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Sexual Medicine Reviews Apr 2021Female orgasmic disorder (FOD) is defined as the absence, delay, infrequency, or marked diminishment in intensity of orgasm in at least 75% of sexual experiences,... (Review)
Review
INTRODUCTION
Female orgasmic disorder (FOD) is defined as the absence, delay, infrequency, or marked diminishment in intensity of orgasm in at least 75% of sexual experiences, persisting for at least 6 months and causing distress, has specified subtypes, and affects up to 28% of women in the United States and up to 46% in countries across Asia. Orgasmic difficulties are relatively common and create distress for a substantial number of women, though efficacious treatments exist.
OBJECTIVE
This article provides a review of psychological treatment of FOD.
METHODS
A literature search was conducted using PsycINFO to identify research reporting methods and outcomes of psychological treatment of FOD in peer-reviewed journals and textbooks. Search terms were female orgasmic disorder, anorgasmia, female sexual dysfunction, and orgasm. This search was supplemented with hand-searching references of review articles and journal articles.
RESULTS
Psychological treatment has been shown to be effective in helping women with FOD to gain or regain the ability to have orgasms, with higher success rates overall of treating lifelong or generalized vs acquired or situational FOD. Of the variety of treatment approaches that have been tested, the most consistent support emerges for directed masturbation, sensate focus, and psychotherapy. Approaches with little evidence for efficacy as a primary mode of treatment include systematic desensitization, bibliotherapy, and coital alignment technique training.
CONCLUSION
While existing research provides a solid foundation of knowledge, treatment of FOD has seen little innovation since the 1980s. Future research should aim for broader understanding of etiologies of all types of FOD, understanding reasons for lack of treatment success for women who have not improved with treatment, and identifying ways of tailoring FOD treatment and success rates for multicultural and community populations. Erica Marchand. Psychological and Behavioral Treatment of Female Orgasmic Disorder. Sex Med Rev 2021;9:194-211.
Topics: Coitus; Female; Humans; Masturbation; Orgasm; Sexual Behavior; Sexual Dysfunctions, Psychological; United States
PubMed: 33069622
DOI: 10.1016/j.sxmr.2020.07.007 -
Sexual Medicine Reviews Apr 2020Body awareness has been linked to female sexual response in laboratory manipulation studies and is used in clinical settings to ameliorate sexual difficulties. (Review)
Review
INTRODUCTION
Body awareness has been linked to female sexual response in laboratory manipulation studies and is used in clinical settings to ameliorate sexual difficulties.
AIM
To evaluate and review the literature on body awareness and female sexual function.
METHODS
A literature review was conducted through PsycInfo, PsycARTICLES, and PubMed using terms such as body awareness and sexual function. A manual search also was conducted using reference lists.
MAIN OUTCOME MEASURES
Studies were included if manipulated body awareness was a main variable of interest and if outcome variables included female sexual functioning or sexual response.
RESULTS
29 studies were included in this review and grouped into 3 categories: sensate focus (n = 7), mindfulness (n = 13), and laboratory manipulations of body awareness (n = 9). Body awareness is identified as an area of importance for female sexuality. Explicit instructions aimed at increasing body awareness, including those used in the clinical techniques of sensate focus and mindfulness, appear to enhance sexual response for many women, including women with low sexual arousal, hypoactive desire, anorgasmia, and sexual pain and in non-clinical samples. Induction of implicit body awareness also resulted in increased arousal in 1 study.
CONCLUSION
Body awareness appears to enhance sexual well-being for some women. This is supported by laboratory manipulation studies conducted on women with and without sexual difficulties and by intervention studies using sensate focus and mindfulness for women with a range of sexual problems. The extent to which enhanced body awareness accounts for results in intervention studies is often unclear because of other features of the interventions and/or study design. This review provides the field with a summary of intervention and laboratory studies on body awareness, with results pointing toward body awareness as an integral component of treatment for sexual dysfunction. Seal BN, Meston CM. The Impact of Body Awareness on Women's Sexual Health: A Comprehensive Review. Sex Med Rev 2020;8:242-255.
Topics: Body Image; Female; Humans; Mindfulness; Sexual Health; Women's Health
PubMed: 29678474
DOI: 10.1016/j.sxmr.2018.03.003 -
Wiadomosci Lekarskie (Warsaw, Poland :... Oct 2019Sexual disorders are very common problems in the psychiatric patients. Many factors induce sexual dysfunction, e.g. the effects of antidepressants and antipsychotics.... (Review)
Review
Sexual disorders are very common problems in the psychiatric patients. Many factors induce sexual dysfunction, e.g. the effects of antidepressants and antipsychotics. The article reviews literature on sexual disorders in psychiatric diseases such as schizophrenia, bipolar disorder, depressive, anxiety, obsessive-compulsive disorders and eating disorders. Bipolar disorder significantly affects the quality of life and increases the risk of sexual dysfunction. In the manic phase there is an increase in libido, which is associated with the risky sexual behavior. Depressive disorders are associated with reduced libido and dissatisfaction with sexual activity. Panic disorder and obsessive-compulsive disorder are correlated with less frequent sexual contact. Decreased sexual desire and sexual aversion are strongly associated with anxiety disorders. The prevalence of sexual dysfunction in patients with schizophrenia is high among both those treated and untreated. Women suffering from schizophrenia have anorgasmia, decreased libido, vaginal dryness, vaginism, and dyspareunia. Men suffering from schizophrenia as the main complaints give lowering the drive of difficulty in maintaining an erection, delaying orgasm. In patients with eating disorders, libido decreases as well as sexual activity and the level of sexual satisfaction decreases. Satisfaction with sexual life is an important factor affecting the quality of life. Patients rarely deal with problems in sexual life, so questions about this area of life should not be overlooked during a medical interview.
Topics: Female; Humans; Libido; Male; Orgasm; Quality of Life; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 31982027
DOI: No ID Found -
Sexual Medicine Reviews Jun 2024Female sexual dysfunction (FSD) consists of low libido, sexual arousal problems, anorgasmia, and dyspareunia. Sexual function is an important aspect of life for many... (Review)
Review
INTRODUCTION
Female sexual dysfunction (FSD) consists of low libido, sexual arousal problems, anorgasmia, and dyspareunia. Sexual function is an important aspect of life for many women and is closely correlated with overall well-being. FSD is often underrepresented in the academic space when compared with male sexual disorders, such as erectile dysfunction. As FSD spans many fields (eg, urology, gynecology, psychology), bibliometric analyses are an important resource to highlight landmark articles.
OBJECTIVES
To identify key articles about FSD by citation number and bibliometric analysis to facilitate future scholarly efforts into more FSD research.
METHODS
We searched for articles in the Web of Science Core Collection between 1900 and 2023 using terms specific to FSD. We identified relevant FSD articles and selected the top 50 most cited. A bibliometric analysis was performed to collect and analyze data about title, authorship, publication year, citation number, journal and impact factor, country and institution, study type, citation index, specialty, and conflict of interest.
RESULTS
An overall 6858 results were identified. The top 50 most cited articles were published between 1997 and 2014 in 12 countries, across 32 institutions, and in 20 journals. The United States produced the most articles. The Journal of Sexual Medicine published the most articles. The mean number of citations per article was 351.64. Observational studies were most common. More than half were sponsored. Of all the specialties, most articles were categorized as urology and nephrology. Research about FSD has been much less impactful than research about male sexual dysfunction, possibly owing to stigma and decreased clinical training.
CONCLUSION
As FSD covers many fields, bibliometric analyses are invaluable to understand the vast body of knowledge. We hope that this research emphasizes the lack of attention that FSD has had and that it provides health care professionals with a valuable tool to understand the trajectory of FSD to guide future education efforts.
Topics: Humans; Bibliometrics; Female; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 38490968
DOI: 10.1093/sxmrev/qeae013 -
Sexual Medicine Reviews Oct 2022Studies demonstrate the connection between adverse sexual function and medical conditions such as diabetes and heart disease. However, in the areas of spinal and spinal... (Review)
Review
INTRODUCTION
Studies demonstrate the connection between adverse sexual function and medical conditions such as diabetes and heart disease. However, in the areas of spinal and spinal cord pathologies that require surgical interventions, there are scant data.
OBJECTIVES
We undertook a narrative review to synthesize what is known on the topic, raise awareness, and call for action.
METHODS
PubMed and Google Scholar identified case reports and primary studies evaluating female sexual dysfunction associated with spinal pathology as well as surgical intervention success were reviewed to contextualize and characterize female sexual dysfunction.
RESULTS
Available case reports and primary studies suggest that female sexual dysfunction can result from traumatic spinal etiologies, malignant tumors, and benign tumors with and without bony involvement. Although identified as a key preoperative predictor in maintenance or improvement of neurologic status, sexuality is rarely addressed in the neurosurgical care plan. In spinal stenosis and degenerative spine disease, over half of patients report pain with sexual activity. Importantly, while pain can hinder sexual activity in females, there are other sexual issues, including desire and subjective arousal, lubrication, orgasm, and satisfaction that are usually not explored. Studies show the impact of spinal pathologies on frequency of sexual intercourse, hypoesthesia, anorgasmia, and depression. Surgical intervention of spinal pathologies has been cited to improve back pain however other types of sexual dysfunction usually fails to improve after surgical intervention.
CONCLUSIONS
The lack of high-quality research with adequate numbers of female participants that appropriately characterizes the nuances of female sexual dysfunction across various spinal pathologies, with post-surgical intervention analysis and consideration of surgical approach, necessitates consideration for future study. A pre-op and post-op sexual history in all woman undergoing spinal surgery should be a standard of care. Moscicki P, Bachmann GA. Characterization of Female Sexual Dysfunction Associated with Spinal Pathology and Surgery. Sex Med Rev 2022;10:493-498.
Topics: Female; Humans; Orgasm; Pain; Sexual Behavior; Sexual Dysfunction, Physiological; Sexuality
PubMed: 35853824
DOI: 10.1016/j.sxmr.2022.01.003 -
Sexual Medicine Reviews Oct 2022Studies demonstrate the connection between adverse sexual function and medical conditions such as diabetes and heart disease. However, in the areas of spinal and spinal... (Review)
Review
INTRODUCTION
Studies demonstrate the connection between adverse sexual function and medical conditions such as diabetes and heart disease. However, in the areas of spinal and spinal cord pathologies that require surgical interventions, there are scant data.
OBJECTIVES
We undertook a narrative review to synthesize what is known on the topic, raise awareness, and call for action.
METHODS
PubMed and Google Scholar identified case reports and primary studies evaluating female sexual dysfunction associated with spinal pathology as well as surgical intervention success were reviewed to contextualize and characterize female sexual dysfunction.
RESULTS
Available case reports and primary studies suggest that female sexual dysfunction can result from traumatic spinal etiologies, malignant tumors, and benign tumors with and without bony involvement. Although identified as a key preoperative predictor in maintenance or improvement of neurologic status, sexuality is rarely addressed in the neurosurgical care plan. In spinal stenosis and degenerative spine disease, over half of patients report pain with sexual activity. Importantly, while pain can hinder sexual activity in females, there are other sexual issues, including desire and subjective arousal, lubrication, orgasm, and satisfaction that are usually not explored. Studies show the impact of spinal pathologies on frequency of sexual intercourse, hypoesthesia, anorgasmia, and depression. Surgical intervention of spinal pathologies has been cited to improve back pain however other types of sexual dysfunction usually fails to improve after surgical intervention.
CONCLUSIONS
The lack of high-quality research with adequate numbers of female participants that appropriately characterizes the nuances of female sexual dysfunction across various spinal pathologies, with post-surgical intervention analysis and consideration of surgical approach, necessitates consideration for future study. A pre-op and post-op sexual history in all woman undergoing spinal surgery should be a standard of care.
Topics: Humans; Female; Surveys and Questionnaires; Sexual Behavior; Coitus; Sexuality; Pain
PubMed: 37051949
DOI: 10.1016/j.sxmr.2022.01.003 -
The Canadian Journal of Urology Aug 2019There are many factors that may contribute to infertility, including psychosocial issues. The understanding of the cultural and spiritual background of patients can help... (Review)
Review
There are many factors that may contribute to infertility, including psychosocial issues. The understanding of the cultural and spiritual background of patients can help elicit a sexual history that may lead to a diagnosis and subsequent successful treatment plan. Within this context, we present a case report of a Hasidic couple with primary infertility. Evaluation revealed what we are referring to as "cultural anorgasmia," with the male partner having never been educated about nor experienced an orgasm due to his religious upbringing. Counseling about basic anatomy and the physiology of sexual arousal and orgasm was successful in overcoming anorgasmia and achieving pregnancy.
Topics: Female; Follow-Up Studies; Humans; Infertility, Male; Jews; Male; Orgasm; Referral and Consultation; Sexual Behavior; Sexual Dysfunctions, Psychological; Young Adult
PubMed: 31469644
DOI: No ID Found -
Archives of Medical Science : AMS 2022Many biological, psychological and sociocultural factors influence the prevalence of sexual dysfunctions and sexual behavior. The purpose of the study was to evaluate...
INTRODUCTION
Many biological, psychological and sociocultural factors influence the prevalence of sexual dysfunctions and sexual behavior. The purpose of the study was to evaluate the prevalence of sexual dysfunctions and sexual behaviors.
MATERIAL AND METHODS
The study was the third edition of a general population-based, cross sectional survey, evaluating sexual attitude, sexual behaviors within and outside relationships and type of sexual dysfunctions present in the Polish population. The survey consisted of 82 questions, grouped into five blocks that contained open- and closed-ended general questions, inquiries about early sexual contacts, sex life, relationships, sexual behaviors and preferences. A standard questionnaire was used to obtain data on age, education, marital status, religious beliefs, medical history, disabilities and other illnesses. A total of 1054 responders aged from 18 to over 70 years participated in the study. Risk factors and other causes contributing to certain sexual dysfunctions defined in the DSM-5 and in the available literature were analyzed.
RESULTS
In this research, 40% of women and 36.5% of men had at least one sexual dysfunction. Analysis of the total population showed that decreased sexual desire (29.0%), occasional climaxing (28.5%) and anorgasmia (21.0%) were the dysfunctions most frequently reported by women. In men, premature ejaculation (23%) and excessive sexual needs (16.3%) were most prevalent. Both men and women with arousal problems reported significantly more comorbid sexual dysfunctions ( < 0.001).
CONCLUSIONS
Sexual dysfunctions are highly prevalent in the Polish population. Of note, it is alarming that only very few patients seek professional help when sexual problems occur.
PubMed: 35832714
DOI: 10.5114/aoms.2019.86794 -
Cureus Feb 2023A 72-year-old man with cardiovascular disease, depression, and anxiety presented to a chiropractor with a six-year history of anorgasmia, anejaculation, and erectile...
A 72-year-old man with cardiovascular disease, depression, and anxiety presented to a chiropractor with a six-year history of anorgasmia, anejaculation, and erectile dysfunction as well as chronic, episodic low back pain. He previously saw a neurologist, two urologists, and had extensive and expensive testing, including brain, cervical, thoracic, lumbar, and pelvic imaging and electrodiagnostic testing. The patient had a disc bulge at L5/S1 causing moderate spinal canal stenosis while other testing was relatively normal. He had previously tried discontinuing a selective serotonin reuptake inhibitor, trialing psychological counseling, and administering penile injections, all without any improvement in sexual function. The chiropractor identified lower extremity weakness, sensory, reflex, and balance deficits and initiated a one-month trial of care, applying lumbar mobilizations and thrust manipulation at L1/2. The patient reported resolution of anorgasmia and anejaculation the first week, which was maintained over a total three months' follow-up. Low back pain also did not return. The current case report highlights the apparent success of lumbar spinal manipulation in improving anorgasmia and anejaculation in an older man. This response may be explained in that the sympathetic (T10-L2) and somatic (S2-4) innervation required for male orgasm and ejaculation is derived from the lumbosacral region. Further research is needed to determine if these findings are reproducible.
PubMed: 36909050
DOI: 10.7759/cureus.34719 -
Journal of Clinical Medicine Oct 2019Major depressive disorder is a serious mental disorder in which treatment with antidepressant medication is often associated with sexual dysfunction (SD). Given its... (Review)
Review
Major depressive disorder is a serious mental disorder in which treatment with antidepressant medication is often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) has a low rate of spontaneous reports by patients, and this side effect therefore remains underestimated in clinical practice and in technical data sheets for antidepressants. Moreover, the issue of TESD is rarely routinely approached by clinicians in daily praxis. TESD is a determinant for tolerability, since this dysfunction often leads to a state of patient distress (or the distress of their partner) in the sexually active population, which is one of the most frequent reasons for lack of adherence and treatment drop-outs in antidepressant use. There is a delicate balance between prescribing an effective drug that improves depressive symptomatology and also has a minimum impact on sexuality. In this paper, we detail some management strategies for TESD from a clinical perspective, ranging from prevention (carefully choosing an antidepressant with a low rate of TESD) to possible pharmacological interventions aimed at improving patients' tolerability when TESD is present. The suggested recommendations include the following: for low sexual desire, switching to a non-serotoninergic drug, lowering the dose, or associating bupropion or aripiprazole; for unwanted orgasm delayal or anorgasmia, dose reduction, "weekend holiday", or switching to a non-serotoninergic drug or fluvoxamine; for erectile dysfunction, switching to a non-serotoninergic drug or the addition of an antidote such as phosphodiesterase 5 inhibitors (PD5-I); and for lubrication difficulties, switching to a non-serotoninergic drug, dose reduction, or using vaginal lubricants. A psychoeducational and psychotherapeutic approach should always be considered in cases with poorly tolerated sexual dysfunction.
PubMed: 31591339
DOI: 10.3390/jcm8101640