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Sexual Medicine Apr 2023Premature ejaculation (PE) is a nosologic entity with issues in its conceptualization and definition.
BACKGROUND
Premature ejaculation (PE) is a nosologic entity with issues in its conceptualization and definition.
AIM
To understand if the altered sexual response in men with PE is in the orgasm phase, as currently assumed, or the arousal phase with difficulties in modulating, regulating, or decreasing sexual arousal.
METHODS
Men were recruited who looked for help for PE and met the diagnostic criteria according to clinical standards. The participants completed a sociodemographic survey and the Premature Ejaculation Diagnostic Tool. They also performed a masturbation exercise with a maximum of 5 stops, with the intention of prolonging the arousal phase. The time of the exercise was measured from the beginning of genital masturbation to ejaculation.
OUTCOMES
We calculated the total time of the exercise, the median time at each start, and the number of dropouts. We performed a pairwise comparison analysis between starts and made a survival curve representing the percentage of men who remained in the exercise.
RESULTS
A total of 481 men with PE participated (mean ± SD; age, 29.25 ± 8.72 years). We found that the expected median survival time until ejaculation was 317.00 seconds (95% CI, 288.34-345.65). However, the average time during stimulation decreased as the exercise progressed, and statistically significant differences were observed in their pairwise comparison ( < .001). Also, the chances of ejaculation increased as the exercise progressed, with 62.16% of the participants ejaculating before the end of the exercise. The results indicated increasing sexual arousal, where stops in stimulation were progressively less effective at maintaining ejaculation times at starts.
CLINICAL IMPLICATIONS
We showed that the arousal phase is altered in PE, not the orgasm phase, and this could finally have implications in the diagnosis and/or treatment of this condition.
STRENGTHS AND LIMITATIONS
The analysis of the times at starts and stops in a masturbation exercise in men with PE, had been barely addressed before. In the future, it would be important to verify the effect of stops during sexual intercourse and to incorporate a control group of men without PE.
CONCLUSIONS
We propose a new conceptualization and definition for PE: is the inability to modulate, regulate, or decrease arousal during any sexual activity, even with brief stops during sexual stimulation, causing unwanted ejaculation.
PubMed: 37124144
DOI: 10.1093/sexmed/qfad014 -
Socioaffective Neuroscience & Psychology 2016The pursuit of sexual pleasure is a key motivating factor in sexual activity. Many things can stand in the way of sexual orgasms and enjoyment, particularly among women....
BACKGROUND
The pursuit of sexual pleasure is a key motivating factor in sexual activity. Many things can stand in the way of sexual orgasms and enjoyment, particularly among women. These are essential issues of sexual well-being and gender equality.
OBJECTIVE
This study presents long-term trends and determinants of female orgasms in Finland. The aim is to analyze the roles of factors such as the personal importance of orgasms, sexual desire, masturbation, clitoral and vaginal stimulation, sexual self-esteem, communication with partner, and partner's sexual techniques.
DESIGN
In Finland, five national sex surveys that are based on random samples from the central population register have been conducted. They are representative of the total population within the age range of 18-54 years in 1971 (=2,152), 18-74 years in 1992 (=2,250), 18-81 years in 1999 (=1,496), 18-74 years in 2007 (=2,590), and 18-79 years in 2015 (=2,150). Another dataset of 2,049 women in the age group of 18-70 years was collected in 2015 a national Internet panel.
RESULTS
Contrary to expectations, women did not have orgasms that are more frequent by increasing their experience and practice of masturbation, or by experimenting with different partners in their lifetime. The keys to their more frequent orgasms lay in mental and relationship factors. These factors and capacities included orgasm importance, sexual desire, sexual self-esteem, and openness of sexual communication with partners. Women valued their partner's orgasm more than their own. In addition, positive determinants were the ability to concentrate, mutual sexual initiations, and partner's good sexual techniques. A relationship that felt good and worked well emotionally, and where sex was approached openly and appreciatively, promoted orgasms.
CONCLUSION
The findings indicate that women differ greatly from one another in terms of their tendency and capacity to experience orgasms. The improvements in gender equality and sexual education since the 1970s have not helped women to become more orgasmic. Neither has the major increase in masturbation habits (among women in general). One challenge for future studies is to understand why women value their partner's orgasms more than their own.
PubMed: 27799078
DOI: 10.3402/snp.v6.31624 -
Toxics May 2022The neurotoxicity of bilirubin has been extensively reported in numerous studies. However, the association between bilirubin and male fertility has not yet been studied....
The neurotoxicity of bilirubin has been extensively reported in numerous studies. However, the association between bilirubin and male fertility has not yet been studied. The main goal of this study was to investigate the association between serum total bilirubin and sperm quality in an adult population. In this cross-sectional study, 9057 participants who attended the MJ health examination (2010-2016) were enrolled. Sperm specimens were collected by masturbation, and sperm quality was analyzed in accordance with the WHO criteria. Serum total bilirubin levels were measured by an automatic biochemical profile analyzer. Thereafter, the associations between serum total bilirubin and sperm quality were determined by a multivariable linear regression. Serum total bilirubin was inversely associated with sperm concentration and normal morphology with β values of -13.82 (95% CI: -26.99, -0.64) and -18.38 (95% CI: -30.46, -6.29) after adjusting for covariables. The highest levels of serum total bilirubin were significantly associated with sperm concentration and normal morphology with β values of -14.15 (95% CI: -28.36, 0.06) and -21.15 (95% CI: -33.99, -8.30). Our study highlighted the potential impact of serum bilirubin on sperm quality in a male population. Additional longitudinal research is necessary to explore these findings and underlying mechanisms.
PubMed: 35736904
DOI: 10.3390/toxics10060295 -
The Journal of Sexual Medicine Mar 2020Although antidepressants are well known to cause sexual side effects in adults, the long-term effects of antidepressant use during development on adult sexual function...
INTRODUCTION
Although antidepressants are well known to cause sexual side effects in adults, the long-term effects of antidepressant use during development on adult sexual function is unknown.
AIM
To explore differences in sexual desire and sexual behavior between adults who did vs did not use antidepressants during childhood or adolescence.
METHODS
An online survey of 610 young adults (66% women) assessed childhood and current mental health and use of antidepressants and other psychiatric medications before the age of 16 years and currently, partnered and solitary sexual desire, and frequency of masturbation and partnered sexual activity. Antidepressants were coded into either selective serotonin reuptake inhibitors (SSRIs) or non-SSRI antidepressants.
MAIN OUTCOME MEASURE
Scores on the Sexual Desire Inventory, and self-reported frequency of masturbation and partnered sexual activity.
RESULTS
For women, childhood SSRI use was associated with significantly lower solitary sexual desire, desire for an attractive other, and frequency of masturbation. This was true even when controlling for childhood mental health concerns, current mental health, and current antidepressant use. However, there was no effect of childhood SSRI use on women's partnered sexual desire or partnered sexual activity. There was no significant effect of childhood antidepressant use on men's sexual desire or masturbation. However, in men, childhood use of non-SSRI antidepressants was associated with significantly higher frequency of partnered sexual activity. Childhood use of non-SSRI antidepressants, or nonantidepressant psychiatric medication, was not associated with adult sexual desire or behavior in either women or men.
CLINICAL IMPLICATIONS
It is possible that SSRI use during childhood interrupts the normal development of sexual reward systems, which may be a risk factor for sexual desire dysfunction in adult women.
STRENGTHS & LIMITATIONS
Strengths include a large sample, use of attention checks and validated measures, and careful assessment of childhood mental health history; however, generalizability is limited by a predominantly white, young adult sample. These data are cross-sectional, and therefore, causal explanations for the association between childhood SSRI use and adult sexual well-being should be considered preliminary, warranting replication.
CONCLUSION
These findings point to a critical need for well-controlled, prospective research on possible long-term effects of antidepressant use, particularly SSRI use, on the development of adult sexual well-being. Lorenz TK. Antidepressant Use During Development May Impair Women's Sexual Desire in Adulthood. J Sex Med 2020;17:470-476.
Topics: Adolescent; Antidepressive Agents; Cross-Sectional Studies; Female; Humans; Libido; Male; Masturbation; Mental Health; Risk Factors; Self Report; Selective Serotonin Reuptake Inhibitors; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Partners; Surveys and Questionnaires; Young Adult
PubMed: 31937517
DOI: 10.1016/j.jsxm.2019.12.012 -
Sexual Medicine Oct 2021Although faking orgasm among women appears quite common, the roles of orgasmic problems and relationship type in partnered sex and masturbation have not been fully...
INTRODUCTION
Although faking orgasm among women appears quite common, the roles of orgasmic problems and relationship type in partnered sex and masturbation have not been fully explored.
AIM
We assessed the relationship between orgasmic problems (separately in partnered sex and masturbation) and faking orgasm across various types of relationships while also considering the role of demographic and sexual function related covariates.
METHODS
In this study of 1,168 Hungarian women, we assessed orgasmic problems, sexual functioning, and the prevalence and frequency of faking orgasm in 3 relationship types: romantic relationships, one-night stands, and continuing sexual relationships of more than one night.
MAIN OUTCOME MEASURE
Differences in faking orgasm across 3 types of relationships; the association between faking orgasm in 1 type of relationship with faking orgasm in other types of relationships; and the relationship of "orgasmic problems" in partnered sex and masturbation to the presence and frequency of faking orgasm in various relationship types.
RESULTS
A subset of women who faked orgasm in 1 relationship type were more likely to fake orgasm in other relationship types. Orgasmic problems predicted the occurrence and frequency of faking orgasm in all 3 relationship types, though to different degrees. Other factors, including orgasmic difficulty during masturbation, the frequencies of masturbation and partnered sex, and the self-rated importance of sex were also related to the frequency of faking orgasm.
CONCLUSION
Our findings suggest that faking orgasm has both dispositional and situational elements. "Orgasmic problems" in partnered sex was a consistent and robust predictor of the occurrence and frequency of faking orgasm in different relationship types. Hevesi K, Horvath Z, Sal D, et al. Faking Orgasm: Relationship to Orgasmic Problems and Relationship Type in Heterosexual Women. Sex Med 2021;9:100419.
PubMed: 34419691
DOI: 10.1016/j.esxm.2021.100419 -
Sexual Medicine Dec 2023Female Reddit users frequently discussed potential causes of orgasm difficulties and its implications on mental health and relationships.
BACKGROUND
Female Reddit users frequently discussed potential causes of orgasm difficulties and its implications on mental health and relationships.
AIM
This study aimed to evaluate the experiences of women discussing orgasms on the Internet site Reddit. We sought to qualitatively analyze the topics that arose in users' discussions to better understand the potential causes of orgasm difficulties and its implications on quality of life.
METHODS
Posts on the subreddit r/TwoXChromosomes containing the keywords "orgasm" and "climax" were included in the dataset. Posts and their associated comments were qualitatively analyzed using the grounded theory approach. Two independent researchers coded each thread to identify dominant themes and emergent concepts.
OUTCOMES
The most frequently coded primary topics included: (1) orgasm (32.2% [n = 337]), (2) psychological (17.8% [n = 186]), (3) relationships (15.4% [n = 161]), and (4) treatment (10.7% [n = 112]).
RESULTS
Qualitative analysis of 107 threads and approximately 6300 comments resulted in 5 major categories: psychological aspect of orgasms, difficulty orgasming with partners, partners' responses to orgasmic dysfunction, types of orgasms, and treatments for orgasmic dysfunction. Preliminary themes included (1) the presence of an emotional component or history of trauma related to orgasmic difficulty, (2) difficulty orgasming with a partner regardless of ability to orgasm during masturbation and a variety of stimulation required to orgasm, (3) mixed partner responses to orgasmic dysfunction, (4) the definition of a normal orgasm, and (5) self-motivated treatment for orgasmic dysfunction, including clitoral stimulation devices and masturbation techniques. Notably, few posters discussed their orgasmic dysfunction with healthcare providers.
CLINICAL TRANSLATION
The study reveals insights into the possible causes, psychosocial implications, and treatment of orgasm difficulties from a patient perspective, and can guide future research on female orgasms in a more precise, patient-oriented direction.
STRENGTHS AND LIMITATIONS
The anonymous nature of the forum allowed for insight into sensitive topics related to female orgasms and sexual trauma. Limitations include the demographic distribution of Reddit users, which was primarily younger women in their 20s and 30s, which restricts generalizability.
CONCLUSION
Reddit provides a medium for individuals with orgasm difficulties to discuss their experiences. Posts addressed users' inability to orgasm, their mental health and relationships, the stimulation required for orgasm, and treatments for orgasmic dysfunction. Interestingly, very few posts discussed healthcare, potentially suggesting that women do not classify their orgasmic dysfunction as a health issue.
PubMed: 38053613
DOI: 10.1093/sexmed/qfad061 -
Psychiatria Polska Oct 2023We present a case of a 32-years-old female patient diagnosed with paranoid schizophrenia for many years who has developed neuroleptic malignant syndrome (NMS) as a... (Review)
Review
We present a case of a 32-years-old female patient diagnosed with paranoid schizophrenia for many years who has developed neuroleptic malignant syndrome (NMS) as a result of long-acting antipsychotic's injection. Since the initial ineffectiveness of benzodiazepines, the course of electroconvulsive therapy (ECT) has been carried out. In spite of the initial promising response to ECT 3 weeks after the admission her somatic and mental state deteriorated greatly, that was hardly explicable solely by the potential loss of effectiveness of ECT or laboratory tests. Diagnostics extended with imaging tests and gynecological examination revealed the connective tissue-covered cap of a popular multivitamin supplement in patient's vagina. During the following deepened interview, she admitted that in fact 6 months ago a piece had gotten stuck while masturbating. However due to the sense of shame and subjective lack of disturbing symptoms she had left it unsaid. One month after the evacuation of the foreign body she has been discharged from the hospital remaining the full remission. The presented case shows that inflammation in the body can complicate catatonia and NMS, causing a non-specific course and difficulties in diagnosis and treatment. In some patients, the inflammatory process may be caused by a foreign body located in various natural orifices in the body. It appears significant in the group of psychiatric patients. Once again it highlights the tremendous role of meticulously conducted interview including the patient's autoerotic life.
Topics: Humans; Female; Adult; Masturbation; Neuroleptic Malignant Syndrome; Benzodiazepines; Electroconvulsive Therapy; Foreign Bodies; Antipsychotic Agents; Catatonia
PubMed: 36542768
DOI: 10.12740/PP/OnlineFirst/138338 -
Turkish Journal of Urology Jul 2021To analyze the presence of Epstein-Barr-virus (EBV) in sperm samples from patients diagnosed with some impairment of the fertility parameters evaluated using seminogram...
OBJECTIVE
To analyze the presence of Epstein-Barr-virus (EBV) in sperm samples from patients diagnosed with some impairment of the fertility parameters evaluated using seminogram and to observe if there is any difference with the normozoospermic samples. We hypothesize that an EBV infection is responsible for the upregulation of the miRNA 199-3p, which binds to the 3'UTR of endothelin-1 (ET-1). ET-1 is a key factor to produce Vimentin (Vim3), and therefore, it influences the expression of Vim3. Since Vim3 is predominantly detectable in sperms without any structural defects, the newly identified regulation mechanism can be responsible for the loss of sperm quality.
MATERIAL AND METHODS
This study was performed from January 2017 to December 2020 and included 27 patients who provided ejaculated samples obtained by masturbation. Ejaculates were evaluated according to the Word Health Organization's criteria. Posteriorly, the samples were sorted according to the seminogram diagnosis and further analyzed using different enzyme-linked absorbed immune assays to determine the level or concentration of Epstein-Barr nuclear antigen (EBNA), ET-1, and Vim3.
RESULTS
All sperm samples with the impairment of fertility parameters contained the EBNA and presented a downregulation of ET-1 and Vim3. In addition, sperms located in the swim ups are also partially positive for the EBV virus in different clinical aspects.
CONCLUSION
Based on the regulation mechanism here presented, it seems that the EBV induces changes at the miRNA level, which are responsible for the decreasing of sperm quality.
PubMed: 35118954
DOI: 10.5152/tud.2021.21553 -
Archivio Italiano Di Urologia,... Jun 2022We aimed to verify the rate of masturbation (Mst) in a group of 150 Italian patients complaining Erectile Dysfunction (ED).
OBJECTIVE
We aimed to verify the rate of masturbation (Mst) in a group of 150 Italian patients complaining Erectile Dysfunction (ED).
MATERIALS AND METHODS
Our diagnostic protocol for penile and sexual problems included the collection of the patient's history, general and local clinical examination, and metabolic and hormonal analyses. Selected patients were also submitted to nocturnal penile tumescence test (Rigiscan), Duplex ultrasound of the penis, Magnetic Resonance Imaging, neurological tests and cardiological examination. A group of 150 Italian males (aged between 20 and 86 years) who complained ED and who presented to our Andrological Center to research the possibility of correcting their ED and being able to recover adequate sexual erectile activity were included in this study. In this group of patients suffering from ED we decided to evaluate the practice of Mst by asking specific questions: 1. Do you sometimes practice Mst? 2. How often in a week? 3. Is Mst hidden or known by the partner? 4. What do you use as a masturbatory sexual stimulus? The frequency of Mst was assessed according to a Likert scale as follow: a: No Mst; b:1-2/week; c: 2-3/week; d: > 3/week; e: daily or more. We also asked if it was possible to have penetrative marital intercourse on the same day as Mst (1-10 hours). We also asked what they used as a triggering sexual stimulus: press magazines, TV movies, the WEB.
RESULTS
Only 5/150 patients did not report Mst while 27/145 pts (aged 20-30 years) reported it more than 3 times a week; 44/145 (aged 31-50 years) 1-3 times a week and 27/145 (51-86 years) 1-2 times a week. Almost all patients used WebPorn as a stimulus for Mst. A group of patients over the age of 50 said they were quite satisfied with the physical results of Mst even though they would prefer to have sex as part of a couple relationship.
CONCLUSIONS
The outburst of Mst in this web-dominated era could affect the sexual activity of individual males and couples.
Topics: Adult; Aged; Aged, 80 and over; Erectile Dysfunction; Erotica; Humans; Male; Masturbation; Middle Aged; Penile Erection; Penis; Young Adult
PubMed: 35775352
DOI: 10.4081/aiua.2022.2.228 -
Sexual Medicine Sep 2016Attitudes toward masturbation are extremely varied, and this practice is often perceived with a sense of guilt.
INTRODUCTION
Attitudes toward masturbation are extremely varied, and this practice is often perceived with a sense of guilt.
AIM
To evaluate the prevalence of ego-dystonic masturbation (EM), defined as masturbation activity followed by a sense of guilt, in a clinical setting of sexual medicine and the impact of EM on psychological and relational well-being.
METHODS
A series of 4,211 men attending an andrology and sexual medicine outpatient clinic was studied retrospectively. The presence and severity of EM were defined according to ANDROTEST items related to masturbation, determined by the mathematical product of the frequency of masturbation and the sense of guilt after masturbation.
MAIN OUTCOME MEASURES
Clinical, biochemical, and psychological parameters were studied using the Structured Interview on Erectile Dysfunction, ANDROTEST, and modified Middlesex Hospital Questionnaire.
RESULTS
Three hundred fifty-two subjects (8.4%) reported any sense of guilt after masturbation. Subjects with EM were younger than the remaining sample (mean age ± SD = 51.27 ± 13.43 vs 48.31 ± 12.04 years, P < .0001) and had more psychiatric comorbidities. EM severity was positively associated with higher free-floating (Wald = 35.94, P < .001) and depressive (Wald = 16.85, P < .001) symptoms, and subjects with a higher EM score reported less phobic anxiety (Wald = 4.02, P < .05) and obsessive-compulsive symptoms (Wald = 7.6, P < .01). A higher EM score was associated with a higher alcohol intake. Subjects with EM more often reported the partner's lower frequency of climax and more problems achieving an erection during sexual intercourse. EM severity was positively associated with worse relational and intrapsychic domain scores.
CONCLUSION
Clinicians should consider that some subjects seeking treatment in a sexual medicine setting might report compulsive sexual behaviors. EM represents a clinically relevant cause of disability, given the high level of psychological distress reported by subjects with this condition, and the severe impact on quality of life in interpersonal relationships.
PubMed: 27052770
DOI: 10.1016/j.esxm.2016.03.024