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Hormones and Behavior May 2011In men and women sexual arousal culminates in orgasm, with female orgasm solely from sexual intercourse often regarded as a unique feature of human sexuality. However,...
In men and women sexual arousal culminates in orgasm, with female orgasm solely from sexual intercourse often regarded as a unique feature of human sexuality. However, orgasm from sexual intercourse occurs more reliably in men than in women, likely reflecting the different types of physical stimulation men and women require for orgasm. In men, orgasms are under strong selective pressure as orgasms are coupled with ejaculation and thus contribute to male reproductive success. By contrast, women's orgasms in intercourse are highly variable and are under little selective pressure as they are not a reproductive necessity. The proximal mechanisms producing variability in women's orgasms are little understood. In 1924 Marie Bonaparte proposed that a shorter distance between a woman's clitoris and her urethral meatus (CUMD) increased her likelihood of experiencing orgasm in intercourse. She based this on her published data that were never statistically analyzed. In 1940 Landis and colleagues published similar data suggesting the same relationship, but these data too were never fully analyzed. We analyzed raw data from these two studies and found that both demonstrate a strong inverse relationship between CUMD and orgasm during intercourse. Unresolved is whether this increased likelihood of orgasm with shorter CUMD reflects increased penile-clitoral contact during sexual intercourse or increased penile stimulation of internal aspects of the clitoris. CUMD likely reflects prenatal androgen exposure, with higher androgen levels producing larger distances. Thus these results suggest that women exposed to lower levels of prenatal androgens are more likely to experience orgasm during sexual intercourse.
Topics: Adult; Arousal; Coitus; Female; Genitalia, Female; Humans; Libido; Middle Aged; Orgasm; Young Adult
PubMed: 21195073
DOI: 10.1016/j.yhbeh.2010.12.004 -
Acta Dermato-venereologica Jan 2019Treatment of male androgenetic alopecia with 5α-reductase inhibitors is efficacious. However, the risk of adverse sexual effects remains controversial. This systematic... (Meta-Analysis)
Meta-Analysis
Treatment of male androgenetic alopecia with 5α-reductase inhibitors is efficacious. However, the risk of adverse sexual effects remains controversial. This systematic review and meta-analysis investigated the risk of adverse sexual effects due to treatment of androgenetic alopecia in male patients with finasteride, 1 mg/day, or dutasteride, 0.5 mg/day. Fifteen randomized double-blinded placebo-controlled trials (4,495 subjects) were meta-analysed. Use of 5α-reductase inhibitors carried a 1.57-fold risk of sexual dysfunction (95% confidence interval (95% CI) 1.19-2.08). The relative risk was 1.66 (95% CI 1.20-2.30) for finasteride and 1.37 (95% CI 0.81-2.32) for dutasteride. Both drugs were associated with an increased risk, although the increase was not statistically significant for dutasteride. As studies into dutasteride were limited, further trials are required. It is important that physicians are aware of, and assess, the possibility of sexual dysfunction in patients treated with 5α-reductase inhibitors.
Topics: 5-alpha Reductase Inhibitors; Administration, Oral; Alopecia; Dutasteride; Ejaculation; Erectile Dysfunction; Finasteride; Humans; Libido; Male; Randomized Controlled Trials as Topic; Risk Assessment; Risk Factors; Sexual Behavior; Sexual Dysfunction, Physiological
PubMed: 30206635
DOI: 10.2340/00015555-3035 -
Archives of Sexual Behavior Nov 2016This study explored the role of psychological trait factors in sexual desire and sexual activity. In particular, it investigated how these factors may contribute to...
This study explored the role of psychological trait factors in sexual desire and sexual activity. In particular, it investigated how these factors may contribute to maintaining a balance between motivational aspects and self-control abilities, as both have been considered important in relation to adaptive sexuality. Moreover, the study explored the relationship between sexual desire, activity, and satisfaction. Participants completed questionnaires assessing sexual desire (dyadic, solitary), sexual activity (with a partner, alone), sexual satisfaction, approach and avoidance motivation, attachment, self-control, sensation seeking, and mindfulness. Cluster analyses, based on participants' level of sexual desire and sexual activity, highlighted three distinct profiles for each gender related to different types of psychological functioning: (a) participants with high dyadic sexual desire and activity were the most sexually satisfied, showed optimal psychological functioning, and were characterized by a balance between motivational tendencies to seek positive rewards and self-control abilities (high approach motivation, secure attachment, high self-control, high mindfulness); (b) participants with high dyadic and solitary sexual desire and activity were moderately satisfied and showed a type of psychological functioning predominantly characterized by impulsivity (an overly high motivation to obtain rewards in women, and low self-control in men); (c) participants with low dyadic sexual desire and activity were the least sexually satisfied and were characterized by high motivation to avoid negative consequences and low self-control (high avoidance motivation, insecure attachment, and poor mindfulness). These results shed further light on how fundamental psychological factors contribute to explain the individual variability in sexual desire, activity, and satisfaction.
Topics: Adult; Cluster Analysis; Female; Humans; Libido; Male; Mindfulness; Motivation; Orgasm; Personal Satisfaction; Self-Control; Sex Factors; Sexual Behavior; Sexual Partners; Sexuality
PubMed: 25787208
DOI: 10.1007/s10508-014-0467-z -
Ugeskrift For Laeger Apr 2021Sexual behaviour is a normal and healthy part of life. However, some individuals report excessive sexual appetite and/or an inability to control sexual behaviour. The... (Review)
Review
Sexual behaviour is a normal and healthy part of life. However, some individuals report excessive sexual appetite and/or an inability to control sexual behaviour. The literature has conceptualised this behaviour as hypersexuality (HS). The aim of this review is to address the challenges associated with diagnosing HS reliably and the lack of empirical evidence on treatment of HS. Further research is required in order to define when or if excessive sexual behaviour is a clinical disorder or symptomatic of either a medical or psychiatric disorder and how this condition should be treated effectively.
Topics: Compulsive Behavior; Humans; Libido; Paraphilic Disorders; Sexual Behavior
PubMed: 33913428
DOI: No ID Found -
CNS Neuroscience & Therapeutics 2008We sought to determine whether maca, a Peruvian plant, is effective for selective-serotonin reuptake inhibitor (SSRI)-induced sexual dysfunction. We conducted a... (Comparative Study)
Comparative Study Randomized Controlled Trial
We sought to determine whether maca, a Peruvian plant, is effective for selective-serotonin reuptake inhibitor (SSRI)-induced sexual dysfunction. We conducted a double-blind, randomized, parallel group dose-finding pilot study comparing a low-dose (1.5 g/day) to a high-dose (3.0 g/day) maca regimen in 20 remitted depressed outpatients (mean age 36+/-13 years; 17 women) with SSRI-induced sexual dysfunction. The Arizona Sexual Experience Scale (ASEX) and the Massachusetts General Hospital Sexual Function Questionnaire (MGH-SFQ) were used to measure sexual dysfunction. Ten subjects completed the study, and 16 subjects (9 on 3.0 g/day; 7 on 1.5 g/day) were eligible for intent-to-treat (ITT) analyses on the basis of having had at least one postbaseline visit. ITT subjects on 3.0 g/day maca had a significant improvement in ASEX (from 22.8+/-3.8 to 16.9+/-6.2; z=-2.20, P=0.028) and in MGH-SFQ scores (from 24.1+/-1.9 to 17.0+/-5.7; z=-2.39, P=0.017), but subjects on 1.5 g/day maca did not. Libido improved significantly (P<0.05) for the ITT and completer groups based on ASEX item #1, but not by dosing groups. Maca was well tolerated. Maca root may alleviate SSRI-induced sexual dysfunction, and there may be a dose-related effect. Maca may also have a beneficial effect on libido.
Topics: Adult; Antidepressive Agents, Second-Generation; Depressive Disorder; Dose-Response Relationship, Drug; Double-Blind Method; Female; Humans; Lepidium; Libido; Male; Middle Aged; Phytotherapy; Pilot Projects; Plant Extracts; Plant Roots; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 18801111
DOI: 10.1111/j.1755-5949.2008.00052.x -
Scientific Reports Nov 2021The removal of the spleen due to disease or trauma may be followed by disorders due to the asplenism, including immunodeficiency, hematological and metabolic diseases,...
The removal of the spleen due to disease or trauma may be followed by disorders due to the asplenism, including immunodeficiency, hematological and metabolic diseases, mainly dyslipidemia, which can lead to sepsis, pulmonary embolism and early death. Although patients frequently report sexual disinterest after splenectomy, this feature has been experimentally studied only in a translational investigation performed by the same group of this work. To study libido and other sexual functions after the complete removal of the spleen in humans. This study was performed on 60 healthy adults, 30 men and 30 women, after more than 1 year of total splenectomy to treat isolated splenic trauma. The International Index of Erectile Function was applied to men and the Female Sexual Function Index to women. The analysis compared the responses obtained in the periods before and after the splenectomy. Laboratory tests with hematological and biochemical analyses, including sex hormones, were performed in all patients. The pre- and postoperative results were compared in each group using the paired t-test, with each patient being his or her own control and with significance to p < 0.05. A decrease in libido and an increase in sexual dysfunction was observed after splenectomy in all men and women, p < 0.001. All postoperative laboratory tests showed normal values in both genders. Asplenia is associated with a marked decrease in libido and intense sexual dysfunction in both men and women, with normal hematological and biochemical laboratory tests, including hormonal exams.
Topics: Adult; Female; Follow-Up Studies; Humans; Male; Middle Aged; Postoperative Complications; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Splenectomy; Young Adult
PubMed: 34741128
DOI: 10.1038/s41598-021-01371-7 -
American Family Physician Oct 2017Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians. There is conflicting evidence... (Review)
Review
Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians. There is conflicting evidence on the benefit of male testosterone therapy for age-related declines in testosterone. Physicians should not measure testosterone levels unless a patient has signs and symptoms of hypogonadism, such as loss of body hair, sexual dysfunction, hot flashes, or gynecomastia. Depressed mood, fatigue, decreased strength, and a decreased sense of vitality are less specific to male hypogonadism. Testosterone therapy should be initiated only after two morning total serum testosterone measurements show decreased levels, and all patients should be counseled on the potential risks and benefits before starting therapy. Potential benefits of therapy include increased libido, improved sexual function, improved mood and well-being, and increased muscle mass and bone density; however, there is little or mixed evidence confirming clinically significant benefits. The U.S. Food and Drug Administration warns that testosterone therapy may increase the risk of cardiovascular complications. Other possible risks include rising prostate-specific antigen levels, worsening lower urinary tract symptoms, polycythemia, and increased risk of venous thromboembolism. Patients receiving testosterone therapy should be monitored to ensure testosterone levels rise appropriately, clinical improvement occurs, and no complications develop. Testosterone therapy may also be used to treat hypoactive sexual desire disorder in postmenopausal women and to produce physical male sex characteristics in female-to-male transgender patients.
Topics: Adult; Androgens; Cardiovascular Diseases; Female; Health Status; Humans; Hypogonadism; Libido; Male; Middle Aged; Risk Factors; Sexual Dysfunction, Physiological; Testosterone; United States; Women's Health
PubMed: 29094914
DOI: No ID Found -
American Family Physician Sep 2005For centuries, chasteberry has been used to treat many hormone-related gynecologic conditions. The current literature supports the use of chasteberry for cyclical breast... (Review)
Review
For centuries, chasteberry has been used to treat many hormone-related gynecologic conditions. The current literature supports the use of chasteberry for cyclical breast discomfort and premenstrual syndrome; data on its use for menstrual irregularities and fertility disorders are weak. Its traditional use as a galactagogue (i.e., a substance that enhances breast milk production) is not well supported in the literature and should be discouraged. There are no clinical data to support the use of chasteberry for reducing sexual desire, which has been a traditional application. Chasteberry is well tolerated; reported adverse effects are minor and may include gastrointestinal complaints, dizziness, and dry mouth. No herb-drug interactions have been reported, but caution is advised for its concomitant use with dopamine agonists or antagonists. Optimal standardization and dosing recommendations await clarification in clinical studies.
Topics: Female; Humans; Infertility, Female; Lactation; Libido; Menstruation Disturbances; Phytotherapy; Plant Extracts; Vitex
PubMed: 16156340
DOI: No ID Found -
Reviews in Endocrine & Metabolic... Dec 2022Sexual function, and testosterone (T) levels, progressively decline in aging men. Associated morbidities and metabolic disorders can accelerate the phenomenon. The... (Review)
Review
Sexual function, and testosterone (T) levels, progressively decline in aging men. Associated morbidities and metabolic disorders can accelerate the phenomenon. The specific contribution of low T to sexual function impairment in aging men has still not been completely clarified. Similarly, the role of T replacement therapy (TRT), as well as the combination of TRT with phosphodiesterase type 5 inhibitors (PDE5i) for patients with erectile dysfunction (ED), is still conflicting. Here we aim to summarize and critically discuss all available data supporting the contribution of low T to sexual impairment observed with aging as well as the possible role of TRT. Available data on men with sexual dysfunction show that reduced sexual desire is the most important correlate of male hypogonadism. Conversely, aging and associated morbidities substantially attenuate the relationship between ED and T. TRT is effective in improving sexual function in middle-aged and older subjects but its role is small and extremely variable. Lifestyle interventions can result in similar outcomes to those of TRT. In conclusion, it is our opinion that PDE5i along with lifestyle measures should be considered the first approach for treating ED even in subjects with milder T deficiency. When these interventions fail or are difficult to apply, TRT should be considered.
Topics: Middle Aged; Humans; Male; Aged; Testosterone; Hypogonadism; Erectile Dysfunction; Libido; Sexual Dysfunction, Physiological
PubMed: 35999483
DOI: 10.1007/s11154-022-09748-3 -
American Family Physician Aug 2000Decreased libido disproportionately affects patients with depression. The relationship between depression and decreased libido may be blurred, but treating one condition... (Review)
Review
Decreased libido disproportionately affects patients with depression. The relationship between depression and decreased libido may be blurred, but treating one condition frequently improves the other. Medications used to treat depression may decrease libido and sexual function. Frequently, patients do not volunteer problems related to sexuality, and physicians rarely ask about such problems. Asking a depressed patient about libido and sexual function and tailoring treatment to minimize adverse effects on sexual function can significantly increase treatment compliance and improve the quality of the patient's life.
Topics: Algorithms; Antidepressive Agents; Decision Trees; Depression; Female; Humans; Libido; Male; Medical History Taking; Patient Compliance; Quality of Life; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunctions, Psychological
PubMed: 10969857
DOI: No ID Found