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PubMed1993

Improvement in fluoxetine-associated sexual dysfunction in patients switched to bupropion.

BACKGROUND: This study was conducted to determine the effect of bupropion on the sexual functioning of male and female outpatients who developed anorgasmia or delayed orgasm while receiving fluoxetine treatment for depression. METHOD: Thirty-nine patients who satisfied criteria for participation in the study discontinued fluoxetine treatment and entered a 2-week washout phase followed by an open 8-week bupropion treatment phase. Three parameters of sexual functioning were followed throughout the study: orgasm function, libido, and satisfaction with overall sexual functioning. Depression was also evaluated at each visit. RESULTS: All patients reported orgasm delay and/or failure at the time of fluoxetine discontinuation. Orgasm function, libido, and satisfaction with sexual functioning improved during the 2-week fluoxetine washout period and during the bupropion treatment phase. Ninety-four percent of patients (29/31) had complete or partial resolution of their orgasm dysfunction at the end of bupropion treatment, and 81% of patients (25/31) were "much" or "very much" more satisfied with their overall sexual functioning. Most patients entered the study with decreased libido on fluoxetine. Libido was "much" or "very much" increased for 81% of patients (25/31) at the end of the study. In addition, depression scores on the Hamilton Rating Scale for Depression and Clinical Global Impressions-Severity scale significantly improved during the bupropion treatment phase. Finally, bupropion was well tolerated by most patients. CONCLUSION: Bupropion may be an appropriate antidepressant for patients who develop sexual dysfunction during fluoxetine treatment or for whom sexual dysfunction is a concern.

Ambulatory Care↗
PubMed1994

Sexual asphyxiophilia (Koczwarism) in women and the biological phenomenon of female ejaculation.

Life threatening eroticizing behavior, asphyxiophilia (sexual asphyxia) is practiced in women, as in men, in order to heighten sexual excitement and to achieve orgasm, which is in some women accompanied by expulsions of fluid (ejaculation) from the urethra. The relatively easily achieved orgasm induced by the mechanism of asphyxia is hypothesized to be the common reason for repetitive deviant asphyxiophilic behavior. Moreover, in women of the ejaculatory type (female ejaculators), the desire to induce ejaculatory orgasm by asphyxia may also come into play as this kind of orgasm is usually assessed as sensation of greater delight than orgasm without ejaculation.

Asphyxia↗
PubMedDate not supplied

Sexual dysfunction induced by serotonin reuptake antidepressants.

Serotonin reuptake inhibitor (SRI) antidepressants have been associated with sexual dysfunction, though there have been few prospective reports specifically examining this problem. The purpose of this study was to determine if three SRIs affected sexual function in patients with an anxiety disorder or major depressive disorder over a 3-month period. Sixty-one patients were evaluated for at least 2 months in a prospective study of the effects of fluoxetine, sertraline, and paroxetine on five aspects of sexual function: libido, erection/lubrication, orgasm quality, orgasm delay, and sexual frequency. Measurements were made at baseline and at each month on visual analog scales. For men and women, orgasm quality was lower and orgasm delay longer at Months 1, 2, and 3 compared with baseline (p < .001). Erection scores were lower over time (p < .02) but this change was less dramatic. Lubrication, libido, and sexual frequency were not appreciably changed over 3 months. Anorgasmia was significantly more common in women than men at Months 1 and 2. Orgasm appears to be a primary sexual function affected by SRIs.

1-Naphthylamine↗
PubMed2001

Sexual response in women with spinal cord injury: neurologic pathways and recommendations for the use of electrical stimulation.

BACKGROUND: Determination of the exact level and degree of a woman's spinal cord injury (SCI) has allowed researchers to document the aspects of sexual response that are altered with specific patterns of SCI. Based on these findings, recommendations can be made regarding the development and testing of electrical stimulation systems designed to facilitate sexual responses in women with SCI. DESIGN: Literature review. FINDINGS: Studies of the arousal stages of response indicate that psychogenic vaginal lubrication is maintained with pinprick sensation in T11-T12 dermatomes, and that reflex lubrication occurs in women with upper motor neuron injuries affecting the sacral segments. Studies of the orgasmic stage support the hypothesis that orgasm is a reflex response of the autonomic nervous system that appears to depend on an intact sacral arc. CONCLUSIONS: Laboratory studies of arousal and orgasm among women with different types of SCI, and comparisons with able-bodied controls, provide valuable information regarding female sexual neurophysiology. Electrical stimulation can be used to improve sexual response, as well as bladder and bowel function. Interventions that interfere with the sacral reflex arc, such as sacral rhizotomy, can impair the ability to achieve orgasm. To develop alternative treatment protocols, further investigation of sexual response and orgasm is recommended.

Electric Stimulation Therapy↗
PubMed1991

Postmenopausal sexuality in Thai women.

We evaluate sexuality in 100 natural menopausal women as pertains to hormones, symptoms related to intercourse, and marital relationship with sexual desire, orgasm and coital frequency. The mean age was 56.8 years while menopausal age was 50.3 years. The postmenopausal syndrome presented 55.0% occurring 1 to 7 years after menopause (mean 3.4 years). The common sexual problems after menopause were loss of libido, orgasmic dysfunction, and dyspareunia. Both sexual desire and activity decreased when compared with premenopausal period. Ninety percent of the subjects had sexual desire less than once a month. Only 14% of the subjects occasionally reached orgasm while the other 86% never had orgasm after menopause. The levels of FSH, LH, estradiol and testosterone were also reported. There was no correlation of hormone estradiol and testosterone, symptoms related to intercourse and marital relationship with sexual desire, orgasm, or coital frequency.

Adult↗
PubMed2003

Sexuality in healthy postmenopausal women.

OBJECTIVE: To assess the influence of psychosocial factors, behavior and hormones on postmenopausal sexuality. METHODS: Nine hundred and ninety-nine women (age range 41-60 years) underwent physical and supplementary tests and answered questionnaires regarding sexual behavior. Sixty healthy women with 1 or more years of amenorrhea, without hormone replacement therapy and with a partner capable of intercourse were chosen from this group. Logistic regression models with dependent variables (sexual satisfaction and orgasmic capacity) and independent variables (sexual initiation, psychosocial factors, behavior, relationship, menopause and hormones) were developed. RESULTS: Important variables for sexual satisfaction were: good self-esteem (p< 0.01), first orgasm obtained by masturbation (p = 0.004), major personal income (p = 0.007), sexual initiation in adulthood (p = 0.008), value physical contact with partner (p = 0.021) and major orgasmic capacity p = 0.040). The following contributed (towards orgasmic capacity with the partner: sexual initiation in adulthood (p = 0.012), regular physical activity (p = 0.040) and higher testosterone levels (p = 0.050). CONCLUSIONS: The importance of relationship, psychological, hormonal, economic and behavioral factors confirm the complexity of sexuality, and we note that current as well as prior events seem to affect the sexual satisfaction and orgasmic capacity of healthy postmenopausal women.

Adult↗
PubMed1982

Labial and vaginal blood volume responses to visual and tactile stimuli.

Five women volunteers participated in two experimental sessions designed to evaluate the response patterns of two objective psychophysiological measure of women's sexual arousal to different methods (and intensities) of sexual stimulation (i.e., an erotic film and manual self-stimulation). A vaginal photoplethysmograph was used to measure vaginal blood volume response and a labial thermistor-clip was used to measure temperature changes of one of the minor labia. Both measures usually covaried in a highly significant manner during both types of stimulation, with the largest responses typically being evoked by the physical stimulation. The response patterns for the two measures were also similar following both methods of stimulation if the woman did not experience orgasm; both measures decreased to some extent after the stimulation ended but usually remained well above the prestimulatory baseline. Orgasm, however, affected the two genital measures differently. The vaginal blood volume measure decreased dramatically during the reported orgasm, possibly because of vaginal contractions, and then increased to at least the preorgasmic level that occurred during the stimulation. The labial measure did not change during the reported orgasm but decreased relatively rapidly soon after.

Adult↗
PubMed1978

Development of masturbation in college women.

To elucidate a number of hypotheses about the development of sexual responsivity in women, a random sample of 100 undergraduate women was interviewed about their masturbation histories, techniques in masturbation, and the relationship of masturbation to intercourse. Masturbation had been practiced by 74%. It began most commonly as an accidental discovery. Learning the sexual nature of masturbation from peers and written sources seemed to result in methods more imitative of heterosexual activities and to increase the enjoyment and goal-directedness of the behavior. The view that experiencing sexual pleasure depends on social transmission of scripts was thus supported. Several techniques were related to orgasm ability in masturbation and intercourse. Women who were orgasmic in masturbation and who masturbated with that goal were more likely to continue the behavior than those with other goals. Frequency of masturbation and frequency of intercourse were not related, failing to support the notion of a unitary "sex drive". Nor was "clitoral fixation" documented by any relationship between reliance on clitoral stimulation in both masturbation and intercourse. Masturbating to orgasm was not related to orgasm ability in intercourse.

Adolescent↗
PubMed1983

Coitarche and orgastic capacity.

In a group of 2,159 gynecological patients, aged 21 to 40, the age at the first sexual intercourse was ascertained and correlated with orgastic capacity during coitus in marital life. All had been married for at least 1 year. Of the examined females, 1,093 who reached orgasm mostly or always during sexual intercourse had their first coitus earlier than 394 women with rare and 165 women with no coital orgasm. The difference between orgastic women and examinees with rare orgasm was significant at the 0.01 level. The difference between females with adequate sexual reactivity and females with no coital orgasm was significant at the 0.001 level.

Adolescent↗
PubMed1986

Relations between sex hormone levels and sexual behavior in men.

Using a sample of 33 healthy young men, 6 blood samples were obtained in the course of 2 weeks, and testosterone, dihydrotestosterone, and estradiol levels determined. The amount of free testosterone in the saliva was also ascertained for 23 of the subjects. All participants kept a daily record of their sexual activity during the investigational period. An interindividual comparison revealed a significant positive correlation between serum testosterone levels and the frequency of orgasms as well as a significant negative correlation between estradiol concentrations and the frequency of sexual activity without orgasm. The comparison of hormone levels to sexual behavior, prior to and after the individual sampling, reveals significant positive correlations between the serum testosterone and the extent of the free testosterone on the one hand and both the preceding and subsequent frequency of orgasms on the other. The estradiol levels showed a significant negative correlation with both the preceding and the subsequent frequencies of sexual activity without orgasm.

Adult↗
PubMed1985

Sexual activity and sleep in humans.

Polysomnographic recordings were obtained in 10 subjects (5 men and 5 women) for three conditions: following masturbation with orgasm, following masturbation without orgasm, and after reading neutral material. The analysis of several sleep parameters did not reveal any effect of masturbation on sleep. These results suggest that physiological changes that occur during masturbation, with or without orgasm, have no major effect on sleep organization. Other factors associated with sexual activity and potentially responsible for sleepiness after orgasm are discussed, and further strategies to study the interrelationship of sexual activity and sleep are proposed.

Adult↗
PubMed2004

Sexual functioning and patient expectations of sexual functioning after hysterectomy.

OBJECTIVE: The purpose of this study was to assess sexual functioning and patient expectations of sexual functioning after hysterectomy. STUDY DESIGN: Seventy-five patients who had undergone hysterectomy at an urban academic medical center were surveyed about sexual function at the time of hysterectomy and after hysterectomy. Chi-squared tests compared responses for discrete outcomes. RESULT: Most patients expected no change in sexual desire or orgasm quality. Hysterectomy had no effect on the frequency of sexual activity or on orgasmic response. Postoperatively, patients were less likely to report pain with intercourse (relative risk, 5.34; 95% CI, 2.2-12.95; P =.00002): 49.3% of patients had discussed sexual functioning after hysterectomy with their physicians, and 64.8% of patients recalled initiating the discussion. CONCLUSION: Most patients expected and experienced no change in sexual desire, orgasm frequency, or orgasm intensity. Hysterectomy appears to result in decreased pain with sexual relations.

Adult↗
PubMed1998

Love as sensory stimulation: physiological consequences of its deprivation and expression.

For the present purpose, love is defined as one's having stimulation that one desires. The nature of the stimulation can range on a continuum from the most abstract cognitive, to the most direct sensory, forms. Thus, this definition of love encompasses having an emotional bond with a person for whom one yearns, as well as having sensory stimulation that one desires. We address some of the physiological and perceptual consequences both of having, and of not having, love. We propose a neural mechanism by which deprivation of love may generate endogenous, compensatory sensory stimulation that manifests itself as psychosomatic illness. In addition, we propose a neuroendocrine mechanism underlying sexual response and orgasm. The latter includes vaginocervical sensory pathways to the brain that can produce analgesia, release oxytocin, and/or bypass the spinal cord via the vagus nerve. We present evidence of the existence of non-genital orgasms, which suggests that genital orgasm is a special case of a more pervasive orgasmic process. Through recent studies, the mechanisms and manifestations of love and its deprivation are becoming better understood. The better is our understanding of love, the greater is our respect for the significance and potency of its role in mental and physical health.

Analgesia↗
PubMed2004

On categorization and quantification of women's sexual dysfunctions: an epidemiological approach.

The objectives of this study are to compare the two definitions of female sexual dysfunction, namely dysfunction per se (A category) and personal distress caused by dysfunction (B category), and to gauge their associations with some sociodemographic aspects and level of sexual well-being. The subjects were a nationally representative sample of sexually active Swedish women (n: 1056) aged 18-65 y, who participated in a combined structured interview/questionnaire investigation. The functions analysed were: self-reported sexual desire, interest, lubrication, orgasm, genital pain and vaginism, which were subclassified for the A and B categories into no, mild (sporadically occurring) and manifest dysfunction. Sexual well-being was reported along a six-grade scale ranging from very satisfied to very dissatisfied. The sociodemographic items registered were: education, occupation, financial situation, social group, immigrant status, location of domicile and church-going. Aggregated mild and manifest dysfunction per se of sexual interest, orgasm and vaginal lubrication were reported by about 60-90%. More than one-third had dyspareunia, but few reported vaginism. Mild dysfunctions were clearly more common than manifest dysfunctions. Not fully 45% of those with manifest low interest and orgasm perceived these dysfunctions as manifestly distressing, while in 60-70% lubricational insufficiency of dyspareunia led to manifest distress. Age and the included sociodemographic variables had marginal or no influence on sexual functions. A four-factor sexual function pattern was identified, closely linking A and B categories in a pairwise manner. Three factors, labelled sexual desire, orgasm and genital function were powerful classifiers (discriminant analysis) of level of sexual well-being. Hence, it is a matter of taste whether to use the A or the B category. Together, they can explain the gross level of satisfaction with sexual life to an adequate extent.

Adolescent↗
PubMed2001

[Sexual satisfaction of women--development and results of a questionnaire].

In sexology the existing questionnaires do not sufficiently consider the experiencing of sexuality and the extent of sexual satisfaction. That is why a questionnaire was developed which includes, besides the frequency and duration of sexual activities, the satisfaction with frequency and duration of these activities and the desired sexual behaviour. A first study with this questionnaire was carried out on 112 women with heterosexual behaviour, aged 20 to 48 years. The frequent desire with regard to coital orgasm as one result of our investigation confirms the centering of orgasm in other studies. But half of the women do not describe orgasm as the favoured feeling during sexual intercourse. For 37% of the women the emotional and physical closeness to the partner is explicitly more important than experiencing an orgasm. According to the comparison of extreme groups sexual satisfaction particularly correlates with self-determination realized in partnership and with satisfaction of communicational desires and need for tenderness within the partnership.

Adult↗
PubMed1976

New data about female sexual response.

This paper reports on a 195-subject pilot study of female sexual responses. The questionnaire used in the study is described, and the data obtained are discussed and integrated with established research and theory. Discussion focuses on the relatively low frequency with which women actually experience orgasm in sexual relations and the need to understand the reasons for this phenomenon. The concept of the normality of this varied capacity for orgasm is presented in contrast to the usual tendency to evaluate female responses by male standards. Several sexual patterns and different types of orgasms in the female are identified, and the relationship between the type of responses perceived and various other factors is discussed. Responses indicated that, on the average, the strength and degree of gratification provided by an orgasm is not related to the method of induction or to the subjective localization of the pulsating sensations.

Adolescent↗
PubMed1994

Absorbed states play different roles in female and male sexual response: hypotheses for testing.

The absorbed state-sexual arousal-orgasm pathway hypotheses assert that absorbed states of consciousness accompanying sexual arousal (sometimes called altered states of consciousness or sexual trance) play important roles in sexual response not previously recognized. Absorbed states are an obligatory pathway to high physiological sexual arousal and to orgasm in many, perhaps all, females. The role of absorbed states in males is facilitation of arousal and orgasm, with enhancement of pleasure and subjective quality of the experience. But the absorbed states pathway is not an obligatory feature of arousal and orgasm in most males. These hypotheses are empirically testable; absorbed states have objectively measurable defining characteristics as well as subjective dimensions presenting greater but not intractable methodological difficulties. Inclusion of a cognitive psychology of absorbed states can bring us closer to a more adequate and integrated psychobiological understanding of sexual response in both women and men.

Arousal↗
PubMedDate not supplied

Sexual response in women with spinal cord injuries: implications for our understanding of the able bodied.

This study assesses the impact of psychogenic and reflex sexual arousal on women with complete and incomplete spinal cord injuries (SCIs) and explores the effects of SCI on orgasm in women. Thirty women with SCIs and 10 able-bodied women participated in the study. Three individual experiments were conducted over a 3-day period, assessing (a) the impact of SCI on psychogenic sexual arousal, (b) the impact of SCI on orgasm; and (c) the impact of SCI on reflex sexual arousal. Results support the hypothesis that women with complete SCIs and upper motor neuron injuries affecting the sacral spinal segments and women with incomplete upper motor neuron SCIs had the capacity for reflex lubrication. Women with SCIs were significantly less likely than able-bodied women to achieve orgasm. However, there was not a significant difference among women with different SCIs to achieve orgasm.

Adolescent↗