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PubMed2006

What can prevalence studies tell us about female sexual difficulty and dysfunction?

INTRODUCTION: Many recent studies have investigated the prevalence of female sexual difficulty/dysfunction. AIM: Investigate female sexual difficulty/dysfunction using data from prevalence studies. METHODS: We reviewed published prevalence studies excluding those that had not included each category of sexual difficulty (desire, arousal, orgasm, and pain), were based on convenience sampling, or had a response rate <50% or a sample size <100. Main Outcome Measures. For each study we used the prevalence of any sexual difficulty as the denominator and calculated the proportion of women reporting each type of difficulty. For each category of sexual difficulty we used the prevalence of that difficulty lasting 1 month or more as the denominator and calculated the proportion of difficulties lasting several months or more and 6 months or more. RESULTS: Only 11 of 1,248 studies identified met our inclusion criteria. These studies used different measures of sexual dysfunction, so generating a simple summary prevalence was not possible. However, we observed consistent patterns in the published data. Among women with any sexual difficulty, on average, 64% (range 16-75%) experienced desire difficulty, 35% (range 16- 48%) experienced orgasm difficulty, 31% (range 12-64%) experienced arousal difficulty, and 26% (range 7-58%) experienced sexual pain. Of the sexual difficulties that occurred for 1 month or more in the previous year, 62-89% persisted for at least several months and 25-28% persisted for 6 months or more. Two studies investigated distress. Only a proportion of women with sexual difficulty were distressed by it (21-67%). CONCLUSIONS: Desire difficulty is the most common sexual difficulty experienced by women. While the majority of difficulties last for less than 6 months, up to a third persist for 6 months or more. Sexual difficulties do not always cause distress. Consequently, prevalence estimates will vary depending on the time frame specified by researchers and whether distress is included in these estimates.

Attitude to Health↗
PubMed1984

Hyperprolactinemia and sexual disturbances among uremic women on hemodialysis.

The investigation of a sample of 99 women on maintenance hemodialysis has shown the presence of sexual disturbances to a great extent: the rate of sexual intercourse and the ability to reach orgasm were significantly lower than in age-matched control women. 80% declared a reduction in their sexual desire and the frequency of intercourse was also lower as compared to the period prior to dialysis. Ageing decreased the sexual activity in both the ill and healthy population, but in uremic patients the sexual activity ended at an earlier age. The patients with hyperprolactinemia reported lower frequencies of intercourse and lower percentages of orgasm than normoprolactinemic ones. The incidence of sexual dysfunction and the role of hyperprolactinemia in this respect were similar to those which are found among male patients on hemodialysis.

Adult↗
PubMed1996

[Treatment of estrogen deficiency-induced sex disorders].

OBJECTIVE: Is it possible to successfully treat sexual disturbances related to an estrogen deficiency syndrome with estrogens? METHODS: For 4 months, sexual dysfunctions (loss of libido, dyspareunia, difficulties in experiencing orgasm) were treated with a transdermal system-the estrogen patch-in one group cyclically and in a second continually. Women with uterus got 1 mg/day norethisterone acetate for 12 days a month. RESULTS: By estrogen therapy alone, success was seen in 40/41% for loss of libido, in 75/56% for dyspareunia and in 47/25% for difficulties of orgasm. CONCLUSIONS: In spite of the complexity of the biopsychosocial causes of the sexual disturbances in relation with an estrogen deficiency syndrome, the replacement therapy is successful in many cases.

Administration, Cutaneous↗
PubMed1982

Sexual dysfunction and clomipramine.

Three cases of orgasmic inhibition by clomipramine are reported, one in a male and two in females. All were depressed patients with obsessive-compulsive features. Orgasmic dysfunction manifested shortly after beginning clomipramine therapy despite a return of libido as the depression lifted. Two of these patients switched to desipramine which led to a resolution of sexual dysfunction while maintaining the patients depression free. The third patient manipulated dosage times to diminish the orgastic problem. Strong anticholinergic and/or anti-adrenergic properties of clomipramine are suspected to underlie the development of this problem.

Adult↗
PubMed1985

Perceived sexual satisfaction and marital happiness of bisexual and heterosexual swinging husbands.

This study compared the sexual satisfaction and marital happiness of 50 bisexual and 50 heterosexual married male volunteers. All participants chosen were in swinging marriages. Age, length of current marriages, and socioeconomic status were matched and controlled between samples. The bisexual sample reported: (a) significantly more frequent orgasms with females, from masturbation, and from all sexual activities combined; and (b) a significantly greater incidence of orgasms from fantasies or dreams. Although both samples gave high ratings to their sexual satisfaction and marital happiness, both measures were rated significantly higher by the heterosexual males.

Adult↗
PubMed1978

An experimental investigation of preorgasmic reconditioning and postorgasmic deconditioning.

The effects of pre- and postorgasmic presentation of moderately erotic cues were assessed in an analogue study. Eight heterosexual male volunteers (18 to 23 years) participated in three assessment (baseline, termination-of-treatment, and two- to three-month followup) and eight masturbatory conditioning sessions. Three slides of nude females of initially equal erotic value were paired respectively with the plateau, refractory, and resolution phases of the subjects' sexual cycles. Over treatment, stimuli paired with the plateau phase increased significantly in penile tumescence indices of eroticism; conversely, stimuli paired with the refractory phase decreased significantly. The conditioned effects on tumescence were largely extinguished at followup. While treatment did not alter short-term subjective indices of eroticism, stimuli presented during the refractory phase were rated significantly less erotic than the other stimuli at followup. The findings suggest that the "pairing" model of orgasmic conditioning is insufficient to account for previously reported clinical findings. A broader conceptualization of the mechanisms of orgasmic conditioning, and implications for treatment are discussed.

Attention↗
PubMed1995

Female sexual side effects associated with selective serotonin reuptake inhibitors: a descriptive clinical study of 33 patients.

OBJECTIVE: After the advent of selective serotonin reuptake inhibitors on the U.S. market in 1988, American psychiatrists have been faced with more choices of antidepressants for the treatment of depression. The prescribing of SSRIs has been increasing in popularity because they are easily titrated by the physicians and tolerated by patients. However, the SSRI use is frequently associated with female sexual dysfunction. The aim of this study was to describe these SSRI-associated female sexual side effects. METHODS: In a retrospective series, clinic records of 110 female SSRI-treated outpatients were reviewed for loss of or decreased libido, orgasmic disturbances (anorgasmia or delayed orgasm), as well as clinical management patterns to alleviate sexual side effects. RESULTS: Twenty-one fluoxetine-, nine paroxetine-, and five sertraline-treated cases with female sexual inhibition were identified. The fates of SSRI-associated sexual adverse effects and clinical managements of restoring these side effects were described. CONCLUSIONS: With some limitations in interpreting the data, the findings of this study suggest that SSRI-associated female sexual dysfunction occurs at a higher rate than we previously thought, equal potentials in implicating female sexual side effects among three SSRIs, and the absence or the low incidence of female sexual adverse effects from bupropion, and that these side effects can be managed by waiting for a spontaneous remission, dosage reduction of SSRIs, substitution with bupropion and other antidepressants, or the use of an antidote.

1-Naphthylamine↗
PubMed1995

Sexual life in women after colectomy-proctomucosectomy with S-pouch.

In a consecutive series, 30 women were interviewed and gynecologically examined after pelvic pouch operation because of inflammatory bowel disease. The examination displayed: colpitis in two, bacterial vaginosis in one and cervical cancer in situ in one of the women. Unwanted infertility was reported by five women, probably due to female factors in three. Sixteen women had felt sexually unattractive by the temporary ileostomy. At follow-up, after closure of the ileostomy, 23 women experienced a considerable sexual desire, 28 could experience orgasm and 20 nearly always had orgasm at intercourse. Insufficient vaginal lubrication during intercourse was reported by seven women. This could be explained by hormonal or other factors in four women and might be owing to side-effects of the operation in three. Four women reported slight deep dyspareunia and one superficial dyspareunia. The result indicated a low frequency of sexual problems after pelvic pouch operation.

Adult↗
PubMed1985

The psychosexual histories of young women with bulimia.

While it is known that anorexia nervosa patients show a wide range of sexual knowledge, attitudes and practices, the psychosexual histories of bulimia patients have not been studied. In this paper the psychosexual histories of 20 bulimic patients and 20 matched control subjects are presented. Bulimic patients were more likely to experience orgasm with masturbation, were more likely to have experimented with anal intercourse, and were more likely to describe their libido as 'above average.' Control subjects were more likely to experience orgasm during sexual intercourse. Bulimic patients associated high body weights with unattractiveness, and tended to withdraw from social and sexual activity at high weights. In other aspects of their sexual behaviour, and in their attitudes to sexual matters, the two groups were similar.

Adolescent↗
PubMed1975

Sexual functioning in women with spinal cord injury.

The literature on women with spinal cord injury deals primarily with the factors of hormonal function, fertility and delivery. Unfortunately, information is limited concerning issues which are relevant to the total sexual functioning of these women. Little is known about potential hazards of contraceptives, the incidence of gynecological problems, the reactivity of vagina and external genitalia during sexual excitement, the nature of orgasmic experience, factors leading to orgasm and responsivity of nongenital erogenous zones. Sociocultural restrictions on vomen's sexual responsivity and willingness to discuss such issues are considered along with areas for future research, The authors emphasize the need to consider the totality of sexual functioning in future research and the need for women professionals to join research teams on this topic.

Coitus↗
PubMed2001

Evaluation of male sexual function by the International Index of Erectile Function after deep dorsal vein arterialization of the penis.

PURPOSE: The objective of vascular surgery for erectile dysfunction is to provide long-term improvement of erectile function. We evaluated that claim after deep dorsal vein arterialization by a cross-sectional study of multifaceted male sexual function with the validated International Index of Erectile Function (IIEF). MATERIALS AND METHODS: We performed a mail survey of male sexual function after deep dorsal vein arterialization in 68 consecutive literate men who underwent surgery between 1984 and 1998 for severe erectile dysfunction. The IIEF questionnaire and a questionnaire on patient characteristics were answered in a self-administered and nominative manner. Scores of the responders pertaining to the 5 domains of male sexuality were compared with those of the control groups used for the psychometric validation of the IIEF. RESULTS: Of the patients 38 (55.9%) with a mean age plus or minus standard deviation of 46.5 +/- 11.9 years responded. Mean followup was 61.2 +/- 34.7 months. Compared to controls with erectile dysfunction controls men who underwent deep dorsal vein penile arterialization had significantly higher scores for erectile function, sexual desire, orgasmic function, intercourse satisfaction and overall satisfaction. Conversely compared with normal controls these patients reported significantly lower erectile function, orgasmic function, intercourse satisfaction and overall satisfaction scores, whereas sexual desire scores were similar in the 2 groups. No correlations were noted of the 5 IIEF domains with the duration of followup after arterialization. When erectile function scores were graded, 25.0% and 28.1% of patients reported no and or mild dysfunction, respectively, while 15.6% still complained of severe erectile dysfunction. CONCLUSIONS: Long-term improvement in the various aspects of male sexual function was observed after deep dorsal vein penile arterialization in a significant proportion of patients.

Coitus↗
PubMed2001

Treating symptoms of female sexual arousal disorder with the Eros-Clitoral Therapy Device.

OBJECTIVE: The aim of this study was to determine the effect of the Eros-Clitoral Therapy Device (Eros-CTD) on the sexual function of women with and without symptoms of female sexual arousal disorder (FSAD). DESIGN: Periodic survey of sexual function in women using the Eros-CTD over a six-week period. SUBJECTS: A total of 19 women participated in the study--10 with symptoms of FSAD and nine without symptoms of FSAD--ranging in age from 28 to 65 years, with a mean age of 45.2 years. METHODS: Ten patients with symptoms of FSAD and 10 without symptoms were instructed in the use of the small, portable vacuum device, Eros-CTD. One woman without symptoms of FSAD withdrew early in the study for personal reasons. The patients were instructed in the correct use of the device and were asked to complete one Female Intervention Efficacy Index (FIEI) each week. The patients also kept diaries of their use of the device, noting the frequency, length, and strength of vacuum. RESULTS: There was a significant improvement in all symptoms of FSAD (P < .05), including increased sensation, improved vaginal lubrication, enhanced ability to orgasm, and greater overall satisfaction. Patients without FSAD also reported similar changes in sensation, lubrication, ability to orgasm, and overall satisfaction. LIMITATIONS: This study was done on a small sample of self-selected patients, was of limited duration, and had no long-term follow-up. All of these factors should be considered in interpreting the data. CONCLUSION: The Eros-CTD was safe and effective in improving symptoms of FSAD in this group of women. Further studies on the efficacy of the Eros-CTD are indicated.

Adult↗
PubMedDate not supplied

[Treatment of diminished sexual response associated with the use of oral contraceptives (author's transl)].

Loss of libido associated with the use of oral contraceptives has been studied in 113 women of reproductive age who had taken a combined pill for periods ranging from 1 to 3 years. The patients were divided in four groups. In the first group (I) of 24 women oral contraceptive treatment was discontinued and all women received in intra-uterine contraceptive device (IUCD). The second group (II) of 36 patients, the brand of oral contraceptive was changed. Women in group (III) had their oral contraceptive maintained receiving in addition a mixture of an androgen and an estrogen (methyltestosterone 4 mg and ethynilestradiol 0.002 mg) daily. To women of group (IV) the oral contraceptive was discontinued but the androgen-estrogen mixture was given. All women in this group received an IUCD. Evaluation of the psyco-sexual parameters included changes in libido, time to reach an orgasm, duration and intensity or orgasms. Frequency of intercourse and response to autostimulation was also investigated. Libido was restored in 94.2% of patients in group II, in 97.3% of group III and in 92.8% of group IV. In group I only 55.6% of patients had libido fully restored. In view of the prompt restoration of libido in all groups except in patients discontinuing oral contraceptive therapy, it is suggested that loss of libido in oral contraceptive users has an important physological component which can be overcome probably by psychotherapy. Short term treatment with a mixture of methyltestosterone and ethynilestradiol seems to be highly effective in restoring libido in all patients.

Adolescent↗
PubMed2002

[Female sexual dysfunction as adverse effect of pharmacological treatment].

This review describes female sexual dysfunction (FSD) as an adverse effect to pharmacological treatment. FSD covers libido, arousal, orgasm, and pain problems. The existing knowledge of the influence of medication upon female sexual function is very sparse. Treatment with SSRIs and other antidepressants may cause decreased libido and organism problems. Antipsychotic treatment often causes libido, lubrication, and orgasm problems. Spironolactone may cause decreased libido and impaired lubrication. Whether antihypertensives, H2-receptor antagonists and sex hormones have sexual adverse effects has not been clarified properly. Some drugs, such as bupropion and sildenafil, may enhance the sexual function, but further studies have to be carried out. The need for further research on the topic is stressed.

Antidepressive Agents↗
PubMed2003

Antidepressant-related erectile dysfunction: management via avoidance, switching antidepressants, antidotes, and adaptation.

The ideal antidepressant would control depression with no adverse effect on sexual function. Erectile dysfunction and other sexual dysfunction associated with antidepressant medication treatment are problems with many antidepressants and can lead to patient dissatisfaction and decreased compliance with treatment. A computerized MEDLINE search (English language, 1966-2003) was performed using the terms antidepressive agents, erectile dysfunction, and sexual dysfunction. Emphasis was placed on studies with specific sexual function measurements taken before and after treatment and placebo control. Mixed mediator, nonserotonergic antidepressants that block postsynaptic serotonin type 2 receptors (nefazodone, mirtazapine) or that primarily increase dopamine or norepinephrine levels (bupropion) were thought to be good choices for avoiding antidepressant-associated sexual dysfunction or for switching patients in whom antidepressant-associated sexual dysfunction emerged. Comparisons with serotonin reuptake inhibitors (SRIs) have revealed less desire and orgasm dysfunction with nonserotonergic bupropion, less orgasm dysfunction with nefazodone, and superior overall satisfaction with sexual functioning with bupropion or nefazodone. However, most of these studies have design flaws that make evidence-based claims of efficacy difficult to substantiate. Agents proposed for antidote use in antidepressant-associated sexual dysfunction have either not been studied in men or not proved efficacious in randomized placebo-controlled trials. Switching to and augmentation with bupropion or nefazodone have also not clearly shown efficacy in controlled trials and require care and monitoring to avoid SRI discontinuation symptoms and loss of antidepressant efficacy. Few proposed treatment options, apart from avoidance, have proved effective for antidepressant-associated sexual dysfunction, which can have negative consequences on depression management.

Antidepressive Agents↗
PubMed2005

The Ebony Sex Survey and the sex lives of African-American women: a call to healthcare providers.

Abuse, sexual satisfaction, and sexual dysfunction are issues that are not readily addressed in the African-American population, but they are on the minds of many. Ebony decided to pose these and other questions to African-American women in a survey titled, "Are You Satisfied?" Respondents were subscribers to Ebony as well as newsstand readership. Participants either filled out the survey on the Ebony website or sent in a paper copy to be tabulated. African-American women (N=7800) from all walks of life responded and discussed their abuse histories, their relationships, their ability or inability to reach orgasm, their medical histories and level of comfort in discussing their problems with their physicians, as well as many other issues. Results indicate that 37% of the sample self-reported early sexual abuse at the hands of immediate and/or extended family members; 15%-18% have been treated for high blood pressure, STDs/HIV, and/or fibroids; and 33% have experienced an inability to achieve orgasm in the last year. Of the sample 47% stated that they had not discussed these problems with their physicians.

Adolescent↗
PubMed2004

[Sexual behaviors of pregnant women].

Pregnancy and childbirth are both the part of woman's sexual life. Changes occur in every trimester of pregnancy have significant influence on the sexual behaviours. The purpose of our monograph was the analysis of behaviours of pregnant women. We comprised intensity and effectiveness of the sexual relations in each trimester of pregnancy. We analysed life circumstances affects on the sexual behaviour (own bedroom) and sexual life in every trimester of the pregnancy in compliance with: libido, prevalence of orgasm, sensitivity and erotic imaginations. The inquiry concerned the sexual positions preferred by pregnant women too. We paid respect on the subjective attractiveness evaluation in pregnancy and on fear of sex in pregnancy. We found some differences in every trimester of pregnancy refer to libido and orgasms frequency with particular reduction of these phenomenon's in third trimester. The increase of both: sexual imaginations and fear for sex was found. The fear for sex in pregnancy mainly concerns the appearance of bleeding or miscarriage.

Adult↗
PubMed2006

[Sexuality of pregnant women].

Over the time when the sexual intercourse has been considered merely one of a number of forms of sexual contact, views on sexuality during pregnancy have undergone considerable transformation. A great many of authors emphasise, that the pregnancy is a stimulus for partners to search for ways to maintain mutual emotional bond, close physical affinity and satisfy sexual needs not necessarily finished with an intercourse. The fact, that one of the two partners is pregnant, imposes some restrictions on sexual life. Not rarely, in particular in the first trimester of pregnancy, a female is little interested in sex. It is due to, inter alia, hormonal changes resulting in nausea, fatigue and increased nervosity. These symptoms contribute to general feebleness and reduction of the level of sexual needs and difficulty to become aroused and sexually ready. In spite of that, a lot of women have the need to keep physical and emotional contact with their partners. For a number of couples, pregnancy becomes a stimulus to search for new ways of pleasing each other in love play, that does not necessarily leads with an intercourse. Most studies concerning sexuality during pregnancy focus on observing sexual activity, physiological changes, mutual relationship of partners, analysis of sexual intercourses and investigation of so-called sexual satisfaction. Examination of sexual satisfaction ruchedes the frequency of sexual contacts, intercourses, foreplay, concurrence of orgasms in the two partners, partners' happiness, sexual satisfaction and mutual heartiness. In some researchers' opinion, sexual satisfaction correlates with the feeling of happiness resulting form being pregnant, pregnant woman's feeling still attractive and experience of orgasm. However, some researchers observe reduced sexual activity during pregnancy, except for the second trimester, when sexual activity is similar to the one outside pregnancy. Pregnant women prefer the following types of sexual activity: non-genital fondling, stimulation of the clitoris, vagina and breasts, oral and anal stimulation and masturbation. Females and their partners are underinformed on sexual life in pregnancy. The research indicates that 68% young mothers were not informed during pregnancy by a gynaecologist or midwife about sexual problems in pregnancy and, in particular, about possibility to derive sexual satisfaction. The research makes it evident, that experiencing sexual satisfaction by pregnant women improves their self-esteem, facilitates mutual relationship between partners and tightens the marital bond.

Adult↗