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Journal of Sex & Marital Therapy 2021The victims of sexual violence may develop FSD. This retrospective study examined the characteristics of women victims of sexual abuse who had FSD who attended a...
The victims of sexual violence may develop FSD. This retrospective study examined the characteristics of women victims of sexual abuse who had FSD who attended a tertiary hospital from 2004 to 2017. Patients were divided in two groups: women who were victims of sexual violence and women who were not victims (controls). One thousand and ten women (60.4%) presented with FSD and 610 of them were eligible for inclusion, 134 (21.97%) reported they were victims of sexual violence, and the abuser was mostly someone close to the victim (92.31%). Depression was more prevalent in the women who were victims (32.1% vs. 18.3%; p<0.05), 74.0% vs. 59.8% had hypoactive sexual desire disorder (HSDD) (p<0.05), 20.3% of victims vs. 7.19% of controls (p<0.05) had primary anorgasmia, and 51.15% of the victims and 39.61% of controls reported anorgasmia. The victims reported a lower sex drive (39.6% vs. 52.3%), and reduced arousal (48.8% vs. 61.3%; all p<0.05). More of the victims than controls reported that their partners had engaged in an extramarital relationship (19.0% vs. 9.25%, p<0.05).
Topics: Female; Humans; Libido; Retrospective Studies; Sex Offenses; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 34039255
DOI: 10.1080/0092623X.2021.1930309 -
Ceska Gynekologie 2024A deficit or problematic achievement of female orgasm is often classified as a sexual disorder that creates complications in the sex life of couples. This assumption is...
A deficit or problematic achievement of female orgasm is often classified as a sexual disorder that creates complications in the sex life of couples. This assumption is generally accepted, even though vaginal anorgasmia is an accepted statistical norm and non-coital methods of generating female orgasm are not as easy as they are for men. Female orgasms manifest themselves in different ways; they are variable and can be dependent on a number of variable factors. Some theories suggest a high degree of correlation between the capacity for orgasmic experience, sexual attitudes and behaviour, but also with reproductive potential or the stability of the given couple's relationship. Female orgasm is often seen as a discriminatory mechanism influencing attitudes towards sexuality or even as a kind of fertility catalyst. There is no consensus on the importance of female orgasm. The results of some relevant studies refute theories about the female orgasm's positive influence on adaptive functions of the couple's relationship, as well as its influence on fertility. The orgasm in women is most likely an evolutionary by-product of its male variant, since the clitoris and penis have an identical embryonic basis of development. Female anorgasmia should not be considered an unquestioned diagnosis, let alone a psychiatric construct leading to a paradigm in which anorgasmia is categorically the cause of frustration or other problems.
Topics: Female; Male; Humans; Orgasm; Sexual Behavior; Coitus; Sexual Dysfunctions, Psychological; Sexual Dysfunction, Physiological
PubMed: 38418254
DOI: 10.48095/cccg202452 -
Journal of Pediatric and Adolescent... Jun 2020Clitoral epidermal inclusions cysts are most frequently seen following trauma, especially female genital mutilation. Spontaneous clitoral epidermal inclusion cysts are... (Review)
Review
BACKGROUND
Clitoral epidermal inclusions cysts are most frequently seen following trauma, especially female genital mutilation. Spontaneous clitoral epidermal inclusion cysts are rare with an unclear etiology and their impact on later sexual function has not been described.
CASE
A 15-year-old spontaneously developed a clitoral mass that progressively enlarged over seven years, ultimately leading to secondary anorgasmia. Surgical removal resulted in restoration of normal anatomy and complete return of clitoral function. Final pathology revealed the mass to be an epidermal inclusion cyst.
SUMMARY AND CONCLUSION
Clitoral epidermal inclusion cysts typically present in childhood or early adolescence and can lead to sexual dysfunction if left untreated. Physicians must consider the potential sequelae of these cysts when counseling and managing these patients.
Topics: Adolescent; Adult; Child; Clitoris; Epidermal Cyst; Female; Humans; Magnetic Resonance Imaging; Sexual Dysfunctions, Psychological
PubMed: 32028052
DOI: 10.1016/j.jpag.2020.01.150 -
Agri : Agri (Algoloji) Dernegi'nin... Nov 2020Recent studies have shown a more frequent occurrence of sexual dysfunction in patients with headache. The aim of this study was to assess the effects of demographic and...
OBJECTIVES
Recent studies have shown a more frequent occurrence of sexual dysfunction in patients with headache. The aim of this study was to assess the effects of demographic and clinical characteristics and psychiatric symptoms on sexual dysfunction in Turkish female patients with migraine.
METHODS
In all, 18 sexually active patients with episodic migraine (EM), 12 patients with chronic migraine (CM), and 22 healthy controls of similar age were enrolled in the study. A numeric rating scale was administered to assess pain intensity. The psychiatric symptoms and sexual function of all of the participants were evaluated using the Beck depression and anxiety scales and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS).
RESULTS
The mean GRISS subscale scores did not differ significantly between the migraine groups and the control group (all p values <0.05). A positive correlation was found between the duration of headache and GRISS subscales of noncommunication, dissatisfaction, vaginismus, and anorgasmia in EM patients. In addition, there was a negative correlation with the infrequency and avoidance subscales. No correlation was detected between the GRISS subscale scores and the demographic and clinical characteristics of the patients with CM, with the exception of the level of education. Higher pain intensity scores and the presence of anxiety or depression among the EM and CM patients significantly affected all of the subscale scores of the sexual function inventory.
CONCLUSION
Although there was no relationship between migraine chronicity and sexual dysfunction, our data indicated that patient demographic characteristics, greater pain severity, and comorbidities of depression or anxiety were associated with greater sexual dysfunction among patients with EM and CM.
Topics: Adolescent; Adult; Case-Control Studies; Female; Humans; Middle Aged; Migraine Disorders; Risk Factors; Severity of Illness Index; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Turkey; Young Adult
PubMed: 33398864
DOI: 10.14744/agri.2020.47640 -
Minerva Obstetrics and Gynecology Apr 2021Genitourinary syndrome of menopause (GSM) may affect up to 90% of menopausal women, including vulvovaginal atrophy (VVA), burning, pain, bleeding, irritation,...
Genitourinary syndrome of menopause (GSM) may affect up to 90% of menopausal women, including vulvovaginal atrophy (VVA), burning, pain, bleeding, irritation, dyspareunia, anorgasmia, and urinary symptoms. Vaginal symptoms from lack of estrogens can have a significant impact on the sexual health and quality of life (QoL) in as many as 50% of postmenopausal women. Several therapeutic alternatives, both hormonal and non- hormonal, have been proposed. Microablative CO
2 laser is one of the three non-surgical energy-based therapies, with Erbium:YAG laser and temperature-controlled radiofrequency (RF). Microablative CO2 laser induces morphological changes in vaginal tissues and results of several clinical trials suggest that this type of laser improves symptoms of GSM. Moreover, this treatment seems to be safe. Given the increasingly widespread use of laser CO2 as a non-hormonal alternative treatment for GSM, the authors reviewed the current published literature evaluating this therapy, to compare efficacy and safety of different protocols.Topics: Atrophy; Female; Humans; Lasers, Gas; Menopause; Quality of Life; Vaginal Diseases
PubMed: 32720802
DOI: 10.23736/S2724-606X.20.04612-2 -
Urology Aug 2020To describe our experience with amphetamine/dextroamphetamine salts (AMP) as a treatment for delayed orgasm/anorgasmia (DO/AO).
OBJECTIVE
To describe our experience with amphetamine/dextroamphetamine salts (AMP) as a treatment for delayed orgasm/anorgasmia (DO/AO).
METHODS
We identified patients with DO/AO from September 2017 to September 2019. Baseline characteristics and patient-reported orgasmic latency time (OLT) were recorded. After extensive screening, patients were treated with AMP. Validated questionnaires were administered including International Index of Erectile Function, quantitative Androgen Deficiency in the Aging Male and Adult ADHD Self-Report Scale. OLT change, adverse effects, and patient satisfaction were assessed. Baseline characteristics were compared using chi-squared test. OLT changes were compared with one-way ANOVA. Multivariable logistic regression was performed to identify predictors of treatment success. P < 0.05 was statistically significant.
RESULTS
Seventeen men received AMP - 6 of 17 (35.3%) for AO and 11 of 17 (64.7%) for DO, with median follow-up 1.0 year (interquartile range [IQR] 1.0 year). Amongst responders, AMP improved subjective experience of sex in 8 of 17 (47.1%) patients (2/6 with AO). Of those, 6 of 17 (35.3%; 1/6 with AO) experienced reduced OLT or increased frequency of orgasm. Non-responders were older than responders, with median age 69.5 (IQR 4.3) vs 61.0 years (IQR 12.3; P = 0.024). There were no other significant differences in baseline characteristics among responders. Of note, 6 of 8 (75%) responders and 8 of 9 (88.9%) non-responders failed other treatment modalities prior to AMP. Among responders with DO and improved OLT, mean OLT decreased by 72.3% (40.7 to 11.1 minutes, P = 0.049) during intercourse. Minimal side effects were noted including insomnia and jitters, each in one patient respectively.
CONCLUSION
AMP as a treatment for AO/DO merits further investigation. Measurable improvements in OLT or frequency of orgasm occurred in more than a third of patients. Larger prospective multicenter studies with strict inclusion and exclusion criteria are warranted.
Topics: Aged; Amphetamine; Central Nervous System Stimulants; Ejaculation; Humans; Male; Middle Aged; Orgasm; Pilot Projects; Prospective Studies; Sleep Initiation and Maintenance Disorders; Time Factors
PubMed: 32360625
DOI: 10.1016/j.urology.2020.04.081 -
Erectile and Ejaculatory Dysfunction Associated with Use of Psychotropic Drugs: A Systematic Review.The Journal of Sexual Medicine Aug 2021Sexual dysfunction may be a side effect of treatment with antipsychotics, antidepressants, and other psychotropic drugs. (Review)
Review
BACKGROUND
Sexual dysfunction may be a side effect of treatment with antipsychotics, antidepressants, and other psychotropic drugs.
AIM
To review the evidence concerning male sexual dysfunctions in patients taking psychotropic drugs to provide specific information to nonpsychiatric physicians for the management of these dysfunctions.
METHODS
A systematic search of Medline and Embase databases was performed up to October 15, 2020. We included randomized controlled trials comparing the effects of psychotropic drugs versus placebo or versus another drug of the same class, for at least 5 weeks.
OUTCOMES
We considered studies whose male population could be evaluated separately from the female population and with a separate analysis of the different phases of the male sex cycle.
RESULTS
We included 41 studies in the final review. There was a significant association between sexual dysfunction and antidepressant drug therapy, compared to placebo (decreased libido OR 1.89, 95% CI:1.40 to 2.56, 22 series, 11 trials, 7706 participants; erectile dysfunction OR = 2.28, 95% CI: 1.31 to 3.97; 11 trials, 3008 participants; ejaculatory dysfunction OR = 7.31, 95% CI: 4.38 to 12.20,19 trials, 3973 participants). When the effects of selective serotonin reuptake inhibitors (SSRIs) were evaluated separately from those of serotonin/norepinephrine reuptake inhibitors (SNRIs), the use of SNRIs but not that of SSRIs was characterized by significantly higher odds of erectile dysfunction compared to placebo. Only limited data were found regarding the effects of antipsychotics on the phases of the male sexual cycle, as it was shown that aripiprazole and risperidone showed lower and higher odds for erectile or ejaculatory dysfunction, respectively, compared to other atypical antipsychotics.
CLINICAL IMPLICATIONS
Treatment of male sexual dysfunction in patients taking psychotropics requires a basic knowledge of the different drugs that affect sexual function with different mechanisms.
STRENGTHS & LIMITATIONS
The effects of psychotropic drugs on erectile function and ejaculation were evaluated separately. The great variability of the mechanisms of action makes it difficult to make comparisons between the effects of the different classes of psychotropic drugs.
CONCLUSIONS
Administration of antipsychotics affects male sexual function with different mechanisms, although the increase in prolactin values associated with the administration of first-generation antipsychotics and some atypical, such as risperidone, seems to play a primary role in determining male sexual dysfunction. Most antidepressants cause decreased libido, ejaculatory and erectile dysfunction, however the administration of SNRIs appears to be possibly associated with a specific risk of erectile dysfunction. Trinchieri M, Trinchieri M, Perletti G, et al. Erectile and Ejaculatory Dysfunction Associated with Use of Psychotropic Drugs: A Systematic Review. J Sex Med 2021;18:1354-1363.
Topics: Antidepressive Agents; Ejaculation; Erectile Dysfunction; Female; Humans; Male; Psychotropic Drugs; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunction, Physiological
PubMed: 34247952
DOI: 10.1016/j.jsxm.2021.05.016 -
Women's Health (London, England) 2024Breast cancer accounts for one in three new cancer cases in women each year. Despite having a higher survival rate than other cancers, it is associated with various side... (Review)
Review
Breast cancer accounts for one in three new cancer cases in women each year. Despite having a higher survival rate than other cancers, it is associated with various side effects, including anorgasmia, vaginismus, hair loss, and decreased libido. This review aims to explore trends in the incidence of sexual dysfunction in breast cancer survivors, the etiology of sexual dysfunction, and the role of factors such as family history, age, duration of marriage, and depression in predisposing patients. We summarize the limitations of the treatment modalities already used to cater to sexual dysfunction in breast cancer survivors and patients. The authors conducted searches on databases such as PubMed and Google Scholar using relevant search terms: sexual dysfunction, breast cancer, breast cancer survivors, chemotherapy, dyspareunia, vaginismus, and anorgasmia from 1997-2023. The inclusion criteria encompassed all types of articles with abstracts or titles indicating research on sexual dysfunction in breast cancer survivors in Asia. A total of 64 articles were included out of which 10 were systematic reviews and meta-analyses. The literature search yielded results showing high incidence rates of breast cancer in Asia (45.4%), with 31.6%-91.2% of breast cancer survivors likely to experience sexual dysfunction. Regional differences were noted, as female sexual dysfunction occurred in 74.1% of Asian breast cancer women. Further randomized controlled trials should be conducted to assess the effectiveness of treatment modalities. Personalized approaches should be tailored to address beliefs, such as the potential impact of sexual activity on disease recovery. Utilizing a family history of breast cancer as a preemptive tool can help reduce the risk of developing female sexual dysfunction in survivors, and factors such as age and depression should be considered when formulating solutions.
Topics: Female; Humans; Breast Neoplasms; Cancer Survivors; Vaginismus; Sexual Dysfunction, Physiological; Sexual Behavior; Survivors
PubMed: 38481086
DOI: 10.1177/17455057241237687 -
Minerva Obstetrics and Gynecology Apr 2022This study aimed to evaluate the quality of life (QoL) and sexual function of women who underwent total abdominal hysterectomy and total laparoscopic hysterectomy.
BACKGROUND
This study aimed to evaluate the quality of life (QoL) and sexual function of women who underwent total abdominal hysterectomy and total laparoscopic hysterectomy.
METHODS
In this prospective cohort study, a total of 121 patients who underwent total abdominal hysterectomy (N.=65) and total laparoscopic hysterectomy (N.=56) operations for benign indications were included. Sociodemographic features, obstetric histories, and clinical characteristics of the patients were noted. Quality of life assessment was conducted with the World Health Organization Quality of Life-BREF questionnaire, which has five domains: overall quality of life + health, physical health, psychological health, social relationships, and environment. Sexual function was assessed by the Golombok-Rust Inventory of Sexual Satisfaction Scale with subscales of infrequency, non-communication, avoidance, non-sensuality, dissatisfaction, vaginismus, and anorgasmia. The patients were asked to fill in both questionnaires before the operation and six months after the operation.
RESULTS
Of the 121 patients, 104 of them completed the postoperative surveys. In the total laparoscopic hysterectomy group, the individual improvements of the overall quality of life + health physical, and psychological health domains were statistically higher than the total abdominal hysterectomy group. In terms of sexual function, the total abdominal hysterectomy group had worse avoidance, non-sensuality, dissatisfaction, and vaginismus subscale scores and total score both in the preoperative and postoperative period compared to the total laparoscopic hysterectomy group. However, the individual differences and the number of patients exhibiting sexual dysfunction before and after surgery were not statistically significant in both groups.
CONCLUSIONS
Laparoscopic hysterectomy was superior to abdominal hysterectomy in improving the quality of life of the patients. Both abdominal and laparoscopic hysterectomies were not found to affect female sexuality.
Topics: Female; Humans; Hysterectomy; Laparoscopy; Prospective Studies; Quality of Life; Vaginismus
PubMed: 35421916
DOI: 10.23736/S2724-606X.21.04741-2 -
Journal of Clinical Medicine Jan 2021Antipsychotic medication can be often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) remains... (Review)
Review
Antipsychotic medication can be often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) remains underestimated in clinical practice. However, psychotic patients consider sexual issues as important as first rank psychotic symptoms, and their disenchantment with TESD can lead to important patient distress and treatment drop-out. In this paper, we detail some management strategies for TESD from a clinical perspective, ranging from prevention (carefully choosing an antipsychotic 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: prescribing either aripiprazole or another dopaminergic agonist as a first option antipsychotic or switching to it whenever possible. Whenever this is not possible, adjunctive treatment with aripiprazole seems to also be beneficial for reducing TESD. Some antipsychotics, like olanzapine, quetiapine, or ziprasidone, have less impact on sexual function than others, so they are an optimal second choice. Finally, a variety of useful strategies (such as the addition of sildenafil) are also described where the previous ones cannot be applied, although they may not yield as optimal results.
PubMed: 33467621
DOI: 10.3390/jcm10020308