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Sexual Medicine Jun 2021Delayed ejaculation (DE) is a poorly understood and uncommon male sexual dysfunction. The etiology of DE includes psychological and biological factors, which are usually...
INTRODUCTION
Delayed ejaculation (DE) is a poorly understood and uncommon male sexual dysfunction. The etiology of DE includes psychological and biological factors, which are usually combined. Herein, we report a case of acquired and situational DE due to improper male condom size.
AIMS
To identify and correct the possible cause of acquired and situational DE.
METHODS
A male patient presented with new-onset DE for 6 months. His physical and mental examination was unremarkable. Laboratory results were all normal. He was diagnosed with acquired, situational DE and received sessions of sexual counseling. However, his DE persisted until he accidentally used a larger condom. He then reported normal orgasm.
MAIN OUTCOME MEASURES
Resolution of acquired and situational DE.
RESULTS
His DE was improved after using a more proper condom size.
CONCLUSION
Most patients are believed to have psychological problems and proper condom use is under-recognized. To the best of our knowledge, this is the first report of DE caused by this etiology. Wainipitapong S, Wiwattarangkul T, Bumphenkiatikul T. Delayed Ejaculation Due to Improper Male Condom Size: A Case Report. Sex Med 2021;9:100373.
PubMed: 34077869
DOI: 10.1016/j.esxm.2021.100373 -
The Primary Care Companion For CNS... Apr 2021
Topics: Ejaculation; Female; Humans; Male; Orgasm; Sexual Dysfunctions, Psychological
PubMed: 34000160
DOI: 10.4088/PCC.20l02746 -
The Journal of Sexual Medicine Mar 2021Labia minora surgeries are gaining popularity and we have limited data available to help counseling patients, especially in the adolescent population.
BACKGROUND
Labia minora surgeries are gaining popularity and we have limited data available to help counseling patients, especially in the adolescent population.
AIM
This study is meant to assess the complications and satisfaction of patients who had the surgery as adolescent.
METHODS
We identified and reviewed all labia minora surgeries performed to address symptoms within the adolescent population from 2006 to 2016. A cross-sectional study was then performed. Questionnaires were sent through an Internet-based survey. Adolescent and adult populations from the literature were used for comparison.
OUTCOMES
A three-part questionnaire assessed surgical indications, current satisfaction regarding the surgery, and the sexual function, including the Female Sexual Function Index (FSFI) and the Female Genital Self-Image Scale (FGSIS).
RESULTS
A total of 44 cases, from 12 to 18 years old, were included for the retrospective review. The major complaint leading to surgery was described as daily basis discomfort (39%) and aesthetics (33%). Surgical indications were similar for the survey responder group. 3 patients (6.8%) underwent redo surgery. We were able to reach 28 of the 44 potential participants for the cross-sectional study. A total of 17 questionnaires were completed (39%). We found a 20.5% rate of complication with 14% dehiscence, 9.3% significant bleeding, and 1 case of wound infection. This complication rate is higher than what has been found in the literature so far. All responders were partially (53%) or fully (47%) satisfied with the surgery. Results of FSFI were different in two of the 6 domains: lower lubrification (P = .0416) and higher orgasm (P = .0495) score compared to adolescent controls. The cutoff criteria for Hypoactive Sexual Desire Disorder was met by 75%. Patients responded positively to the FGSIS questionnaire (M = 21.65, 95% CI: 20.31-22.98).
CLINICAL IMPLICATIONS
This study helps to identify specificities of the adolescent population who underwent labia minora surgery, potential increased complication rates compared to the adult population, even with overall significant postoperative satisfaction.
STRENGTHS & LIMITATIONS
Lack of adequate control group for the FSFI and FGSIS, a small sample size, and a low response rate could have biased our results. To our knowledge, this is the biggest study to date to address this issue exclusively within the adolescent population, with the addition of validated questionnaires. The long delay since surgery (Mean = 8.3 yrs) permits to highlight temporal changes and potential long term complications.
CONCLUSIONS
Patients seem to have no regret about the surgery and sexual dysfunction rate comparable to the literature data, except for possible increased hypoactive sexual desire disorder. Jodoin A, Dubuc E. Labia Minora Surgery in the Adolescent Population: A Cross-Sectional Satisfaction Study. J Sex Med 2021;18:623-631.
Topics: Adolescent; Adult; Child; Cross-Sectional Studies; Esthetics; Female; Humans; Personal Satisfaction; Plastic Surgery Procedures; Retrospective Studies; Vulva
PubMed: 33536146
DOI: 10.1016/j.jsxm.2020.12.003 -
Deutsches Arzteblatt International Sep 2020The 11 edition of the International Statistical Classification of Diseases (ICD-11) is due to come into force in 2022. The goal of the present partial evaluation of the...
BACKGROUND
The 11 edition of the International Statistical Classification of Diseases (ICD-11) is due to come into force in 2022. The goal of the present partial evaluation of the GeSiD study findings is to provide the first ever estimate of the prevalence of different types of sexual dysfunction in Germany as defined by the diagnostic guidelines that are soon to take effect.
METHODS
The representative GeSiD study was carried out in 4955 men and women who belonged to a doubly stratified random sample of data from residence registration offices across Germany. The participation rate was 30.2%. Various types of sexual dysfunction were ascertained for the first time by means of a screening instrument based on the new ICD-11 guidelines.
RESULTS
The reported prevalence of one or more sexual problems, including mild distress, in the previous 12 months was 33.4% in men (95% confidence interval [31.0; 35.9]) and 45.7% in women [43.0; 48.4]. Some 80.4% of men and 72.1% of women stated that they had had at least one sexual contact in the past year. Sexual dysfunction causing marked distress, as per the ICD-11 guidelines, was reported by 13.3% [11.6; 15.1] of the sexually active men (most commonly, erectile dysfunction in 6.6% and early ejaculation in 4.5%), and by 17.5% [15.6; 19.6] of the sexually active women (most commonly, hypoactive sexual desire in 6.9% and orgasmic dysfunction in 5.8%). Orgasmic dysfunction was approximately twice as common in women as delayed ejaculation was in men. The prevalence of erectile dysfunction increased with age, while that of early ejaculation decreased. Women felt particularly impaired by pain associated with sexual activity.
CONCLUSION
The findings of this study indicate the importance of sexual dysfunction as an obstacle to sexual health. The study provides the first prevalence estimates for the new ICD-11 guidelines and simultaneously offers a screening instrument for sexual dysfunction that can be used economically in routine practice.
Topics: Adolescent; Adult; Aged; Female; Germany; Humans; International Classification of Diseases; Male; Middle Aged; Prevalence; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Young Adult
PubMed: 33357346
DOI: 10.3238/arztebl.2020.0653 -
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 -
Global Spine Journal May 2022Retrospective cohort.
STUDY DESIGN
Retrospective cohort.
OBJECTIVES
Delayed ejaculation (DE) is a distressing condition characterized by a notable delay in ejaculation or complete inability to achieve ejaculation, and there are no existing reports of DE following lumbar spine surgery. Inspired by our institutional experience, we sought to assess national rates of DE following surgery of the lumbar spine.
METHODS
We queried the Optum De-identified Clinformatics Database for adult men undergoing surgery of the lumbar spine between 2003 and 2017. The primary outcome was the development of DE within 2 years of surgery. Multivariable logistic regression was performed to identify factors associated with the development of DE.
RESULTS
We identified 117 918 men who underwent 162 646 lumbar spine surgeries, including anterior lumbar interbody fusion (ALIF), posterior lumbar fusion (PLF), and more. The overall incidence of DE was 0.09%, with the highest rate among ALIF surgeries at 0.13%. In multivariable analysis, the odds of developing DE did not vary between anterior/lateral lumbar interbody fusion, PLF, and other spine surgeries. A history of tobacco smoking (OR = 1.47, 95% CI 1.00-2.16, = .05) and obesity (OR = 1.56, 95% CI 1.00-2.44, = .05) were associated with development of DE.
CONCLUSIONS
DE is a rare but distressing complication of thoracolumbar spine surgery, and patients should be queried for relevant symptoms at postoperative visits when indicated.
PubMed: 33047620
DOI: 10.1177/2192568220962435 -
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 -
Medical Hypotheses May 2020Based on the ancient role of oxytocin and its homologues as amplifiers of reproduction we argue for an evolutionary coupling of oxytocin to signaling pathway which...
Based on the ancient role of oxytocin and its homologues as amplifiers of reproduction we argue for an evolutionary coupling of oxytocin to signaling pathway which support restorative mechanisms of cells and tissue. In particular, the survival and function of different categories of stem cells and primordial cells are enhanced by mitogen-activated protein kinase (MAPK) pathways. Furthermore, oxytocin stimulates the AMP-activated protein kinase pathway (AMPK) in numerous of cell types which promotes the maintenance of different cell structures. This involves autophagic processes and, in particular, may support the renewal of mitochondria. Mitochondrial fitness may protect against oxidative and inflammatory stress - a well-documented effect of oxytocin. The combined specific trophic and protective effects oxytocin may delay several degenerative phenomena including sarcopenia, type-2 diabetes and atherosclerosis. These effects may be exerted both on a central level supporting the function and integrity of the hypothalamus and peripherally acting directly on blood vessels, pancreas, heart, skeletal muscles and adipose tissue etc. Furthermore, in the capacity of being both a hormone and neuromodulator, oxytocin interacts with numerous of regulatory mechanisms particularly the autonomic nervous system and HPA-axis which may reduce blood pressure and affect the immune function. The potential of the oxytocin system as a behavioral and molecular target for the prevention and treatment of cardiovascular disease is discussed. Focus is put on the affiliative and sexual significance and the different options and limitations associated with a pharmaceutical approach. MeSH: Aging, Atherosclerosis, Heart, Hypothalamus, Inflammation, Love, Orgasm, Oxytocin.
Topics: Cardiovascular Diseases; Humans; Hypothalamus; Oxytocin; Pharmaceutical Preparations; Sarcopenia
PubMed: 32032912
DOI: 10.1016/j.mehy.2020.109597 -
Urologiia (Moscow, Russia : 1999) Dec 2019Delayed ejaculation is a form of sexual disorders, which is characterized by constant or intermittent delays or absence of ejaculation and orgasm, despite normal sexual...
Delayed ejaculation is a form of sexual disorders, which is characterized by constant or intermittent delays or absence of ejaculation and orgasm, despite normal sexual arousal and erectile function. Delayed ejaculation is one of the most studied and rare types of male sexual dysfunctions, which leads to depression, anxiety, and often is a reason of low self-esteem, reduced satisfaction of a man with his partner, and worsening of relationships between partners. In some cases, delayed ejaculation and anejaculation cause infertility. Current views on epidemiology, diagnostics and treatment strategy of delayed ejaculation are presented in the article.
Topics: Ejaculation; Humans; Male; Orgasm; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 32003187
DOI: No ID Found -
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