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Topics in Spinal Cord Injury... 2017Sexuality is an important part of life, and it is necessary for clinicians to have a specific format in which to address sexual issues with their patients. A systematic... (Review)
Review
Sexuality is an important part of life, and it is necessary for clinicians to have a specific format in which to address sexual issues with their patients. A systematic approach to working with patients with spinal cord injury (SCI) to improve their sexual functioning and response is presented. Nonjudgmental communication about sexual concerns is followed by a detailed pre- and postinjury medical, psychosocial, and sexual history. If preexisting sexual issues are present, it is recommended that the patient be referred for assessment and treatment of these separate from the patient's SCI-related concerns. Physical examination, with special attention to issues that could impact the patient's sexuality, is followed by a detailed neurologic assessment with specific attention to the T11-L2 and S3-5 spinal segments. Education of the patient with regard to his or her sexual potential and the need to be flexible in his or her sexual repertoire is followed by self-exploration and practice. Routine follow-up is suggested after patient's initial sexual exploration. Treatment of confounding and iatrogenic factors related to SCI is followed by more sexual experience. Afterwards the clinician is encouraged to use simple techniques to treat sexual issues and follow-up with the patient to assess the outcome. A structured program utilizing vibratory stimulation with or without midodrine is described as a way to achieve ejaculation and potentially orgasm, and techniques for treating severe autonomic dysreflexia are discussed. If these interventions do not alleviate the patient's sexual concerns, the clinician should refer the patient for more specialized consultation.
Topics: Female; Humans; Libido; Male; Orgasm; Personal Satisfaction; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Health; Spinal Cord Injuries
PubMed: 29339878
DOI: 10.1310/sci2301-57 -
Frontiers in Psychiatry 2022Masturbation is a behavior that can enhance sexual functioning. This study aims to analyze differences between men and women in different masturbation parameters, and to...
OBJECTIVE
Masturbation is a behavior that can enhance sexual functioning. This study aims to analyze differences between men and women in different masturbation parameters, and to examine their relation with orgasm satisfaction in sexual relationships.
METHOD
One thousand three hundred and thirty-fifth men and women from the Spanish population aged 18-83 years ( = 36.91; = 11.86) participated in an online survey. A questionnaire was used to collect socio-demographic. Sexual history data, negative attitude toward masturbation, solitary sexual desire and orgasm subjective experience upon masturbation were assessed. Given the differences between men and women, independent regression models are proposed to explain orgasm satisfaction in the sexual relationships context.
FINDINGS
Men, compared to women, masturbated at a younger age ( < 0.001), and reported higher current masturbation frequency ( < 0.001) and more solitary sexual desire ( < 0.001). Women reported greater intensity in the subjective orgasm experience on its Affective ( < 0.001), Sensory ( < 0.001) and Intimacy ( < 0.001) dimensions. Regarding regression models, the Affective dimension of orgasm was a common parameter in men (β = 0.36; < 0.001) and women (β = 0.24) to explain orgasm satisfaction during sexual relationships. In men, solitary masturbation frequency (β = -0.10; = 0.027) acquired a significant role. In women, the model also included age (β = 0.09; = 0.038), negative attitude toward masturbation (β = -0.12; = 0.005) and solitary sexual desire (β = -0.19; = 0.001).
CONCLUSION
When dealing with men and women's orgasm difficulties in the sexual relationships context, it is important to consider the role of masturbation. In men and women, the Affective dimension of the orgasm experience explain the orgasm satisfaction in sexual relationship. Also, in men, the solitary masturbation frequency is negatively related with orgasm satisfaction in sexual relationship, supporting the compensatory hypothesis of masturbation. In women, in addition to the Affective dimension, the orgasm satisfaction in sexual relationship is explained, negatively, by the negative attitude toward masturbation, and positively, by the solitary sexual desire, which could be associated with more sexual self-knowledge. The relevance of masturbation in understanding sexual functioning is highlighted.
PubMed: 35935426
DOI: 10.3389/fpsyt.2022.903361 -
International Journal of Environmental... Jan 2022Currently, no validated instrument exists for assessing the subjective experience of orgasm in the gay population. The Orgasm Rating Scale (ORS), previously validated in...
Currently, no validated instrument exists for assessing the subjective experience of orgasm in the gay population. The Orgasm Rating Scale (ORS), previously validated in the heterosexual population, comprises four dimensions: Affective, Sensory, Intimacy, and Rewards. This study validated it for sexual relationships in the gay population by obtaining its factorial invariance by sexual orientation and sex, its internal consistency reliability, and evidence of validity in its relationship with other variables. We assessed 1600 cisgender Spanish adults-heterosexuals, gays, and lesbians-divided into 4, sex-based groups of 400 each, according to the Kinsey scale scores. Participants reported recent experiences of orgasm in the context of sexual relationships and responded to the ORS and other scales assessing attitude toward sexual fantasies and sexual functioning. The ORS structure showed a strict multigroup-level invariance by sexual orientation and sex, confirming its four-dimensional structure. The subjective orgasm intensity was associated with a positive attitude toward sexual fantasies and sexual functioning. Scores obtained on the Affective, Intimacy, and Rewards dimensions confirmed the ability to discriminate between gay people with and without orgasmic difficulties. The ORS's Spanish version presents good psychometric properties as a validated scale to evaluate the subjective experience of orgasm in the gay population.
Topics: Adult; Female; Humans; Male; Orgasm; Reproducibility of Results; Sexual Behavior; Sexual Partners; Sexual and Gender Minorities
PubMed: 35055709
DOI: 10.3390/ijerph19020887 -
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 -
Archives of Sexual Behavior May 2023The subjective orgasm experience (SOE) is the psychological perception of orgasm sensations and closely related to sexual health. Here, SOE was studied through the...
The subjective orgasm experience (SOE) is the psychological perception of orgasm sensations and closely related to sexual health. Here, SOE was studied through the context in which it is experienced (sexual relationships and solitary masturbation), gender, and sexual orientation. For this purpose, data were collected from 4255 people (1927 men and 2328 women) of different sexual orientations (heterosexual = 1545; bisexual = 1202; and gay = 1508) who completed two versions of the Orgasm Rating Scale (ORS) for both contexts (i.e., sexual relationships and solitary masturbation) along with a socio-demographic questionnaire. Results showed that the ORS in the context of solitary masturbation is an instrument invariant by gender and sexual orientation. Significant differences in SOE were found by context: it was more intense in the context of sexual relationships (vs. solitary masturbation); by gender: women (vs. men) reported greater intensity; and by sexual orientation, with heterosexual people (vs. gay and bisexual people) having a more intense experience.
Topics: Female; Humans; Male; Orgasm; Sexual Behavior; Masturbation; Heterosexuality; Surveys and Questionnaires
PubMed: 36508069
DOI: 10.1007/s10508-022-02493-3 -
Sexual Medicine Apr 2022Orgasm is a complex, multimodal reflex induced typically by genital stimulation. Genitally stimulated orgasms (GSOs) activate excitatory neurochemical pathways in the...
INTRODUCTION
Orgasm is a complex, multimodal reflex induced typically by genital stimulation. Genitally stimulated orgasms (GSOs) activate excitatory neurochemical pathways in the brain and spinal cord that ultimately stimulate sympathetic outflow and the inhibition of parasympathetic spinal circuits in the lower lumbar cord. However, some women claim to have orgasms spontaneously without genital stimulation.
AIMS
To report the case of a 33-year-old woman who developed the ability to attain and control the duration of a subjective orgasmic state without genital stimulation after tantric training.
METHODS
Blood was taken at weekly intervals before, during, and after spontaneously-induced orgasms that lasted 5 or 10 minutes, or after a 10-minutes period of book reading. Plasma was analyzed using ELISA for luteinizing hormone, follicle stimulating hormone, free testosterone, and prolactin. The woman also provided subjective scores for different types of orgasms using the Mah and Binik (2002) Orgasm Rating Scale (ORS).
RESULTS
Prolactin levels post orgasm increased by 25% and 48%, respectively, after the 5- or 10-minutes non-genitally stimulated orgasm (NGSO), and were still elevated from baseline 30 minutes after orgasm. No changes were observed in FSH or free testosterone. The pattern of sensory, affective, and evaluative orgasm ratings after a 10-minutes NGSO was similar to orgasms induced by clitoral or anal stimulation. Book reading did not result in any change in prolactin.
CONCLUSION
Prolactin surges after orgasm are an objective marker of orgasm quality. The increase in prolactin after her NGSOs indicate that they induce the same physiological changes as GSOs and result from "top-down" processing in the brain. Pfaus JG, Tsarski K, A Case of Female Orgasm Without Genital Stimulation. Sex Med 2022;10:100496.
PubMed: 35220156
DOI: 10.1016/j.esxm.2022.100496 -
Translational Andrology and Urology Aug 2016Men with post orgasmic illness syndrome (POIS) become ill rather immediately after ejaculation, whether spontaneously at night, during sexual intercourse or... (Review)
Review
Men with post orgasmic illness syndrome (POIS) become ill rather immediately after ejaculation, whether spontaneously at night, during sexual intercourse or masturbation. Two subtypes are distinguished: primary and secondary POIS. It also occurs before or after a man has been sterilized. POIS is an invalidating most probably auto-immune disease leading to much distress in males and their partners. It is characterized by five criteria. Its symptoms are described by seven clusters. However, the manifestation of these symptoms varies from one male to the other but is relatively constant in the person himself. Among men the symptoms vary in intensity, durations and sort of symptoms. POIS is a chronic disorder that manifests itself in POIS "attacks" that occur within a few minutes to a few hours after ejaculation, and disappear spontaneously after 3 to 7 days. POIS is not associated with increased total serum IgE concentrations. On the contrary, there are indications that POIS is triggered by specific cytokines that are released by an auto-immune reaction to the man's seminal fluid. Indirect clinical evidence suggests that the antigen (Ag) triggering the POIS systemic reaction is not bound to spermatozoa but to seminal fluid produced by prostatic tissue. In addition, POIS may also occur-although rarely-in females. In those cases, it is hypothesized that the Ag is associated with female prostatic tissue around the vagina.
PubMed: 27652231
DOI: 10.21037/tau.2016.07.01 -
Sexual Medicine Dec 2022Faking orgasm by women reportedly occurs quite frequently, with both relationship characteristics and orgasmic difficulty being significant predictors.
INTRODUCTION
Faking orgasm by women reportedly occurs quite frequently, with both relationship characteristics and orgasmic difficulty being significant predictors.
AIM
We explored women's motives that might mediate the associations between orgasmic difficulty and relationship satisfaction on the one hand, with the frequency of faking orgasm on the other.
METHODS
In a study of 360 Hungarian women who reported "ever" faking orgasm during partnered sex, we assessed the direct and indirect (mediated) associations between orgasmic difficulty, relationship satisfaction, and the frequency of faking orgasm.
OUTCOMES
Determination of motives that mediate the association between orgasmic difficulty and the frequency of faking orgasm, and the association between relationship satisfaction and the frequency of faking orgasm.
RESULTS
Increased orgasmic difficulty was directly related to increased frequency of faking orgasm (β = 0.37; P < .001), and each variable itself was related to a number of motives for faking orgasm. However, the only motive assessed in our study that mediated the relationship between orgasmic difficulty and the frequency of faking orgasm was insecurity about being perceived as abnormal or dysfunctional (indirect effect: β = 0.13; P < .001). A similar pattern emerged with relationship satisfaction and frequency of faking orgasm. These two variables were directly related in that lower relationship satisfaction predicted higher frequency of faking orgasm (β = -0.15; P = .008). Furthermore, while each variable itself was related to a number of motives for faking orgasm, the only motive assessed in our study that mediated the relationship between the 2 variables was insecurity about being perceived as abnormal or dysfunctional (indirect effect: β = -0.06; P = .008).
CLINICAL TRANSLATION
Insecurity related to being perceived as abnormal or deficient, along with sexual communication, should be addressed in women with a history of faking orgasm but who want to cease doing so.
STRENGTHS AND LIMITATIONS
The sample was relatively large and the online survey adhered to best practices. Nevertheless, bias may result in sample characteristics when recruitment is achieved primarily through social media. In addition, the cross-sectional sample prevented causal determination and represented Western-based values.
CONCLUSIONS
The associations between orgasmic difficulty and faking orgasm, and between relationship satisfaction and faking orgasm, are both direct and indirect (mediated). The primary motive for mediating the indirect association between the predictor variables and the frequency of faking orgasm was the insecurity about being perceived as deficient or abnormal. Hevesi K, Horvath Z, Miklos E, et al. Motives that Mediate the Associations Between Relationship Satisfaction, Orgasmic Difficulty, and the Frequency of Faking Orgasm. Sex Med 2022;10:100568.
PubMed: 36115263
DOI: 10.1016/j.esxm.2022.100568 -
Medical Sciences (Basel, Switzerland) Dec 2019The majority of sexual health research has focused on erectile dysfunction following prostate cancer treatment. Ejaculatory and orgasmic dysfunction are significant side... (Review)
Review
The majority of sexual health research has focused on erectile dysfunction following prostate cancer treatment. Ejaculatory and orgasmic dysfunction are significant side effects following the treatment of prostate cancer. Orgasmic dysfunction covers a range of issues including premature ejaculation, anorgasmia, dysorgasmia, and climacturia. This review provides an overview of prevalence and management options to deal with orgasmic dysfunction. A Medline Pubmed search was used to identify articles relating to these problems. We found that orgasmic dysfunction has a very large impact on patients' lives following prostate cancer treatment and there are ways for physicians to treat it. Management of patients' sexual health should be focused not only on erectile dysfunction, but on orgasmic dysfunction as well in order to ensure a healthy sexual life for patients and their partners.
PubMed: 31835522
DOI: 10.3390/medsci7120109 -
European Journal of Obstetrics,... May 2022Dyspareunia is a main symptom of urethral diverticulum in the female population, reported up to 60% of patients. Pain may cease after diverticulectomy as published in...
OBJECTIVE
Dyspareunia is a main symptom of urethral diverticulum in the female population, reported up to 60% of patients. Pain may cease after diverticulectomy as published in previous retrospective studies. To date scarce or no data exists on the postoperative outcome in terms of sexual function. The present study wants to quantify sexual function and evaluate lower urinary tract symptoms in sexually active patients after resection of urethral diverticulum.
STUDY DESIGN
In this prospective cohort trial at a tertiary referral center, we evaluated 40 female patients who presented with symptomatic urethral diverticulum and were sexually active. All of them underwent a standardized surgical procedure with inverted U-shape colpotomy between 2008 and 2018. The patients completed the Female Sexual Function Index (FSFI), which is determined by the mean score of the different domains, and underwent urodynamic assessment both at baseline examination before surgery and 12 months postoperatively. For statistical analysis, we conducted a paired Wilcoxon rank sum test analyzing the non-normally distributed non-parametric variables of the female sexual function index.
RESULTS
In two patients a malignancy was found in postoperative histology and received a different therapeutical approach. They have been excluded from statistical analysis. Sexual function improved in all domains (n = 38): total score (Z = -5.4, P < 0.000), satisfaction (Z = -5.3, P < 0.000), pain (Z = -5.4, P < 0.000), arousal (Z = -2.6, P = 0.010), lubrication (Z = -2.4, P = 0.020), desire (Z = -2.6, P = 0.009) and orgasm (Z = -2.2, P = 0.029). Maximum urethral closure pressure deteriorated from 39 to 36 cmH2O (P = 0.0008) and residual urine increased from 10 ml to 20 ml after surgery (P = 0.0019). No statistical significance is found for bladder capacity and free urinary flow.
CONCLUSIONS
All domains of the female sexual function index improved. Patients' bothersome symptoms, mainly pain may cease and sexual satisfaction increases, which is reassuring concerning patients' preoperative consent. We should be aware that occasionally an unexpected malignancy may be detected and it is mandatory to examine all excised tissue histologically. Lower urinary tract function remains clinically unchanged, although maximum urethral closure pressure deteriorated and postvoid residual increased though not being clinically significant.
Topics: Diverticulum; Female; Humans; Male; Orgasm; Pain; Prospective Studies; Surveys and Questionnaires; Urethral Diseases
PubMed: 35313135
DOI: 10.1016/j.ejogrb.2022.03.021