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Results for “Sexual Dysfunction, Physiological”

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PubMed2000

Sexual dysfunction in gay and bisexual men with HIV infection: evaluation, treatment and implications.

Sexual dysfunction problems are common in people with HIV infection, but their relevance has been recently highlighted in response to the increased survival shown by many individuals with HIV, and the publicity surrounding the development of new treatments for male sexual dysfunction. Thirty-four gay/bisexual men with HIV infection presenting with sexual dysfunction were assessed. Antiretroviral combination therapy including protease inhibitors was taken by 44%, other combinations not including protease inhibitors by 24%, while 32% were not taking any antiretrovirals. Primarily psychogenic sexual dysfunction was thought to be present in 44%, primarily organic dysfunction in 22% and a mixed aetiology in 34%. Treatments offered included psychological interventions and physical methods of treatment, alone or in combination. Treatment was effective, with 76% reporting resolution of the problems, 14% reporting improvement and only 10% reporting no change. Practical and ethical issues raised by the findings are discussed.

Adult↗
PubMed2002

Development of a sexual function questionnaire for clinical trials of female sexual dysfunction.

OBJECTIVE: To better evaluate efficacy in clinical trials of drugs as potential treatments for female sexual dysfunctions (FSD), a brief, multidimensional measure of female sexual function was developed. METHODS: Data from semistructured interviews with 82 women with or without FSD, aged 19-65 years, generated a pool of 61 items that addressed aspects of female sexual function. On review by a panel, individual items were selected for face validity and clinical relevance. Thirty-one items were used as a sexual function questionnaire (SFQ-V1) in two multicenter, phase II clinical trials totaling 781 women with FSD. Normative data were generated from a sample of 201 women without FSD. RESULTS: Factor analysis produced seven domains of female sexual function: desire, physical arousal-sensation, physical arousal-lubrication, enjoyment, orgasm, pain, and partner relationship. The internal consistency of the domains ranged from 0.65 to 0.91, and test-retest reliability ranged from 0.21 to 0.71 for Cohen's weighted kappa and 0.42 to 0.78 for Pearson's correlation coefficient. There was a significant difference between the baseline mean SFQ domain scores of patients with FSD compared with those of women without FSD (p < 0.0001). End-of-study SFQ scores were significantly different for women who reported improvement vs. women who reported no improvement (p < 0.001). CONCLUSIONS: The SFQ produced seven domains of female sexual function with excellent internal consistency, moderate to good reliability, excellent discriminant validity, and sensitivity. The results suggest that the SFQ may be a valuable new tool for evaluating and diagnosing subsets of FSD and, ultimately, for evaluating treatments of these disorders.

Adult↗
PubMed1991

The use of a self-report questionnaire to assess the frequency of sexual dysfunction in family practice clinics.

The epidemiology of sexual dysfunction has been investigated recently in various clinical and nonclinical conditions but, to date, little research has been conducted in the family practice setting. The authors have developed a brief self-report questionnaire addressing most of the common sexual problems, and assessed its usefulness as a screening device in two distinctly different family practice clinics. The proposed questionnaire has gained over 90% response rate in each practice, indicating an appropriate level of acceptability. The sex- and practice-specific prevalence ranged from 31% to 63%, and was found to be significantly higher among male patients than among female patients. Overall dissatisfaction with the present sexual life of either the respondent or his partner (as indicated by the former) was expressed by nearly 20% of the respondents, the majority of whom reported on both self and partner's dissatisfaction. Relatively few patients of those who reported on a sexual problem had ever sought any professional help, but approximately 50% of men and 25% of women indicated that the family physician was their preferred expert for this purpose. It is concluded that sexual dysfunction is highly prevalent in the family practice setting but is nevertheless under-reported. Anonymous screening in one's practice, as presented in this study, will provide the family physician with valuable information, and may contribute to further direct discussions of these delicate concerns.

Adolescent↗
PubMed2003

Sexual dysfunction after treatment for gynaecologic and breast malignancies.

PURPOSE OF REVIEW: This review summarizes current knowledge about the nature of sexual dysfunction in gynaecologic and breast cancers, highlighting recent publications on treatment effects and communication issues. RECENT FINDINGS: In both gynaecologic and breast cancer, sexual dysfunction causes much distress to patients, from the time of diagnosis through to long-term follow-up. It appears that younger women in particular experience difficulties related to loss of reproductive function and relationship problems, plus more abrupt vaginal changes, than older women. Chemotherapy has been shown to be associated with short and long-term effects on sexual functioning and quality of life in breast cancer, and it is anticipated that this would extend to gynaecologic cancers also. The addition of endocrine treatments to chemotherapy in breast cancer appears not to affect levels of sexual functioning, although this may depend on the age of the woman. Sexual self-schema appears to be an important concept in predicting sexual dysfunction. Communication with women about sexual issues is vital, but evidence suggests this is lacking. SUMMARY: We are beginning to understand more about the sexual implications of different treatments and to identify factors which predict sexual dysfunction. More research is still required to identify how sexual dysfunction is affected in different groups of women and how best to help women who experience sexual difficulties. Recent findings suggest that there is a need to increase communication and support about sexual issues.

Adaptation, Psychological↗
PubMed1990

Sexual dysfunction in Parkinson's disease.

Sexual functioning was investigated in 50 parkinsonian male and female patients using a questionnaire. A loss of sexual interest and functioning was reported in a high percentage of patients. Depression was not prevalent but 70% had some evidence of autonomic nervous system dysfunction that may be related to sexual dysfunction. It is concluded that the sexual function is frequently impaired in Parkinson's disease.

Aged↗
PubMed1984

Sexual counseling for the nontherapist.

Sexual health is a part of total health. Sexual problems can cause marital dissolution and emotional impoverishment. The physician is seen as a wise authority figure often and one who can provide sexual guidance and counsel. To be an effective counselor, an obstetrician/gynecologist must acquire sexual knowledge, comfort, and counseling skills. A sexual history is a recommended routine--as part of the new workup, when management of organic problems and treatment (mastectomy, hysterectomy, radical vulvectomy) necessitate inquiry into the patient's sexual practices and sexual value system, and when the patient presents with suspected "functional" or obscure complaints (hyperventilation, palpitations, chronic pelvic pain, recurrent vaginal discharge without obvious pathogens, chronic concerns that everything is all right "down there", cancerphobia). The sexual problem history is readily applicable, especially when a patient presents with an explicit sexual concern. The PLISSIT method is a paradigm that can be utilized effectively with usual referral for intensive therapy (sex therapy) if sexual counseling is ineffectual. The obstetrician/gynecologist can play an important role in facilitating healthful sexual changes in women and couples, enhancing intimacy, and enriching the marital bond.

Confidentiality↗
PubMed2002

Inflammatory bowel disease in women: impact on relationship and sexual health.

Inflammatory bowel disease (IBD) has an impact on the quality of life of women regarding partner relationships and sexual health. Partner relationship and sexual health in women with IBD has been targeted minimally for investigation in the literature devoted to psychological, relationship, and sexual functioning. The purpose of the present article is to describe the concerns of women with IBD, specifically evaluating individual concerns, partner relationships, and sexual functioning after surgery and to elucidate some of the difficulties in identifying such problems. Gynecologic issues and pregnancy concerns are described. Actual case studies are presented that reveal many of the difficulties women with IBD encounter in their relationships as a consequence of disease activity and treatment interventions. Additional research evaluating relationship difficulties, sexual comfort, and sexual behaviors as a consequence of disease activity is required to understand further and improve the quality of life and well-being of these women.

Adolescent↗
PubMed2006

Sexual activity and function in middle-aged and older women.

OBJECTIVE: Data on the sexual activity of middle-aged and older women are scant and vary widely. This analysis estimates the prevalence and predictors of sexual activity and function in a diverse group of women aged 40-69 years. METHODS: The Reproductive Risk Factors for Incontinence Study at Kaiser (RRISK) was a population-based study of 2,109 women aged 40-69 years who were randomly selected from long-term Kaiser Permanente members. Women completed self-report questionnaires on sexual activity, comorbidities, and general quality of life. Logistic and linear regression and proportional odds models were used when appropriate to identify correlates of sexual activity, frequency, satisfaction, and dysfunction. RESULTS: Mean age was 55.9 (+/- 8) years and nearly three fourths of the women were sexually active. Of the sexually active women, 60% had sexual activity at least monthly, approximately two thirds were at least somewhat satisfied, and 33% reported a problem in one or more domains. Monthly or more frequent sexual activity was associated with younger age, higher income, being in a significant relationship, a history of moderate alcohol use, and lower body mass index (BMI) (all P < .05). Satisfaction with sexual activity was associated with African-American race, lower BMI, and higher mental health score (all P < .05). More sexual dysfunction was associated with having a college degree or greater, poor health, being in a significant relationship, and a low mental health score (all P < .05). CONCLUSION: Middle-aged and older women engage in satisfying sexual activity, and one third reported problems with sexual function. Demographic factors as well as some issues associated with aging can adversely affect sexual frequency, satisfaction, and function. LEVEL OF EVIDENCE: II-3.

Adult↗
PubMed2006

A double-blind comparison between bupropion XL and venlafaxine XR: sexual functioning, antidepressant efficacy, and tolerability.

In this double-blind, multicenter study, bupropion XL, a norepinephrine-dopamine reuptake inhibitor, and venlafaxine XR, a serotonin-norepinephrine reuptake inhibitor, were compared with regard to sexual functioning, efficacy, and tolerability. A total of 348 sexually active adult outpatients with depression were randomized to receive bupropion XL (titrated to a target dose of 300-450 mg/d) or venlafaxine XR (titrated to a target dose of 150-225 mg/d) for 12 weeks. Total scores on the primary dependent variable, the Changes in Sexual Functioning Questionnaire (self-report), increased for subjects receiving bupropion XL and decreased for those treated with venlafaxine XR; the mean change scores differed significantly between groups from week 2 onward. Among subjects with normal pretreatment sexual functioning, Changes in Sexual Functioning Questionnaire total scores remained essentially unchanged for the bupropion XL group but were decreased significantly for the venlafaxine XR group; mean change scores also differed between groups from week 2 onward. Although the therapies resulted in similar change on the 17-item Hamilton Depression Rating Scale, remission rates were significantly higher among those treated with bupropion XL (46%) versus venlafaxine XR (33%) (odds ratio, 1.93; 95% confidence interval, 1.07-3.46). Aside from adverse effects of venlafaxine XR on sexual function, both treatments were reasonably well tolerated. In conclusion, in this patient population (ie, relatively young, sexually active outpatients), bupropion XL was at least as effective as venlafaxine XR and had a significantly more favorable sexual side effect profile.

Adult↗
PubMed2005

Sexual dysfunction in women with hyperprolactinemia: a pilot study report.

PURPOSE: Hyperprolactinemia is a common hormonal disorder in women that may affect the phases of female sexual function (FSD). We investigated sexual function in patients with hyperprolactinemia. MATERIAL AND METHODS: A total of 25 women with primary hyperprolactinemia and 16 age matched voluntary healthy women who served as the as control group were evaluated with a detailed medical and sexual history, including a female sexual function index (FSFI) questionnaire and the Beck Depression Inventory. Serum prolactin, dehydroepiandrosterone sulfate, free testosterone, androstenedione, 17alpha-hydroxyprogesterone, estradiol, free thyroxin and thyrotropin were measured. These variables were compared statistically between the 2 groups. RESULTS: Except for prolactin serum hormone levels in women with hyperprolactinemia were not different from those in the control group. The median total FSFI score was 23.40 (IQR 17.70 to 27.30) in the hyperprolactinemic group, whereas healthy women had a median total FSFI score of 31.10 (IQR 27.55 to 32.88, p < 0.0001). FSD was diagnosed in 22 of 25 patients (88%), while 4 of 16 healthy women (25%) had FSD (p = 0.03). Desire (p = 0.001), arousal (p < 0.0001), lubrication (p = 0.001), orgasm (p = 0.001), satisfaction (p = 0.07) and pain (p = 0.003) domain scores were also significantly lower in women with hyperprolactinemia. Total FSFI (p = 0.009, r = -0.405), desire (p = 0.001, r = -0.512), arousal (p = 0.002, r = -0.466), orgasm (p = 0.026, r = 0.348) and satisfaction (p = 0.041, r = -0.320) scores negatively correlated with mean prolactin but not with the other hormones measured. CONCLUSIONS: A significant percent of women with hyperprolactinemia whom we evaluated had sexual dysfunction. No hormonal changes other than prolactin and no depression was found as a cause of FSD.

Adult↗