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PubMed1984

A review of female ejaculation and the Grafenberg spot.

A review of recent works related to the concept of female ejaculation, defined as a partial, infertile homologue to male ejaculation, indicated that we have insufficient evidence to accept or reject the concept on scientific grounds. The claim that "female ejaculate" is similar to semen from a vasectomized male is without foundation. Although recent discussion of female ejaculation has tended to focus on whether or not the fluid sometimes expelled from the urethra upon orgasm is invariably urine, the Bartholin's glands are another potential source of orgasmic expulsions which could properly be called "female ejaculate." "Grafenberg spot" is a neologism referring to an area which some women report is erotically sensitive when massaged via the anterior vaginal wall. "Urethral sponge" is another term which seems to refer to this anatomical/phenomenological reality. The relationship between stimulation of this area and subsequent orgasmic expulsion has yet to be studied systematically.

Acid Phosphatase↗
PubMed1986

Subjective perceptions to the intravenous "rush" of heroin and cocaine in opioid addicts.

Subjective responses to intravenous heroin and cocaine administration were investigated by questionnaire in a population of 40 male and 29 female confirmed heroin addicts. Responses of males and females were very similar for the heroin rush, ranking pleasure, relaxation, satisfaction, warmth, and thirst highest among 20 feelings surveyed and ranking feelings like sexual orgasm low, only fifteenth out of 20. Responses of males and females for the cocaine rush were similar in that both ranked excitement, pleasure, thirst, strength, and anxiety very high, in the top six responses, and both rated feelings like sexual orgasm relatively low, rank 9 for males and 15 for females. However, male and female responses for cocaine differed in that males ranked power very high, rank 2; and females ranked power relatively low, rank 10; but ranked satisfaction, rank 5; warmth, rank 5; and relaxation, rank 12; much higher than males who ranked them 15, 16, and 17, respectively. Despite the fact that sexual feelings were infrequently identified with rushes, the results best supported an interpretation that the population was largely inorgasmic without drugs, but found attractive orgasmic pleasure in heroin and cocaine. Males and females perceived the cocaine rush differently, but the reason of these differences is uncertain.

Adult↗
PubMed1977

Marital sexual dysfunction: female dysfunctions.

The diagnosis, treatment, and referral of married women with sexual dysfunctions require information about the current physiologic deficit, previous sexual capacity, level of sexual desire, masturbatory experience, means of orgasmic attainment, preferred sexual partner, quality of marriage, husband's sexual capacities, and method of contraception. For classification purposes, the three basic physiologic deficits--excitement phase dysfunction, orgasmic phase dysfunction, and vaginismus--are subdivided into primary and secondary types. Primary dysfunctions represent longstanding developmental problems and are usually purely psychological in origin. Secondary dysfunctions occur after a period of normal sexual functioning and may be organic or psychological in origin. The actual determinants of dysfunctions are not well understood, but those factors commonly associated are discussed. The lack of knowledge about the nature of sexual desire, prevalence of dysfunctions, and significance of the inability to attain orgasm with coitus is emphasized. The physician's role in giving advice and treatment is defined.

Adult↗
PubMed2005

[Primary headache associated with sexual activity].

Benign coital headache is known as a rare type of primary headache related to sexual activity. The pathogenesis of this type of headache remains unknown. Clinical manifestation is typical and connected with three phases of sexual activity. Coital cephalalgia is divided into two subtypes: preorgasmic and orgasmic headache. Some authors specifie the third type--postural type. Preorgasmic headache starts as a dull bilateral ache and increases with sexual excitement. Orgasmic headache has sudden, intense character and occurs at orgasm. Postural headache has been reported to develop after coitus. The author describes four cases of different types of sexual headache, which were effectively treated. Indomethacin was effective in all patients as direct treatment and propranolol was effective in patients to whom it was administrated as preventive treatment.

Adult↗
PubMed2005

[Anorgasmy prevalence in women attended at Familiar Medicine Unit no. 1 in Obregon, Sonora, Mexico].

OBJECTIVE: To estimate the prevalence of anorgasmy in women. PATIENTS AND METHODS: An observational, descriptive and transversal study was done from August 2002 to January 2003 surveying women with sexual activity in a clinic of the Mexican Institute of Social Security in Obregon, Sonora. The questionnaire was validated by the UNAM. The analyzed variables were: age, scholar degree, the age in which women started sexual activity, number of children, marital status, the number of sexual partners, pleasure to sex for the women, satisfaction and feeling like doing sex, who decides and begins to do sex, frequency of sexual intercourse, knowledge about orgasm and one's own experience, as well as psychosomatic symptoms. Data were analyzed by descriptive statistics, chi square test and Likert's scale. RESULTS: Seventy-three women were surveyed, with ages between 16 and 46 years. Anorgasmy frequency was of 6.8%; 53.4% of the women had secondary education and 37% superior education. Time of active sexual life varied between 1 and 30 years; the knowledge about orgasm was of 74%. CONCLUSIONS: The orgasmic dysfunction is lower in this region than that reported in the bibliography, this could be due to the greater scholar degree of women, social and cultural issues, and the women's independence. Nevertheless, the health team must be qualified to detect and treat it, in order to avoid complications.

Adolescent↗
PubMed1982

Reported sexual behavior in late pregnancy. Selected associations.

The time intervals prior to delivery both for the last reported sexual intercourse and for the last reported orgasm were considered in terms of several variables in 413 puerperas. Although there were no significant differences in the reported time of last intercourse in terms of any of the demographic factors studied, orgasm in the absence of intercourse (reported events within seven days of delivery) was relatively more common and intercourse in the absence of orgasm relatively less common in study subjects with more years of formal education (p less than 0.01). Reported sexual behavior did not differ in respect to the length of gestation at delivery, selected pregnancy complications or the immediate condition of the newborn.

Coitus↗
PubMed1995

[First sexual intercourse in women].

Out of a group of 700 Czech girls aged 16 to 18 years questioned by means of interviews 344 (49.1%) already had their first heterosexual coitus. Thirty-three of them reached orgasm during their first sexual intercourse and during second and further intercourses they were orgasmic mostly or always. The second subgroup comprised 32 girls who were anorgasmic not only during their first sexual intercourse but also during their further sexual life. Statistically significant differences between these two subgroups were found in the following items: Orgasmic girls were more frequently longing for their first sexual intercourse whereas of the anorgasmic girls the motives were curiosity or the effort to satisfy their partners. The majority of these girls experienced the first sexual intercourse as unpleasant and reported frequent occurrence of bleeding. Furthermore, they had to regret more frequently the loss of their fathers during the first 6 years of their lives than the girls of the first subgroup had.

Adolescent↗
PubMed1990

The role of anxiety in premature ejaculation: a psychophysiological model.

Despite the prevalence of premature ejaculation and the success in its treatment, researchers have yet to offer a compelling, empirically based theory regarding its nature or etiology. This study explored a model that argues that anxiety may not be necessary for the existence of this dysfunction. Fifteen premature ejaculators (PEs) and 17 nonpremature ejaculators (NPEs) engaged in self-stimulation to orgasm both in the laboratory and at home. The following specific hypotheses were tested: Compared to NPEs, PEs would demonstrate (i) shorter orgasmic latencies, both in the lab and at home, and (ii) equally accurate estimates of these latencies. Results offered strong support for both hypotheses. These findings, and those derived from a questionnaire completed by subjects, were seen as consistent with a psychophysiologic model of premature ejaculation. According to this model, the role of anxiety is seen as variable, interacting with the somatic vulnerability of the individual to determine orgasmic latency.

Adult↗
PubMed1990

Incidence and prevalence of the sexual dysfunctions: a critical review of the empirical literature.

The research which has assessed the incidence and prevalence of sexual dysfunctions is reviewed. Twenty-three studies are evaluated. Studies completed with community samples indicate a current prevalence of 5-10% for inhibited female orgasm, 4-9% for male erectile disorder, 4-10% for inhibited male orgasm, and 36-38% for premature ejaculation. Stable community estimates with regard to the current prevalence of female sexual arousal disorder, vaginismus, and dyspareunia are not available. Recent studies completed with clinical samples suggest an increase in the frequency of orgasmic and erectile dysfunction and a decrease in premature ejaculation as presenting problems. Desire disorders have increased as presenting problems in sex clinics, with recent data indicating that males outnumber females. Methodological limitations of these studies are identified and suggestions for future research are offered.

Cross-Sectional Studies↗
PubMed1995

Social and sexual function following ileal pouch-anal anastomosis.

PURPOSE: Patients who undergo surgery for ulcerative colitis are usually young and active. When surgery becomes necessary, their future social and sexual function is of major concern. This study was performed to be able to give more detailed information of what is to be expected. METHODS: Forty-nine consecutive patients (26 men and 23 women) who underwent ileal J-pouch-anal anastomosis for ulcerative colitis between November 1983 and September 1986 in the authors' institution were personally interviewed regarding details of their preoperative and postoperative social and sexual functions. RESULTS: Eighty-eight percent had reduced capacity to work preoperatively compared with 6 percent postoperatively. Thirty-one percent resumed work in the period with diverting ileostomy. Leisure time activities were reduced in 47 percent preoperatively, whereas 6 percent had limitations postoperatively. In 35 percent of women, frequency of intercourse was increased postoperatively, and none reported a decreased frequency. None of the women who were able to achieve orgasm preoperatively reported a postoperative disturbance of this ability, and 16 percent experienced an increased quality of orgasm. Postoperatively none reported dyspareunia, vaginal discharge, or changes in their menstrual cycle. Frequency of intercourse and ability to achieve orgasm remained unchanged for the majority of men; however, one developed erectile dysfunction, and one complained of retrograde ejaculation. Sexual activity in men was less affected by the presence of an ileostomy, and 69 percent had intercourse in the period with ileostomy compared with 30 percent of women. None of the patients complained of anal pain, soiling, or fecal leakage during intercourse, but one women reported some discomfort from the pouch during intercourse. None of the patients wanted to return to a life with an ileostomy. CONCLUSION: The social and sexual function, quality of life, after ileal J-pouch anastomosis is improved when compared with the period with ulcerative colitis and the time with diverting ileostomy. In men, however, a frequency of sexual dysfunction similar to what is seen after proctectomy for benign diseases should be underlined.

Adolescent↗
PubMedDate not supplied

Sexual function of women taking antihypertensive agents: a comparative study.

OBJECTIVE: To develop a method to evaluate the effects of clonidine and prazosin on sexual function in hypertensive women. DESIGN: Crossover, active-drug controlled pilot study. SETTING: Community recruitment to a university-based teaching hospital. PATIENTS: Ten premenopausal and eight postmenopausal women with mild hypertension and unimpaired sexual function. INTERVENTION: Periodic, self-administered daily diaries assessed the sexual arousal and desire and orgasmic function of women receiving placebo, clonidine, and prazosin. MEASUREMENTS AND MAIN RESULTS: Using analysis of variance for orgasmic characteristics and comparison of the percentages of yes responses to the sexual function questions, no significant difference in the levels of sexual function of women receiving placebo, clonidine, and prazosin was found. However, there was a suggestion that clonidine and prazosin affected some aspects of sexual function. Of the women who received clonidine first, fewer were receptive to partner approach during medication therapy (49%) than during placebo (61%). Fewer women wished for their partners to approach them (WISH) during therapy (41% and 53% for clonidine and prazosin, respectively) than during placebo (60%). In the group that received prazosin first, WISH was affected (32% for prazosin, 31% for clonidine, 45% for placebo). Orgasmic strength increased from 2.1 on placebo to 2.7 on clonidine (second medication), measured on a four-point Likert scale. CONCLUSIONS: This pilot study developed a method using self-administered daily diaries for evaluating the effects of antihypertensive agents on sexual function in hypertensive women. These potential effects need to be evaluated in larger studies.

Analysis of Variance↗
PubMed2002

Assessment of sexual and voiding function after total mesorectal excision with pelvic autonomic nerve preservation in males with rectal cancer.

PURPOSE: Total mesorectal excision with pelvic autonomic nerve preservation has been reported to be an optimal surgery for rectal cancer. It minimizes local recurrence and sexual and urinary dysfunction. The aim of this study was to assess the safety of total mesorectal excision with pelvic autonomic nerve preservation in terms of voiding and sexual function in males with rectal cancer. METHODS: We performed urine flowmetry using Urodyn and a standard questionnaire using the International Index of Erectile Function and the International Prostate Symptom Score before and after surgery in 68 males with rectal cancer. RESULTS: Significant differences in mean maximal urinary flow rate and voided volume were seen before and after surgery (18.9 +/- 5.7 13.7 +/- 7.0, 240 +/- 91.9 143 +/- 78; < 0.05, < 0.05, respectively), but no differences in residual volume before and after surgery were apparent (4.4 +/- 2.6 8.1 +/- 4.4; > 0.05). The total International Prostate Symptom Score was increased after surgery from 6.2 +/- 5.8 to 9.8 +/- 5.9 ( < 0.05). There were no changes of score for one of each of seven International Prostate Symptom Score items in 49 patients (73.5 percent) to 61 patients (89.7 percent). Five International Index of Erectile Function domain scores (erectile function, intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction) were significantly decreased after surgery (18.2 +/- 9.3 13.5 +/- 9, 8.4 +/- 4.2 4.4 +/- 2.9, 5.8 +/- 2.9 4.4 +/- 2.9, 6.1 +/- 2.4 4.8 +/- 2, 6.1 +/- 2.2 4.5 +/- 2.3, respectively; < 0.05). Erection was possible in 55 patients (80.9 percent); penetration ability was possible in 51 patients (75 percent). Complete inability for erection and intercourse was observed in three patients (5.5 percent). Retrograde ejaculation was noted in 9 patients (13.2 percent). International Index of Erectile Function domains such as sexual desire and overall satisfaction were greatly decreased in 39 patients (57.4 percent) and 43 patients (63.2 percent), respectively. Multiple regression analysis of factors affecting postoperative sexual dysfunction showed that age older than 60 years (sexual desire, P = 0.019), within six months (erectile function, P = 0.04; intercourse satisfaction, P = 0.011; orgasmic function, P = 0.03), lower rectal cancer (erectile function, P = 0.02; intercourse satisfaction, P = 0.036; orgasmic function, P = 0.027) were significant factors adversely affecting sexual function. CONCLUSION: Total mesorectal excision with pelvic autonomic nerve preservation showed relative safety in preserving sexual and voiding function. The International Prostate Symptom Score and International Index of Erectile Function questionnaires were useful in assessing urinary and sexual function.

Adult↗
PubMed2004

Sexual dysfunction is common in women with lower urinary tract symptoms and urinary incontinence: results of a cross-sectional study.

OBJECTIVE: The aim of this study was to determine the prevalence of sexual dysfunctions in women with urinary incontinence and/or lower urinary tract symptoms as compared to a general female population. METHODS: We extensively evaluated 227 consecutive women (mean age 52; age range 19-66) complaining of urinary incontinence (UI) and/or lower urinary tract symptoms (LUTS) with a comprehensive history (including several validated questionnaires), a complete physical examination and a urodynamic multichannel evaluation. Two hundred and sixteen patients were eligible for sexual function investigation because 11 out of 227 (5%) were not interested in dealing with questions regarding their own sexuality and were thus excluded from the final evaluation results. A group of 102 age-matched women (mean age 54; age range 19-63) assessed for a yearly routine gynaecological evaluation and not complaining of urinary symptoms were enrolled as cross-sectional controls and investigated in accordance with the Female Sexual Function Index (FSFI). RESULTS: Sexual dysfunction was diagnosed in 99 out of 216 patients (46%). Of these, 34 (34%) reported hypoactive sexual desire, 23 (23%) reported sexual arousal disorder; 11 patients (11%) complained of orgasmic deficiency, and 44 (44%) suffered from sexual pain disorder (e.g., dyspareunia or non-coital genital pain). Women reporting low sexual desire commonly suffered from stress incontinence (47%). We found that 60% of the women with sexual arousal disorders and 61% of those with sexual pain disorders also complained of recurrent bacterial cystitis. Forty-six percent of those complaining of orgasmic phase difficulties also reported a troublesome urge incontinence. The FSFI values in both groups scored as follows (patients versus controls; median value; p value): desire: 2.0 vs. 3.2 (p<0.01); arousal: 2.8 vs. 3.6 (p=n.s.); lubrication: 3.2 vs. 4.4 (p=0.01); orgasm: 4.1 vs. 4.4 (p=n.s.); sexual satisfaction: 2.7 vs. 4.0 (p<0.01); sexual pain: 1.8 vs. 4.0 (p<0.001). CONCLUSIONS: Women reporting UI or LUTS also complained of sexual dysfunctions in a significantly higher number than a general, healthy female population not complaining of urinary symptoms. Investigation of female sexuality is suggested for these patients.

Adult↗
PubMed2004

Female sexual dysfunction in a healthy Austrian cohort: prevalence and risk factors.

PURPOSE: Data on prevalence and risk factors for female sexual dysfunction (FSD) are rare, particularly from Europe. Aim of our study was therefore to investigate this issue in a cohort of women undergoing a health investigation. PATIENTS AND METHODS: A consecutive series of women aged 20-80 years participating in a health-screening project in Vienna underwent a detailed health investigation and completed a 23-item questionnaire on several aspects of FSD including desire, arousal, pain and orgasmic disorders. Prevalence of FSD in different age groups and risk factors for FSD were calculated. RESULTS: A total of 703 women aged 43+/-15 years entered this study. Within the total study population, 22% reported on desire disorders, 35% on arousal disorders, and 39% on orgasmic problems, all of which increased significantly with age. Pain disorders were reported by 12.8% being most frequently in the women aged 20-39 years. In women aged 60-69 years, still 50% reported having at least "occasionally" sexual desire and 30% had more than two sexual intercourses per month. In this age group, 50% stated that a healthy sexual life is at least moderately important to them. Apart from age few risk factors for FSD were identified. Sportive activity was the only correlate to desire- and arousal disorders, psychological stress for orgasmic disorders. CONCLUSIONS: This study provides insights into age-specific changes of FSD in apparently healthy women. The importance of this subject is underlined by the high prevalence of FSD particularly in the elderly paralleled by a persisting interest in sexual activity.

Adult↗
PubMedDate not supplied

Prospective assessment of sexual function in women treated for recurrent major depression.

Although multiple factors may influence the sexual function of depressed women over the course of treatment, the independent contributions of these factors are poorly understood. The current study examined the effects of depression, SSRI treatment, and sexual partner availability on women's sexual function. The sexual function of 68 recurrently depressed women was assessed at 3-month intervals over a 1-year course of treatment with interpersonal psychotherapy with or without adjunctive SSRI treatment. Random regression models assessing changes in sexual function were conducted to test the effects of three time-dependent covariates: depression symptom scores, sexual partner availability, and SSRI medication status. Controlling for the other variables, depressive symptoms were associated with decrements in sexual desire, sexual cognition/fantasy, sexual arousal, orgasmic function, and global evaluations of sexual function. SSRI treatment was associated with orgasmic difficulty only. The availability of a sexual partner was associated with increased sexual arousal, orgasmic function, and sexual behavior. Among treatment remitters, patient reports of severe sexual dysfunction did not change over the course of treatment, although mild improvement was observed in patients' global assessment of the quality of their sexual function. This report illustrates the prevalence and persistence of sexual dysfunction in this sample, and highlights the importance of monitoring both pharmacologic and psychosocial variables that can affect the sexual function of recurrently depressed women throughout the course of treatment.

Adult↗
PubMed2005

Treatment with percutanous testosterone gel in postmenopausal women with decreased libido--effects on sexuality and psychological general well-being.

OBJECTIVES: To elucidate if percutanous treatment with 10mg testosterone per day could enhance sexuality and psychological well-being in postmenopausal women presenting problems with low libido. Secondary to study the influence on blood lipids, hemoglobin and erythropoietin levels. METHODS: Fifty-three postmenopausal women participated. As a complement to their already on-going HRT, 10mg of a testosterone gel (Testogel, Besins-Iscovesco) or placebo was administered. Treatment continued for three plus three months in a double blind, randomized, crossover design. RESULTS: The scores concerning "frequency of sexual activity, orgasm and intercourse", "sexual arousal, fantasies and enjoyment", "satisfaction with orgasms", and "interest in sex" were all significally improved for testosterone addition as compared to placebo both before and after crossover. Testosterone levels increased more than 10-fold during treatment while DHT-levels were more than doubled. Estrogen levels were not affected during the addition of testosterone. Liver enzymes, total cholesterol, triglycerides, HDL and LDL revealed no significant differences between any of the periods or groups. Endometrial thickness did not change significantly during treatment. Hemoglobin and erythropoietin remained unchanged. No significant differences in the number of experienced side effects were found. CONCLUSION: Testosterone gel of 10mg had positive effects on several aspects of sexual life such as frequency of sexual activity, orgasm, arousal, fantasies and sexual interest in postmenopausal women on HRT. Several psychological variables were positively influenced. The given dose resulted in too high serum levels. Even if no negative effects were observed, monitoring of serum levels and a decreased dose should be considered in future studies.

Administration, Cutaneous↗
PubMedDate not supplied

Classification of sexual dysfunctions: towards DSM-V and ICD-11.

This article reports on the changes in the classification of sexual dysfunctions since DSM-III, and on the results of the efforts to make these disorders compatible in DSM-IV and ICD-10. A comparison is made between the ways in which sexual dysfunctions are conceptualized in DSM-III, DSM-III-R, DSM-IV, and ICD-10. Special attention is given to the extent to which: (1) in the diagnostic criteria due weight is given to the physiological and psychological aspects, and to the different phases of the sexual response cycle; and (2) these disorders apply to people of different sexes and sexual orientations, and to problems arising while using different sexual techniques. After publication of DSM-III, the classification of sexual dysfunctions has evolved considerably. Moreover, there are still important differences between DSM-IV and ICD-10. Suggestions for DSM-V and ICD-11 are (among others): (1) introduction of excessive (hyperactive) sexual desire in addition to diminished (hypoactive) sexual desire; (2) differentiation between genital arousal disorder and sexual excitement disorder; and (3) differentiation between orgasmic disorder, anhedonic orgasm, ejaculation disorder, and premature orgasm.

Female↗
PubMed2006

Sexual function following bowel vaginoplasty.

PURPOSE: We review our 23-year experience with bowel vaginoplasty, with particular attention to postoperative quality of life and sexual function. MATERIALS AND METHODS: We reviewed the records of 57 patients who underwent bowel replacement vaginoplasty between 1980 and 2004. A total of 42 patients had the Mayer-Rokitansky syndrome, of whom 6 had varying forms of intersexuality, 6 had undergone surgery for pelvic malignancy, 1 had aphallia, 1 had cloacal exstrophy and 1 was the survivor of a conjoined twin separation. Replacement vaginoplasty was done using sigmoid colon in 39 patients, ileum in 9 and cecum in 9. Followup ranged from 18 months to 24 years, with a mean of 8.8 years. Outcome was evaluated by retrospective chart review, and the FSDQ, a validated, IRB approved instrument, was used to evaluate postoperative sexual function. RESULTS: Among the 57 patients postoperative sexual function was evaluated in 44, 9 were lost to followup and 4 were considered too young for evaluation. Of the 44 patients 36 responded to the FSDQ, 6 refused and 2 were unable to complete the questionnaire adequately. Of the 36 patients who responded 15 were married and 31 were sexually active. On a scale of 0 to 5, 28 patients (78%) reported sexual desire, 33% sexual arousal, 33% sexual confidence and 28 (78%) sexual satisfaction. In addition, 20 patients (56%) reported frequent orgasms, 8 (22%) occasional orgasms and 8 (22%) no orgasms. A total of 32 patients (89%) reported adequate lubrication for intercourse and 2 reported dyspareunia. Two of the 36 patients performed home dilation and required estrogen suppositories. A total of 34 patients used home douching and 20 required pads for mucus production. CONCLUSIONS: It appears that isolated bowel segments provided excellent tissue for vaginal replacement. For technical reasons we believe that colonic segments, particularly sigmoid, are preferable to small bowel. Sexual function following bowel vaginoplasty appears to be adequate and durable.

Adolescent↗