Classification of sexual dysfunctions in women.
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Decision Making↗
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Results for “Sexual Dysfunction, Physiological”
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Changes in sexual function during acute and six-month fluoxetine therapy: a prospective assessment.
Sexual dysfunction has been reported as an unwanted effect associated with selective serotonin reuptake inhibitors therapy, but the nature and frequency of such effects have not been characterized systematically. Sexual function was assessed in depressed patients participating in a multicenter trial of acute and continuation fluoxetine therapy using a 4-item self-rated scale. Patients were evaluated at study entry, after 13 weeks of fluoxetine 20 mg daily, and during 25 weeks of continuation therapy with fluoxetine 20 mg daily, fluoxetine 90 mg weekly, or placebo. In a 13-week open-label trial, among 501 patients who met Diagnostic and Statistical Manual of Mental Disorders criteria for depression, 51.6% of women and 40.6% of men reported improvement, 35.0% of women and 41.9% of men reported no change, and 13.4% of women and 17.4% of men reported worsening in overall sexual function. During double-blind continuation therapy, there were no statistically significant differences in change in sexual function between treatments. Worsened sexual function that occurred during continuation treatment was strongly associated with worsened depressive symptoms. Depression is associated with sexual dysfunction, and improvement in sexual functioning related to the antidepressant effects of fluoxetine may be more common than drug-associated deterioration in sexual function. Among patients who report worsening, effects may be most pronounced on orgasm. Deterioration in sexual function does not appear to be a late-onset drug-specific event, but is strongly related to worsening depressive symptoms.
Adult↗
Systematic review of sexual problems: epidemiology and methodology.
We conducted a comprehensive systematic literature review of five sexual problems in order to estimate their population prevalence and to investigate issues arising from the reviewing of epidemiological literature. Two independent reviewers scrutinized abstracts, extracted data, and assessed methodological quality. Twenty-eight relevant studies were identified. Prevalence figures varied considerably, and meta-analysis was not possible because of heterogeneity in study quality and design. Prevalence depends on case definition, characteristics of the study population, and time frame of the prevalence estimates, therefore, design, implementation, and reporting of epidemiological studies needs standardization before systematic reviews and meta-analyses can be carried out.
Dyspareunia↗
How does premature ejaculation impact a man s life?
No systematic study has examined the psychological impact of premature ejaculation (PE) on the man and his partner. This study explores this vital issue by reporting on interviews of 28 men with self-diagnosed PE. From a qualitative perspective, these interviews assess whether these men had concerns about their PE and, if so, what they were. These men focused on two major themes: impact on self-confidence and future/current relationships. This suggests that PE has a similar qualitative impact on the individual as erectile dysfunction. Further investigation will need to determine how prevalent these concerns are in the PE population and also to delineate the impact on the men s partners.
Adult↗
Reliability and validity of the Sexual Interest and Desire Inventory-Female (SIDI-F), a scale designed to measure severity of female hypoactive sexual desire disorder.
The Sexual Interest and Desire Inventory-Female (SIDI-F) is a 13-item scale developed as a clinician-administered assessment tool to quantify the severity of symptoms in women diagnosed with hypoactive sexual desire disorder (HSDD). The present investigation assessed the reliability and validity of the SIDI-F as a measure of HSDD severity. Results show that the SIDI-F exhibits excellent internal consistency, with Cronbach's alpha of 0.9. The validity of the SIDI-F as a measure of HSDD severity was confirmed by a number of observations. Women with a clinical diagnosis (Diagnostic and Statistical Manual of Mental Disorders [DSM-IV-TR; American Psychiatric Association, 2000]) of HSDD had significantly lower SIDI-F scores than women not meeting diagnostic criteria for any subtype of female sexual dysfunction and women diagnosed with female orgasmic disorder. There was a high correlation between scores on the SIDI-F and scores on the Female Sexual Function Index (FSFI; Rosen et al., 2000) and an interactive voice response version of the Changes in Sexual Functioning Questionnaire (CSFQ; Clayton, McGarvey, & Clavet, 1997; Clayton, McGarvey, Clavet, & Piazza, 1997), two validated measures that assess general female sexual dysfunction. In contrast, there was a poor correlation between SIDI-F scores and scores on a slightly modified Marital Adjustment Scale (Locke, Wallace, 1959; MAS), an assessment of general (nonsexual) relationship satisfaction. Taken together, the results of the present investigation indicate that the SIDI-F is a reliable and valid measure of HSDD severity, independent of relationship issues.
Adult↗
Prevalence and comorbidity of sexual dysfunctions in a Portuguese clinical sample.
We investigated the prevalence and comorbidity of sexual dysfunction in a clinical Portuguese sample. A total of 96 participants (47 females and 49 males with a diagnosis of sexual dysfunction (DSM-IV; American Psychological Association, 1994) assigned by a group of trained sex therapists) answered the Female Sexual Function Index (FSFI; Rosen et al., 2000) and the International Index of Erectile Function (IIEF; Rosen et al., 1997). Results indicated erectile dysfunction (70%) and female hypoactive sexual desire disorders (40.4%) as the most prevalent complaints, with premature ejaculation (22.4%), vaginismus (25.5%), and female orgasmic disorder (21.3%) also showing relevant prevalences. Comorbidity studies indicated higher levels of overlapping among female sexual difficulties with strong associations between desire, subjective arousal, and orgasmic disorders, as well as between dyspareunia and vaginismus.
Adult↗
Sexual dysfunction and chronic illness: the role of flexibility in coping.
Sexual dysfunction is common among individuals with chronic illnesses and is associated with distress and reduced quality of life. Because of the long-term, often irreversible nature of sexual dysfunction in chronic illness and limitations of pharmacological treatments, there is a need to understand cognitive and behavioral coping processes in this population. We present a model of coping with sexual dysfunction that focuses on the construct of flexibility, including the definition of sexual functioning and its centrality to overall self-concept. We describe how this model can be applied in a comprehensive approach to treating sexual dysfunction in individuals with chronic illnesses.
Adaptation, Psychological↗
The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS): psychometric properties within a Dutch population.
The aim of the present study was to investigate the psychometric properties of the Female Sexual Function Index (FSFI; Rosen et al., 2000) and the Female Sexual Distress Scale (FSDS; Derogatis, Rosen, Leiblum, Burnett, & Heiman, 2002) within a Dutch population of approximately 350 women with and without sexual complaints. The main conclusions of this study are that the multidimensional structure of the FSFI and the unidimensional structure of the FSDS are fairly well replicated in a Dutch sample. The amount of variance explained by confirmatory and exploratory factor analyses was good. Internal consistency and stability of the FSFI and its subscales and the FSDS are satisfactory to good, and the subscales are reasonably stable across demographic variables. The discriminant validity and the ability of the scales to predict the presence or absence of sexual complaints was excellent. The convergent and divergent construct validity of the FSFI and the FSDS was good. These results support the reliability and psychometric validity of the FSFI and the FSDS in the assessment of dimensions of female sexual functioning and sexual distress in clinical and nonclinical samples.
Adult↗
A randomized open-label comparison of the impact of olanzapine versus risperidone on sexual functioning.
The objective of this study was to compare sexual functioning in patients treated with olanzapine or risperidone. This open-label trial included 46 patients randomized to olanzapine (5-15 mg/d) or risperidone (1-6 mg/d) for 6 weeks. We used sexual dysfunction was assessed by a semistructured interview based on the items of the UKU side effect rating scale. Three olanzapine-treated patients (12.0%), compared with 11 risperidone-treated patients (52.4%), reported sexual dysfunctions (p = .008) in the semistructured interview. Only 4 patients (8.7%) spontaneously reported sexual dysfunction. The mean dose was 9.4 mg/d for olanzapine and 3.4 mg/d for risperidone. The mean (+/-SD) prolactin levels (ng/mL) in olanzapine-and risperidone-treated patients were 25.1 (+/- 23.5) and 43.5 (+/- 26.1), respectively. Less sexual dysfunction occurred in the group treated with olanzapine compared with the risperidone group. Direct questioning about sexual functioning is necessary to avoid underestimating the frequency of sexual side effects in patients with schizophrenia and related psychotic disorders.
Adult↗
Sexual activity, sexual disorders and associated help-seeking behavior among mature adults in five Anglophone countries from the Global Survey of Sexual Attitudes and Behaviors (GSSAB).
We conducted a telephone survey during 2001-2002 to investigate sexual behavior, sexual dysfunction, and related help-seeking behavior in five Anglophone countries. In total, 5,998 individuals (2,992 men and 3,006 women) aged 40-80 years in the United States, Canada, the United Kingdom, Australia, and New Zealand completed the survey. The majority of subjects were sexually active, and although many men and women had experienced sexual dysfunctions, few had sought medical care for these dysfunctions. Further investigation is required to determine whether national differences in the prevalence of sexual dysfunctions are due to genetic predisposition, health factors, cultural perception or socioeconomic situation.
Attitude to Health↗
Low relationship satisfaction and high partner involvement predict sexual problems of women with fibromyalgia.
To examine the predictive potential of relationship variables on sexual functioning in women with fibromyalgia, we instructed 63 women (age 21-54 years) to fill out several questionnaires. Low relationship satisfaction was the strongest and most-frequent predictor of problematic sexual functioning. In addition, more fatigue and--only after taking account of relationship satisfaction--more active engagement (i.e., involvement) of the spouse were associated with reduced sexual functioning and satisfaction. Our study suggests that for women with fibromyalgia, relationship satisfaction is good for sexual functioning. Although having an involved spouse is good for the relationship, it may be bad for sexual functioning.
Adult↗
Sexual relationships in couples with a diabetic partner.
This study assessed the quality of the sexual relationship in 51 couples that included a Type I diabetic partner (23 male and 28 female). Using traditional diagnostic criteria, the frequencies of sexual dysfunction was higher in diabetic than in healthy men, as in previous studies. Diagnosis based on a multiaxial system showed that both male and female diabetics had more arousal phase dysfunctions than did healthy spouses. Diabetics and healthy spouses were similar in terms of sexual initiative and discrepancies between sexual desire and activity levels. Although peripheral neuropathy was correlated with sexual dysfunction in diabetic men, a stronger predictive factor was a rating of the couple's acceptance of the diabetes. Nevertheless sexual dysfunction was blamed on the diabetes by 22 of 23 couples who had a sexual problem.
Adult↗
Specific components in the etiology, assessment, and treatment of male sexual dysfunctions: controlled outcome studies.
Controlled outcome studies investigating specific components in the etiology, assessment, and treatment of male sexual disorders are reviewed. Premature ejaculators appear just as accurate in assessing their levels of sexual arousal as are men not suffering from this condition. Absolute levels of sexual activity or desire do not seem to be as important for these individuals as has been suggested. Attempts to distinguish organic versus functional erectile failure using the MMPI or historical data have generally proved unsuccessful. Treatment effectiveness in premature ejaculation may be due to elevating the sensory threshold or may be an artifact of simply prescribing more frequent sexual activities. Removing performance demands through cognitive restructuring and sexual communication training shows promise in the treatment of erectile failure.
Ejaculation↗
Books helpful to patients with sexual and marital problems: a bibliography.
The aim of this project was to develop a current, problem-focused list of books helpful to patients with sexual and/or marital problems. Survey forms requesting respondents to list books helpful to patients with specific marital/sexual problems were sent to all members of the Society for Sex Therapy and Research (SSTAR) and the clinical members of the Society for the Scientific Study of Sex (SSSS). Of 933 forms, 170 (18%) were returned. Responses were verified for accuracy and a full citation was developed for each. Tabulations of responses were calculated and a bibliography developed.
Humans↗
Gender differences in factors associated with hypoactive sexual desire.
Several factors have been identified as playing an etiological role in hypoactive sexual desire. It has been assumed that these factors appear equally among men and women, however, there is little empirical validation for this. An investigation of 69 men and women was undertaken to explore whether certain medical, psychological, sexual, and/or interpersonal factors were more likely to present in men versus women. Significant differences were found with regard to age, psychological distress, relationship satisfaction, level of stress, and the duration of another sexual dysfunction. Implications for a refined understanding of hypoactive sexual desire and for treatment are discussed.
Adult↗
Sexual functioning in HIV+ and HIV- injected drug-using women.
As part of a natural history study of HIV disease in injected drug users, 38 HIV positive (HIV+) asymptomatic or low-symptomatic women and 37 HIV negative (HIV-) women, mostly of minority inner-city background, underwent a comprehensive survey of sexual functioning. At study baseline, the sample as a whole showed a relatively high prevalence of problems in all major phases of the sexual response cycle and in vaginismus and vaginal pain. Statistically significant group differences indicate higher rates of problems in sexual functioning in HIV+ women even at an early stage of disease progression.
Adult↗
Sexual difficulties, concerns, and satisfaction in homosexual men: an empirical study with implications for HIV prevention.
Minimal research has investigated the prevalence of sexual disorders in homosexual men. We examined sexual performance concerns, problems, and satisfaction in a convenience sample of 197 homosexual men who attended a health seminar. Sexual dysfunction and sexual concerns were found to be common problems. Almost all men reported some sexual difficulty over their lifetime, and more than half reported a current sexual difficulty. A further 25% of the sampled men identified other sexual concerns as well. Despite these figures, most participants-whether single, dating, or in a relationship-reported average to above-average sexual satisfaction. Correlates of sexual satisfaction included more liberal attitudes toward human sexuality, greater comfort with men's sexual attractions to other men, lower levels of internalized homophobia, and greater satisfaction with one's relationship status. Painful receptive anal intercourse appeared to be a common, yet previously underacknowledged, difficulty. Almost half of the respondents described HIV/AIDS as having a negative impact on their sexual functioning, with most reporting an increase in fear of sex as the major negative outcome.
Adult↗
Sexual dysfunction in women with diabetes mellitus.
Sexual problems in men with diabetes mellitus are common and often result from diabetic complications. However, although diabetic complications are similar in both sexes, little attention has been given to the effects of diabetes on female sexuality and sexual function. It is reasonable to suggest that women with diabetes will experience sexual problems due to neuropathy, endocrine changes and vascular complications. However there is little research into the physical effects of diabetes on female sexual function. Reduced vaginal lubrication in women with diabetes has been reported yet this is rarely documented as a sexual problem. Previous studies in women with diabetes may also neglect the importance of the subjective qualities associated with female sexuality and sexual expression.
Clitoris↗