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PubMed2006

Female sexual dysfunction in a population-based study in Iran: prevalence and associated risk factors.

To explore the prevalence and risk factors of female sexual dysfunction (FSD) in Iran. A total of 2626 women aged 20-60 years old were interviewed by 41 female general practitioners and answered a self-administered questionnaire on several aspects of FSD including desire, arousal, pain and orgasmic disorders (OD). Criteria of sexual dysfunction followed classification by DSM-IV. The sexual function was evaluated by the Female Sexual Function Index (FSFI). The subjects were randomly identified from 28 counties of Iran. Data on medical history, toxic habits and current use of medication were also obtained. Of the women interviewed, 31.5% (759) reported FSD. The prevalence increased with age, from 26% in women aged 20-39 years to 39% in those >50 years (tested for trend P<0.001). Thirty-seven percent reported OD, 35% desire disorders (DD) and 30% arousal disorders (AD), all of which increased significantly with age. Pain disorders were reported by 26.7%, occurring most frequently in women aged 20-29 years. The educational level (P=0.01) and marriage age (<18 years) (P=0.04) were inversely correlated with the risk of DD, OD and AD. No significant differences were detected in smoking history (P=0.18), the presence of previous pelvic surgery (P=0.08) and contraception methods used (P=0.42). A history of psychological problems (P=0.04), married status (P=0.03), low physical activity (P=0.012), chronic disease (P<0.01), multiparity (P<0.05) menopause status (P<or=0.01) and spousal erectile dysfunction (P=0.01) were significantly associated with FSD. This study provides a quantitative estimate of the prevalence and the main risk factors for FSD in Iranian women.

Adult↗
PubMed2006

Sexual problems among married Nigerian women.

We interviewed and examined 293 married women, 15-49 years of age, seeking primary care at a teaching hospital in central Nigeria. One or more sexual problems were identified in 71% of women. The proportion of specific sexual problems was 39% for a desire problem, 40% for an arousal problem, 31% for a sex pain problem and 55% for an orgasmic problem. Poor marital communication, lack of foreplay, Islamic religion and advancing age were independently associated with a desire problem. Absence of foreplay was independently associated with an arousal problem. Lack of foreplay, lower abdominal pain, gynaecological conditions, working outside the home and younger age were independently associated with a sex pain problem. The absence of foreplay, poor marital communication and being a housewife were independently associated with an orgasmic problem. Sexual problems are common among married Nigerian women seeking outpatient care.

Adolescent↗
PubMed2006

Influence of weight reduction by sibutramine on female sexual function.

BACKGROUND: It is well known that selective serotonin reuptake inhibitors (SSRIs) can cause sexual dysfunction, so it is possible that sibutramine, a serotonin and norepinephrine reuptake inhibitor, could induce sexual dysfunction. DESIGN AND SUBJECTS: The effect of sibutramine on sexual function was evaluated in 46 overweight and obese (body mass index (BMI) > or = 23 kg/m2) but otherwise healthy married women (28-44 years). Participants were randomly assigned at baseline to either the sibutramine or control group. The Female Sexual Function Index (FSFI) questionnaire was used to assess sexual function at baseline and after treatment with behavioral therapy plus sibutramine 10 mg once daily or behavioral therapy alone (control) for 8 weeks. RESULTS: Mean weight loss from baseline to week 8 was -6.03% in sibutramine group and -0.38% in the control group. There was significant improvement of FSFI total score, arousal domain score and lubrication domain score in the sibutramine group (P<0.05), and significant differences in arousal, orgasm, satisfaction domain score and total score (P<0.05) in favor of sibutramine. Decreases in body weight and BMI were correlated with the improvement of arousal (r = -0.44 and r = -0.48, respectively) and orgasm (r = -0.45 and r = -0.46, respectively) domains. CONCLUSION: Treatment with sibutramine plus behavioral therapy did not induce sexual dysfunction and sibutramine-induced weight reduction appeared to have a positive impact on sexual function in this small group of overweight and moderately obese women. The degree of improvement in sexual function was correlated with the degree of weight reduction.

Adult↗
PubMed2006

Serotonin 2A -1438 G/A and G-protein Beta3 subunit C825T polymorphisms in patients with depression and SSRI-associated sexual side-effects.

The occurrence of sexual side-effects from antidepressants is thought to be mediated through serotonin 2A (5HT2A) receptors. It is currently unknown if functional polymorphisms in the 5HT2A receptor or its G-protein second messenger complex are related to sexual dysfunction in patients taking an selective serotonin reuptake inhibitor (SSRI) for depression. The purpose of this study was to determine the relationship of the 5HT2A -1438 G/A and GNB3 C825T single nucleotide polymorphisms with overall sexual well-being and individual components of sexual health as measured by the Changes in Sexual Functioning Questionnaire (CSFQ). We evaluated 89 outpatients (18-40 years of age) at low risk for other causes of sexual dysfunction who were being treated for depression with an SSRI and did not have sexual difficulties before taking the antidepressant. Outcome measures were stratified by 5HT2A and GNB3 genotypes. After controlling for age, gender, anxiety scale scores, and depression scale scores, persons with a GG genotype of the 5HT2A -1438 single nucleotide polymorphisms (SNP) were significantly more likely to be categorized as having sexual dysfunction than persons with a GA or AA genotype (OR=3.6; 95% CI 1.03, 12.6; p=0.046). Furthermore, the 5HT2A -1438 GG genotype was a significant predictor of lower arousal scores (p=0.022) after accounting for other measures. There was no significant relationship between any outcome measure and GNB3 genotype.

Adolescent↗
PubMed2000

Unconsummated marriage: clarification of aetiology; treatment with intracorporeal injection.

OBJECTIVE: To clarify the aetiological factors in unconsummated marriage in Iran, and to report the results of intracorporeal injection therapy for erectile dysfunction in these circumstances. PATIENTS AND METHODS: During a 2-year period, 200 cases of unconsummated marriage were evaluated. A detailed history was obtained to clarify the circumstances of the problem; if simple measures failed to resolve the problem, intracorporeal injection with papaverine +/- phentolamine was used. RESULTS: The main factor associated with an unconsummated marriage was the intense social pressure to accomplish hasty coitus with an unfamiliar woman (some men having had no social contact with their new bride) and in the presence of relatives waiting nearby for evidence of the bride's virginity and confirmation of coitus. The initial problem was then further compounded with resultant erectile failure caused by anxiety about sexual performance. Inability to consummate the marriage was caused by premature ejaculation in 23%, erectile dysfunction in 61%, and a combination in 16%; 70% of patients were able to consummate the union after intracorporeal injection with papaverine +/- phentolamine. CONCLUSIONS: In addition to psychological causes and a lack of sexual education, the social circumstances in which partners are obliged to initiate and complete coitus are important factors in the aetiology of unconsummated marriage. Intracorporeal injection is useful in treating this problem and it should be the therapy of choice for unconsummated marriage in developing countries, where the conditions do not favour psychotherapy and where alternative erectogenic agents are expensive or unavailable.

Adolescent↗
PubMed2003

[Position of sexual medicine in medical specialties].

The position of sexual medicine among the different medical subspecialities is discussed. Sexuality is seen under its socio-communicative, reproductive and lust-aspects which in turn influence specific characteristics of sexual medicine, as e.g. its biopsychosocial way of thinking, its focus on the couple, the alloying of different forms of therapy and especially the stressing of the communicative meaning of sexual behaviour as a form of non-verbal communication. Hence therapeutic interventions aim at the restoration of the sexual relationship as a means of fulfilling fundamental needs and desires as for acceptance, warmth, security and so on and thus exceed the cure of the sexual dysfunction. Sexual Medicine should be integrated into the study of medicine as a subject of its own.

Austria↗
PubMed2005

Utilizing hypnosis and ego-state therapy to facilitate healthy adaptive differentiation in the treatment of sexual disorders.

Much of the literature focuses on the pathology that falls to the far right of the Watkins (1997) differentiation-dissociation continuum, such as Dissociative Identity Disorder and Dissociative Disorder NOS. Adding a "far left" to this continuum, as well as a construct of what the "far left" looks like, makes apparent the value of healthy adaptive differentiation for those individuals that fall to the "far left" of the spectrum; those who don't differentiate enough. A discussion of sexual dysfunction at this end of the continuum and cases of Hypoactive Sexual Desire Disorder and Vaginismus demonstrate the clinical effectiveness of an approach combining hypnosis and ego-state therapy to facilitate healthy adaptive differentiation.

Adaptation, Psychological↗
PubMed2002

Sexual dysfunction: overview of prevalence, etiological factors, and treatments.

Sexual dysfunctions and sexual problems are reviewed from the perspective of prevalence, broad etiological factors, and available treatments. Although a large percentage of individuals experience sexual problems, with estimates between 10 and 52% of men and 25 and 63% of women, the prevalence of sexual dysfunctions that meet diagnostic criteria is lower and less well established by large scale population-based studies. Sexual problems and dysfunctions are correlated with other health conditions, including cardiovascular disorders, common diseases such a s diabetes, health habits, and mental health. Adequate sexual functioning also appears to be associated with personal well-being and relationship stability, although this may be more accurate for men than women. Efficacious and effective treatments exist for some of the sexual disorders, and there is an increasing focus on medical (particularly pharmacological) treatments being tested by the pharmaceutical industry. Sexual problems and dysfunctions have been notably under-researched, particularly from the perspective on consequences to individual mental health, relationships, and family functioning.

Attitude to Health↗
PubMed2003

The contributions of John Money: a personal view.

John Money has been a dominant voice in sexology in the last part of the 20th century, breaking new ground in a wide variety of areas. In the process, he has been cantankerous, outspoken, and ever willing to do battle, but also original and thought provoking. This paper begins with an examination of science in general, moves on to psychology and sexology, and then examines Money s contributions to sexology in some detail. The latter are many and varied, including the development of the concept of gender, his theory of gender identity based on his work with intersex individuals, the John-Joan case, and his importance in establishing transsexualism as a diagnostic category and an academic discipline. Also important are his contributions to the development of the nomenclature of sexology, his importance to the sexology movement as a teacher, his significant research on a large variety of sexual topics, his ability to convince government agencies that sex was deserving of funding, and his association with the Erickson Educational Foundation. He also was a significant figure in the development of the Society for the Scientific Study of Sexuality (SSSS) and in raising the standard of its journal (The Journal of Sex Research), and therefore it is only fitting that an award be named after him. Though Money remains controversial, he has contributed significantly to the development of sexology as a discipline.

Female↗
PubMed2006

Dysfunctional sexual beliefs as vulnerability factors to sexual dysfunction.

The differences on sexual beliefs presented by men and women with sexual dysfunction and their sexually functional counterparts were investigated. A total of 488 participants (160 females and 232 males without sexual problems and 47 females and 49 males with a DSM-IV diagnosis of sexual dysfunction) answered the Sexual Dysfunctional Beliefs Questionnaire. Findings showed that, although effects have only reached statistical significance for the female group, both dysfunctional men and women endorsed more sexual dysfunctional beliefs than functional. Women presented significantly more age related beliefs (after menopause women loose their sexual desire, as women age, the pleasure they get from sex decreases) and body image beliefs (women who are not physically attractive cannot be sexually satisfied). Additionally, sexually dysfunctional males presented higher scores (not statistically significant) on 'macho' belief (a real man has sexual intercourse very often) and the beliefs about women satisfaction (the quality of the erection is what most satisfies women). Overall, findings support the idea that sexual beliefs may play a role as vulnerability factors for sexual dysfunction.

Adult↗
PubMed1992

Sexual concerns of the patient with pulmonary disease.

Pulmonary disease can impair sexual functioning. The medications used to alleviate the disease can both help and hinder sexual functioning; some patients may have greater disability from the psychological sequelae. Younger patients (those with asthma or cystic fibrosis) tend to have intermittent flareups and can usually function fairly well sexually between bouts. Older patients with chronic obstructive pulmonary disease tend to have a more prolonged course; they are also more prone to concomitant disease that can interfere with sexual functioning. Through careful and concerned questioning, the physician can do much to help both of these groups to better sexual functioning.

Asthma↗
PubMed2004

Sexuality in patients with ulcerative colitis before and after restorative proctocolectomy: a prospective study.

BACKGROUND: The purpose of this study was to assess sexuality in patients with ulcerative colitis (UC), before and one year after an ileal-pouch anal anastomosis (IPAA). METHODS: Group I comprised 14 medically treated patients (7 M) and Group II comprised 29 patients (18 M), operated with colectomy and ileostomy, with preservation of the rectum. Patients were interviewed about desire, excitement and general sexual satisfaction before and one year after the IPAA operation. RESULTS: Most of the patients had restarted sexual activity < or = 3 months after surgery. Sexual desire and desire for intercourse had not changed from before the IPAA operation. In Group I, one woman suffered from dyspareunia both before and after the IPAA. In Group II, three women had dyspareunia before the IPAA and four after surgery. Erection and ejaculation were normal in all men before the IPAA operation. After IPAA, one man in Group I and two men in Group II had loss of ejaculation. In Group 1, 10 out of 14 patients were satisfied with their sexual life both before and after the IPAA. In Group II the corresponding figures were 15 out of 28 before and 22 after IPAA surgery. CONCLUSIONS: A third of the patients stated that they were dissatisfied with their sexual life before IPAA. Although a few patients experienced sexual imperfections such as loss of ejaculation and dyspareunia, the majority of patients in both groups considered that the overall general satisfaction with their sexual life had normalized considerably after surgery.

Adult↗