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PubMed1990

Hormonal status and sexual behaviour of 16 men after surgical castration.

Sixteen castrated sexual offenders were investigated blood plasma levels of testosterone [T], dihydrotestosterone [DHT], luteinizing hormone [LH] and follicle-stimulating hormone [FSH]. Levels of T and DHT were significantly decreased in comparison with normal values. Levels of both gonadotropic hormones were significantly elevated. There was a great reduction in the occurrence of orgasm and ejaculation in castrated men. Only six of these sixteen men were able to reach orgasm. Only two of these men stated that they had a small amount of ejaculate by orgasm. Phalloplethysmographic [PPG] examination were provided with electrocapacitance PPG equipment. In only two men investigated was there no specific erotic reactions to visual stimuli. PPG responses in 8 men were small, in 4 average and in 2 only were these reactions high. No changes in sexual orientation were found after castration. In most men after surgical castration sexual arousal is preserved. Low, with low frequency of orgasm and very low sexual interest.

Adult↗
PubMed1999

Hysterectomy and sexual functioning.

CONTEXT: Women considering hysterectomy often are concerned about its potential effects on their sexual functioning but the effects of hysterectomy on sexual functioning remain unclear. OBJECTIVE: To examine changes in sexual functioning after hysterectomy. DESIGN AND SETTING: A 2-year prospective study (Maryland Women's Health Study) of hysterectomy, which included measures of sexual functioning prior to hysterectomy and at 6, 12, 18, and 24 months after hysterectomy, performed during 1992 and 1993. PATIENTS: Of 1299 women interviewed prior to hysterectomy, 1101 (84.8%) completed the study and provided information about their sexual functioning. Most were between the ages of 35 and 49 years, white, married or living with a partner, and high school graduates. MAIN OUTCOME MEASURES: Frequency of sexual relations, dyspareunia, orgasm, vaginal dryness, and sexual desire. RESULTS: The percentage of women who engaged in sexual relations increased significantly from 70.5% before hysterectomy to 77.6% and 76.7% at 12 and 24 months after hysterectomy. The rate of frequent dyspareunia dropped significantly from 18.6% before hysterectomy to 4.3 % and 3.6% at 12 and 24 months after hysterectomy. The rates of not experiencing orgasms dropped significantly from 7.6% before hysterectomy to 5.2% and 4.9% at 12 and 24 months after hysterectomy. Low libido rates also decreased significantly from 10.4% before hysterectomy to 6.3% and 6.2% at 12 and 24 months after hysterectomy. The distribution of women not reporting vaginal dryness in the past month improved significantly from 37.3% before hysterectomy to 46.8% and 46.7% at 12 and 24 months after hysterectomy. Prehysterectomy depression was associated with experiencing dyspareunia, vaginal dryness, low libido, and not experiencing orgasms after hysterectomy. CONCLUSIONS: Sexual functioning improved overall after hysterectomy. The frequency of sexual activity increased and problems with sexual functioning decreased.

Adult↗
PubMed1976

Frequency of sexual dysfunction in a general gynecological clinic: an epidemiological approach.

Epidemiological data on female sexual functioning are presented. Fifty-nine 30- to 39-year-old Black women attending a gynecology clinic at University Hospitals of Cleveland for nonsexual complants were interviewed to determine the frequency of sexual dysfunction. Seventeen percent had difficulty achieving orgasm in partner sexual behavior. Most of these women had prior history of adequate sexual functioning; 5% had never been orgasmic. Ten of the 49 women who had no orgasmic difficulty were not satisfied with their sexual relationships. The relative risk of sexual dysfunction was 5 times greater in women who had undergone pelvic surgery.

Adult↗
PubMed1994

Sexual function in a community sample of middle-aged women with partners: effects of age, marital, socioeconomic, psychiatric, gynecological, and menopausal factors.

A randomly selected community sample of 436 women with partners was studied with regard to frequency of sexual intercourse and orgasm with their partners and to attitudes to their sexual relationships. Associations were examined between these factors and demographic, psychiatric, marital, gynecological, and menopausal status. Frequency of sexual intercourse, orgasm, and enjoyment of sexual activity with the partner were most closely associated with younger age and better general marital adjustment, with the partners' ages also appearing to influence frequency of sexual intercourse and the duration of the relationships to affect enjoyment of sexual activity. Women's satisfaction with their sexual relationships was most closely associated with marital adjustment and bore no relation to age. Weak positive associations were found between higher socioeconomic status and frequency of orgasm and enjoyment of sexual activity. Psychiatric factors (psychiatric disorder and neuroticism) made little contribution to differences in frequency of sexual activity although they were associated with attitudes towards it. Sexual behavior was largely unrelated to gynecological symptoms. Little difference was found between age-matched subgroups of pre- and postmenopausal women in frequency of sexual behavior and attitudes towards their sexual relationships.

Adaptation, Psychological↗
PubMed1982

Sexuality and pregnancy: a review.

Marital success and failure may be related to sexual satisfaction, including orgasmic capability. Pregnancy represents a life crisis to the pregnant woman and her husband. Complex psychosocial and physiological demands may produce insecurities, anxieties, and somatic complaints. The expectant mother may seek to fulfill increasing nurturant needs through increased physical contact such as cuddling or being held. A pregnant woman's interest in sexual activity may be affected by her changing physical appearance and the hormonal milieu of pregnancy. Although there are marked individual variations and methodological biases and differences among empirical studies, pregnancy appears to be usually accompanied by a decrease in sexual desire, coital frequency, and orgasm. Sexual behavior in pregnancy has been traditionally restricted and is currently poorly defined. Sexual proscriptions may precipitate sexual frustration and marital estrangement. Abortion is only rarely caused by coitus. The relationship of coitus and orgasm to prematurity and distress of the fetus and newborn has not been clearly established. Coitus can indirectly result in maternal, fetal, and neonatal morbidity and mortality through the spread of sexually transmitted diseases. Deaths from air embolism in pregnancy associated with cunnilingus and vaginal insufflation have been reported.

Adaptation, Psychological↗
PubMed1985

Clinical follow-up of couples treated for sexual dysfunction.

The present status of 38 couples who had been treated at a clinic for sexual dysfunction 3 years previously was determined by a self-report assessment battery. The battery consisted of the Sexual Interaction Inventory, the Locke-Wallace Marriage Inventory, and the Sexual History Form completed at pretreatment, immediately posttreatment, 3 months after treatment, and at 3-year follow-up. An additional Follow-up Questionnaire was completed at the 3-year point only. At 3-year follow-up, analysis of data by diagnostic category indicated that sexual desire dysfunction for both men and women was particularly resistant to sustained behavioral change. Men with erectile difficulty reported significant improvement in their ability to maintain erections during intercourse but not in their ability to achieve erections prior to intercourse. Data from men with premature ejaculation revealed some immediate significant posttherapy gains, which, with the exception of length of foreplay, were not sustained at 3-year follow-up. For women with global inorgasmia, a significant increase in orgasmic response was reported. Data from women with situational orgasmic difficulties indicated some success in improving frequency of orgasm through masturbation and through genital caress; however, these changes did not reach statistical significance. Across all diagnostic categories, both men and women respondents reported increased satisfaction in their sexual relationship. Satisfaction in the marital relationship showed a more varied response pattern.

Adult↗
PubMed1985

EEG during masturbation and ejaculation.

The occurrence of a distinctive EEG pattern specifically related to sexual arousal and orgasm would provide a reliable and convenient means of identifying such events in the laboratory and would also provide clues to cerebral structures involved in the processes. EEG-polygraph recordings were obtained under rigorously controlled conditions in four normal male subjects during masturbation and ejaculation. The EEG data were subjected to both impressionistic and quantitative analyses. They showed no remarkable changes during the sequence of relevant physiological responses. The sole effect was a slight depression of alpha activity, a well-known nonspecific effect associated with changes in attention and arousal. Examination of the literature shows little agreement among reported results of studies of EEG changes during orgasm. It is likely that at least some reported changes were artifactual. It is concluded that the case for the existence of EEG changes specifically related to sexual arousal and orgasm remains unproven.

Adult↗
PubMed1985

Vaginal eroticism: a replication study.

Vaginal eroticism was investigated in a group of 27 coitally experienced volunteers by means of systematic digital stimulation of both vaginal walls. Erogenous zones were found in all subjects, mainly located on the upper anterior wall and the lower posterior one. An orgasmic response was elicited by stimulation of these zones in 89% of the subjects. This study supports previous findings regarding vaginal eroticism. It does not support the existence of the discrete anatomical structure called the Grafenberg spot. It supports the contention that there are two distinct types of female orgasm, vaginally evoked and clitorally evoked. It also supports the finding that some women expel a fluid through the urethra at the time of orgasm. In this particular case the fluid was chemically indistinguishable from urine.

Adult↗
PubMed1990

Return of sexual functioning following penile replant surgery.

The penis, scrotum, and testicles of a 31-year-old man were cut off in a fight. Fourteen hours later the penis and one testicle were reattached, but the testicle later had to be removed. By 3 weeks normal urinary function returned but the penis was misshapen. The patient had suicidal intentions. His partner was sexually supportive but afraid to touch the penis. By 10 weeks penile swelling occurred in response to a movie with frank sexual content. By 12 weeks the penile swelling was sufficient for entry but the partner was acutely afraid that her vaginal contractions would tear the scars. The man was concerned because he experienced only mild sexual tensions. Physical examination reassured both, and they gained hope for recovery. At 16 weeks erections were still not full but active intercourse was attempted and he experienced seminal seepage and mild orgasmic sensations; she was relaxed enough to have orgasm. Testosterone was administered at regular intervals from the 19th week on, with immediate improvement of erection. By 32 weeks full erection, ejaculation, and orgasmic functions returned and the couple resumed their normal sexual practices.

Adult↗
PubMed1978

Styles of sexual expression in women: clinical implications of multivaritanalyses.

Two different multivariate techniques were applied to self-reported trait and behavioral data concerning sexual behavior from a sample of North American women. Canonical correlation delineated three styles in which certain demographic attributes and cognitive indices of sexual arousal were related to forms of sexual expression. The first style was characterized by respondents who experienced high rates of intercourse and orgasm in a cohabitation arrangement but who did not necessarily report satisfaction with their sexual responsivity. A second style was characterized by older women currently without partners who expressed a liking for erotic literature and media, direct genital stimulation, and frequent masturbation but who were dissatisfied with their sexual responsivity. The third style, which included respondents most satisfied with their sexual responsivity, was characterized by women who were more aware of physiological changes during sexual arousal and who enjoyed gently seductive erotic activities, breast stimulation, and genital stimulation. A discriminant analysis showed that those women who were most highly satisfied with their sexual responsivity experienced frequent intercourse and orgasm consistency, enjoyed gently seductive erotic activities and breast stimulation, but were unresponsive to erotic literature and media. A second discriminant analysis showed that women who achieved orgasm most consistently were older, were more aware of physiological changes during sexual arousal, reported higher frequencies of masturbation and intercourse, and were less likely to be aroused by erotic preliminaries. These results are discussed within the context of the literature on the treatment and prevention of sexual dysfunction.

Adolescent↗
PubMed1983

Determinants of sexual dissatisfaction in sexually distressed couples.

Forty-five couples seeking sex therapy were administered a 15-item symptom checklist regarding both specific sexual dysfunctions and more general interpersonal difficulties, along with an objective criterion measure of overall sexual dissatisfaction. For males, the most common complaint involved too infrequent intercourse, followed by failure of their partner to reach orgasm and concern with their own sexual adequacy. For women, five of the six most prevalent complaints involved difficulty with becoming sexually aroused or reaching orgasm. For both sexes, the incidence of specific sexual dysfunctions was considerably lower than for more general interpersonal difficulties. For both males and females, important determinants of sexual distress included the partner's lack of response to sexual requests, infrequent intercourse, lack of affection for the partner, and the absence of specific sexual dysfunctions in oneself. In addition, males' sexual dissatisfaction was strongly influenced by their wives' failure to reach orgasm, whereas wives were more responsive to concerns regarding their own sexual adequacy.

Adult↗
PubMed1981

Menarche and orgastic capacity.

In a group of 1,756 gynecological patients married for at least one year, three-quarters of whom were being treated for sterility, the relationship between age at menarche and the frequency of orgasm during coitus was examined. Statistical analysis revealed a close correlation between these two factors: in orgastic women, r = -0.878; in patients with rare or no orgasm, r = +0.914; and in persons with sexual dissatisfaction r = +0.722. The percentage of orgastic women decreased, and the number of patients with rare or no orgasm during coitus or with sexual dissatisfaction increased with advancing age of menarche.

Adult↗
PubMed2003

The effect of tension-free vaginal tape (TVT) procedure on sexual function in women with stress urinary incontinence.

The aim of this study was to evaluate the effects of tension-free vaginal tape (TVT) on sexual function in women with stress urinary incontinence (SUI) by questionnaire. Thirty-two sexually active and married women who were planned for TVT to treat SUI constituted the patient group, and 25 women who were healthy, sexually active and married, were selected as the control group; the ages of both groups matched. Sexual functions (desire, arousal, orgasm, pain and satisfaction) were evaluated with the Index of Female Sexual Function (IFSF), and continence status during sexual intercourse was asked about both preoperatively and postoperatively in the 6th month. The mean domain scores of sexual functions such as desire, arousal, orgasm, pain and overall satisfaction preoperatively and postoperatively were 3.37+/-0.69, 3.82+/-0.62, 3.40+/-0.95, 3.41+/-0.98, 3.16+/-1.09 and 3.32+/-0.79, 3.71+/-0.53, 3.06+/-1.04, 2.75+/-1.29, 2.88+/-0.63, respectively, and postoperative scores insignificantly decreased. Also, these scores in the control group were 3.64+/-0.66, 3.96+/-0.73, 4.12+/-0.78, 3.96+/-1.14 and 3.68+/-0.92. In comparison with the control group, whereas all of the preoperative domain scores were found to be decreased but were statistically insignificant except orgasmic function, postoperative scores significantly worsened, except for desire and arousal. However, preoperatively nine patients explained that they had incontinence during sexual intercourse, and this problem persisted in two postoperatively ( p = 0.043). This study shows that both SUI and the TVT procedure negatively affect sexual function in women.

Adult↗
PubMed2005

Effects of pregnancy and childbirth on postpartum sexual function: a longitudinal prospective study.

This study was conducted to evaluate the effects of pregnancy and childbirth on postpartum sexual function. Nulliparous, English-literate women were enrolled who had presented to the UNC Hospital's obstetrical practice; these women were 18 years of age and older and at 30-40 weeks' gestation. Questionnaires were completed regarding sexual function prior to pregnancy, at enrollment, and at 2, 6, 12, and 24 weeks postpartum. Demographic and delivery data were abstracted from the departmental perinatal database. One hundred and fifty women were enrolled. At 6, 12, and 24 weeks postpartum, 57, 82, and 90% of the women had resumed intercourse. At similar postpartum timepoints, approximately 30 and 17% of women reported dyspareunia; less than 5% described the pain as major. At these times, 39, 60, and 61% of women reported orgasm. Orgasmic function was described as similar to that prior to pregnancy or improved by 71, 77, and 83%. Delivery mode and episiotomy were not associated with intercourse resumption or anorgasmia; dyspareunia was only associated with breast-feeding at 12 weeks (RR = 3.36, 95% CI = 1.77-6.37). Most women resumed painless intercourse by 6 weeks and experienced orgasm by 12 weeks postpartum. Function was described as similar to or improved over that prior to pregnancy.

Adult↗
PubMed2005

Retarded ejaculation in men: an overview of psychological and neurobiological insights.

Disorders of orgasm and ejaculation are erroneously mixed up in the DSM-IV classification system. Male Orgasmic Disorder to denote "delayed ejaculation" is inadequate as orgasm and ejaculation represent clinical expressions of different neurobiological phenomena. Unfortunately, the DSM-IV criteria for delayed ejaculation were accepted regardless of any research with appropriate methodology and design. The psychological approach and associated psychotherapy to solve this problem is rather disappointing. The neurobiological approach, which started with animal studies, has demonstrated various neurotransmitters with the potency to inhibit ejaculation. Indeed, several experimental drugs have been tested in rats, showing the successful acceleration of ejaculation. We propose that human research should start with the development of an operational definition of delayed ejaculation. To achieve this goal, we propose unselected epidemiological stopwatch studies which also provide information on the prevalence and incidence of delayed ejaculation in men. Currently, no effective and safe drugs are available to accelerate ejaculation time in men. The best way to treat lifelong delayed ejaculation is, thus far, to inform the patients about biological and psychological inhibiting factors which they need to avoid, and to remain critical about unrealistic expectations from psychotherapy. Psychotherapy may be useful in subgroups, particularly in the absence of effective and safe drugs.

Animals↗
PubMed1979

Sexual behavior and response in relation to complications of pregnancy.

A detailed written questionnaire survey of 155 puerperas is reviewed. Sexual and obstetric data were examined for possible associations leading to premature or low-birth-weight infants. Among 25 patients delivering premature infants (16 with babies weighing less than 2,500 grams), no significant association could be made between coitus, orgasm, and/or other sexual experiences and the proximity to the onset of labor. Orgasmic patients appeared to have a consistently lower percentage of early deliveries. No particular method of sexual gratification was unique except that masturbation was consistently associated with a lower risk of prematurity throughout various stages of gestation. Speculations are advanced to explain these observations. Sexual activity appears to be safe throughout pregnancy in almost all patients. Ruptured membranes on admission may be associated with recent sexual stimulation without orgasm.

Adolescent↗
PubMed1985

Sexual and marital relationships after treatment for nonseminomatous testicular cancer.

Data from 121 patient questionnaires suggest that treatment for nonseminomatous testicular cancer not only causes sterility but also disrupts marital and sexual happiness in 10 to 20 per cent of patients. Treatment included unilateral orchiectomy and retroperitoneal lymphadenectomy alone in 47 men; 30 had additional chemotherapy, 8 had additional radiotherapy, and 26 were treated with all three modalities. Erectile and orgasmic problems were more prevalent when radiotherapy was included. Compared with healthy men, patients reported less sexual activity, lower sexual desire, more erectile dysfunction, more difficulty achieving orgasm, reduced orgasmic intensity, and, for 82 per cent, a greatly reduced semen volume. The longer the time since treatment, the more likely the patient was to have antegrade ejaculation. Although the patients' 12.8 per cent divorce and/or separation rate is not unusually high, those whose marriages ended cited sexual dysfunction and cancer treatment as significant sources of stress. Sterility was a frequent source of anxiety for one quarter of the patients.

Adolescent↗
PubMed1995

Decreased sexual capacity after external radiation therapy for prostate cancer impairs quality of life.

PURPOSE: The aim of this study was to assess to what extent patients treated with radiation therapy for prostate cancer experience change in sexual functioning and to what extent this effects quality of life. METHODS AND MATERIALS: Information was provided by 53 men treated with radiation therapy for localized prostate cancer. Assessment was made with the "Radiumhemmets Scale of Sexual Functioning," which measures sexual desire, erectile capacity, orgasm, and to what extent a decrease in any of these aspects of sexual functioning affects quality of life. Function before treatment was assessed retrospectively. RESULTS: Sexual desire diminished among 77% after treatment. The erection stiffness decreased in 77%. Before external radiation therapy, 66% had an erection usually sufficient for intercourse. Half of the men lost this ability after treatment. Of those retaining orgasm after treatment, 47% reported a decreased orgasmic pleasure and 91% a reduced ejaculation volume. Of all men, 50% reported that quality of life had decreased much or very much due to a decline in the erectile capacity following external radiation therapy. CONCLUSION: The results of the present study indicate that external radiation therapy for prostate cancer is associated with a reduction in sexual desire, erectile capacity, and organism functions. In a majority of patients this reduces quality of life. Previously, we may have underestimated the importance an intact sexual function has for the quality of life in this patient category of elderly men.

Aged↗