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The Journal of Sexual Medicine Nov 2016The Hypogonadism Impact of Symptoms Questionnaire (HIS-Q) is a patient-reported outcome measurement designed to comprehensively evaluate the symptoms of hypogonadism and... (Observational Study)
Observational Study
INTRODUCTION
The Hypogonadism Impact of Symptoms Questionnaire (HIS-Q) is a patient-reported outcome measurement designed to comprehensively evaluate the symptoms of hypogonadism and to detect changes in these symptoms in response to treatment.
AIM
To conduct item analysis and reduction, evaluate the psychometric properties of the HIS-Q, and provide guidance on interpreting the instrument score.
METHODS
A 12-week observational, longitudinal study of hypogonadal men was conducted. Participants completed the HIS-Q every 2 weeks. Blood samples were collected to evaluate testosterone levels. Participants also completed the Aging Male's Symptoms Scale, the International Index of Erectile Function, the Short Form-12 Health Survey, and the Patient-Reported Outcomes Measurement Information System Sexual Activity, Satisfaction with Sex Life, Sleep Disturbance, and Applied Cognition Scales (at baseline and weeks 6 and 12). Clinicians completed the Clinical Global Impression of Severity and Change measurements and a clinical form.
MAIN OUTCOME MEASURES
Individual item performance was evaluated using descriptive statistics and Rasch analyses. Reliability (internal consistency and test-retest), validity (concurrent and know groups), and responsiveness were assessed.
RESULTS
In total, 177 men participated in the study (mean age = 54.1 years, range = 23-83). The original 53-item draft HIS-Q was reduced to 28 items; the final instrument included five domains (sexual, energy, sleep, cognition, and mood) with two sexual subdomains (libido and sexual function). For all domains, test-retest reliability was acceptable (intraclass correlation coefficients > 0.70), construct validity was good (|r > 0.30| for all comparisons). Known-groups validity was demonstrated for all HIS-Q domain scores, subdomain scores, and the total score as measured by the Clinical Global Impression of Severity, and total testosterone level at baseline (P < .05 for all comparisons). All domains and subdomains were responsive to change based on patient-rated anchor questions (P < .05 for all comparisons).
CONCLUSION
The final 28-item HIS-Q is reliable, valid, and responsive. The HIS-Q is suitable for inclusion in future clinical trials to help characterize the effects of testosterone replacement therapy.
Topics: Adult; Affect; Aged; Aged, 80 and over; Hormone Replacement Therapy; Humans; Hypogonadism; Libido; Longitudinal Studies; Male; Middle Aged; Personal Satisfaction; Psychometrics; Quality of Life; Reproducibility of Results; Sexual Behavior; Surveys and Questionnaires; Testosterone; Young Adult
PubMed: 27692845
DOI: 10.1016/j.jsxm.2016.09.006 -
The International Journal of Eating... Mar 2010To describe sexual functioning in women with eating disorders. (Comparative Study)
Comparative Study
OBJECTIVE
To describe sexual functioning in women with eating disorders.
METHOD
We assessed physical intimacy, libido, sexual anxiety, partner status, and sexual relationships in 242 women from the International Price Foundation Genetic Studies relative to normative data.
RESULTS
Intercourse (55.3%), having a partner (52.7%), decreased sexual desire (66.9%), and increased sexual anxiety (59.2%) were common. Women with restricting and purging anorexia nervosa had a higher prevalence of loss of libido than women with bulimia nervosa and eating disorder not otherwise specified (75%, 74.6%, 39%, and 45.4%, respectively). Absence of sexual relationships was associated with lower minimum lifetime body mass index (BMI) and earlier age of onset; loss of libido with lower lifetime BMI, higher interoceptive awareness and trait anxiety; and sexual anxiety with lower lifetime BMI, higher harm avoidance and ineffectiveness. Sexual dysfunction in eating disorders was higher than in the normative sample.
DISCUSSION
Sexual dysfunction is common across eating disorders subtypes. Low BMI is associated with loss of libido, sexual anxiety, and avoidance of sexual relationships.
Topics: Adult; Anorexia Nervosa; Anxiety; Body Mass Index; Bulimia Nervosa; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Feeding and Eating Disorders; Female; Humans; Libido; Prevalence; Sexual Behavior
PubMed: 19260036
DOI: 10.1002/eat.20671 -
The Journal of Sexual Medicine Feb 2020Erectile function, libido, and sexual bother are incompletely correlated: a man may or may not be satisfied for a given level of erectile function; similarly, 2 men may...
INTRODUCTION
Erectile function, libido, and sexual bother are incompletely correlated: a man may or may not be satisfied for a given level of erectile function; similarly, 2 men may have the same erectile function and different levels of sexual desire.
AIM
To explore the relationship between erectile function, sexual satisfaction and sexual desire.
METHODS
We examined the Spearman correlation among erectile function (International Index of Erectile Function [IIEF-6]), sexual desire, and sexual bother in 3,944 questionnaires completed by patients after radical prostatectomy as part of routine care. IIEF-6 scores were adjusted if a patient indicated that the reason for not having intercourse was other than lack of ability of confidence (eg, lack of partner).
MAIN OUTCOME MEASURE
Patient-reported outcome instruments.
RESULTS
Median age at surgery and preoperative IIEF-6 were 63 years and 26, respectively. Among questionnaires completed after surgery, there was moderate correlation among the IIEF-6 score and both sexual desire (Spearman rho: 0.41) and sexual bother (Spearman rho: 0.30). In men who reported high or moderate bother relating to sexual function, there was a narrow distribution of erectile function scores, with most men reporting poor function (median IIEF-6: 6, interquartile range 3, 11). For men who reported small or no problem with sexual function, the distribution of erectile function scores was wide, and particularly bimodal as a function of sexual desire. Among patients with high desire, the correlation between sexual bother and erectile function was 0.61 (ie, the poorer is your function, the greater you are bothered), whereas it was -0.081 among patients with low desire, meaning that some men are not bothered by poor erections.
CLINICAL IMPLICATIONS
We provided useful insights to help physicians during sexual counselling after surgery for prostate cancer.
STRENGTH & LIMITATIONS
The study included a large number of patients and provides evidence for implementation of patient-reported outcome insturments. Limitations include the retrospective nature of our data.
CONCLUSION
Sexual desire helps explain the moderate correlation between erectile function and sexual bother. Sexual desire and bother questions should be incorporated in patient-reported outcome instruments for male sexual function. Bravi CA, Tin A, Montorsi F, et al. Erectile Function and Sexual Satisfaction: The Importance of Asking About Sexual Desire. J Sex Med 2020;17:349-352.
Topics: Aged; Coitus; Erectile Dysfunction; Humans; Libido; Male; Middle Aged; Orgasm; Penile Erection; Prostatectomy; Prostatic Neoplasms; Retrospective Studies; Sexual Behavior; Sexual Partners; Surveys and Questionnaires
PubMed: 31735617
DOI: 10.1016/j.jsxm.2019.09.024 -
California Medicine Apr 1968Ever since World War II, there has been a noticeable change in the sexual behavior and responses in men and women. Women, in general, are becoming sexually more...
Ever since World War II, there has been a noticeable change in the sexual behavior and responses in men and women. Women, in general, are becoming sexually more assertive and demanding and men more indifferent and lethargic. In patients of middle age, sexual boredom is particularly pronounced in men, whereas the post-menopausal female becomes more interested in sexual pleasure. In the youth of the "cool" generation, both boys and girls are quite open about sex, but their sexual activities precede emotional involvement. The similarities in dress and behavior of both sexes indicate a wish for a twin rather than a search for a lover. In the age group between 25 and 45, women demand equal orgasms since they have become economically independent and are relatively free of the fear of pregnancy. This seems to have mobilized a deep-seated unconscious fear and hatred of women in the male, making him sexually apathetic. In both sexes there is a growing alienation between romantic love and sex.
Topics: Humans; Libido; Male; Sexual Behavior
PubMed: 5652746
DOI: No ID Found -
Cleveland Clinic Journal of Medicine May 2019
Topics: Diagnosis, Differential; Eunuchism; Fatigue; Humans; Libido; Male; Middle Aged; Obesity
PubMed: 31066666
DOI: 10.3949/ccjm.86a.18097 -
The Journal of Clinical Endocrinology... Aug 2016The Testosterone Trials are a coordinated set of seven trials to determine the efficacy of T in symptomatic men ≥65 years old with unequivocally low T levels. Initial... (Randomized Controlled Trial)
Randomized Controlled Trial
CONTEXT
The Testosterone Trials are a coordinated set of seven trials to determine the efficacy of T in symptomatic men ≥65 years old with unequivocally low T levels. Initial results of the Sexual Function Trial showed that T improved sexual activity, sexual desire, and erectile function.
OBJECTIVE
To assess the responsiveness of specific sexual activities to T treatment; to relate hormone changes to changes in sexual function; and to determine predictive baseline characteristics and T threshold for sexual outcomes.
DESIGN
A placebo-controlled trial.
SETTING
Twelve academic medical centers in the United States.
PARTICIPANTS
A total of 470 men ≥65 years of age with low libido, average T <275 ng/dL, and a partner willing to have sexual intercourse at least twice a month.
METHODS
Men were assigned to take T gel or placebo for 1 year. Sexual function was assessed by three questionnaires every 3 months: the Psychosexual Daily Questionnaire, the Derogatis Interview for Sexual Function, and the International Index of Erectile Function.
RESULTS
Compared with placebo, T administration significantly improved 10 of 12 measures of sexual activity. Incremental increases in total and free T and estradiol levels were associated with improvements in sexual activity and desire, but not erectile function. No threshold T level was observed for any outcome, and none of the 27 baseline characteristics predicted responsiveness to T.
CONCLUSIONS
In older men with low libido and low T levels, improvements in sexual desire and activity in response to T treatment were related to the magnitude of increases in T and estradiol levels, but there was no clear evidence of a threshold effect.
Topics: Aged; Erectile Dysfunction; Hormone Replacement Therapy; Humans; Libido; Male; Placebos; Sexual Behavior; Sexual Dysfunction, Physiological; Surveys and Questionnaires; Testosterone; Treatment Outcome
PubMed: 27355400
DOI: 10.1210/jc.2016-1645 -
Archives of Sexual Behavior Apr 2008This article reviews what is currently known about how men and women respond to the presentation of visual sexual stimuli. While the assumption that men respond more to... (Review)
Review
This article reviews what is currently known about how men and women respond to the presentation of visual sexual stimuli. While the assumption that men respond more to visual sexual stimuli is generally empirically supported, previous reports of sex differences are confounded by the variable content of the stimuli presented and measurement techniques. We propose that the cognitive processing stage of responding to sexual stimuli is the first stage in which sex differences occur. The divergence between men and women is proposed to occur at this time, reflected in differences in neural activation, and contribute to previously reported sex differences in downstream peripheral physiological responses and subjective reports of sexual arousal. Additionally, this review discusses factors that may contribute to the variability in sex differences observed in response to visual sexual stimuli. Factors include participant variables, such as hormonal state and socialized sexual attitudes, as well as variables specific to the content presented in the stimuli. Based on the literature reviewed, we conclude that content characteristics may differentially produce higher levels of sexual arousal in men and women. Specifically, men appear more influenced by the sex of the actors depicted in the stimuli while women's response may differ with the context presented. Sexual motivation, perceived gender role expectations, and sexual attitudes are possible influences. These differences are of practical importance to future research on sexual arousal that aims to use experimental stimuli comparably appealing to men and women and also for general understanding of cognitive sex differences.
Topics: Affect; Erotica; Female; Humans; Interpersonal Relations; Libido; Male; Peer Group; Photic Stimulation; Reference Values; Sex Characteristics; Sex Factors; Sexual Behavior; Social Environment; Visual Perception
PubMed: 17668311
DOI: 10.1007/s10508-007-9217-9 -
Fertility and Sterility Apr 2002To review the randomized controlled trials of the efficacy of combined estrogen-androgen (E-A) preparations on sexual functioning in postmenopausal women. (Review)
Review
OBJECTIVE
To review the randomized controlled trials of the efficacy of combined estrogen-androgen (E-A) preparations on sexual functioning in postmenopausal women.
PATIENT(S)
Naturally and surgically menopausal women.
MAIN OUTCOME MEASURE(S)
Changes in aspects of sexual functioning.
RESULT(S)
In general, a high degree of agreement exists among the findings of these well-controlled trials that combined E-A preparations enhance psychological well-being as well as sexual desire and interest and, sometimes, increases the frequency of sexual intercourse and orgasm compared with estrogen-alone treatment in both naturally and surgically postmenopausal women.
CONCLUSION(S)
In selected cases, combined E-A therapy can enhance the quality of life for both naturally and surgically postmenopausal women.
Topics: Androgens; Animals; Estrogen Replacement Therapy; Estrogens; Female; Humans; Libido; Postmenopause; Randomized Controlled Trials as Topic; Sexual Behavior
PubMed: 12007902
DOI: 10.1016/s0015-0282(02)03002-9 -
Mayo Clinic Proceedings Apr 2018The International Society for the Study of Women's Sexual Health process of care (POC) for management of hypoactive sexual desire disorder (HSDD) algorithm was developed... (Review)
Review
The International Society for the Study of Women's Sexual Health process of care (POC) for management of hypoactive sexual desire disorder (HSDD) algorithm was developed to provide evidence-based guidelines for diagnosis and treatment of HSDD in women by health care professionals. Affecting 10% of adult females, HSDD is associated with negative emotional and psychological states and medical conditions including depression. The algorithm was developed using a modified Delphi method to reach consensus among the 17 international panelists representing multiple disciplines. The POC starts with the health care professional asking about sexual concerns, focusing on issues related to low sexual desire/interest. Diagnosis includes distinguishing between generalized acquired HSDD and other forms of low sexual interest. Biopsychosocial assessment of potentially modifiable factors facilitates initiation of treatment with education, modification of potentially modifiable factors, and, if needed, additional therapeutic intervention: sex therapy, central nervous system agents, and hormonal therapy, guided in part by menopausal status. Sex therapy includes behavior therapy, cognitive behavior therapy, and mindfulness. The only central nervous system agent currently approved by the US Food and Drug Administration (FDA) for HSDD is flibanserin in premenopausal women; use of flibanserin in postmenopausal women with HSDD is supported by data but is not FDA approved. Hormonal therapy includes off-label use of testosterone in postmenopausal women with HSDD, which is supported by data but not FDA approved. The POC incorporates monitoring the progress of therapy. In conclusion, the International Society for the Study of Women's Sexual Health POC for the management of women with HSDD provides a rational, evidence-based guideline for health care professionals to manage patients with appropriate assessments and individualized treatments.
Topics: Benzimidazoles; Delphi Technique; Female; Humans; Libido; Practice Guidelines as Topic; Sexual Dysfunctions, Psychological; Sexual Health; Societies, Medical; Surveys and Questionnaires; Women's Health
PubMed: 29545008
DOI: 10.1016/j.mayocp.2017.11.002 -
Animal : An International Journal of... Apr 2017The objective was to determine the effects of immunization against gonadotropin-releasing hormone on reproductive characteristics in boars. A total of 72 boars were used...
The objective was to determine the effects of immunization against gonadotropin-releasing hormone on reproductive characteristics in boars. A total of 72 boars were used in a randomized design with three treatments: single immunization (SI) (10 weeks of age) or double immunization (DI) (10 and 15 weeks of age) with Improvest® and intact controls (no Improvest®; CNT) (n=24/group). At 10, 15, 20, 25 and 40 weeks of age, blood was collected and serum harvested to evaluate testosterone concentrations. Testosterone concentrations were less for DI boars compared with CNT boars and SI boars at 20 and 25 weeks (P<0.001), but not at 40 weeks of age. At week 25, 18 pigs (n=6/group) were sacrificed and testes were removed, weighed and measured, and seminiferous tubules were examined and scored using histological slides of testes parenchyma. A sample of neck fat was assessed for boar taint aroma. All testicular measurements and weights and seminiferous tubule scores were less for DI boars compared with SI and CNT boars (P<0.001). More (P<0.05) SI and CNT boars had detectable boar taint aroma than DI boars. Libido was assessed at 32, 36, 47, 60 and 63 weeks of age and semen collected at 60 weeks of age was analyzed for indicators of quality. There were no effects of treatment (P=0.41) or treatment by week (P=0.71) on libido. Semen volume, gel weight and total number of sperm cells, determined in a subset of boars (n=3/treatment), were not different among treatments. Sperm concentration was greater for DI than SI (P=0.01), and tended to be greater for DI compared with CNT (P=0.10). Sperm motility tended to be greater for DI boars compared with CNT boars (P=0.066). In conclusion, our results show that there are no long-term effects of immunocastration on reproductive characteristics in boars.
Topics: Animals; Body Weight; Gonadotropin-Releasing Hormone; Immunization; Libido; Male; Orchiectomy; Reproduction; Semen; Sperm Count; Sperm Motility; Spermatozoa; Swine; Testis; Testosterone; Time
PubMed: 27786141
DOI: 10.1017/S1751731116002081