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PubMed2005

Quality of sex life in women with endometriosis and deep dyspareunia.

OBJECTIVE: To characterize sexual function among women with endometriosis and deep dyspareunia (DD). DESIGN: Cross-sectional survey. SETTING: University teaching hospital. PATIENT(S): Three-hundred nine women undergoing surgery because of infertility, pelvic pain, or adnexal masses. Three groups of patients with DD were created: women with deep infiltrating endometriosis of the uterosacral ligament (group U), women with endometriosis without uterosacral ligament lesions (group E), and controls (group C). INTERVENTION(S): Laparoscopy. MAIN OUTCOME MEASURE(S): Sexual function questionnaire. RESULT(S): The prevalence of DD since the first intercourse was significantly higher among women with endometriosis than in controls (P=.029). When group U was compared with group E and C, the pain score was higher, the number of intercourses per week was reduced, the orgasm was less satisfying, and the patients felt less relaxed and fulfilled after sex. No significant difference was observed in pain score and coital frequency between subjects with monolateral and bilateral lesions of the uterosacral ligament. CONCLUSION(S): Among subjects with DD, those with deep infiltrating endometriosis of the uterosacral ligament have the most severe impairment of sexual function; the presence of bilateral lesions does not influence the severity of the symptoms. Women with endometriosis have frequently suffered DD during their entire sex lives.

Adult↗
PubMed2007

[Clitoris and G spot: an intimate affair].

Ultrasonography is a good means for studying the clitoris and its relationship with the G spot. We used it to demonstrate that clitoral bodies have a descending movement and come close to the distal anterior vaginal wall during a voluntary or reflex contraction of levator ani muscles. This fact could explain the particular sensitivity of the G spot and its role in the orgasm.

Clitoris↗
PubMed2005

Mode of delivery and pelvic floor muscle strength and sexual function after childbirth.

OBJECTIVE: To investigate the respective roles of the mode of delivery and strength of pelvic floor muscles in the sexual function of women. METHOD: Thirty-two women who were delivered vaginally and 21 women who underwent cesarean delivery at the Celal Bayar University School of Medicine Obstetrics Department were enrolled in the study, and 15 nulliparas were recruited as controls. Sexual function was assessed in all women by a validated questionnaire (the Female Sexual Function Index). Desire, arousal, lubrication, orgasm, satisfaction, and pain were measured separately, and pelvic floor muscle strength was assessed by a perineometer. Sexual function was compared among the 3 groups. The correlation between pelvic floor muscle strength and sexual function was also investigated. RESULTS: Pelvic floor muscle strength was significantly lower in the group vaginally delivered compared with the group delivered by cesarean section and the nulliparous group (P<0.05). There was no difference between the groups regarding sexual function (P>0.05), and there was also no correlation between sexual function and pelvic muscle strength. CONCLUSION: Pelvic floor muscle strength and mode of delivery did not affect sexual function in our study participants. The muscular component of female sexual function should be further investigated.

Adult↗
PubMed2006

Burden of phase-specific sexual dysfunction with SSRIs.

OBJECTIVE: This study examines phase-specific sexual dysfunction among patients who are being treated for major depression and who do not meet criteria for global sexual dysfunction. METHODS: 6297 adult outpatients receiving antidepressant monotherapy completed the Changes in Sexual Functioning Questionnaire (CSFQ). The sub-sample for this study (n = 3114) comprises participants who were receiving treatment with a SSRI or SNRI and did not meet the gender-specific criterion for global sexual dysfunction on the CSFQ. RESULTS: Among this sub-sample, 95.6% of women and 97.9% of men exhibited impairment in at least one phase of sexual functioning. Men were significantly more likely than women to experience dysfunction in the desire phase (91.2% vs. 79.0%; OR = 2.76; 95% C.I. = 2.14 to 3.5) and the orgasmic phase (85.1% vs. 45.4%; OR = 6.9; 95% C.I. = 5.6 to 8.4) but were significantly less likely than women to experience dysfunction in the arousal phase (71.9% vs. 83.3%; OR = .51; 95% C.I. = .43 to .62). The prevalence of phase-specific dysfunction did not vary significantly by SSRI/SNRI for males or females. CONCLUSION: Among patients who do not experience clinically significant global sexual dysfunction on SSRI/SNRI monotherapy, dysfunction in at least one phase of the sexual response cycle is very common and may reduce sexual health-related quality of life.

Adrenergic Uptake Inhibitors↗
PubMed2006

Climacturia following radical prostatectomy: prevalence and risk factors.

PURPOSE: Following radical prostatectomy urine leakage during orgasm is a poorly defined entity. We defined the prevalence, quantity, bother and coping mechanisms associated with this complication, called climacturia. MATERIALS AND METHODS: A self-administered questionnaire was given to a cohort of sexually active men after radical prostatectomy. We inquired about the frequency, quantity, bother and coping mechanisms associated with climacturia. We also recorded uroflowmetry and an American Urological Association symptom score (International Prostate Symptom Score) in each patient. RESULTS: Of the 42 patients enrolled with a mean age of 58.9 years and average time since radical prostatectomy of 23.6 months climacturia was reported in 19 (45%). Of the men 68% reported that it happened rarely or only occasionally, while 21% reported that it occurred most of the time or always. In terms of urine quantity 58% of respondents reported only a few drops but 16% reported a loss of more than 1 ounce. Of the patients 52% percent reported no or minimal bother but 48% reported that climacturia caused significant bother. Only 21% of respondents thought that it was of significant bother to their partners. Of the respondents 84% emptied the bladder before intercourse and 11% used condoms. Age, Gleason score and time since surgery were not predictors of climacturia. No association between peak urine flow on uroflowmetry or International Prostate Symptom Score and climacturia was found. CONCLUSIONS: Climacturia is a common clinical entity, occurring in almost half of all patients after radical prostatectomy. It can be a significant problem with respect to urine volume loss, associated bother and condom use. Patients must be informed about this complication before undergoing radical prostatectomy.

Adaptation, Psychological↗
PubMed2005

A randomized double-blind 12-week study of quetiapine, risperidone or fluphenazine on sexual functioning in people with schizophrenia.

Sexual dysfunction is common in people suffering from schizophrenia and is reported by patients to be a significant reason for medication nonadherence. This report contains data for 27 people with schizophrenia who participated in a randomized double-blind 12-week trial of risperidone (4 mg/day), quetiapine (400 mg/day) or fluphenazine (12.5 mg/day). At baseline and endpoint, subjects were rated on the Changes in Sexual Function Questionnaire (CSFQ), the Prolactin-Related Adverse Event Questionnaire (PRAEQ) and had prolactin levels drawn. Endpoint prolactin levels were 50.6 +/- 40.4, 24.4 +/- 18.5, and 8.2 +/- 4.4 mg/dl for risperidone (N = 12), fluphenazine (N = 9) and quetiapine (N=6), respectively (F = 7.5,df = 2, p = 0.005, controlling for sex). Orgasm quality/ability improved significantly for quetiapine as compared to fluphenazine and risperidone (F = 4.41, df = 2, p = 0.033). Seventy-eight percent of patients on fluphenazine reported sexual dysfunction whereas did only 42 and 50% of those on risperidone and quetiapine. Forty percent of quetiapine patients reported they felt better about their sexuality as compared to previous treatment, as did 55% on risperidone. Conversely, only 13% of fluphenazine subjects reported any improvement. Hormonal problems (menstrual problems, gynecomastia, galactorrhea) were predominately observed in risperidone-treated subjects. Overall, quetiapine was associated with a normalization of prolactin levels and had the greatest benefits among these drugs regarding sexual functioning.

Adult↗
PubMed1993

Coitus late in pregnancy: risk of preterm rupture of amniotic sac membranes.

OBJECTIVES: Coitus with or without orgasm in late pregnancy is inconsistently associated with preterm rupture of amniotic sac membranes. We tested the hypothesis that during late pregnancy sexual behaviors including sexual positioning relate to the occurrence of premature rupture of membranes. STUDY DESIGN: Women aged 15 to 45 years having preterm premature rupture of membranes, term premature rupture of membranes, or preterm delivery without premature rupture of membranes were matched singly by age, race, and parity to control women delivered of term infants. Information about six sexual activities, obstetric history, cervical infections, smoking during pregnancy, and sociodemographic information was obtained by face-to-face interview. RESULTS: Only the male superior position was significantly associated with preterm premature rupture of membranes (odds ratio 2.40, 95% confidence interval 1.16 to 4.97) and preterm delivery without premature rupture of membranes (odds ratio 1.82, confidence interval 1.02 to 3.25) after confounding variables were controlled for. No sexual positioning or sexual activities related significantly to term premature rupture of membranes. CONCLUSION: Most sexual positions and activities during late pregnancy are not associated with adverse pregnancy outcomes.

Adolescent↗
PubMed1999

Contraceptive status and sexual function of climacteric Chinese women.

The objective of the present survey was to assess the contraceptive status and sexual function of climacteric Chinese women. One cross-sectional study randomly recruited 742 premenopausal, perimenopausal, and naturally menopausal women aged 45-55 years from Beijing. Contraceptive methods were used by 75.6% of premenopausal and 54.2% of perimenopausal women. The primary methods were the IUD and barrier method. The women's choices of methods were related to parity and frequency of sexual activities. Sexual activity was related to the satisfaction of contraceptive methods. Perimenopausal and postmenopausal women were about half as likely to enjoy sexual activity and to experience orgasms than premenopausal women. Women of higher socioeconomic status had a lower risk for decreased sexual functioning. The IUD was the most popular and the most appropriate contraceptive method for perimenopausal women. Sexual function was associated with the women's satisfaction with the contraceptive method used, their menopausal status, and their socioeconomic class.

China↗
PubMed2003

Seeking help for sexual function complaints: what gynecologists need to know about the female patient's experience.

OBJECTIVE: To further explore the patient experience of seeking help for a sexual function complaint. DESIGN: Survey administered on a Web-based instrument. SETTING: Healthy volunteers visiting an online Website. PATIENT(S): The majority of participants were married (73%), Caucasian (88%), and premenopausal (67%). Most commonly reported sexual complaints included low desire (77%), low arousal (62%), and difficulty achieving orgasm (56%). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Patient experience survey on a women's sexual health website. RESULT(S): Although 40% of the women reported that they did not seek help from a physician for sexual function complaints, 54% reported that they would like to. Although only a minority of the women internalized their experience with extremely negative emotions like shame, devaluation, or disgust, the experience was not a particularly emotionally positive one along the lines of relief, optimism, or confidence, and a great deal of frustration and anxiety about treatment was reported. CONCLUSION(S): The extent to which health professionals currently receive exposure to training in human sexuality as well as the way in which female sexual complaints are handled in the medical setting remain ambiguous. The inflow of patients with sexual function complaints only will increase, and it is time for physicians to start to acknowledge women's sexuality with the same importance their patients do.

Ethnicity↗
PubMed2003

Sexuality after sigmoid colpopoiesis in patients with Mayer-Rokitansky-Kuster-Hauser Syndrome.

OBJECTIVE: To assess the functional outcome and sexuality of patients after creation of a sigmoid neovagina. DESIGN: Clinical study performed between 1992 and 2002, with a mean follow-up of 3.3 years (range, 6 months to 9 years). SETTING: Tertiary care center. PATIENT(S): Sixteen consecutive patients with Rokitansky syndrome. INTERVENTION(S): Creation of a neovagina with an antiperistaltic (n = 13) or isoperistaltic (n = 3) sigmoid graft and colovestibular anastomosis by interrupted suture (n = 11) or PCEEA forceps (n = 5). All patients had a neovaginal vault suspension (n = 16). MAIN OUTCOME MEASURE(S): Functional results were evaluated in patients 6 or more months after the operation (n = 12) by using the standardized Female Sexual Function Index (FSFI). This index assesses four domains of sexual dysfunction: desire disorder, arousal disorder, orgasm disorder, and sexual pain disorder. Lubrification and "sexual" quality of life was also evaluated. Normal patients had a mean full FSFI score of 30 +/- 5 of 36. RESULT(S): The mean full FSFI score was 28 +/- 5 (range: 22-34). Seventy-two percent of patients had vaginal intercourse at least once a week; in this subset, the mean full FSFI score was 30 +/- 3 (range: 25-34). CONCLUSION(S): Sigmoid neovagina allowed a normal sexual life in patients who had sexual relations.

Adolescent↗
PubMed1977

A study of the relationship between coitus and the luteinizing hormone surge.

Twenty-seven wives participating in a study of sexual activity patterns had identifiable shifts in basal body temperature and midcycle surges of serum luteinizing hormone (LH). When sexual activity data were examined using the LH surge as a centering point, it was observed that the day before the LH surge had only an average probability of coitus and organism. These findings suggest that neither coitus nor orgasm often triggers ovulation in humans. This cannot be taken as evidence that coitus-induced ovulation never occurs.

Adult↗
PubMed1978

Oxygen tension of the vaginal surface during sexual stimulation in the human.

An oxygen electrode was maintained by suction on the vaginal wall in seven women. The basal value of pO2 was 9.3 mm Hg +/- 10.7 (mean +/- standard deviation) before clitoral self-stimulation was initiated. When stimulation took place the oxygen tension rose and peaked immediately after orgasm to 39.5 +/- 14.1 mm Hg. It then declined and fell to 20.1 +/- 13.8 mm Hg 10 minutes after the peak value. The changes correlate closely with changes in vaginal blood flow. The increased oxygen tension may be one of the factors that enhance of even initiate the motility of spermatozoa when deposited intravaginally.

Adult↗
PubMed1995

Radical retropubic prostatectomy: the influence of accessory pudendal arteries on the recovery of sexual function.

Arterial insufficiency is a major factor responsible for impotence in men following nerve sparing radical prostatectomy. Previously, accessory internal pudendal arteries have been identified traveling over the anterolateral surface of the prostate. Based on this observation, during the last 7 years we have consistently looked for the presence of these arteries and have developed a surgical technique for their preservation. Between 1987 and 1994, 835 potent men underwent radical prostatectomy and accessory pudendal arteries were identified in 33 (4%). Following the development of the surgical technique, it was possible to preserve arteries in 19 of 24 patients (79%). Followup evaluation of 1 year or longer was available for 22 men who did not undergo wide excision of a neurovascular bundle. Recovery of erection sufficient for unassisted intromission and orgasm occurred in 8 of 12 patients (67%) in whom the arteries were preserved and in 5 of 10 (50%) in whom the arteries were sacrificed. We conclude that 1) the presence of accessory internal pudendal arteries is rare (4%); 2) although these arteries were preserved in 79% of the patients, dissection of these arteries from the dorsal vein complex may be associated with excessive bleeding, and 3) because potency rates are similar in men with or without preservation of accessory arteries, routine preservation may not be productive.

Aged↗
PubMed1989

Small penis and the male sexual role.

We interviewed and examined 20 patients with the primary diagnosis of micropenis in infancy. The patients were divided into 2 groups: 8 prepubertal (10 to 13 years old) and 12 postpubertal (17 to 43 years old). All but 1 had been given human chorionic gonadotropin, testosterone or cortisone during childhood. Only 1 child in the prepubertal group had a stretched penile length above the 10th percentile. All postpubertal patients were below the 10th percentile. Puberty was delayed in only 2 patients in the older group. All patients were heterosexual and they had erections and orgasms. Eleven patients had ejaculations, 9 were sexually active and reported vaginal penetration, 7 were married or cohabiting and 1 had fathered a child.

Adaptation, Psychological↗
PubMed1989

Sexual function and fertility in patients treated for posterior urethral valves.

We interviewed 21 men treated in infancy for posterior urethral valves about their sexual function. Of the men 10 provided semen samples (1 of which was incompletely analyzed) and 7 provided urine voided after masturbation. Erections and orgasm were normal in 20 men and 1 had lifelong impotence. Nine men had slow or dry ejaculation. There was no evidence on urinalysis of retrograde ejaculation except in 1 patient. Semen counts were within the fertile range. Of 9 patients 5 had viscous semen with a pH of more than 8.0. Three patients had initiated pregnancies.

Adult↗
PubMed1985

Testicular and sexual function in adults with prune belly syndrome.

Testicular and sexual function was investigated in 9 patients between 16 and 28 years old with prune belly syndrome. At personal interview all patients claimed to experience normal erections and orgasm but 7 had retrograde ejaculation. Examination showed a normally developed male habitus. Orchiopexies had been performed in late childhood or adolescence. Two patients were anorchic and the surviving testicles were small in the remaining 7. Serum testosterone was low in 1 patient and normal in 6 but at the expense of high luteinizing hormone levels in 4. All patients had a high serum follicle-stimulating hormone level, reflecting the azoospermia found in 5 patients tested. Three biopsies from atypical cases showed poor histological findings but 2 revealed early spermatogenesis. The testes in patients with prune belly syndrome are similar to undescended testes in otherwise normal men. Late orchiopexy produces sexually active but infertile men.

Adolescent↗
PubMed2001

Sexual activity during late pregnancy and risk of preterm delivery.

OBJECTIVE: To examine the association between sexual activity during late pregnancy and preterm delivery. METHODS: Women at least 16 years old and carrying singleton fetuses were recruited between 24 and 29 weeks' gestation from prenatal clinics in central North Carolina. They were interviewed by telephone about sexual activity before and during pregnancy. One hundred eighty-seven women delivered between 29 and 36 weeks and had a follow-up interview after delivery. Four hundred nine women who were selected randomly from the cohort served as controls and had a follow-up interview between 29 and 36 weeks (mean gestational age 39.2 weeks). RESULTS: Intercourse during late pregnancy was associated with a reduced risk of preterm delivery. The conditional odds ratio (OR) was 0.34 and 95% confidence interval (CI) 0.23, 0.51 for preterm delivery within 2 weeks after intercourse. Similar decreased risk for preterm delivery was found with recent female orgasm. Adjusting for race, age, education, and living with a partner had little effect on results. Cases were more likely than controls to report poorer health, medical reasons for reducing sexual activity, less interest in sex, and receipt of advice to restrict sexual activity during pregnancy. Results did not differ substantially according to presence or absence of bacterial vaginosis at 28 weeks. CONCLUSION: These data provide evidence against the hypothesis that sexual activity generally increases risk of preterm delivery between 29 and 36 weeks. However, we cannot exclude the possibility that a small subgroup of susceptible women might have adverse consequences of sexual activity.

Adult↗
PubMed2006

Female sexual function after spinal cord injury.

Over the past 10 years, studies of the impact of spinal cord injuries on female sexuality have expanded from questionnaire studies in small populations with unknown levels and degrees of injury to laboratory-based analyses of women with known injury patterns. These studies have provided detailed information on how specific injury patterns affect specific aspects of the female sexual response. Research findings have supported the hypothesis that the sympathetic nervous system is regulatory for psychogenic genital vasocongestion and that orgasm is a reflex response of the autonomic nervous system. Based on these results, a new system for the classification of sexual function in women with spinal cord injury (SCI) is proposed. Moreover, studies related to the treatment of sexual dysfunction in women with cord injury are reviewed.

Autonomic Nervous System↗