, rooted in biological, psychosexual and context-related factors, correlated not only to the couple concerned, but also to family and socio-cultural issues. Female sexual identity, sexual function and sexual relationship interact to give female sexual health its full meaning or, on the contrary, its problematic profile. Women's sexuality is discontinuous throughout the life cycle and is dependent on personal, current contextual and relationship variables as well as historical factors. Female sexual dysfunctions (FSD) occur along a continuum from dissatisfaction (with or without significant distress) to complete dysfunction (with or without significant distress). Sexual problems reported by women are not discrete and often co-occur, co-morbidity being one of the leading characteristics of female sexual dysfunctions. Socio-cultural factors may modulate the expression and complaining modality, i.e. wording of a sexual disorder. The meaning of sexual intimacy is to be understood, as it is indeed a strong modulator of the sexual response and of the quality of satisfaction the woman experiences, besides being the simple adequacy of the sexual function. Quality of feelings for the partner and the partner's health and sexual problems may further contribute to FSD. To improve women's sexual health, physicians should receive a formal training in sexual medicine both in the general medical training and in the speciality course; should become competent in the first level medical diagnosis of FSD; have an interdisciplinary approach and acknowledge the socio-cultural and context-dependent differences in FSD etiology and wording.

Cultural Characteristics↗
PubMed2003

[Disseminated sclerosis and sexuality].

Since the onset of multiple sclerosis (MS) mainly occurs in younger persons between the age of 20 and 40, sexual dysfunctions have great impact on their quality of life. About 50% of all female and about 75% of all male patients complain of sexual dysfunctions. The primary symptoms among males are erective and ejaculative dysfunctions and reduced libido, while female patients mainly complain of reduced libido, problems achieving orgasm, decreased vaginal lubrication and changes in vaginal sensitivity. Secondary organic symptoms include fatigue, spasticity, muscular weakness, bladder problems, pain, cognitive and behavioural changes. Tertiary dysfunctions refer to general psychosocial problems in relation to chronic, progressive disease. One third of all couples in which either the man or the woman suffers from MS complain of problems in sexual and marital life, where especially the healthy female partner in general has sexual problems. Diagnosing and treating sexual dysfunctions in MS should ideally be carried out by a specialized "MS-team" with the core professionals being the neurologist, urologist, (neuro) psychologist and the nurse. Information about symptoms and their possible causes is an important part of the treatment, and not least learning more efficient coping strategies. Both for the patient and for the couple honest and open informative communication including information about sexual aids and perhaps also medical treatment will often result in minimizing the sexual problems and increasing quality of life.

Adaptation, Psychological↗
PubMed2003

[Pleasure and pain in sexual relations. The basis and reasons for sex counseling by the general practitioner].

An essential factor for successful sex counseling by the family doctor is an atmosphere of openness and trust between physician and patient. However, few patients will begin to talk about their sexual problems of their own accord. The physician should therefore allow himself sufficient time for such counseling, be aware of his own limitations, and develop an ear attuned to involuntary remarks by the patient. During talks, only sparse use should be made of technical terms, the better to encourage the patient. The problems most commonly described in the doctor's office are functional disorders with a psychosomatic cause, and triggering factors may vary considerably (a high level of stress at the workplace, social or financial crises, monotonous leisure activities). In view of this, a somatic investigation should always be preceded by careful history-taking.

Adult↗
PubMed2003

[Sexual function in postmenopausal women using hormone replacement therapy].

BACKGROUND: The loss of sexuality observed in the climacteric period is difficult to evaluate. An important advance has been the development of the Female Sexual Function Index (FSFI), a test based on the norms of the International Consensus Development Conference on Sexual Female Dysfunctions. AIM: To study the effects of hormone replacement therapy (HRT) on sexuality, applying the FSFI. MATERIAL AND METHODS: The FSFI was applied to 300 healthy women between 45-64 years, sexually active, beneficiaries of the Southern Metropolitan Health Service. RESULTS: The mean age of the sample studied was 51 +/- 5 years, 27% were HRT users, 21% had had an hysterectomy and 98% had a stable couple. The total score of the FSFI decreased from 27.3 +/- 5.8 in women between 45 and 49 years of age to 19.3 +/- 7.0 in women between 60 and 64 years (p < 0.01). A significantly better sexuality was observed in HRT users, with FSFI scores of 28.1 +/- 5.5 and 24.6 +/- 6.8 in HRT users and non users, respectively (p < 0.01). Women on HRT obtained a higher score in all of the test domains, especially in lubrication, orgasm and sexual satisfaction. CONCLUSIONS: Female sexuality decreases with aging. HRT users have a better sexual function than non users.

Cohort Studies↗
PubMed2004

Differences in sexual functioning between patients with benign and malignant breast tumors.

The aim of this study was to compare differences in sexual behavior between patients with benign and malignant breast tumors. A total of 187 patients treated for breast tumors (benign or malignant) at the General Hospital >>Pozega<<, Croatia, filled in the questionnaire between January 2001 and May 2003. Patients were asked to fill in the questionnaire one to ten years after treatment of breast tumor, while they were on their regular control visit. Deterioration in sexual life experienced 36.27% of patients with benign tumors and 51.76% of patients with malignant tumor (p<0.01). The main reason of sex life impairment in both groups was distortion of body image perception. Most of partners did not change their behavior toward women with breast tumors (48.72% for benign group and 41.82% or malignant group, p>0.05). A great amount of women in both groups felt certain change in her >>body image<<, but in greater extent in malignant group (41.18% vs. 25.49%), (p<0.05). From our results we can see that patients in this study do not recognize need for consultation with their physician regarding sex life after treatment of tumor (41.18% for benign and 35.29% in malignant group). It can be concluded that considerable amount of attention should be given to psychological aspects of recovery which can improve prognosis and quality of life in general.

Adult↗
PubMed2005

[Why women consult sexologists: an approach for practicing physicians].

Female sexual dysfunctions are less known than male ones because women are more discrete and introverted. Female genitals are mostly internal and women live sex more cerebrally and sentimentally than men. Still half the patients my current sexological consultation are women. They seek help due for lack of desire, frigidity, coital or clitoridal anorgasmy, dyspareuny, vaginism and problems related to pregnancy or the post-partum period. This article describes how to construct a precise clinical etiology following a "5 circles" scheme, which will help to determine the most adequate therapeutic approach.

Female↗