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La Tunisie MedicaleVitiligo is a dermatosis that alters the quality of life, self-esteem and body image We evaluated, through a review of the literature sexual disorders (SD) in patients... (Review)
Review
Vitiligo is a dermatosis that alters the quality of life, self-esteem and body image We evaluated, through a review of the literature sexual disorders (SD) in patients with vitiligo. Few studies were available. Those most likely to have "sexual difficulties", among persons with vitiligo, would be those with low self-esteem. Relational problems with the opposite sex are mainly related to feelings of shame and embarrassment. Large depigmented skin area and genital involvement seem predictive of the occurrence of sexual disorders. All items of the sexual function (desire, excitement, vaginal lubrication / erection, ability to reach orgasm, and satisfaction from orgasm) may be affected.
Topics: Body Image; Female; Humans; Orgasm; Quality of Life; Sexual Behavior; Sexual Dysfunction, Physiological; Surveys and Questionnaires; Vitiligo
PubMed: 35244897
DOI: No ID Found -
Indian Journal of Sexually Transmitted... 2022Female sexual dysfunction (FSD) is a much-neglected aspect of feminine health, especially in patriarchal cultures. We collated data from pertinent published literature... (Review)
Review
Female sexual dysfunction (FSD) is a much-neglected aspect of feminine health, especially in patriarchal cultures. We collated data from pertinent published literature on FSD to explore the types, associations, and best possible approach to FSD in the Indian context. We fed search words "female sexual dysfunction," "sexual health," "India," into medical search engines such as PubMed, Google Scholar, Clinical Key, ProQuest, SciVal for locating pertinent articles from which data was synthesized and extracted. Female sexual response is complex and is influenced by physiological, behavioral, social, and cultural factors. The latest Diagnostic and Statistical Manual of Mental Disorders-5 criteria classified FSD into female sexual interest/arousal disorder, female orgasmic disorder and genito-pelvic pain/penetration disorder, along with categories common to both genders like substance/drug induced and other unspecified subsets. Diagnosis requires detailed and specific history taking and clinical evaluation to rule out comorbidities. Treatment is multifaceted and prolonged, involving pharmacological, psychological, and behavioral therapy in both partners. Almost all Indian studies in this field have small sample sizes and none of the studies focused on FSD as the primary complaint. FSD is still an unexplored field of Indian medicine. Although newer treatment options and techniques are being explored, there is much to achieve. We need to develop culturally suitable questionnaires taking into account the Indian female psyche. Management should be holistic and involve focused liaison clinics, including dermatology, gynecology, psychiatry, clinical psychology, and urology specialties.
PubMed: 36743096
DOI: 10.4103/ijstd.IJSTD_82_20 -
Fertility and Sterility Nov 2015Orgasm and ejaculation are two separate physiological processes that are sometimes difficult to distinguish. Orgasm is an intense transient peak sensation of intense... (Review)
Review
Orgasm and ejaculation are two separate physiological processes that are sometimes difficult to distinguish. Orgasm is an intense transient peak sensation of intense pleasure creating an altered state of consciousness associated with reported physical changes. Antegrade ejaculation is a complex physiological process that is composed of two phases (emission and expulsion), and is influenced by intricate neurological and hormonal pathways. Despite the many published research projects dealing with the physiology of orgasm and ejaculation, much about this topic is still unknown. Ejaculatory dysfunction is a common disorder, and currently has no definitive cure. Understanding the complex physiology of orgasm and ejaculation allows the development of therapeutic targets for ejaculatory dysfunction. In this article, we summarize the current literature on the physiology of orgasm and ejaculation, starting with a brief description of the anatomy of sex organs and the physiology of erection. Then, we describe the physiology of orgasm and ejaculation detailing the neuronal, neurochemical, and hormonal control of the ejaculation process.
Topics: Animals; Ejaculation; Hormones; Humans; Male; Orgasm; Penis; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Synaptic Transmission
PubMed: 26385403
DOI: 10.1016/j.fertnstert.2015.08.033 -
Journal of Nuclear Medicine : Official... Aug 2023The endogenous μ-opioid receptor (MOR) system plays a key role in the mammalian reward circuit. Human and animal experiments suggest the involvement of MORs in human...
The endogenous μ-opioid receptor (MOR) system plays a key role in the mammalian reward circuit. Human and animal experiments suggest the involvement of MORs in human sexual pleasure, yet this hypothesis currently lacks in vivo support. We used PET with the radioligand [C]carfentanil, which has high affinity for MORs, to quantify endogenous opioid release after orgasm in man. Participants were scanned once immediately after orgasm and once in a baseline state. Hemodynamic activity was measured with functional MRI during penile stimulation. The PET data revealed significant opioid release in the hippocampus. Hemodynamic activity in the somatosensory and motor cortices and in the hippocampus and thalamus increased during penile stimulation, and thalamic activation was linearly dependent on self-reported sexual arousal. Our data show that endogenous opioidergic activation in the medial temporal lobe is centrally involved in sexual arousal, and this circuit may be implicated in orgasmic disorders.
Topics: Humans; Orgasm; Analgesics, Opioid; Brain; Positron-Emission Tomography; Magnetic Resonance Imaging
PubMed: 37442599
DOI: 10.2967/jnumed.123.265512 -
The World Journal of Men's Health Apr 2017In addition to urinary incontinence and erectile dysfunction, several other impairments of sexual function potentially occurring after radical prostatectomy (RP) have... (Review)
Review
In addition to urinary incontinence and erectile dysfunction, several other impairments of sexual function potentially occurring after radical prostatectomy (RP) have been described; as a whole, these less frequently assessed disorders are referred to as neglected side effects. In particular, orgasmic dysfunctions (ODs) have been reported in a non-negligible number of cases, with detrimental impacts on patients' overall sexual life. This review aimed to comprehensively discuss the prevalence and physiopathology of post-RP ODs, as well as potential treatment options. Orgasm-associated incontinence (climacturia) has been reported to occur in between 20% and 93% of patients after RP. Similarly, up to 19% of patients complain of postoperative orgasm-associated pain, mainly referred pain at the level of the penis. Moreover, impairment in the sensation of orgasm or even complete anorgasmia has been reported in 33% to 77% of patients after surgery. Clinical and surgical factors including age, the use of a nerve-sparing technique, and robotic surgery have been variably associated with the risk of ODs after RP, although robust and reliable data allowing for a proper estimation of the risk of postoperative orgasmic function impairment are still lacking. Likewise, little evidence regarding the management of postoperative ODs is currently available. In general, physicians should be aware of the prevalence of ODs after RP, in order to properly counsel all patients both preoperatively and immediately post-RP about the potential occurrence of bothersome and distressful changes in their overall sexual function.
PubMed: 28459142
DOI: 10.5534/wjmh.2017.35.1.1 -
Fertility and Sterility Jan 2020Post-orgasmic illness syndrome is a rare disorder causing a debilitating cluster of flu-like and allergic type symptoms that occur within seconds, minutes or hours after... (Review)
Review
Post-orgasmic illness syndrome is a rare disorder causing a debilitating cluster of flu-like and allergic type symptoms that occur within seconds, minutes or hours after ejaculation. Symptoms occur after intercourse, masturbation or spontaneous ejaculation and last from 2 to 7 days. The condition is chronic and follows a primary pattern occurring in adolescence and a secondary acquired pattern with onset later in life. The true incidence is unknown as the condition is likely under-reported and under-diagnosed. The pattern of symptoms suggests an allergic or auto-immune etiology; however, the exact pathophysiology is unknown and there is no effective treatment. Men suffering from post-orgasmic illness syndrome describe emotional trauma and significant impairment of their quality of life.
Topics: Anti-Allergic Agents; Humans; Male; Orgasm; Sexual Dysfunction, Physiological; Syndrome
PubMed: 32033716
DOI: 10.1016/j.fertnstert.2019.11.021 -
BMJ (Clinical Research Ed.) Feb 1997
Topics: Adrenergic alpha-Antagonists; Humans; Informed Consent; Male; Orgasm; Postoperative Complications; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunction, Physiological
PubMed: 9040313
DOI: 10.1136/bmj.314.7077.319 -
Socioaffective Neuroscience & Psychology 2016Although humans experience orgasms with a degree of statistical regularity, they remain among the most enigmatic of sexual responses; difficult to define and even more...
BACKGROUND
Although humans experience orgasms with a degree of statistical regularity, they remain among the most enigmatic of sexual responses; difficult to define and even more difficult to study empirically. The question of whether animals experience orgasms is hampered by similar lack of definition and the additional necessity of making inferences from behavioral responses.
METHOD
Here we define three behavioral criteria, based on dimensions of the subjective experience of human orgasms described by Mah and Binik, to infer orgasm-like responses (OLRs) in other species: 1) physiological criteria that include pelvic floor and anal muscle contractions that stimulate seminal emission and/or ejaculation in the male, or that stimulate uterine and cervical contractions in the female; 2) short-term behavioral changes that reflect immediate awareness of a pleasurable hedonic reward state during copulation; and 3) long-term behavioral changes that depend on the reward state induced by the OLR, including sexual satiety, the strengthening of patterns of sexual arousal and desire in subsequent copulations, and the generation of conditioned place and partner preferences for contextual and partner-related cues associated with the reward state. We then examine whether physiological and behavioral data from observations of male and female rats during copulation, and in sexually-conditioned place- and partner-preference paradigms, are consistent with these criteria.
RESULTS
Both male and female rats display behavioral patterns consistent with OLRs.
CONCLUSIONS
The ability to infer OLRs in rats offers new possibilities to study the phenomenon in neurobiological and molecular detail, and to provide both comparative and translational perspectives that would be useful for both basic and clinical research.
PubMed: 27799081
DOI: 10.3402/snp.v6.31883 -
Topics in Spinal Cord Injury... 2017Sexual function and to a lesser extent reproduction are often disrupted in women with spinal cord injuries (SCI), who must be educated to better understand their sexual... (Review)
Review
Sexual function and to a lesser extent reproduction are often disrupted in women with spinal cord injuries (SCI), who must be educated to better understand their sexual and reproductive health. Women with SCI are sexually active; they can use psychogenic or reflexogenic stimulation to obtain sexual pleasure and orgasm. Treatment should consider a holistic approach using autonomic standards to describe remaining sexual function and to assess both genital function and psychosocial factors. Assessment of genital function should include thoracolumbar dermatomes, vulvar sensitivity (touch, pressure, vibration), and sacral reflexes. Self-exploration should include not only clitoral stimulation, but also stimulation of the vagina (G spot), cervix, and nipples conveyed by different innervation sources. Treatments may consider PDE5 inhibitors and flibanserin on an individual basis, and secondary consequences of SCI should address concerns with spasticity, pain, incontinence, and side effects of medications. Psychosocial issues must be addressed as possible contributors to sexual dysfunctions (eg, lower self-esteem, past sexual history, depression, dating habits). Pregnancy is possible for women with SCI; younger age at the time of injury and at the time of pregnancy being significant predictors of successful pregnancy, along with marital status, motor score, mobility, and occupational scores. Pregnancy may decrease the level of functioning (eg, self-care, ambulation, upper-extremity tasks), may involve complications (eg, decubitus ulcers, weight gain, urological complications), and must be monitored for postural hypotension and autonomic dysreflexia. Taking into consideration the physical and psychosocial determinants of sexuality and childbearing allows women with SCI to achieve positive sexual and reproductive health.
Topics: Autonomic Dysreflexia; Autonomic Nervous System; Female; Humans; Orgasm; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Health; Spinal Cord Injuries; Women's Health
PubMed: 29339874
DOI: 10.1310/sci2301-20 -
Sexual Medicine Aug 2021Despite its role in social cognition and affiliative behavior, less is known about the role played by oxytocin in human sexual behavior. (Review)
Review
INTRODUCTION
Despite its role in social cognition and affiliative behavior, less is known about the role played by oxytocin in human sexual behavior.
AIM
In the present systematic review, we aimed to find the levels of oxytocin related to human sexual arousal and orgasm.
METHODS
We conducted the study according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We performed a systematic search in the principal databases for studies that reported collection of salivary or plasmatic samples, with dosage of oxytocin in relation to sexual activity during induction of sexual arousal and orgasm.
RESULTS
414 articles were obtained. After duplicates removal and the application of pre exclusion criteria, 16 articles were considered eligible and 13 articles were included with a Cohen's k of 0.827. Most of the studies used sexual self-stimulation and collected plasmatic or salivary samples to measure oxytocin. The sexual arousal and orgasm were assessed based on subjective reports.
MAIN OUTCOME MEASURE
The primary outcomes were the oxytocin levels collected during the induction of sexual arousal and orgasm.
CONCLUSIONS
Several studies collected only subjective reports about the sexual arousal and the orgasm. Most of the studies found higher levels of oxytocin during the orgasm or ejaculation. Given the sexual arousal evoked by self-stimulation in which sexual fantasies play an important role, it should be possible to postulate for a role of the oxytocin in sexual desire. In particular, we hypothesize a complex role of the oxytocin in the modulation of sexual fantasies and thoughts that are relevant in the sexual desire and help to trigger genital and sexual arousal. Cera N, Vargas-Cáceres S, Oliveira C, et al. How Relevant is the Systemic Oxytocin Concentration for Human Sexual Behavior? A Systematic Review. Sex Med 2021;9:100370.
PubMed: 34118520
DOI: 10.1016/j.esxm.2021.100370