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Addiction & Health Jul 2022Alcohol is a potent substance that causes both acute and chronic changes in almost all neurochemical systems, with the result that heavy drinking can produce serious...
BACKGROUND
Alcohol is a potent substance that causes both acute and chronic changes in almost all neurochemical systems, with the result that heavy drinking can produce serious psychological symptoms including depression, anxiety, and psychoses. It also affects sexual health adversely and causes sexual dysfunction.
METHODS
This study aimed to find the prevalence and pattern of sexual dysfunction in male patients with alcohol dependence. This cross-sectional study included 100 patients attending psychiatry out patient department (OPD) at a tertiary care center in west India. Informed written consent was taken for collecting socio-demographic and clinical data in a uniform and standard manner. Sexual dysfunction was assessed using a sexual dysfunction checklist, constructed by Arackal and Benegal at the national institute of mental health and neuroscience, Bangalore containing 12 items from the diagnostic criteria for research and ICD-10 classification of mental and behavioral disorders. The Leeds dependence questionnaire was used to assess the severity of alcohol dependence.
FINDINGS
Sexual dysfunction was present in 62% of the patients. Among the patients, 36% had difficulty achieving an erection, 34% had difficulty maintaining an erection, 37% reported premature ejaculation, 7% had delayed ejaculation, 14% reported anorgasmia, 1% had ejaculation with a flaccid penis, 2% had pain during intercourse, 6% were dissatisfied with the frequency of intercourse, 4% were dissatisfied with their sexual partner, and 7% were dissatisfied with their performance.
CONCLUSION
Sexual dysfunction is significantly and positively associated with duration, amount of alcohol consumed per day, and severity of alcohol dependence.
PubMed: 36544980
DOI: 10.34172/ahj.2022.1335 -
Urology Journal Apr 2022To study the effect of female sexual abnormalities on the etiology of penile fracture, which is an important urological emergency.
PURPOSE
To study the effect of female sexual abnormalities on the etiology of penile fracture, which is an important urological emergency.
MATERIALS AND METHODS
The sexual function of the partners of patients with penile fracture (study group, n = 90) treated at our clinic and healthy women (control group, n = 90) were evaluated on a voluntary basis. In both groups, sexual function was evaluated with the Female Sexual Function Index (FSFI). Each substance of the FSFI was evaluated separately by comparing both groups and the effect on the development of penile fracture was investigated.
RESULTS
There was no difference in demographic and clinical characteristics between the study and control groups. Evaluation of sexual function with FSFI revealed that the scores of vaginal lubrication, orgasm, satisfaction, and pain subscales were lower in the study group (p < .001). Among these subscales, anorgasmia was determined as the factor with the largest effect on the development of penile fracture (OR = 7.333, 95% CI = 2.666-20.166, p < .001). No correlation was found between the largest dimension of penile fracture and FSFI total and subscale scores in the study group.
CONCLUSION
We believe that female vaginal dryness and dyspareunia in particular are factors which could cause the development of penile fracture during sexual intercourse. The treatment could prevent the development of penile fracture in the male.
Topics: Coitus; Dyspareunia; Female; Humans; Male; Orgasm; Personal Satisfaction; Sexual Behavior; Surveys and Questionnaires
PubMed: 35398882
DOI: 10.22037/uj.v19i.6818 -
The Journal of Sexual Medicine May 2022Many patients have goals related to sexual health when seeking gender-affirming vaginoplasty, and previous investigations have only studied the ability to orgasm at...
BACKGROUND
Many patients have goals related to sexual health when seeking gender-affirming vaginoplasty, and previous investigations have only studied the ability to orgasm at cross-sectional timepoints.
AIM
Our aim is to quantify the time to orgasm postoperative gender-affirming vaginoplasty and describe potential correlative factors, including preoperative orgasm, to improve preoperative counseling.
METHODS
A retrospective chart review was utilized to extract factors thought to influence pre and postoperative orgasm in patients undergoing robotic peritoneal flap vaginoplasty. Mean days to orgasm plus one standard deviation above that mean was used to define the time at which patients would be considered anorgasmic.
OUTCOMES
Orgasm was documented as a categorical variable on the basis of surgeon interviews during pre and postoperative appointments while time to orgasm was measured as days from surgery to first date documented as orgasmic in the medical record.
RESULTS
A total of 199 patients underwent surgery from September 2017 to August 2020. The median time to orgasm was 180 days. 178 patients had completed 1 year or greater of follow-up, and of these patients, 153 (86%) were orgasmic and 25 patients (14%) were not. Difficulty in preoperative orgasm was correlated only with older age (median age 45.9 years vs 31.7, P = .03). Postoperative orgasm was not significantly correlated with preoperative orgasm. The only factor related to postoperative orgasm was smoking history: 12 of 55 patients (21.8%) who had a positive smoking history and sufficient follow-up reported anorgasmia (P-value .046). Interventions for anorgasmic patients include testosterone replacement, pelvic floor physical therapy, and psychotherapy.
CLINICAL IMPLICATIONS
Preoperative difficulty with orgasm improves with gender-affirming robotic peritoneal flap vaginoplasty, while smoking had a negative impact on postoperative orgasm recovery despite negative cotinine test prior to surgery.
STRENGTHS & LIMITATIONS
This investigation is the first effort to determine a timeline for the return of orgasmic function after gender-affirming vaginoplasty. It is limited by retrospective review methodology and lack of long-term follow-up. The association of smoking with postoperative orgasm despite universal nicotine cessation prior to surgery may indicate prolonged smoking cessation improves orgasmic outcomes or that underlying, unmeasured exposures correlated with smoking may be the factor inhibiting recovery of orgasm.
CONCLUSION
The majority of patients were orgasmic at their 6-month follow-up appointments, however, patients continued to become newly orgasmic in appreciable numbers more than 1 year after surgery. Blasdel G, Kloer C, Parker A, et al. Coming Soon: Ability to Orgasm After Gender Affirming Vaginoplasty. J Sex Med 2022;19:781-788.
Topics: Cross-Sectional Studies; Female; Humans; Middle Aged; Orgasm; Retrospective Studies; Sex Reassignment Surgery; Vagina
PubMed: 35337785
DOI: 10.1016/j.jsxm.2022.02.015 -
The Journal of Sexual Medicine May 2020Investigation of vaginal penetration cognitions and metacognitive beliefs in genito-pelvic pain and penetration disorder (GPPPD) could be important for understanding the...
BACKGROUND
Investigation of vaginal penetration cognitions and metacognitive beliefs in genito-pelvic pain and penetration disorder (GPPPD) could be important for understanding the underlying mechanisms of sexual disorders.
AIM
The aim of this study was to compare healthy controls and GPPPD women for vaginal penetration cognitions and metacognitions.
METHODS
Outpatients with GPPPD (n = 135) and healthy controls (n = 136) were evaluated with Sociodemographic Data Form, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV (SCID-I), SCID nonpatient version, Golombok-Rust Inventory of Sexual Satisfaction Female Form (GRISS), Vaginal Penetration Cognition Questionnaire, Metacognitions Questionnaire (MQ), Hamilton Anxiety Rating Scale (HAM-A), SCID and Hamilton Depression Rating Scale (HAM-D).
OUTCOMES
The relationship between metacognitions and vaginal penetration cognitions was detected, and patients with GPPPD and healthy controls were compared for metacognitions.
RESULTS
The MQ total score and all MQ subdimension scores other than positive beliefs about worry of GPPPD were found to be significantly higher in the GPPPD group than in controls. All Vaginal Penetration Cognition Questionnaire subdimension scores except positive cognitions for penetration score were significantly higher in patients with GPPPD than in controls. The total and frequency of sexuality, sexual communication between partners, avoidance of sexuality, nonsensuality, vaginismus, satisfaction, and anorgasmia subscores of the GRISS were significantly higher in the GPPPD group. Cognitive self-consciousness, need for controlling thoughts, and HAM-D values had a significant and independent effect on distinguishing the patients with GPPPD from the controls.
CLINICAL IMPLICATIONS
Our results may be important to address the metacognitions in the treatment of women with GPPPD.
STRENGTHS & LIMITATIONS
The strengths are large-sample case and control groups, comparison with the control group using both clinical interviews and scale evaluations, diagnosis of GPPPD using clinical interviews and with 2 validated scales, exclusion of patients with depression and anxiety disorders, and evaluation of metacognitions not affected by concomitant disorders. The cross-sectional nature of our study and the fact that it was performed only in treatment-seeking groups and recruitment of hospital workers' relatives as a control group were limitations of the study.
CONCLUSION
In addition to the behavioral components of GPPPD treatment, the emphasis on metacognitions especially in the treatment process may have a positive effect on treatment. Teksin Ünal G, Şahmelikoğlu Onur Ö, Erten E. Comparison of Vaginal Penetration Cognitions and Metacognitions Between Women With Genito-Pelvic Pain and Penetration Disorder and Healthy Controls. J Sex Med 2020;17:964-974.
Topics: Cognition; Cross-Sectional Studies; Female; Humans; Metacognition; Pelvic Pain; Surveys and Questionnaires; Vaginismus
PubMed: 32098723
DOI: 10.1016/j.jsxm.2020.01.015 -
Sexual Medicine Reviews Mar 2024Affective neuroscience is the study of the brain substrates of emotional, embodied experiences. Affective neuroscience theory (ANT) is based on experimental evidence... (Review)
Review
INTRODUCTION
Affective neuroscience is the study of the brain substrates of emotional, embodied experiences. Affective neuroscience theory (ANT) is based on experimental evidence that all mammals are hardwired with 7 primary subcortical emotional operating systems, or "core emotions," that have overlapping but distinct circuits buried in the deep, ancient parts of the brain. Imbalances in the 7 core emotions can affect multiple aspects of the individual's psychosocial well-being (eg, depression, anxiety, substance abuse). Here, we propose that core emotions can also influence sexual function and, specifically, that imbalances in core emotions are the bridge connecting psychiatric symptoms (eg, anhedonia) to sexual dysfunction (eg, anorgasmia).
OBJECTIVES
In this targeted review and commentary, we outline potential connections between ANT and sexual medicine research and clinical practice. We summarize ANT by defining the 3-level BrainMind and core emotions; examining how they relate to personality, behavior, and mental health; and determining the implications for sexual health research and clinical practice.
METHODS
A targeted literature review was conducted. Case studies were adapted from client files and clinician interviews and then anonymized.
RESULTS
We propose a novel organizational schema for implementing affective balance therapies for sexual dysfunction, which integrate psychoeducational, somatic, and cognitive therapeutic approaches under the ANT framework. We provide 3 patient case studies (anorgasmia, hypersexuality, spinal cord injury) outlining the implementation of this approach and patient outcomes.
CONCLUSION
ANT has practical translational applications in sexual health research and clinical practice. By integrating our understanding of the role of core emotions in human sexuality, clinicians can better tailor treatments to address sexual dysfunction.
Topics: Humans; Brain; Emotions; Personality Disorders; Sexual Behavior; Sexual Dysfunction, Physiological; Sexuality; Mood Disorders
PubMed: 38281754
DOI: 10.1093/sxmrev/qead048 -
Expert Opinion on Drug Safety Apr 2022Sexual dysfunction is highly prevalent worldwide. A specific form is persistent sexual dysfunction after SSRI withdrawal. We conducted a systematic literature review in... (Review)
Review
BACKGROUND
Sexual dysfunction is highly prevalent worldwide. A specific form is persistent sexual dysfunction after SSRI withdrawal. We conducted a systematic literature review in order to characterize factors related to post SSRI sexual dysfunction (PSSD) and analyzed spontaneous reports of persistent sexual dysfunction reported to the Netherlands Pharmacovigilance Center Lareb.
RESEARCH DESIGN AND METHODS
A systematic literature review was conducted following the PRISMA-ScR guidelines. In addition, reports of PSSD submitted to the Netherlands Pharmacovigilance Center Lareb between 1992 and 2021 were analyzed.
RESULTS
A total of 237 articles were retrieved through the search and 33 articles were selected for inclusion in this review, in accordance with the inclusion criteria. Information regarding the characteristics of the condition, its clinical management, patient characteristics, and impact of PSSD is presented. A total of 86 reports of persistent sexual dysfunction were analyzed. The longest case being a patient with PSSD for 23 years. The main symptoms were: loss or decreased libido (n = 53), erectile dysfunction (n = 23) and anorgasmia (n = 5).
CONCLUSIONS
PSSD impact includes sexual, psychological, and social consequences. Little is known about the mechanisms underlying PSSD and no effective treatment exists. It is necessary to increase recognition of PSSD among prescribers and improve its management at the clinical level.
Topics: Erectile Dysfunction; Humans; Male; Netherlands; Pharmacovigilance; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 34791958
DOI: 10.1080/14740338.2022.2007883 -
International Journal of Urology :... Nov 2022We sought to evaluate the incidence and extent of orgasmic dysfunction in patients after robot-assisted radical prostatectomy and to identify factors that could predict...
OBJECTIVE
We sought to evaluate the incidence and extent of orgasmic dysfunction in patients after robot-assisted radical prostatectomy and to identify factors that could predict patients at risk.
METHODS
A single-center, questionnaire-based, cross-sectional study was conducted on patients who underwent robot-assisted radical prostatectomy (n = 523) between October 2010 and November 2019. In addition to six questions about sexual activity, orgasmic function, altered perception of orgasms, dysorgasmia, and climacturia, the International Consultation on Incontinence Questionnaire Short Form was administered. In February 2020, a letter was mailed inviting patients to participate in the survey. The primary outcome measure was the rate of orgasmic dysfunction. Logistic regression analyses were used to identify predictors of orgasmic dysfunction.
RESULTS
Overall, 259 questionnaires were used for analysis. Among sexually active patients (n = 145), 33 (22.8%) reported anorgasmia, and 83 (57.2%) reported decreased orgasm intensity. Twenty-two (15.1%) patients reported dysorgasmia; among these patients, the pain was experienced almost always or always in 13.6%, sometimes in 13.6%, and a few times in 72.8% of cases. Climacturia was reported by 44 patients (30.3%). Nerve-sparing procedures decreased the risk of anorgasmia (odds ratio 0.37, 95% confidence interval 0.15-0.88) and urinary incontinence increased the risk of climacturia (odds ratio 3.13, 95% confidence interval 1.20-8.15).
CONCLUSIONS
These results indicate that orgasmic dysfunction after robot-assisted radical prostatectomy is relatively common.
Topics: Male; Humans; Cross-Sectional Studies; Incidence; Robotics; Prostatectomy; Urinary Incontinence; Surveys and Questionnaires; Erectile Dysfunction
PubMed: 35858762
DOI: 10.1111/iju.14985 -
Journal of Sex & Marital Therapy 2021Male factor infertility can be challenging to treat. Anejaculation/anorgasmia in men can be distressing for them specially when it is coupled with fertility desires....
Male factor infertility can be challenging to treat. Anejaculation/anorgasmia in men can be distressing for them specially when it is coupled with fertility desires. Understanding the pathophysiology of the condition requires careful evaluation. Although novel techniques exist to retrieve sperms form men suffering from anejaculation/anorgasmia, simple and inexpensive methods should be tried in every possible case.
Topics: Condoms; Ejaculation; Humans; Infertility, Male; Male; Sexual Dysfunctions, Psychological
PubMed: 33263507
DOI: 10.1080/0092623X.2020.1853637 -
BMC Psychiatry May 2024This study aims to conduct an exhaustive evaluation of Vilazodone's safety in clinical application and to unearth the potential adverse event (AE) risks associated with...
OBJECTIVE
This study aims to conduct an exhaustive evaluation of Vilazodone's safety in clinical application and to unearth the potential adverse event (AE) risks associated with its utilization based on FDA Adverse Event Reporting System (FAERS) database.
METHODS
This research employed data spanning from the first quarter of 2011 to the third quarter of 2023 from the FAERS database. Various signal detection methodologies, including the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM), were utilized to ascertain the correlation between Vilazodone and specific AEs.
RESULTS
The study compiled a total of 17,439,268 reports of drug AEs, out of which 5,375 were related to Vilazodone. Through signal mining, 125 Preferred Terms (PTs) encompassing 27 System Organ Classes (SOCs) were identified. The findings indicated a higher prevalence among females and patients within the 45 to 65 age bracket. The principal categories of AEs included Psychiatric disorders, Nervous system disorders, and Gastrointestinal disorders, with prevalent incidents of Diarrhoea, Nausea, and Insomnia. Moreover, the study identified robust signals of novel potential AEs, notably in areas such as sleep disturbances (Sleep paralysis, Hypnagogic hallucination, Rapid eye movements sleep abnormal, Sleep terror, Terminal insomnia, Tachyphrenia), sexual dysfunctions (Female orgasmic disorder, Orgasm abnormal, Disturbance in sexual arousal, Spontaneous penile erection, Anorgasmia, Sexual dysfunction, Ejaculation delayed), and other symptoms and injuries (Electric shock sensation, Violence-related symptom, Gun shot wound).
CONCLUSION
Although Vilazodone presents a positive prospect in the management of MDD, the discovery of AEs linked to its use, particularly the newly identified potential risks such as sleep and sexual dysfunctions, necessitates heightened vigilance among clinicians.
Topics: Humans; Vilazodone Hydrochloride; Male; Female; Adverse Drug Reaction Reporting Systems; Middle Aged; United States; Adult; Aged; Databases, Factual; United States Food and Drug Administration; Young Adult; Adolescent; Bayes Theorem
PubMed: 38755677
DOI: 10.1186/s12888-024-05813-0 -
Cureus Jul 2023Introduction Sexual dysfunction is rarely studied in Indonesian patients with breast cancer. We aimed to assess the prevalence of sexual dysfunction symptoms following...
Introduction Sexual dysfunction is rarely studied in Indonesian patients with breast cancer. We aimed to assess the prevalence of sexual dysfunction symptoms following chemotherapy, as well as the pattern and the associated factors. Methods This cross-sectional study included 135 female breast cancer patients receiving primary chemotherapy. The present study measured the prevalence of sexual dysfunction symptoms using an e-questionnaire containing Common Toxicity Criteria for Adverse Events (CTCAE) version 4 at different time points. Other data included sociodemography, clinicopathology, treatment, and other concurrent symptom characteristics. Bivariate and multivariate logistic regression tests were used to analyze any association among variables. Results In the whole panel, 86 (63.7%) of 135 cases experienced sexual dysfunction. The most common symptom was vaginal dryness (45.9%), followed by decreased libido (45.2%), dyspareunia (13.3%), delayed orgasm (11.1%), and anorgasmia (8.9%). When observed at five different time points, the frequency of symptoms increased during chemotherapy and persisted until six months after completing treatment. Chemotherapy duration of >120 days was associated with a higher probability of vaginal dryness (p=0.012) and decreased libido (p=0.033). Spouse age ≥55 years old and body mass index (BMI) ≥23 kg/m were associated with a reduced probability of decreased libido (p=0.033 and 0.025, respectively). The presence of comorbidity was associated with a reduced probability of delayed orgasm (p=0.034). Conclusions A significant proportion of patients with breast cancer had sexual dysfunction following chemotherapy. Vaginal dryness, decreased libido, and dyspareunia were the commonest symptoms observed. Duration of chemotherapy, spouse age, BMI, and comorbidity were associated with the risk of sexual dysfunction occurrence.
PubMed: 37449290
DOI: 10.7759/cureus.41744