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At least 433 records · Page 24Linked to original sources
PubMed2005

Clitoral therapy device for treatment of sexual dysfunction in irradiated cervical cancer patients.

PURPOSE: The purpose of this pilot study was to evaluate the efficacy of the clitoral therapy device (Eros Therapy) in alleviating sexual dysfunction in irradiated cervical cancer patients. METHODS AND MATERIALS: Eligible patients had a history of cervical cancer treated with radiotherapy and self-reported sexual dysfunction of sexual arousal and/or orgasmic disorders. Patients used the noninvasive, nonpharmacologic clitoral therapy device using a hand-held, battery-powered vacuum to cause clitoral engorgement four times weekly for 3 months during foreplay and self-stimulation. Study instruments included the Female Sexual Function Index, Derogatis Interview for Sexual Functioning, and Dyadic Adjustment Scale. The outcome evaluation was performed at 3 months. RESULTS: Between 2001 and 2002, 15 women were enrolled and 13 completed the study. The median patient age and radiotherapy-enrollment interval was 43.5 years and 2 years, respectively. At baseline, all patients reported symptoms of sexual arousal and/or orgasmic disorders, and some also had sexual desire and pain disorders. At 3 months, statistically significant improvements were seen in all domains tested, including sexual desire, arousal, lubrication, orgasm, sexual satisfaction, and reduced pain. The median Female Sexual Function Index total score increased from 17 to 29.4 (maximal score, 36; p <0.001). The median Derogatis Interview for Sexual Functioning total raw score increased from 46 to 95 (maximal score, 118; p <0.001). At baseline, the Derogatis Interview for Sexual Functioning total T-score corresponded to the bottom 10th percentile of normal sexual functioning. At 3 months, the total T-score placed the patients at the normalcy cutoff. Gynecologic examinations revealed improved mucosal color and moisture and vaginal elasticity and decreased bleeding and ulceration. CONCLUSION: Our results from this pilot study suggest that the clitoral therapy device may alleviate sexual dysfunction in irradiated cervical cancer patients. A randomized, controlled trial is warranted to assess the full benefits of this approach.

Adult↗
PubMed2005

Sexual function in women treated with dilators for vaginal agenesis.

OBJECTIVE: To discover the sexual satisfaction of young women treated with vaginal dilators for vaginal agenesis. DESIGN: Anonymous questionnaire study. MAIN OUTCOME MEASURES: Comparison of sexual desire arousal lubrication, orgasm satisfaction and pain with a normal population. RESULTS: There was no significant difference between the study population and controls for the domains of sexual desire, sexual arousal, and satisfaction with a sexual relationship. There was, however, a significant difference for vaginal lubrication and orgasm where the Rokitansky patients scored lower. 22.3% of patients reported some degree of dyspareunia following vaginal penetration. However, this did not affect their enjoyment of the sexual act. CONCLUSION: The use of graduated vaginal dilators for patients with Mullerian agenesis is highly successful in creating a neovagina. Although the lack of adequate lubrication, pain and difficulty in reaching orgasm is significantly higher in this group, the patients subsequently enjoy sexual satisfaction that is comparable to a normal population.

Adolescent↗
PubMed2004

Female sexual dysfunction after radical cystectomy: a new outcome measure.

OBJECTIVES: To assess, in our contemporary radical cystectomy (RC) series, female sexual dysfunction and whether the type of diversion affected the occurrence of sexual dysfunction. Outcome data after RC with and without orthotopic diversion has focused primarily on cure, urethral recurrence, and continence. METHODS: The baseline and follow-up data from 27 sexually active female patients (mean age 54.79 +/- 12.7 years) who underwent RC from 1997 to 2002 for transitional cell carcinoma of the bladder (16 with Stage T1-T2 and 11 with Stage T3-T4) were obtained. Thirteen patients were premenopausal before RC. Of the 27 patients, 10 (37%) underwent Studor orthotopic diversion, 7 (26%) Indiana cutaneous diversion, and 10 (37%) ileal conduit diversion. A 10-item version of the self-administered Index of Female Sexual Function questionnaire was used to assess sexual dysfunction. The specific domains analyzed in the Index of Female Sexual Function include the degree of vaginal lubrication, ability to achieve orgasm, degree of pain during intercourse, overall sexual desire and interest, and overall sexual satisfaction, with responses graded on a scale of 1 (almost never, never) to 5 (almost always, always). RESULTS: With a mean follow-up of 24.2 months (range 15 to 65.1), the total mean baseline Index of Female Sexual Function score decreased from 17.4 +/- 7.23 to 10.6 +/- 6.62 after RC (P < or =0.05). The most common symptoms reported by the patients included diminished ability or inability to achieve orgasm in 12 (45%), decreased lubrication in 11 (41%), decreased sexual desire in 10 (37%), and dyspareunia in 6 patients (22%). Only 13 (48%) of the 27 patients were able to have successful vaginal intercourse, with 14 (52%) reporting decreased satisfaction in overall sexual life after RC. Eight partners (30%) had a decrease in desire for sexual activity owing to apprehension after cancer diagnosis and treatment. Although the numbers were small, the preliminary data suggested no differences in sexual function between patients undergoing Studor orthotopic diversions and those undergoing Indiana cutaneous diversions. CONCLUSIONS: Sexual dysfunction is a prevalent problem after female RC. The nature of the dysfunction involves multiple domains, including decreased orgasm, decreased lubrication, lack of sexual desire, and dyspareunia. Our early results suggest that the type of continent diversion does not affect sexual function. Surgical modifications such as urethral and vaginal sparing, neurovascular preservation, and tubular vaginal reconstruction sparing may improve female sexual function after RC.

Carcinoma, Transitional Cell↗
PubMed2005

Impact of vaginal surgery for stress urinary incontinence on female sexual function: is the use of polypropylene mesh detrimental?

OBJECTIVES: To evaluate prospectively the impact of a distal urethral polypropylene sling on sexual function using a validated questionnaire. Suburethral slings are currently the most common anti-incontinence surgery performed. Although the use of polypropylene is safe and effective, concern exists that the presence of the material in the vagina may adversely affect sexual function. METHODS: A total of 29 patients agreed to participate in this prospective study. The patients were evaluated with the Female Sexual Function Index, a validated, 19-item questionnaire that assesses six domains of sexual function: desire, arousal, lubrication, orgasm, satisfaction, and pain. The questionnaires were administered at 6-month intervals during the follow-up visits. RESULTS: The mean patient age was 52 years (range 38 to 72). The mean duration of follow-up was 19.4 months (range 7 to 37). No statistically significant difference was found in sexual function after placement of a distal urethral polypropylene sling. Of the 29 patients, 14% were not sexually active before or after surgery. No statistically significant difference was found between preoperative and postoperative desire, arousal, lubrication, orgasm, satisfaction, and pain. CONCLUSIONS: No change was found in overall sexual function in women undergoing placement of a mid to distal polypropylene urethral sling. Specifically, neither a deleterious effect nor statistically significant improvement was found in sexual desire, arousal, lubrication, orgasm, satisfaction, or pain compared with the preoperative baseline values.

Adult↗
PubMed1976

Heart rate and blood pressure responses during sexual activity in normal males.

In order to properly advise cardiac patients in the regulation of their sexual activity, more basic physiologic information is needed concerning the cardiovascular effects of sexual intercourse. This study examined the effects of the male's position during sexual intercourse on heart rate and blood pressure responses. Eight men, 24 to 40 years of age, were studied in the privacy of the bedroom during sexual activity with their wives. The ECG was monitored continuously by portable tape recorder and the arm blood pressure (BP) was measured intermittently with an automatically inflated cuff and ultrasonic detector device controlled by the subject. A total of 35 episodes of sexual intercourse were monitored; 16 were with the male-on-top (MOT) and 19 were in the male-on-bottom (MOB) position. The mean maximal heart rate (HR) for MOT at orgasm was 114 compared to 117 in the MOB position, representing 61 per cent of predicted maximal HR for men in the 20 to 29 age group. Mean BP at orgasm in the MOT was 163/81 and 161/77 in the MOB position. The differences in mean HR, BP, and pressure rate product (PRP) were not statistically significant with regard to position at rest intromission, orgasm, or during the recovery period. This study indicates no difference in the heart rate and BP responses of the male during sexual intercourse in two different positions. There is, therefore, no physiologic basis for advising cardiac patients to utilize the MOB position during sexual intercourse.

Blood Pressure↗
PubMed1985

Sexual function and female radical cystectomy: a case series.

We interviewed 9 sexually active women about sexual function before and after radical cystectomy. Of the women 6 also had received preoperative irradiation. Seven women resumed sexual activity. All subjects experienced dyspareunia on initial attempts but 6 had overcome the pain at followup 6 to 37 months postoperatively. These women were coitally orgasmic and reported no decrease in pleasure or change in the type of sexual stimulation required to produce orgasm. The results provide knowledge about the physiology of female orgasm and a basis for counseling patients.

Adult↗
PubMed2002

[Local investigation concerning psychic and sexual functioning a short time after hysterectomy].

UNLABELLED: Hysterectomy is one of the most common operations done throughout the world. Patients' concerns about sexual functioning after hysterectomy is great. OBJECTIVE: We wanted to evaluate, through a local investigation based on a questionnaire, the psychosexual impact of this operation and to compare our data to those available in the literature. PATIENTS AND METHODS: 534 patients operated between of 01.01.1997 and 31.12.1997 for a benign uterine pathology (prolapse excluded) were included. Questions were about sexual and psychological functioning after hysterectomy. The main outcome measures were changes in the sexual life, sexual desire, orgasm, dyspareunia, frequency of sexual relations. Abdominal and vaginal surgical approaches were compared for some items when possible. RESULTS: After the operation, 83.3% of the patients felt better, 30.4% of the patients mentioned changes in their sexual life, 32% of low libido rates was noticed (and there was a significant difference between abdominal and vaginal surgical approaches), 27.6% of the patients had less frequent orgasm and only 8.8% experienced orgasm more frequently, 15% suffer from dyspareunia, and 15% were more engaged in sexual intercourse. CONCLUSION: Psychosexual impact of hysterectomy is limited and is not more frequent when vaginal surgery is performed, but pre- and post-operative prevention can be useful.

Adult↗
PubMed2002

The clinical relevance of sex hormone levels and sexual activity in the ageing male.

OBJECTIVES: To assess the changes in sex hormone levels with age and the relationship of sexual functioning to testosterone levels, evaluating serum testosterone levels and erectile function in men with lower urinary tract symptoms (LUTS). PATIENTS AND METHODS: The study included 213 men with LUTS (age range 31-78 years) who had no confirmed erectile dysfunction. Their serum total and free testosterone, and sex-hormone binding globulin (SHBG) levels were measured, and they completed the International Index of Erectile Function (IIEF) questionnaire. RESULTS: The total and free testosterone levels decreased and SHBG increased with age, but only the change in free testosterone and SHBG were statistically significant. The correlation with age was closer for free testosterone (r = - 0.356, P < 0.001) than for SHBG (r = 0.177, P = 0.010). Regression analysis of the five domain scores of the IIEF and three hormonal levels, after correcting for age, showed that free testosterone level was significantly correlated with erectile function (r = 0.2136, P = 0.005) and orgasmic function (r = 0.179, P = 0.020), but SHBG levels were significantly correlated only with orgasmic function (r = - 0.154, P = 0.046). Total testosterone levels showed no significant correlation with any of the five domains of the IIEF. CONCLUSIONS: Of the sex hormone levels, the change in free testosterone correlated most closely with ageing and had the closest correlation with sexual activity. Contrary to previous reports, free testosterone and SHBG levels were significantly correlated with orgasmic function and/or erectile function rather than sexual desire. A complete study of sex hormone levels is needed to evaluate patients with erectile dysfunction.

Adult↗
PubMedDate not supplied

The assessment of sexual functions in women with male partners complaining of erectile dysfunction: does treatment of male sexual dysfunction improve female partner's sexual functions?

The aims of this prospective study were to compare sexual functioning between women with male partners who have erectile dysfunction (ED) and women without partners with ED and also to investigate the effect of the treatment of male ED on female partner's sexual function. The study included 87 women and their male partners. We divided the women into two groups: 38 women with male partners complaining of ED (ED group) and 49 women with male partners who have no ED (control group). Of the men with ED, 30 were treated with penile prosthesis implantation (n = 17) or oral sildenafil citrate (n = 13). We evaluated all the men with the International Index of Erectile Function (IIEF; Rosen, Cappelleri, Smith, Lipsky, & Pena, 1999), physical examination, and color penile Doppler ultrasound. We evaluated female sexual function with the Female Sexual Function Index (FSFI; Rosen et al., 2000) to assess sexual desire, arousal, lubrication, orgasm, satisfaction, and pain. We compared female sexual function scores between the women of the male partners with and without ED and also compared before both groups and after the treatment of male partners in the ED group. Additionally, we compare the scores according to the type of treatment given to the male partners. Sexual arousal (p = 0.009), lubrication (p = 0.001), orgasm (p = 0.006), satisfaction (p = 0.000), pain (p = 0.039), and total score (p = 0.003) were highly significantly lower in the ED group than in the control group, although sexual desire did not differ between the two groups (p = 0.515). We investigated the effect of male ED on female sexual functions and found no statistically significant differences in the presence of organic type impotence, older age, and lower erection scores on the IIEF (p = 0.53, p = 0.15, and p = 0.1, respectively). After the treatment of male ED, we observed significant improvement in sexual arousal (p = 0.001), lubrication (p = 0.002), orgasm (p = 0.000), satisfaction (p = 0.000), and pain (p = 0.002) in the women. These findings suggest that female sexual function is affected by male erection status and may improve after the treatment of male sexual dysfunction.

Adult↗
PubMedDate not supplied

The problems in sexual functions of vitiligo and chronic urticaria patients.

Skin has an erogenic function, and skin lesions can have negative impact on sexual life and relationships with others. We compared fifty vitiligo patients and fifty chronic urticaria patients with fifty healthy controls to assess sexual functions; we used Arizona Sexual Experience Scale (ASEX; Mcgahuey, Gelenberg, Laukes, Moreno; & Delgado, 2000). Among females, sexual drive scores of the vitiligo and chronic urticaria groups were significantly lower than those of controls. Vitiligo and chronic urticaria groups experienced significantly more difficulties in sexual arousal and higher failure in attaining and maintaining the lubrication-swelling response of sexual excitement until the completion of sexual act than did controls. Females in the vitiligo and chronic urticaria patient groups had more difficulties in reaching orgasm than did healthy controls. Furthermore, satisfaction from orgasm of the patient groups was significantly less than controls. The total scores of the ASEX in female patient groups were significantly higher than those among controls. Satisfaction from orgasm in male patient group was less than controls. In males, other subitems of ASEX between the patient groups and controls were not significant. This study demonstrated that chronic skin diseases such as vitiligo and chronic urticaria have negative impacts on sexual life.

Adult↗
PubMed1982

Sex therapy and penectomy.

A 65-year-old man, having undergone a penectomy operation that spared the ejaculatory apparatus and some erotically responsive areas, experienced a spontaneous orgasm, with ejaculation, upon being touched in the perineal area during a massage. Unable to duplicate the experience, he (and later his wife) entered sex therapy, which resulted in his being able to have orgasms during lovemaking. The course of the therapy is described, as are certain issues arising from the therapy. Regaining of the man's orgasmic ability was accompanied by a striking improvement in the intrapsychic and interpersonal functioning of the couple, and this is taken to be an example of the "ripple effect" of successful sex therapy. The implications for this therapeutic approach for the rehabilitation of other penectomy patients and their spouses are discussed. Finally the question of surgical penile reconstruction in such cases is explored.

Aged↗
PubMed1983

The Grafenberg spot and female ejaculation: a review of initial hypotheses.

A controversial set of hypotheses have been proposed as an explanation for nonvulval (i.e., nonclitoral) orgasms in women. First, women have a small sensitive area in the anterior wall of the vagina (the Grafenberg spot) which seems to trigger these "deeper" orgasms. Second, stimulation of this area may be associated with ejaculatory response during orgasm. Investigation of these hypotheses was conducted under laboratory conditions in an effort to assess their validity. Eleven women, six of whom claimed to be "ejaculators," were examined by two gynecologists. Gynecologists found an area similar to other descriptions of the Grafenberg Spot in four of the 11 women. It was not found more in ejaculators than nonejaculators. Examination of the ejaculate of six women failed to detect elevated levels of prostatic acid phosphatase and the substance appeared similar in biochemical properties to urine. A number of alternative explanations for the failure to confirm the hypotheses are offered.

Acid Phosphatase↗
PubMed1984

Vaginal erotic sensitivity.

Vaginal erotic sensitivity was investigated in a group of 48 coitally experienced volunteers by means of systematic digital stimulation of both vaginal walls. It was found that 45 subjects reported erotic sensitivity located in most cases on the upper anterior wall, and of those, 30 (66.7%) either reached orgasm or requested to stop stimulation short of orgasm. This study supports previous findings indicating that the vagina of most women has a zone (or zones) of erotic sensitivity whose appropriate stimulation can lead to orgasm; it does not support, however, the particular location and characteristics of the vaginal erogenous zone described by other authors.

Adult↗
PubMed2004

A double-blind randomized placebo control study comparing the objective and subjective changes in female sexual response using sublingual apomorphine.

INTRODUCTION: Female sexual dysfunction and its therapeutic approach is a growing area. AIM: We aimed to assess the subjective and objective changes of the female sexual response, in patients with orgasmic sexual dysfunction using 3 mg SL Apomorphine (APO). METHODS: Twenty-four patients (mean age 32 years old, SD: 9.69) were included in a prospective randomized cross-over protocol. Sexual response was evaluated objectively (duplex ultrasound) and subjectively (self-reported questionnaire) following vibrator stimuli with the addition of 3 mg SL APO or placebo. MAIN OUTCOME MEASURE: Sexual response objective (PSV, EDV, RI) and subjective (arousal and lubrication degree and orgasm achievement). Adverse events were also recorded. RESULTS: Clitoral hemodynamical changes, particularly peak systolic velocity (PSV), were significantly higher with APO (P = 0.003), mean increase of PSV poststimulus was 72.50% with placebo (from 9.7 cm/second to 17.0 cm/second) and 139.14% with APO (from 9.7 cm/second to 21.4 cm/second). SUBJECTIVE CHANGES (AROUSAL AND LUBRICATION) WERE ALSO SIGNIFICATIVE WITH APO (P < 0.05). CONCLUSION: According to our observations, APO seemed to produce more subjective and objective changes in the sexual arousal phase of women with orgasmic sexual dysfunction than placebo. Future research is needed to evaluate the place of this drug in the treatment of the female sexual dysfunction.

Administration, Sublingual↗
PubMed1987

Effect of bromocriptine on affect and libido in hyperprolactinemia.

Six women with primary hyperprolactinemia (mean prolactin level, 50 ng/ml) were matched with six normal women on eight factors influencing life style. Observers blind to endocrine status followed the subjects weekly for 10 weeks. Patients took bromocriptine, 2.5 mg twice daily, or placebo in a randomized double-blind sequence with crossover at 5 weeks. The mean Hamilton score for the patients was compatible with mild depression and higher than that for normal subjects during placebo but not during bromocriptine treatment. Libido was similar in both groups during placebo and bromocriptine. The mean number of orgasms reported per day was lower in patients than in normal subjects during both treatment conditions, although one patient reported orgasms during drug treatment only. Hyperprolactinemia in women may be associated with mild depression and a decrease in orgasmic frequency.

Adult↗
PubMed1997

Sexual functioning in chronically depressed patients treated with SSRI antidepressants: a pilot study.

OBJECTIVE: This prospective study assessed changes in depression and sexual functioning in chronically depressed men and women during treatment with selective serotonin reuptake inhibitors (SSRIs). METHOD: Twenty-five subjects (14 women, 11 men) with DSM-III-R dysthymia, chronic major depression, or double depression were administered the Arizona Sexual Experience Scale and the Hamilton Depression Rating Scale before and after 6 weeks of treatment with sertraline or paroxetine. RESULTS: As measured by scores on the Arizona Sexual Experience Scale, desire, psychological arousal, and overall sexual functioning significantly improved in women; orgasm delay, orgasm satisfaction, and overall sexual functioning significantly worsened in men. CONCLUSIONS: This study suggests that after SSRI treatment, difficulties with desire and psychological arousal in depressed women tend to remit, whereas in men orgasmic dysfunction appears to be a side effect to medication.

Adult↗
PubMed1993

Effect of frequently prescribed cardiovascular medications on sexual function: a pilot study.

OBJECTIVE: To determine the effect on male sexual function of initiating any one of the cardiovascular medications most frequently prescribed at our institution. DESIGN: Men were surveyed via telephone when they received a new prescription for hydrochlorothiazide, furosemide, lisinopril, verapamil, nifedipine, or diltiazem, and after 30 days of daily medication ingestion. To assess Hawthorne effect, men who had no change to their medication regimen also were surveyed at the time of medication refill for maintenance therapy and 30 days later. PARTICIPANTS: Community-dwelling male veterans who received a single new prescription between January 1 and April 1, 1992 (n = 134). MAIN OUTCOME MEASURES: Responses to questions about sexual interest, erectile function, orgasmic ability, and sexual satisfaction. RESULTS: Men who had no change to their medication regimen showed no change in sexual interest, erectile function, orgasmic ability, or satisfaction. Hydrochlorothiazide was associated with decreased orgasmic ability (p = 0.008). Although none of the other changes were statistically significant (p < 0.05), both nifedipine and diltiazem showed a trend toward improved sexual function. CONCLUSIONS: Hydrochlorothiazide may be associated with anorgasmia. More study is needed to determine if nifedipine and diltiazem improve erectile function. Furosemide, lisinopril, and verapamil likely have no effect on sexual function.

Cardiovascular Agents↗
PubMed1987

Plasma oxytocin increases in the human sexual response.

The purpose of this study was to determine whether plasma oxytocin (OT) levels change during human sexual responses and, if so, to demonstrate the temporal pattern of change. Plasma OT levels were measured by RIA before, during, and after private self-stimulation to orgasm in normal men (n = 9) and women (n = 13). Blood samples were collected continuously through indwelling venous catheters. The subjects pressed a signal to indicate the start and finish of orgasm/ejaculation. Objective assessment of sexual arousal and orgasm was obtained by measuring blood-pulse amplitude and electromyographic activity, recorded continuously throughout testing from an anal device containing a photoplethysmograph and electromyograph electrodes connected to a polygraph located in an adjacent room. These measures allowed collection of data from men and women of changes in blood flow and muscle activity in the lower pelvic/pubic area. Plasma OT levels increased during sexual arousal in both women and men and were significantly higher during orgasm/ejaculation than during prior baseline testing. We suggest that the temporal pattern of secretion could be related to smooth muscle contractions of the reproductive system during orgasm.

Adult↗