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PubMedDate not supplied

Controlled studies on women presenting with sexual drive disorder: I. Endocrine status.

A single mid-cycle blood sample was obtained from 15 premenopausal female patients presenting with lifelong absence of sexual drive and from a control group of women with intact sexual drive. Serum levels of testosterone, 5-dihydrotestosterone (5-DHT), 17 beta oestradiol, sex hormone binding globulin, and prolactin were measured and indices of free testosterone and 5-DHT were derived. During the menstrual cycle in which the blood samples were obtained, the study subjects kept a diary of their sexual desire and activities. The only endocrine parameter that is significantly different between the two groups is free testosterone, which is lower in the patients than in the control women. Associations between endocrine parameters and indices of sexual behavior were examined. In the control group, average daily sexual thoughts correlates positively with total testosterone, free testosterone index, and free 5-DHT. Feeling of "need for sex" correlates positively with free 5-DHT index and free testosterone index. Experience of sexual thoughts correlates with need for sex, and average frequency of masturbation correlates negatively with age. In both groups, average coital frequency correlates with free testosterone index.

Adolescent↗
PubMedDate not supplied

Treatment of paraphilia with luteinizing hormone-releasing hormone agonists.

Up to now there have been no published results of therapy of paraphilia (for example, pedophilia or sadism) and sexual aggressive impulsiveness with luteinizing hormone-releasing hormone (LHRH) agonists in the German-speaking countries. After a short introduction about physiologic features and the present state of investigations in treatment of paraphilia with LHRH agonists we describe 11 patients who were treated with the LHRH agonist Leuprolide Acetate over a period of 12 months. The patients showed no tendency toward sexually aggressive behavior and reported an evident reduction of penile erection, ejaculation, masturbation, sexually deviant impulsiveness, and fantasies. One patient died from suicide. In combination with other treatments, LHRH Agonists seem to be a very promising alternative to cyproterone acetate and its possible carcinogene effects.

Adult↗
PubMedDate not supplied

Vaginal intercourse frequency and heart rate variability.

We examined the relationship between recalled and diary recorded frequency of penile-vaginal intercourse (FSI) and both resting heart rate variability (HRV; an index of cardiac autonomic control and parasympathetic tone associated with cardiovascular health outcomes) and resting diastolic blood pressure (DBP) in 120 healthy adults aged 19-38 (subjects scoring above the 87th percentile on the Lie scale of the Eysenck Personality Inventory were excluded from analyses). As in a previous smaller study, greater HRV was associated with greater FSI (but not masturbation or non-coital sex with a partner) and rated importance of intercourse. There were no sex differences in the HRV-FSI relationship, and the relationship was not explained by including measures of Extraversion, Neuroticism, Depression, Trait Anxiety, or partnership satisfaction. However, the previously obtained negative association of FSI with DBP was not replicated.

Adult↗
PubMedDate not supplied

Transvestic fetishism in the general population: prevalence and correlates.

We used a random sample of 2,450 18-60 year-olds in the general population of Sweden to study the prevalence as well as the social, sexual, and health correlates of transvestic fetishism (sexual arousal from cross-dressing). Almost three percent (2.8%) of men and 0.4% of women reported at least one episode of transvestic fetishism. Separation from parents, same-sex sexual experiences, being easily sexually aroused, pornography use, and higher masturbation frequency were significantly associated with transvestic fetishism. A positive attitude to this sexual practice and paraphilia indicators--sexual arousal from using pain, exposing genitals to a stranger, and spying on others having sex--were particularly strong correlates to the dependent variable.

Adult↗
PubMed1975

The assessment of nocturnal REM erection in the differential diagnosis of sexual impotence.

A new method for differentiating psychogenic from organic cases of sexual impotence is described based on the assesst of nocturnal REM erection in nine patients. It is our tentative impression that in psychogenic impotence nocturnal REM erection may be normal in amount and degree and an excellent indicator of erectile potential. In these cases a marked discrepancy exists between the amount and degree of nocturnal erection and the patient's daytime performance level attained during attempted coitus or masturbation. In the organic patients, on the contrary, such a discrepancy does not exist; instead, the maximal nocturnal erection attained corresponds closely to and mirrors the patient's impaired waking performance. This new method may be very useful in the diagnosis, prognosis, and decision as to type of treatment, especially in difficult cases.

Adult↗
PubMed1975

Imagery, shaping, and orgasm.

Shaping is the gradual addition of more or different increments in the learning of complex skill or response pattern. As applied to imagery or fantasy during sexual activity, it provides another tool to be utilized by the therapist. Imagery is seen as a normal if not inevtiable covert level of the sexual response pattern. Careful inquiry will nearly always reveal imagery during masturbation which can be deliberately incorporated with intercourse. The effect of this procedure is to increase both excitatory and orgiastic capabilities.

Behavior Therapy↗
PubMed1978

Sex therapy with orthodox Jewish couples.

The sexual relationship of the Orthodox Jewish couple is profoundly affected by laws and values which, among other factors, prohibit male masturbation and limit sexual activity to specific monthly periods. This paper conceptualizes the interplay of religious, cultural, psychological, and interpersonal dynamics as they are related to both the etiology and treatment of sexual dysfunctions within this group. Three clinical illustrations are presented. They attempt to show that the ubiquitous presence of these Jewish laws and values create an ambience whereby the successful treatment of dysfunctions can only occur through the simultaneous resolution of key marital difficulties and the development of more intimate relational bondings.

Adult↗
PubMed1981

Efficacy of sex education courses in medical school.

After nearly two decades of genesis, human sexuality has become a regular part of the curricula for most medical schools. Evaluation of sex education is less common and often hampered by the absence of appropriate control groups and misinterpretation of statistical analysis. To evaluate a new sex education course at Louisiana State University Medical Center, we compared pre- and postcourse sex knowledge and attitude SKAT scores of 136 sophomore medical students with those of 43 seniors who received no formal sex education. Consistent with prior studies, sophomore pre-post course score changes indicated statistically significant increases in sex knowledge, recognition of sexual myths, and more liberal attitudes toward masturbation, abortion and heterosexuality. The magnitude of postcourse changes, however, was small. Postcourse sophomores and seniors displayed almost no differences in sex knowledge or attitudes. Criteria for sex education evaluation, and whether the formal course in human sexuality actually and effectively enables a student ultimately to better fulfill his/her function as a physician are discussed.

Abortion, Induced↗
PubMed1982

Treatment effectiveness for dysfunctions of sexual desire.

Archival data from the Sex Therapy Center at Stony Brook were analyzed to determine the prevalence of desire phase sexual dysfunctions and the effectiveness of treating them with behavioral sex therapy. When cases were rediagnosed with a multi-axial problem-oriented system, increases from 1974-1981 in both the prevalence of desire phase problems and of male low sexual desire were observed. Data suggested that wives display more extreme patterns of sexual avoidance than do husbands in couples seeking sex therapy. Outcome statistics on marital adjustment, overall sexual satisfaction, the frequency of intercourse and masturbation, and patterns of initiation of sexual activity reveal significant positive changes after treatment. These changes are not due to nonspecific factors and are maintained at follow-up. Sex therapy was equally successful for male-centered vs. female-centered problems, for low sexual desire vs. aversion to sex, and for global or lifelong dysfunctions vs. the more recent or situational ones. Posttreatment gains reflect a minimally adequate sexual relationship, however, rather than an optimal degree of intimacy and pleasure.

Adult↗
PubMed1987

Intracavernosal injection in the treatment of impotence: a prospective study of sexual, psychological, and marital functioning.

This study assessed the sexual, psychosocial, and medical impact of intracavernosal injection of papaverine hydrochloride and phentolamine mesylate in the treatment of impotence. Ninety-six percent of patients initially achieved satisfactory erections with injections. Common side effects of self-injections included bruising (26%), nodule development (21%), abnormal liver function tests (7%), and pain (5%). No nodules resulted in penile bending or pain, and no patient discontinued treatment due to nodule development. Dropout rate to date was 35%. Self-injection treatment was associated with increases in erection quality, intercourse frequency, and sexual satisfaction, and decreases in masturbation frequency for patients. Partners also reported increases in intercourse frequency, coital arousal, and satisfaction. Decreases in general psychiatric symptomatology and increases in relationship satisfaction and self-esteem were apparent for patients, but not for partners.

Erectile Dysfunction↗
PubMed1993

Psychosexual functioning in women with complete testicular feminization: is androgen replacement therapy preferable to estrogen?

Effects of oral testosterone undecanoate (Andriol) on blood hormone levels, moods, sociosexual functioning and self-image of the body were studied in four gonadectomized patients with complete testicular feminization. In a double-blind cross-over experiment, patients were treated with oral testosterone undecanoate (120 mg/day) or placebo for four weeks. Peripheral blood was taken for hormone assays at the end of each four-week period. Psychosexual functioning was reported once weekly, mood scales twice weekly. In three patients testosterone treatment resulted in adult male blood levels of testosterone and estradiol. One patient did not show increased steroid levels, possibly because of hyperthyroxinaemia. No systematic effects were found on coitus, masturbation, sexual thoughts, scores on desire for bodily contact, and on attention for physical appearance. In one patient there was a marked and sustained rise in the positive moods and a fall in negative moods during androgen treatment. These results do not demonstrate that androgen therapy is preferable to estrogen in gonadectomized women with complete testicular feminization with regard to psychosexual functioning.

Adult↗
PubMedDate not supplied

Treatment of an unusual case of masochism.

Masochistic sexual activity is potentially dangerous, rarely reported voluntarily, and hard to treat. This article describes a masochist patient who received sexual gratification from being burnt or crushed. Antiandrogen medication, serotonin uptake inhibitor, and psychodynamic psychotherapy along with sexual education and social-skills training and aversive behavior therapy were all tried over a period of 9 months. The response was measured by effects of treatments on the frequency of erotic fantasies and masturbation. Antiandrogens and aversive behavior therapies may be the most effective treatments for such cases, at least in the short term, although the underlying social deficits and the need to reshape the sexual behavior ought to be addressed in the long term.

Adult↗
PubMedDate not supplied

The sexual struggles of 23 clergymen: a follow-up study.

Nineteen clergymen, 17 of whom were Catholic, were followed up 1 to 6 years after their initial evaluation in a program designed to assess the sexual offenses and rehabilitation potential of offending professionals. Methods used included a semistructured interview with a research psychiatrist and a repeat of the MCMI-III. At follow-up, the clergymen were relatively psychologically healthy. The vast majority of the men had returned to previous or higher levels of vocational functioning and felt that they had benefited from their initial evaluation and therapy. None of those who were initially suspected of sexual compulsivity met criteria for excessive sexual expression at follow-up, and none had re-offended. The typical clergyman, whether heterosexual or homosexual, was struggling with loneliness, masturbation conflicts, and the wish to be known beyond their role by others. The confrontative style of the evaluators in pursuing the veracity of the clergy's initial explanations of their behaviors and the use of penile plethysmography were the primary objections to the methods used. Brief psychotherapy seemed to be a cost-effective, well-received intervention for clergy struggling with their sexual conflicts.

Adult↗
PubMedDate not supplied

The paraphilia-related disorders: an empirical investigation of nonparaphilic hypersexuality disorders in outpatient males.

The frequency distribution of nonparaphilic hypersexual behaviors was investigated in an outpatient sample of 206 consecutively evaluated males seeking help for sexual impulsivity disorders (SIDs), either paraphilia-related disorders (PRD; n = 63) or paraphilias (PA; n = 143). Paraphilia-related disorders associated with help-seeking behaviors included compulsive masturbation (sample prevalence, 69%), protracted heterosexual or homosexual promiscuity (51%), pornography dependence (50%), telephone-sex dependence (24%), and severe sexual desire incompatibility (12%). Eighty-six percent of the PA sample reported at least one lifetime PRD. The subgroup of males with both PAs and lifetime PRDs (n = 123) self-reported the greatest number of lifetime SIDs, the highest incidence of physical and sexual abuse, the fewest years of completed education, and the highest likelihood of current unemployment or disability. As well, the subgroup of males with PAs but no lifetime PRDs (n = 20) self-reported the fewest lifetime SIDs; this subgroup was not statistically different from the PRD group on these aforementioned variables. These data suggest that social disadvantage, as assessed in this sample, is associated with the cumulative incidence of SIDs but not necessarily with the diathesis to develop paraphilic disorders.

Adult↗
PubMedDate not supplied

Correlation of the bovine cervical mucus penetration test with human sperm characterisitics in 1,406 ejaculates.

The bovine cervical mucus penetration test (BCMPT) was performed to determine its usefulness in screening the ability of sperm to successfully penetrate mucus in vitro. Ejaculates were obtained by masturbation from patients attending an infertility clinic. Routine semen analysis was performed using a microcomputerized multiple-exposure photography system. The BCMPT was performed. Overall, the average penetration of the mucus was 38 +/- 0.46 mm. Of the 1,406 ejaculates analyzed, 244 (17%) displayed a negative result (0-20 mm), 291 (21%) a questionable result (21-30 mm), and 871 (62%) a positive result (>30 mm). A highly significant (p < .001) correlation between mucus penetration distance and sperm MD (r = 0.541), MI (r = 0.484), count (r = 0.475), motility (r = 0.448), velocity (r = 0.400) and morphology (r = 0.369) was observed. Overall, the finding of an abnormal semen parameter resulted in a 34 +/- 5% accurate prediction of a negative or questionable BCMPT (<30 mm), while a normal semen parameter resulted in a 90 +/- 4% accurate prediction of a positive BCMPT (>30 mm). Sperm MD showed the strongest positive predictive value (98%), while morphology showed the greatest negative predictive value (50%). Of the 1,406 samples, 25 +/- 2% of the samples with normal semen parameters displayed a negative BCMPT. Conversely, 6 +/- 2% of samples with abnormal parameters showed a positive BCMPT. The BCMPT successfully identifies a significant subpopulation of patients as having an inadequate penetration of mucus with otherwise normal semen characteristics.

Animals↗
PubMedDate not supplied

Interleukin-6 (IL-6) in seminal plasma of infertile men, and lipid peroxidation of their sperm.

Concentrations of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in seminal fluid, as well as levels of sperm lipid membrane peroxidation, were investigated in fertile and infertile men. Semen samples, obtained by masturbation from 37 infertile and 14 fertile men, were examined for the presence of TNF-alpha and IL-6. The level of lipid peroxidation of the sperm membrane was measured by determining malondialdehyde (MDA) formation. The correlation between the IL-6 and the TNF-alpha concentrations in seminal plasma with the levels of lipid peroxidation of the sperm membranes was statistically evaluated. The IL-6 concentration in seminal plasma of infertile men was significantly higher than that of fertile men (p < .05). Similarly, the level of membrane lipid peroxidation was higher for the semen of infertile men than that of fertile men (p < .001). A significant positive correlation was found between IL-6 levels in seminal plasma and membrane sperm lipid peroxidation (p < .002), but not between this parameter and TNF-alpha levels in seminal plasma. These findings suggest a possible association between IL-6 seminal plasma levels and lipid peroxidation of sperm membrane. Stimulation of reactive species production by human sperm and leucocytes, induced by the high levels of IL-6, could explain these results.

Humans↗
PubMedDate not supplied

Effect of progesterone on acrosome reaction, hypoosmotic swelling test, and DNA stability in human spermatozoa.

The association between different sperm parameters, an in vitro effect of progesterone, has not been studied satisfactorily. In this article, the effect of progesterone on acrosome reaction (AR), plasma membrane integrity, and chromatin stability has been assessed in human spermatozoa with normal morphology and motility. Semen samples were obtained by masturbation from 25 patients. Two criteria of classification were utilized in this study: high motility group and normal morphology group incubated with progesterone. The effect of progesterone on AR, plasma membrane integrity, and chromatin stability in human spermatozoa with normal morphology and motility was realized. The results suggest that only the subpopulation of spermatozoa with normal morphology is able to undergo the progesterone-induced AR. It is possible that in the reproductive female tract it takes place a high selection of sperm with chromatin stability determined and optimal plasma membrane to undergo the AR prerequisite for the fecundation.

Acrosome Reaction↗
PubMed2005

On sexual behavior and sex-role reversal.

Sex is not about reproduction; sex is about (re-)combination of DNA. Sex, not reproduction, always involves physical contact between two individuals; to achieve this, strategies of sexual behavior evolved. Sexual behavior, therefore, did not evolve as part of a reproductive strategy, but evolved to enable exchange of genetic material. In multicellular organisms the situation is more complicated than in unicellular organisms, as it is impossible for each cell within a multicellular body to have sex with another cell. Hence, evolution selected a system in which the possibility to have sex was limited to only one cell-line: the germ cells. As a result, sex adopted the character of fertilization, and sex and reproduction became inseparably linked. Still, in some species, including humans, sexual behavior still exhibits features of its evolutionary past: in humans (like in bonobo's) most sexual activity and many sexual behavioral patterns have nothing to do with reproduction (masturbation, homosexual behavior, for example); in humans, sexual behavior also became associated with other strategic objectives, such as intensifying the pair bond, expression of love or power. Different genders - male and female - evolved, and each gender evolved typical gender-related sexual and reproductive strategies as well. In most multicellular species, these strategies became inextricably mixed, and sexual behavior increasingly more - and in most species even exclusively - 'served' the interests of reproduction: sexual behavior became more or less synonymous with reproductive behavior. In most species, the 'mix' of sexual and reproductive strategies evolved into typical gender-related patterns of behavior, that is, in typical 'sex-roles'. Often, males are bigger and more 'beautiful' (= more intensely ornamented) than females; males compete with each other for access to females; males court females, while females choose males ('female choice'). However, ecological circumstances may cause a reversal of sex-roles, resulting in a situation in which females are bigger and more intensely ornamented than males, females compete for access to males, females court males and only males invest in care for the young, provided they are relatively certain of their paternity. Also, as in the case of the spotted hyena, females may be highly virilized and be socially dominant. This 'sex-role reversal' is seen, e.g., when males are relatively rare due to high predation pressure, or when the process of reproduction is very risky for the same reason: then it is 'better' that males, with their plenty of sperm, are wasted, than females with their few, precious eggs. It can be argued, with women being the fair sex, exhibiting competitive behavior and with an actively displaying courtship, and with men investing heavily in their offspring, meanwhile taking all (cultural) kinds of measures to guarantee their paternity, that humans, too, exhibit some degree of sex-role reversal.

Animals↗