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G. Stanley Hall's Adolescence: Brilliance and nonsense.

G. Stanley Hall's two-volume work on adolescence is assessed from the perspective of modern psychology, 100 years after he published it. A surprising number of similarities exist between Hall's views of adolescence and our own, and several of those similarities are discussed here. Some of the most striking differences between Hall's views and the views of today's psychologists are also discussed, specifically, Hall's grounding of his beliefs about adolescent development in a Lamarckian evolutionary psychology that assumed the inheritance of acquired characteristics and memories; his views of sexuality, especially masturbation; and his claim that religious conversion is normative in adolescence. The cultural and historical context of Hall's views is then discussed, with an emphasis on how an awareness of the context of Hall's views can enhance our awareness of the context of our own views today.

History, 19th Century↗

Absence of orgasm-induced prolactin secretion in a healthy multi-orgasmic male subject.

In several studies we have recently demonstrated that orgasm induces prolactin secretion in healthy males and females. This suggests that prolactin may form a feedback regulator of the refractory period following orgasm. To examine this position we investigated the prolactin response of a healthy multi-orgasmic male subject. Blood was drawn continuously during masturbation-induced orgasm. The prolactin response of the case-subject was compared with that of nine healthy adult men with a normal refractory period. The case-subject showed no prolactin response to three orgasms. Data from this multi-orgasmic subject support the hypothesized role of plasma prolactin in contributing to sexual-satiation mechanisms.

Adult↗

Successful treatment of retrograde ejaculation with the alpha1-adrenergic agonist methoxamine: case study.

We treated two patients affected by retrograde ejaculation (RE) with the pure alpha1-adrenergic agonist methoxamine; the drug was self-administered intramuscularly by the patients 30 min prior to intercourse or masturbation. A previous trial with oral imipramine had been ineffective in both patients. Sperm count increased substantially, particularly in the first patient who had insulin-dependent diabetes and was seeking fertility. In this patient, total ejaculated sperm increased from 22 millions to 488 and 419.5 millions on two different occasions, with good motility; two clinical pregnancies were obtained in the partner of this patient after 3 and 4 months of treatment, respectively. The second patient did not desire fertility. In both patients, no side effects were seen except for slight piloerection; blood pressure values increased slightly, and heart rate was unchanged. We conclude that self-administered methoxamine can be a useful, noninvasive and inexpensive treatment of RE, when oral agents are ineffective.

Adrenergic alpha-Agonists↗

Prevalence and correlates of sexual dysfunction among young adult married women in rural China: a population-based study.

The study investigates prevalence of sexual dysfunction (SD), sexual satisfaction and their correlates in the rural female population in China. An anonymous cross-sectional study was carried out in a random sample of 1178 married of age 20-39 years in Dengfeng County, Henan, China. The prevalence of having at least one SD was 43 and 38% of the respondents were satisfied with their sexual life; 64.0% thought that sex was not important to them; and 85.7% believed that they do not have adequate sex-related knowledge. Having SD and high sexual satisfaction were associated with high mental health or vitality quality of life scores and better perceived health status. Other independent predictors of SD included sociodemographic variables, biological variables, life style factors and masturbation. It is concluded that SD was prevalent among the studied women and were associated with mental health. The sexual health among married women needs to be improved in rural China.

Adult↗

Role of oestrogen in male sexual behaviour: insights from the natural model of aromatase deficiency.

OBJECTIVE: In order to evaluate the role of oestrogens on human male sexual behaviour, the gender-identity, psychosexual orientation and sexual activity of a man with a congenital lack of oestradiol resulting from an inactivating mutation of the aromatase P450 gene was investigated. The psychosexual and sexual behavioural evaluations were performed before and during testosterone treatment and before oestradiol treatment, during three phases of different dosages of oestradiol treatment. DESIGN: The study was performed before (phase A) and during (phase B) testosterone enanthate treatment (250 mg i.m. every 10 days, for 6 months), during testosterone withdrawal (phase C), and during each of the following transdermal oestradiol treatments: 50 microg twice a week for 6 months (phase D); 25 microg twice a week for 9 months (phase E), and 12.5 microg twice a week for 9 months (phase F). MEASUREMENTS: Sexual behaviour was investigated by a sexological interview and by a 2-month self-reported daily diary performed during each phase of the protocol study. Furthermore, during each oestradiol treatment (phase C, D, E and F), a study of depression, anxiety trait and sexual behaviour was performed by the Beck Depression Inventory (BDI), the Spielberger Trait Anxiety Inventory (STAI) and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), respectively. Sexual orientation and gender-identity were evaluated by the BEM Sex Role Inventory (BSRI). Serum testosterone and oestradiol were measured during each phase of the study. RESULTS: Before oestradiol treatment (phase C), serum oestradiol was undetectable, while it rose to 356.1, 88.1 and 55.1 pmol/l during phases D, E and F, respectively. Before any oestradiol treatment, during phase D, phase E and phase F serum testosterone was 18.13, 0.72, 14.3 and 18.51 nmol/l, respectively. The patient's gender-identity as assessed by BSRI and by the sexological interview was clearly male. The psychosexual orientation evaluated by BSRI, by the sexological interview and by the analysis of the self-filled diary was heterosexual. Relevant modification of the patient's sexual behaviour occurred only during oestrogen treatment. This was more evident during both phase E and phase F, and concerned the behavioural parameters with an increase of libido, frequency of sexual intercourse, masturbation and erotic fantasies. A reduction of BDI and STAI scores was detected during the oestrogen phases. CONCLUSIONS: The study of the sexual behaviour in this man with aromatase deficiency suggests that oestrogens in humans do not affect gender-identity and sexual orientation but could have a role in male sexual activity.

Adult↗

Effects of nitrogenous components of urine on sperm motility: an in vitro study.

The effects of the major nitrogenous components of urine (ammonia, creatinine, urea and uric acid) on sperm motility were investigated. Semen samples were obtained by masturbation from a young volunteer with a normal spermiogram and fertility. Sperm motility was measured using a Sperm Quality Analyzer and Makler Chamber. When semen was mixed with a urine sample for which acidity and osmolality were adjusted to pH 7.5 and 340 mOsm/kg, the higher the concentration of the urine, the poorer the sperm motility. When solutions of various concentrations of the nitrogenous compounds which are excreted in urine were mixed with semen, sperm motility decreased in proportion to ammonia levels and was markedly decreased after 30 min. However, in the case of creatinine, urea and uric acid, good motility was maintained for 30 min regardless of their amounts. In conclusion, urine ammonia content is detrimental to sperm motility and may be an important factor in retrograde ejaculation.

Adult↗

Sexual problems in men with prostate cancer in comparison with men with benign prostatic hyperplasia and men from the general population.

In a questionnaire study, men with prostate cancer (n = 155) or benign prostatic hyperplasia (n = 131) identified more sexual problems than did men from the general population (n = 129). Sexual dysfunction was acknowledged regarding sexual pleasure and attraction, erectile function and sexual satisfaction and sexual performance. Lowered rates of sexual desire, pleasure and attraction were found when comparing their situation in recollection of pre-treatment situation to the current situation. Lower intercourse frequency and sexual satisfaction were also found. Medication, masturbation and artificial aids to achieve erection were not used as substitutes for shortcomings of erectile function either by men with prostate cancer and benign prostatic hyperplasia nor by their partners. There seemed to be a lack of information about the illness and treatment consequences for sexual life, including what physical dysfunction to expect after surgery and also what possible help to expect to compensate for the shortcomings.

Aged↗

Experiences of staff in dealing with client sexuality in services for teenagers and adults with intellectual disability.

Previous studies have focused on staff attitudes to sexuality rather than their experience of dealing with sexual incidents. A self-completion questionnaire was devised in which seven scenarios were proposed relating to client sexuality (e.g. public masturbation and accusation of sexual abuse). Staff noted whether or not they had encountered this type of incident, and if so, how confident they felt (or would feel) in dealing with it, and whether or not they would enlist the help of colleagues. Questionnaires were sent to all statutory, voluntary and private service providers (including schools) within one community health and social services trust area in Northern Ireland, and 150 staff responded. Around two-thirds of staff reported having dealt with at least one of the seven incidents listed. Staff with previous experience of the incident listed, felt that they could deal with it more confidently in future, as did staff working in residential services rather than day services. The latter group of staff were more likely to enlist the help of colleagues than were residential staff. Nearly 50% of staff identified more training and clear policy guidelines as the two means of increasing their confidence in dealing with issues of client sexuality. These results highlight the need for staff training that spans agencies and results in common approaches to client sexuality. Suggestions for further research are noted.

Adolescent↗

Sex knowledge and sexual attitudes among medical and nursing students.

OBJECTIVES: The aim of this study was to assess the relationship between background and sociodemographic variables, attitudes toward controversial aspects of human sexuality and sex knowledge among medical and nursing students. METHOD: The study design was a questionnaire-based survey of medical and nursing students in Western Australia. Participants were first- through fifth-year medical students at the University of Western Australia and first- through third-year undergraduate nursing students at Edith Cowan University. Outcome measures were students' attitudes toward controversial aspects of human sexuality expressed on a five-point Likert scale and a modified version of the Kinsey Institute/Roper Organization National Sex Knowledge Test. RESULTS: A significant relationship was found between certain background and sociodemographic variables, sexual attitudes and sex knowledge. The background variable most strongly related to both attitudes and knowledge was frequency of attendance at religious services of any religious denomination during the past month, with those attending three or more times more likely to express negative attitudes and have lower sex knowledge scores. Lower sex knowledge was related to negative attitudes toward gay/lesbian/bisexual behaviour, masturbation, premarital sex and contraception. Other important background and sociodemographic variables related to negative attitudes were: never having experienced sexual intercourse; right-wing political orientation; lower family income; gender and ethnicity. CONCLUSIONS: Negative attitudes toward controversial aspects of human sexuality and lower sex knowledge scores among medical and nursing students can be predicted on the basis of background and sociodemographic variables. Education aimed at increasing sex knowledge and modifying negative attitudes may increase students' ability to function more effectively as sexual history takers and sex counsellors.

Attitude↗

[Sexual activity in old age-problem-oriented counselling from the psychiatric point of view].

Empirical investigations often report sexual activity in old age. Society's negative stereotype of the aging person, however, results in the topic being socially taboo and prejudiced. Active sexual intercourse gets less frequent in advancing age, but masturbation and sexual fantasies still prevail. In higher age groups men are seemingly more active than women. Persons living inconstant partnerships are more active than persons living on their own. There is a significant shift from sexual intercourse to tenderness, confidence, and satisfying relations. There are numerous physical, psychological, and social factors influencing sex life in old age. Important physiological alterations and their consequences are to be observed in advancing age. Multiple diseases, drugs, and objective and subjective (e.g. anxiety disorders) after-effects of operations often result in reducing or totally giving up sexual activities. If a doctor has hints pointing to sex problems these ought to be talked about without any prejudice and with an intention of looking for possible solutions. Frequently these problems are indicative of psychological or functional disorders which may respond to a treatment by competent counselor or psychotherapist.

Aged↗

Transdermal testosterone treatment in women with impaired sexual function after oophorectomy.

BACKGROUND: The ovaries provide approximately half the circulating testosterone in premenopausal women. After bilateral oophorectomy, many women report impaired sexual functioning despite estrogen replacement. We evaluated the effects of transdermal testosterone in women who had impaired sexual function after surgically induced menopause. METHODS: Seventy-five women, 31 to 56 years old, who had undergone oophorectomy and hysterectomy received conjugated equine estrogens (at least 0.625 mg per day orally) and, in random order, placebo, 150 microg of testosterone, and 300 microg of testosterone per day transdermally for 12 weeks each. Outcome measures included scores on the Brief Index of Sexual Functioning for Women, the Psychological General Well-Being Index, and a sexual-function diary completed over the telephone. RESULTS: The mean (+/-SD) serum free testosterone concentration increased from 1.2+/-0.8 pg per milliliter (4.2+/-2.8 pmol per liter) during placebo treatment to 3.9+/-2.4 pg per milliliter (13.5+/-8.3 pmol per liter) and 5.9+/-4.8 pg per milliliter (20.5+/-16.6 pmol per liter) during treatment with 150 and 300 microg of testosterone per day, respectively (normal range, 1.3 to 6.8 pg per milliliter [4.5 to 23.6 pmol per liter]). Despite an appreciable placebo response, the higher testosterone dose resulted in further increases in scores for frequency of sexual activity and pleasure-orgasm in the Brief index of Sexual Functioning for Women (P=0.03 for both comparisons with placebo). At the higher dose the percentages of women who had sexual fantasies, masturbated, or engaged in sexual intercourse at least once a week increased two to three times from base line. The positive-well-being, depressed-mood, and composite scores of the Psychological General Well-Being Index also improved at the higher dose (P=0.04, P=0.03, and P=0.04, respectively, for the comparison with placebo), but the scores on the telephone-based diary did not increase significantly. CONCLUSIONS: In women who have undergone oophorectomy and hysterectomy, transdermal testosterone improves sexual function and psychological well-being.

Administration, Cutaneous↗

Hypersexuality and dysexecutive syndrome after a thalamic infarct.

Hypersexuality can result from insults to several neuroanatomical structures that regulate sexual behavior. A case is presented of an adult male with a thalamic infarct resulting in a paramedian thalamic syndrome, consisting of hypersomnolence, confabulatory anterograde amnesia (including reduplicative paramnesia), vertical gaze deficits, and hypophonic speech. A dysexecutive syndrome also manifested, consisting of social disinhibition, apathy, witzelsucht, motor inhibition deficits, and environmental dependence. Hypersexuality uncharacteristic of his premorbid behavior was evident in instances of exhibitionism, public masturbation, and verbal sexual obscenities. In contrast to the few previous reports of hypersexuality following thalamic infarct, this case neither involved mania nor hemichorea. The relevance of the mediodorsal thalamic nucleus in limbic and prefrontal circuits is discussed.

Aged↗

Relationship functioning and sexuality among people with multiple sclerosis.

This study was concerned with how the sexuality and relationships of people with Multiple Sclerosis (MS) are different from those of people from the general population. Three-hundred eighty-one respondents (144 males, 237 females) with MS and 291 respondents (101 males, 190 females) from the general population participated in the study. Sexual satisfaction, sexual dysfunction, relationship satisfaction, and coping style were assessed among all respondents. Information was also obtained from people with MS regarding age of onset and diagnosis of symptoms, as well as severity of symptoms. Overall, males with MS experienced a higher frequency of sexual dysfunction than males from the general population, while females with MS only differed from females from the general population in their levels of masturbation and numbness of the genital area. Coping strategies and levels of cognitive functioning were important predictors of sexual satisfaction, sexual dysfunction, and relationship satisfaction for women with MS, but there were fewer coping or health-related factors that predicted these variables among men with MS. The results of this study are discussed in terms of factors related to sexual satisfaction and positive interpersonal relationships. There is a need to conduct further research in this area so that professionals working with people with MS are informed on strategies to improve the sexuality and relationships of their clients lives.

Adaptation, Psychological↗

Truth and consequences: using the bogus pipeline to examine sex differences in self-reported sexuality.

Men report more permissive sexual attitudes and behavior than do women. This experiment tested whether these differences might result from false accommodation to gender norms (distorted reporting consistent with gender stereotypes). Participants completed questionnaires under three conditions. Sex differences in self-reported sexual behavior were negligible in a bogus pipeline condition in which participants believed lying could be detected, moderate in an anonymous condition, and greatest in an exposure threat condition in which the experimenter could potentially view participants responses. This pattern was clearest for behaviors considered less acceptable for women than men (e.g., masturbation, exposure to hardcore & softcore erotica). Results suggest that some sex differences in self-reported sexual behavior reflect responses influenced by normative expectations for men and women.

Adolescent↗

Sexual functioning and practices in a multi-ethnic study of midlife women: baseline results from SWAN.

This study examined the sexual practices and function of midlife women by ethnicity (African American, Caucasian, Chinese, Hispanic, Japanese) and menopausal status. Sexual behavior was compared in 3,262 women in the baseline cohort of SWAN. Participants were 42 to 52 years old, premenopausal or early perimenopausal, and not hysterectomized or using hormones. Analysis used multivariate proportional odds regression. In our sample, 79% had engaged in sex with a partner in the last 6 months, and a third considered sex to be very important. Common reasons for no sex (n = 676) were lack of partner (67%), lack of interest (33%), and fatigue (16%). Compared with Caucasians, Japanese and Chinese women were less likely, and African Americans more likely, to report sex as very important (p < 0.005). Significant ethnic differences were found for frequency of all practices. Perimenopause status was associated only with higher frequencies of masturbation and pain during intercourse.

Adult↗

Pheromonal influences on sociosexual behavior in postmenopausal women.

To determine whether a putative human sex-attractant pheromone increases specific sociosexual behaviors of postmenopausal women, we tested a chemically synthesized formula derived from research with underarm secretions from heterosexually active, fertile women that was recently tested on young women. Participants (n = 44, mean age = 57 years) were postmenopausal women who volunteered for a double-blind placebo-controlled study designed, to test an odorless pheromone, added to your preferred fragrance, to learn if it might increase the romance in your life. During the experimental 6-week period, a significantly greater proportion of participants using the pheromone formula (40.9%) than placebo (13.6%) recorded an increase over their own weekly average baseline frequency of petting, kissing, and affection (p = .02). More pheromone (68.2%) than placebo (40.9%) users experienced an increase in at least one of the four intimate sociosexual behaviors (p = .04). Sexual motivation frequency, as expressed in masturbation, was not increased in pheromone users. These results suggest that the pheromone formulation worn with perfume for a period of 6 weeks has sex-attractant effects for postmenopausal women.

Adult↗

Autoerotic deaths: four cases.

We describe the circumstances and post mortem medical findings of 4 unusual fatalities where death occurred during autoerotic practice. Three cases occurred in young to middle-aged men--hanging, electrocution and inhalation of a zucchini. The manner of death in each was accidental. The fourth case was an elderly man who died of ischemic heart disease, apparently whilst masturbating with a vacuum cleaner and a hair dryer.

Adult↗

The analysis of an overstimulated child.

This paper shows how environmental and medical overstimulation affected a latency girl in all her developmental phases, leading to severe impairment of object relationships. These factors are seen against the background of an acrimonious parental divorce. Suzie's negative body image was inextricably interwoven with anxieties about her masturbation activities and castration fantasies and this was fueled by her physical condition (lichen sclerosis et atrophicis). She was in a constant state either of withdrawness or excitement. The initial task of the treatment was to provide Suzie with a holding environment so that she could find alternative means of gratification and control in order to manage within a more organized secondary process mode. When her difficulties around excitation abated, she could begin to make analytic use of verbalization, clarification, and interpretations.

Child↗