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PubMed2000

The repertoire of human efforts to avoid sexually transmissible diseases: past and present. Part 1: Strategies used before or instead of sex.

BACKGROUND/OBJECTIVE: Despite the focus by public health programmes on condoms, chastity, or monogamy, people use a much wider variety of strategies to minimise their personal risk of sexually transmissible disease (STD). The objective of this study was to compile a comprehensive list of personal and societal STD avoidance strategies. METHODS: Data from clinical and research observations, computer searches, and historical texts were pooled. RESULTS: In addition to discriminating between potential sexual partners, a variety of behaviours before or instead of sex were identified that have been perceived to alter STD risk. Traditional STD avoidance strategies were often poorly documented and difficult to disentangle from other drives such as the maintenance of social order, paternity guarantee, and eugenics. They also varied in popularity in time and place. Some examples were displacement activities such as masturbation or exercise, circumcision, infibulation, shaving, vaccination, or requiring partners to be tested for infection. Social and moral forces typically discourage non-marital sex, and this affects most people most of the time but few people all of the time. CONCLUSION: The full spectrum of STD avoidance strategies warrants further study because some are ubiquitous across cultures and because they have the potential to complement or undermine safer sex programmes. Because of their greater acceptability, some less efficacious strategies may have greater public health importance than less popular but more efficacious strategies such as condoms.

Female↗
PubMed1998

Sexual functioning of adult patients born with meningomyelocele. A pilot study.

OBJECTIVES: This pilot study was started to get an impression of the sexual activity and sexual difficulties of adult patients born with meningomyelocele in control at Utrecht University Hospital, and to find out whether these problems deserve more attention from the Spina Bifida Team. METHODS: Seventeen patients (9 men, 8 women; aged 19-44) were asked to participate; 11 (8 men, 3 women) decided to take part in this study. All these patients were interviewed by their physician about their present sexual life; 6 of them also completed the 'Questionnaire for screening Sexual Dysfunctions' (QSD). RESULTS: With 1 exception, all patients expressed a desire for sexual contact. Five of them masturbated and 6 patients sometimes had sexual contact. Eight patients had problems in the field of sexuality, but only 3 were dissatisfied with their present sexual life. CONCLUSIONS: It is advantageous to invite adult patients born with meningomyelocele for an interview about their sexual life. When raising this subject, however, one has to act with caution: for quite a few patients (in this study mostly women) sexuality still is a delicate subject.

Adolescent↗
PubMed2000

Relation of sexual dysfunction to hormone levels, diseases and drugs used in andrological patients.

In 169 patients visiting our department complaining of sexual dysfunction, the medical history was taken using a semistructured interview. A clinical investigation and a hormone analysis were added. The age of patients, hormone values, and items of the interview were collected into a common database. The items were categorized as either dichotomous (yes/no) or ordinal. Statistical analysis was performed using regression analysis with the aim to generate hypotheses of relations. An increase of FSH levels and a decrease of testosterone levels with age occurred. None of the relations of hormone levels or diseases to symptoms of sexual dysfunction produced odds ratios (OR) statistically significant different from 1. However, the risk of having a reduced libido and reduced morning erections was lower in psychoneurological diseases, the risk of reduced arousal and libido was lower in men with diabetes mellitus, but the risk of reduced morning erections was higher in these men. The testosterone levels were not associated with the risk of having reduced penile rigidity, duration of erection, arousal and sexual libido, reduced morning erections and the ability to masturbate. Smoking was not associated with reduced arousal, libido and morning erections. However, a significant increase of testosterone levels with number of cigarettes used was observed. We conclude that sexual dysfunction in patients visiting an andrological department for diagnosis and treatment is mostly not associated to any single evaluable factor.

Adult↗
PubMedDate not supplied

Certain aspects of bonobo female sexual repertoire are related to urinary testosterone metabolite levels.

We examined the unknown relationship between testosterone and sexual behaviour in female bonobos (Pan paniscus) on a daily and long-term level. In most animal species, sexual behaviours mainly focus on reproduction. Bonobos, however, also use sexual interactions to a large extent to maintain and restore social relationships. They display an elaborate sexual repertoire that is expressed during fertile as well as non-fertile periods in life and exhibit a high degree of female control over sexual interactions. Using urinary testosterone metabolite levels of cycling and non-cycling females, we found no relationship between daily differences in testosterone metabolite concentrations and any of the sexual behaviours. However, long-term differences in the variables partially confirm the hypothesis of Jurke et al. [2001] stating that in bonobos testosterone is primarily related to non-reproductive sexual interactions. Furthermore, remarkably, a negative correlation of testosterone metabolite levels with the frequency of the females' sexual inspections was demonstrated. No correlation was found with the frequency of sexual presentations performed by the females and with the frequency of masturbation. We present a case study on this topic in an immigrating female.

Animals↗
PubMedDate not supplied

Colitis cystica profunda: self-inflicted by rectal trauma? Report of a case.

Colitis cystica profunda (CCP) is a rare benign condition with a controversial etiology. We report a case of CCP in a patient with a history of anal masturbation, supporting an acquired traumatic etiology. Diagnosis was assisted by transrectal ultrasound. The patient was successfully treated by local excision.

Adult↗
PubMed1982

Partial ejaculatory incompetence: the therapeutic effect of midodrine, an orally active selective alpha-adrenoceptor agonist.

The syndrome of partial ejaculatory incompetence has been reviewed. 6 patients, diagnosed as suffering from partial ejaculatory incompetence, were studied. For each subject, large numbers of spermatozoa were present in the post-masturbation urine sample providing evidence of disturbed ejaculatory function. The effect of a potent alpha-adrenoceptor agonist (Midodrine) was evaluated in these patients by means of a double-blind crossover study. Active treatment resulted in a significant increase in intensity of orgasmic sensation, and in a statistically significant improvement in ejaculatory function.

Adult↗
PubMed2001

Sexuality in patients with noninvasive mechanical ventilation due to chronic respiratory failure.

In patients with chronic respiratory failure (CRF) noninvasive mechanical ventilation (NMV) improves quality of life. We studied some basic issues concerning sexuality in patients with NMV. In 383 patients with NMV for CRF (age, > 40 yr) physiologic data (lung function, blood gases, and exercise) were taken from within the 6 mo period before enrollment. The questionnaire was focused on sexuality after initiation of NMV. Of the patients, 54.3% sent back the questionnaire. NMV was used for 41.1 +/- 27.0 mo. A total of 34.1% of patients were sexually active. Compared with patients receiving NMV, control persons had a higher rate of sexual activity (84%, p < 0.0001) and masturbation rate (13 versus 40%). Sexually active patients had greater VC (2.1 versus 1.8 L), higher FEV(1) (1.4 versus 1.1 L), higher Pa(O(2)) at rest (64.0 versus 60.4 mm Hg), a higher maximal work load (72.0 versus 58.8 W), were younger, and most of them were married or had sexual partners. Changes in sexual activity after NMV initiation were reported to be as follows: "Nothing changed," 46.3%; "less active," 35.8%; "more active," 12.6%; and "fantasy increased," 10.5%. Increased sexual fantasy predominated in men. "Sexually active" patients with NMV had sexual intercourse 5.4 +/- 4.8 times per month. Sexuality in patients receiving NMV for CRF is markedly reduced compared with normal subjects. In half of the patients, sexual activity is influenced by initiation of NMV.

Analysis of Variance↗
PubMed1987

Kleptomania as risk-taking behavior in response to depression.

The psychodynamic etiology of kleptomania has historically been linked to "ungratified sexual instinct." This paper is the first report of kleptomanic behavior associated with masturbation during the shoplifting or at the time of discovery by authorities. However, in this case kleptomania was in fact risk-taking behavior in response to depression. Psychodynamically, risk-taking behavior may be important in kleptomania.

Arousal↗
PubMed2000

Facilitating tolerance of delayed reinforcement during functional communication training.

Few clinical investigations have addressed the problem of delayed reinforcement. In this investigation, three individuals whose destructive behavior was maintained by positive reinforcement were treated using functional communication training (FCT) with extinction (EXT). Next, procedures used in the basic literature on delayed reinforcement and self-control (reinforcer delay fading, punishment of impulsive responding, and provision of an alternative activity during reinforcer delay) were used to teach participants to tolerate delayed reinforcement. With the first case, reinforcer delay fading alone was effective at maintaining low rates of destructive behavior while introducing delayed reinforcement. In the second case, the addition of a punishment component reduced destructive behavior to near-zero levels and facilitated reinforcer delay fading. With the third case, reinforcer delay fading was associated with increases in masturbation and head rolling, but prompting and praising the individual for completing work during the delay interval reduced all problem behaviors and facilitated reinforcer delay fading.

Adult↗
PubMed2005

A comparison of the male customers of female street prostitutes with national samples of men.

Previous research on customers of prostitutes has relied on small samples and qualitative interviews. Conceptions of customers have tended toward either the "every man" perspective, which implies customers are no different than other men, or the "peculiar man" perspective, which implies customers are characterized by stark differences or psychological inadequacies. This study compares a large sample of men (N = 1672) arrested for trying to hire street prostitutes with nationally representative samples of men. Customers were less likely to be married, less likely to be happily married if married, and more likely to report being unhappy in general than men in the national samples. Customers also expressed greater sexual liberalism and reported thinking about sex, masturbating, and participating in other aspects of the sex industry more frequently than men in general. Most differences were small, indicating customers as a category differ from other men in degree rather than quality.

Adolescent↗
PubMed1989

Development of sexuality in female children and adolescents.

Female sexuality (meaning sexual desire, excitement and orgasm) has been of considerable interest in psychiatry. Women's efforts to define and legitimize their own experience of their sexuality have increased in the past 25 years. However, the integration of these new views into the body of psychiatric (especially psychoanalytic) theory has not occurred very actively or successfully. Very little is known about the development of sexuality in childhood and adolescence. This paper looks at various behaviours, interests and events in women's lives that might reveal something about the development of their sexuality. The literature on female masturbation is reviewed and some sex differences high-lighted. The literature on interest in babies, the wish to have babies, and menarche is explored for possible associations with sexuality. Rather than sexuality being a central organizer of experience, it seems quite possible that experience is an organizer of sexuality. Therefore, to better understand female sexuality we need to consider the impact of experiences during childhood and adolescence.

Adolescent↗
PubMed1992

A double-blind placebo controlled trial of medroxyprogesterone acetate and cyproterone acetate with seven pedophiles.

Seven of ten pedophiles in hospital completed a double-blind, placebo-controlled two-dose comparison of medroxyprogesterone acetate and cyproterone acetate. Sequential measures during the 28 week study were: patient self-reports, nurses' observations, phallometry, hormone levels and side-effects. The drugs, which performed equivalently, reduced sexual thoughts and fantasies, the frequency of early morning erections on awakening, the frequency and pleasure of masturbation, and level of sexual frustration. Penile responses were also reduced but to a lesser degree and were more variable. Serum testosterone FSH and LH all declined during drug administration, but by the end of the final placebo phase had essentially returned to (or exceeded) pre-drug values. Our experience suggests that only a minority of pedophiles are likely to accept libido-reducing drugs.

Adult↗
PubMedDate not supplied

Knowledge of HIV transmission and risk behaviour in Kenyan health care workers.

In order to determine knowledge of HIV transmission, sexual risk behaviour and perception of risk in African health care workers, 200 employees at the Aga Khan Hospital, Nairobi, Kenya, were asked to complete an anonymous self-administered questionnaire. There was a 75% response rate. Twenty-five per cent believed that condoms were not protective against HIV transmission. Eighty-nine per cent believed oral sex to be a risk factor, as did 70% for kissing, 41% for masturbation of a partner and 43% for nursing an AIDS patient. Younger people were more likely to think condoms were ineffective (P = 0.007) and that insect bites were a significant risk factor (P = 0.004). Twenty-seven per cent had changed their sexual behaviour as a result of the AIDS epidemic, but 48% did not use condoms with non-regular partners. Four had current or previous homosexual relationships. Seventy per cent believed they were at risk of being HIV positive but only 12% had been tested. We have shown that even in the educated group, misconceptions regarding HIV transmission were high and many continue to be at risk for their sexual behaviour. In addition, in-service training regarding HIV transmission should be considered for health care workers in Africa.

Female↗
PubMed2006

Young people, pornography, and sexuality: sources and attitudes.

The purpose of this study was to investigate the use of and attitudes among young people toward pornography and their sources of information about sexuality. Eight hundred and seventy-six young people ages 15-25 years (555 females and 321 males) who visited a youth center in Sweden for a period of 1 year answered a questionnaire about their use of pornography, their attitudes toward pornography, and sources of information about sexuality. Although most had seen pornographic movies, the youngest boys reported viewing the most pornography. The male participants reported that the most common reason they viewed pornography was to get aroused and to masturbate, whereas the female participants stated that they viewed pornography out of curiosity. The most frequent source of information about sexuality was peers. These results illustrate the importance of sex education to give factual information about sexuality and to counteract the messages about sexuality presented in pornography.

Adolescent↗
PubMed2002

Resiliency in the victim-offender cycle in male sexual abuse.

The prevalence of childhood sexual abuse in child molesters is considerably higher than that in the general population. This finding had led to the "victim-offender cycle" being popularized as an explanation for sexual offending. However, not all child molesters were victimized as children, so it is of interest to examine the factors that contribute to the victim-offender cycle or, conversely, resiliency. This study examined the "moderating factors" that may prevent a male victim of sexual abuse from entering the victim-offender cycle. Two groups were interviewed as part of the study: a "resilient group" (n = 47) and a victim-offender group (n = 41). After correction for age and education level, the resilient group were less likely to have fantasized and masturbated about the abuse, less likely to report deriving pleasure from the abuse, more likely to have had frequent social contact with adolescent peers and to have had more family and nonfamily support during childhood. The findings support the need for multifactorial models of resiliency, the victim-offender cycle, and sexual offending. Recommendations about the prevention of the victim-offender cycle are made, including the need for a thorough systemic assessment of all male victims of sexual abuse and the involvement of their family system in counseling.

Adult↗
PubMed1987

Influence of the day of the week and the weather on people using a telephone support system.

The calls to a telephone counselling service at Louvain, during a 21-month period, from one telephone zone were analysed. Data were studied in relation to the type of weather, which was recorded every day. Calls made by women about health and interpersonal problems showed a relationship to the weather, while calls apparently motivated by masturbation intentions from male callers increased when the weather improved.

Belgium↗
PubMed2005

Dose-dependent effects of testosterone on sexual function, mood, and visuospatial cognition in older men.

CONTEXT: The relationships between testosterone dose and its effects on sexual function, mood, and visuospatial cognition are poorly understood. OBJECTIVE: To elucidate testosterone dose-response relationships in older men, we examined the effects of graded testosterone doses on sexual function, mood, and visuospatial cognition in healthy, older men (age, 60-75 yr). SETTING: This study was performed at the General Clinical Research Center. INTERVENTION/METHODS: Subjects each received a long-acting GnRH agonist to suppress endogenous testosterone production and were randomized to receive one of five doses (25, 50, 125, 300, and 600 mg) of testosterone enanthate weekly for 20 wk. Questionnaires were used to evaluate sexual function. Scores for overall sexual function as well as subcomponents of sexual function (libido, sexual activity, and erectile function) were calculated. RESULTS: Changes in overall sexual function (P = 0.003) and waking erections (P = 0.024) differed by dose. An interaction between libido and being sexually active was observed, such that libido changed by testosterone dose only among men who reported being sexually active at the beginning of the study (P = 0.009). Men's log-transformed free testosterone levels during treatment were positively correlated with overall sexual function (P = 0.001), waking erections (P = 0.040), spontaneous erections (P = 0.047), and libido (P = 0.027), but not with intercourse frequency (P = 0.428) or masturbation frequency (P = 0.814). No effects of testosterone dose were observed on two measures of mood: Hamilton's Depression Inventory (P = 0.359) and Young's Mania Scale (P = 0.851). The number of trials completed on a computer-based test of visuospatial cognition differed by dose (P = 0.042), but the number of squares correctly completed on this task did not differ by dose (P = 0.159). CONCLUSIONS: Different aspects of male behavior respond differently to testosterone. When considered together with previous data from young men, these data indicate that testosterone dose-response relationships for sexual function and visuospatial cognition differ in older and young men.

Affect↗
PubMed1990

Effects of estrogen, androgen, and progestin on sexual psychophysiology and behavior in postmenopausal women.

To assess the contribution of gonadal steroids to sexual behavior in aging women, we conducted a 10-week, double-blind, hormone replacement study of 40 naturally menopausal women (mean age, 58.3 yr). Prospective measurements of basal and stimulated vaginal vasocongestion and daily self-reports of mood, physical symptoms, sexual behavior, and perceived sexual pleasure were collected. Daily treatments were either conjugated equine estrogen, i.e. Premarin (P; 0.625 mg), Premarin and medroxyprogesterone acetate, i.e. Provera (PP; 0.625 and 5 mg, respectively), Premarin and methyltestosterone (PT; 0.625 and 5 mg, respectively), or placebo (PL). Compared to placebo, hormone treatment had significantly reduced hot flashes in the P and PP groups by week 4 and in the PT group by week 5. Headaches were reduced in the P vs. PL group, only. Hormone treatment did not significantly alter mood ratings, sexual behaviors, or psychophysiologically measured sexual arousal. PT treatment significantly increased reports of pleasure from masturbation compared to the other three groups, underscoring the apparent contribution of androgens to self-stimulatory behavior. However, the data suggest that in these physically and sexually healthy women, gonadal steroids do not influence major components of sexual functioning, including arousal and a wide variety of sexual activity and experience.

Analysis of Variance↗