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PubMed1991

The effect of drugs on male sexual function and fertility.

Drugs may have negative effects on male libido, erection, ejaculation and orgasm, as well as on fertility, and research on these effects is increasing. Libido may be decreased by drugs that block dopamine or testosterone, or that cause dysphoria. Erection may be decreased by drugs that divert blood flow from the penis, or drugs that affect spinal reflexes. Ganglion blockers may also inhibit erection. Ejaculation may be diminished by drugs that affect spinal reflexes or be inhibited by ganglion blockage. Enervation of the vas deferens and epididymis may be blocked and cause a smaller emission. Retrograde ejaculation may occur due to blockage of the internal urethral sphincter. Orgasm is usually inhibited by the drugs that inhibit ejaculation. Fertility is impaired by drugs that affect sexual performance or spermatogenesis. Major groups of drugs that may affect male sexual function include drugs of abuse, CNS depressants, antihypertensives, anticholinergics, psychotherapeutics, hormones, and cancer therapeutics, in addition to miscellaneous other agents. Information about these drugs has been arranged in tables so that the provider has a convenient reference to use when explaining to men the effect of drugs on sexual response and fertility.

Drug-Related Side Effects and Adverse Reactions↗
PubMed1988

Sexual behaviour in relation to age: a study of 205 puerperal women.

Sexual desire, frequency of coitus, frequency of orgasm, which partner took the first sexual initiative, and the level of sexual satisfaction were studied in 205 women in puerperium in relation to age in the year preceding pregnancy and during pregnancy. It seems evident that sexual desire and the frequency of coitus and orgasm diminish during pregnancy independently of age. The group of younger women (16 to 20 years old) in our study maintained a relatively higher level of sexual activity especially in comparison to older women (36 to 40 years old). The number of women who took the first sexual initiative increased considerably in pregnancy.

Adolescent↗
PubMed1983

Some effects of orchiectomy, oestrogen treatment and radiation therapy in patients with prostatic carcinoma.

In patients treated for prostatic carcinoma with oestrogen, orchiectomy or external radiation, serum concentrations of testosterone, LH, FSH, prolactin, TeBG and oestradiol-17 beta as well as changes in sexual behaviour and mental mood were studied. Oestrogen treatment as well as orchiectomy reduced serum testosterone concentration to similar values. Neither totally nor subcapsularly orchiectomized patients responded to HCG stimulation. The free testosterone was 68% lower in oestrogen treated than in orchiectomized patients, probably due to a high TeBG concentration induced by oestrogens. patients oestrogen treated for less than 3 years and in whom the treatment had been withdrawn had normal serum testosterone and LH at follow-up. In contrast, low serum testosterone concentration and normal LH were found after oestrogen cessation in patients oestrogen treated for more than 3 years indicating reduced Leydig cell, and/or hypothalamic-hypophyseal function. In patients oestrogen treated for more than 3 years the serum testosterone concentration neither increased after oestrogen cessation nor decreased after orchiectomy. Absorbed testes doses during radiation treatment were measured from a few to more than 10 Gy but were reduced by about 50% if the gonads were protected by lead shields during anterior and posterior treatment sessions. Radiation may affect gonadal function as decreased serum testosterone concentration and increased LH, FSH were found after treatment. Sexual function was altered after oestrogen, orchiectomy and radiation treatment. Sexual activity and capability were distinctly better maintained after radiation than after orchiectomy or oestrogen treatment. Sixty-seven percent of the patients had coitus or masturbated after radiation treatment, all experiencing orgasm. Patients on oestrogen treatment or after orchiectomy had coitus/masturbation less often (17% in both groups). They also experienced orgasm less often (8% and 17% respectively). The group of patients on oestrogen treatment had a higher average score for depression than those treated with orchiectomy or radiation treatment.

Adenocarcinoma↗
PubMed1984

Heart rate, rate-pressure product, and oxygen uptake during four sexual activities.

Heart rate, rate-pressure product, and VO2 were measured in ten healthy men during four specified sexual activities: coitus with husband on top, coitus with wife on top, noncoital stimulation of husband by wife, and self-stimulation by husband. Foreplay generated slight, but statistically significant, increases above resting baseline in cardiac and metabolic variables. From stimulation through orgasm, average effort was modest for relatively short spans. Maximum exercise values occurred during the brief spans of orgasm, then returned quickly to near baseline levels. The two noncoital activities required lower expenditures than the two coital positions, with man-on-top coitus rating the highest. Large variations among subjects and among activities discourage use of a general equivalent activity for comparison, such as "two flights of stairs," to represent "sexual activity."

Adult↗
PubMed1984

Sexual dysfunction in multiple sclerosis.

A questionnaire study on sexual problems occurring with multiple sclerosis (MS) was carried out with 217 patients who had previously participated in the University of Washington Multiple Sclerosis Project. More than one-half of the participating subjects were ambulatory without aids and nearly 75% did not use a wheelchair. Sexual dysfunction was reported by 56% of the women and 75% of the men. Among the women, the most commonly occurring sexual symptoms (in decreasing order of frequency) were fatigue, decreased sensation, decreased libido, decreased frequency or loss of orgasm and difficulty with arousal. Men reported the most common problem was erectile dysfunction, followed by decreased sensation, fatigue, decreased libido, and orgasmic dysfunction. Although loss of mobility, weakness and depression are not significantly associated with sexual dysfunction, spasticity and bladder dysfunction appear to be associated. However, even where these symptoms were absent, sexual dysfunction was perceived in at least 50% of the cases. The data indicate that sexual dysfunction can be anticipated in at least 50% of the women and about 75% of the men affected by MS, regardless of mobility level. It is most likely to occur in patients with spasticity and bladder dysfunction.

Adult↗
PubMed1982

[The married couple with functional sexual disorders in the sexual learning therapy].

Experiences gained with 70 married couples in the course of sexual learning show positive effects obtained by including the couples in the therapeutic group and the therapeutical community as well as some problems of the combination of the training with dynamically orientated group psychotherapy. Several positive experiences from the course of learning therapy are briefly described and several negative experiences showing a disturbing effect are analysed in greater detail, such as the initial performance orientation of the husband with potency disturbances, the humiliatinhg behaviours of his wife, fears of the woman to lose her husband after curing, disagreeable sensations of shame of the woman with orgasm disturbances, her prejudices against clitoral stimulation, her desperate efforts to reach orgasm, distractions, getting accustomed to the refusing behaviour of the partner. trivial quarrelling and deeper conflicts.

Adult↗
PubMed1995

[Biochemistry of Eros].

Analytic study of the biochemical factors in the process of pareunia: hormonal factor of embryonic genital crests, responsible for a double sexualization, both genital and encephalic, which stands for the exteriorization of a perfectly determined later behavior; attractive or repulsive exoactones (pheromones) which play a major part in inter-individual attraction. Study of those many exoactones in both sexes; hormonomediation, leading to the intervention of the hypotalamo-adeno-hypophyso-(cortico)-gonadal axis, with such effectors as sexosteroids, the hypothalamo-adenohypophyseal with the prolactin, the neuro-hypopheseal level (vasopressin, ocytocyne), and the epiphyseal level (melatonin), the terminal effector agents appearing either as libido (androgens, P-Rih), or counter-libido (oestrogens, prolactin) with the involvement of two systems of vertical and horizontal libidinization; neuromediation, with the intervention of the catecholaminergic, cholinergic, indolaminergic (serotonin); neuromodulation, with a rise in the endorphin rate when there is an orgasm; very precise enzymatic phenomena (depolymerases appearing in the vaginal content when there is an orgasm), which cannot be ignored any longer.

Courtship↗
PubMed1995

[Evaluation of sexual function in adults with myelomeningocele].

In the present study, sexual function in 46 patients (22 males and 24 females) with myelomeningocele was assessed by a questionnaire study. The mean age of the patients was 24.0 +/- 9.6 years (with an age range of 18 to 50) for male patients and 25.2 +/- 6.2 years (with an age range of 18 to 42) for female patients. Having interest in the opposite sex and sexual desire were evident in 95% and 100% of male patients, and 83% and 75% of female patients, respectively. In male patients, erection was achieved in 95% by visual stimulation and in 86% by tactile stimulation. However, only 27% of the patients with erectility were satisfied with penile rigidity. Ejaculation and orgasm was noted in 67%. Orgasm was frequently seen in patients whose external sphincter activity was maintained. The age and the degree of lower extremity paralysis according to Sharrard classification were not significantly correlated with sexual function. In female patients, menstruation was regular in 95%, vaginal secrete was adequate in 88%, but only 19% of the patients felt ecstacy around perineal lesion at coital movements. In female patients, sexual function was not correlated with the age, the degree of lower extremity paralysis and detrusor activity-sphincter activity. Although most patients had sexual desire, only 18% of the males, and 33% of the females, had sexual intercourse activities. It appears, therefore, that these patients need to be given appropriate advice.

Adolescent↗
PubMedDate not supplied

Sexual function of diabetic and nondiabetic African American women: a pilot study.

This study explored differences in sexual function of diabetic and nondiabetic African American Women. Using the Watts Sexual Function Questionnaire (WSFQ) to measure components of sexual function, diabetic women disclosed significantly lower levels of sexual desire (p < .02) than control subjects. Both groups were similar in reports of sexual arousal, orgasm, and satisfaction. For diabetics, clinical and metabolic indices such as length of time as a diabetic and level of glycosylated hemoglobin (Hb-A1C) were not related to sexual function. A significant positive relationship was noted between sexual satisfaction and body mass index (BMI) (p < .03). With regard to age, both groups showed significant negative relationships between age and sexual arousal; whereas for diabetics, significant negative correlations were also found between age and sexual desire (p < .01) and orgasm (p < .05). These findings indicate that maintenance of sexual desire may be problematic for diabetics. Being overweight was not a deterrent to sexual satisfaction. Sexual performance problems are more likely to occur for the aging African American woman with diabetes.

Adult↗
PubMed1998

Antidepressant-induced sexual dysfunction.

This article reviews current evidence regarding sexual side effects of antidepressant drugs. Controlled studies have demonstrated that some antidepressant drugs have adverse effects on orgasm and libido. Orgasmic dysfunction and ejaculatory delay appear to be common sexual side effects of the serotonin selective reuptake inhibitors (SSRIs). A variety of treatment options are available if a patient experiences antidepressant-induced sexual dysfunction. Often, modification of the pharmacologic regimen will restore sexual function while maintaining antidepressant activity. The frequency of sexual side effects reported with the SSRIs mandates that the clinician inquire about sexual function if these agents are used. Bupropion and nefazodone appear to have an unusually low incidence of sexual side effects.

Antidepressive Agents↗
PubMed1998

Vasculogenic female sexual dysfunction: vaginal engorgement and clitoral erectile insufficiency syndromes.

The first phase of the female sexual response, associated with neurotransmitter-mediated vascular smooth muscle relaxation, results in increased vaginal lubrication, wall engorgement and luminal diameter as well as increased clitoral length and diameter. Specific physiologic impairments of vasculogenic female sexual dysfunction include vaginal engorgement and clitoral erectile insufficiency syndromes. These syndromes exist when during sexual stimulation abnormal arterial circulation into the vagina or clitoris, usually from atherosclerotic vascular disease, interferes with normal vascular physiologic processes. Clinical symptoms may include delayed vaginal engorgement, diminished vaginal lubrication, pain or discomfort with intercourse, diminished vaginal sensation, diminished vaginal orgasm, diminished clitoral sensation or diminished clitoral orgasm. An animal model of this syndrome, with significant physiologic responses between the control and the atherosclerotic pelvic nerve stimulated hemodynamic responses, is discussed. Non-atherosclerotic, traumatic vascular disease of the ilio-hypogastric-pudendal arterial bed from pelvic fractures or blunt perineal trauma may also result in diminished vaginal/clitoral arterial blood flow following sexual stimulation. Diagnostic studies assessing the hemodynamic integrity of the ilio-hypogastric-pudendal arterial bed to the vagina and clitoris and new oral/topical pharmacologic strategies for enhancing vaginal/clitoral blood flow in patients with vasculogenic female sexual dysfunction are discussed. There is a growing body of evidence that women with sexual dysfunction will commonly have physiologic abnormalities, such as vasculogenic female sexual dysfunction, contributing to their overall sexual health problems.

Animals↗
PubMed1998

Physiological measures of vaginal vasocongestion.

This paper reviews reliability, specificity, and practical applicability of the two most promising and widely used methods for measuring blood flow within the vagina: the oxygenation-temperature method and vaginal photoplethysmography. It was concluded that the oxygenation-temperature method and vaginal pulse amplitude as measured by the photoplethysmograph are both specific indicators of physiological sexual arousal. Although vaginal pulse amplitude seems to be the method of choice for measuring vaginal vasocongestion up to orgasm, and the oxygenation-temperature method for measuring orgasm, these measures should not be used in isolation. It is argued that women's sexual function should be evaluated using vaginal vasocongestion measures in conjunction with subjective indices. Finally, the field is in need of studies comparing physiological and subjective sexual responses in clinical and non-clinical groups.

Animals↗
PubMed1998

Sexual functioning in the spinal cord injured.

This article reviews current knowledge about the impact of SCI on male and female sexual responses including erectile function, lubrication ejaculation and orgasm. The ability to achieve erection, lubrication and ejaculation can be described based upon the degree and type of neurologic injury affecting the sacral spinal segments. The ability of SCI individuals to achieve orgasm has not been found to be based upon the type of degree of neurologic injury. The implications of these findings to increase our understanding of human sexual neurophysiology is also discussed.

Female↗
PubMed1998

[Sex life of pregnant women with cardiopathies].

In a retrospective investigation comprising a group of 116 women with cardiopathies who delivered in 1989-1993. The author evaluated their sex life during the early puerperium, using the author's questionnaire "Sexual behavior and cardiac diseases" supplemented by a controlled interview. 41 women (35.3%) refused the interview on sexual behavior and did not complete the questionnaire. The analyzed group comprised 71 women with cardiac diseases. The maternal mortality rate in the investigated group was 0.86%, the perinatal mortality rate 0.0%, prematurity 3.4% and hypotrophy 5.2%. It was revealed that during the pregestation period 80% of the women with cardiac diseases has regular sex at least once a week and had an orgasm and satisfaction without any fears. With advancing pregnancy the libido declines, as well as the frequency of sexual intercourse, orgasm and sexual satisfaction and fear of sexual intercourse increases. Except during pregnancy and at its onset the spectrum of coital positions is varied. At the end of pregnancy lateral positions predominate. Sexual activity before pregnancy is usually initiated by both partners. At the end of pregnancy in first pregnancies it is the woman, in pluriparas it is usually the man. Interest in the sexual behavior of women with cardiac diseases on the part of cardiologists and obstetricians was minimal. In the author's opinion there is no reason to restrict sex life during pregnancy in women with cardiac diseases functional stage I and II (NYHA, 1964) unless there are obstetric or cardiological contraindications.

Adult↗
PubMed1999

Switching to moclobemide to reverse fluoxetine-induced sexual dysfunction in patients with depression.

OBJECTIVE: To determine the efficacy of substituting moclobemide, a reversible monoamine oxidase-A inhibitor, for fluoxetine to reverse fluoxetine-induced sexual dysfunction in patients with depression. DESIGN: Prospective open trial. SETTING: Outpatient treatment. PARTICIPANTS: Five patients with depressive disorder who experienced sexual side effects during treatment with standard doses of fluoxetine (20 to 40 mg per day). INTERVENTION: Discontinuation of fluoxetine and replacement with moclobemide (300 to 600 mg per day) after a 2-week washout period. OUTCOME MEASURES: Libido, orgasmic function (in women) or erectile and ejaculatory function (in men), and overall improvement in sexual function during a follow-up period of 2 months to 3 years. RESULTS: Among patients receiving fluoxetine questioned about sexual side effects, 4 (1 man and 3 women) had treatment-related diminished libido with poor orgasmic response or partial erectile failure, and 1 female patient had enhanced sexual desire with intense clitoral stimulation. In all patients, sexual disturbances resolved completely after a 2-week washout period and a switch to treatment with moclobemide. Moclobemide was well tolerated. The antidepressant effect of moclobemide was comparable to that of fluoxetine. CONCLUSIONS: Moclobemide may be preferred as a treatment for depression in patients with fluoxetine-induced sexual dysfunction.

Adult↗
PubMed1979

Observations on vaginismus in Irish women.

This article describes a group of 23 Irish women with vaginismus. This figure represents 42% of the total female referrals to the author, and is quite high when compared with other reports. The type of treatment before referral, and the characteristics of the patients, tend to confirm the author's diagnosis, which was made only after vaginal examination. Social and cultural factors unique to Ireland are believed to be of importance in the clinical presentation of this form of sexual dysfunction. A number of differences are seen when women with vaginismus are compared with those who complain of orgasmic dysfunction. These differences relate to childhood experiences, their perception of their marriage, and their sexual dysfunction. The success rate, number of sessions required for treatment, and recovery rate at follow-up are described for vaginismus. All women with this condition who persisted with treatment recovered, whereas those described as failures stopped within three visits. The author believes that the therapeutic claims of sex therapists in recent years must be viewed critically, as self-selection seems to be an important influence on prognosis.

Adult↗
PubMed1991

Psychopathology associated with sexual dysfunction.

The association between sexual disorders and psychological functioning was investigated in this study. Seventy-eight subjects who applied for sex therapy were divided into the following groups: Sexual Desire (SDD) and Erectile Disorder; Orgasm (ORG) and Premature ejaculation (PME) disorders. Fifty-six sexually functional subjects served as matched controls. The MMPI was administered to all subjects. The results indicated that the SDD and Erectile groups produced the most disturbed profiles, while the ORG and PME groups yielded profiles within normal limit (WNL). A good fit of individual to group profiles was found for SDD, but not for PME and ORG; thus, clinical interpretation was possible for the former only.

Adult↗
PubMed1977

Anorgasmia and cataplexy.

Ten married women with cataplexy were found to be rarely orgasmic. Cataplexy is characterized by recurrent episodes of short-lived generalized muscle paralysis. It is precipitated by arousing emotional precipitants such as laughter, fear, and anger. Patients learn to avoid situations exposing them to these precipitants. It is suggested that anorgasmia is a consequence of this general tendency to avoid arousal.

Adult↗