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PubMed2006

Long-term effects of spinal cord injury on sexual function in men: implications for neuroplasticity.

STUDY DESIGN: Secure, web-based survey. OBJECTIVES: Elicit specific information about sexual function from men with spinal cord injuries (SCI). SETTING: World-wide web. METHODS: Individuals 18 years or older living with SCI obtained a pass-code to enter a secure website and then answered survey questions. RESULTS: The presence of genital sensation was positively correlated with the ability to feel a build up of sexual tension in the body during sexual stimulation and in the feeling that mental arousal translates to the genitals as physical sensation. There was an inverse relationship between developing new areas of arousal above the level of lesion and not having sensation or movement below the lesion. A positive relationship existed between the occurrence of spasticity during sexual activity and erectile ability. Roughly 60% of the subjects had tried some type of erection enhancing method. Only 48% had successfully achieved ejaculation postinjury and the most commonly used methods were hand stimulation, sexual intercourse, and vibrostimulation. The most commonly cited reasons for trying to ejaculate were for pleasure and for sexual intimacy. Less than half reported having experienced orgasm postinjury and this was influenced by the length of time postinjury and sacral sparing. CONCLUSION: SCI not only impairs male erectile function and ejaculatory ability, but also alters sexual arousal in a manner suggestive of neuroplasticity. More research needs to be pursued in a manner encompassing all aspects of sexual function.

Adaptation, Psychological↗
PubMed2006

Spinal cord injury influences psychogenic as well as physical components of female sexual ability.

STUDY DESIGN: Secure, web-based survey. OBJECTIVES: Elicit specific information about sexual function from women with spinal cord injuries (SCI). SETTING: World-wide web. METHODS: Individuals 18 years or older living with SCI obtained a pass code to enter a secure website and then answered survey questions. RESULTS: Bladder and/or bowel incontinence during sexual activity and/or sexual intercourse were significant concerns and prevented some women from seeking sexual activity. Autonomic dysreflexia (AD) during sexual activity was interpreted negatively by many and was found to interfere with sexual activity. Most subjects reported difficulty becoming psychologically aroused as well as physically aroused, which were both correlated with feeling that their SCI had altered their sexual sense of self. An inverse relationship existed between developing new areas of arousal above the level of lesion and not having sensation or movement below the lesion. The most commonly reported sexual stimulation leading to the best arousal involved stimulation of the head/neck and torso areas. The majority of subjects reported having experienced intercourse postinjury. Most participants reported difficulty with positioning during foreplay and intercourse, vaginal lubrication, and spasticity during intercourse. Almost half reported experiencing orgasm postinjury and this was positively associated with the presence of genital sensation. CONCLUSION: SCI significantly impairs psychological and physical aspects of female sexual arousal. In addition, bladder and bowel incontinence as well as AD negatively impact sexual activity and intercourse.

Adolescent↗
PubMed2003

Accuracy of reporting of sexual activity during late pregnancy.

Women recalled their sexual activity during pregnancy in telephone interviews occurring during and after the third trimester, as part of a study of preterm delivery in central North Carolina in 1996-97. This retrospective information was compared with prospective daily records for the same time periods in a subsample of 88 women. Relative to the daily records, women reported fewer episodes of intercourse and longer intervals since the most recent orgasm when they recalled this information in interviews. Recall of sexual activity over short, recent time periods during pregnancy appears to be a source of some misclassification. Reliance on retrospective reports may suffice for general measures of objective events, such as any vs. no intercourse over a short time period.

Adolescent↗
PubMed2002

Sexual dysfunction caused by reboxetine.

The author reports on self-experienced, reboxetine-induced sexual dysfunction (prolonged orgasm of reduced intensity) and seminal emission after defecation. Both disorders were accompanied by pain and ceased within two days after discontinuation of the drug.

Adult↗
PubMed1990

[Sexual rehabilitation of patients with cervix cancer].

The effects of therapy on the vita sexualis have a great importance in universal rehabilitation of patients with carcinomas. 168 treated women suffering from an invasive carcinoma of the cervix were consulted about their sex life and the relationship with their partner during the follow-up. Depending on the methods of therapy (radical operation, primary irradiation, combined treatment), loss of libido was seen in 53% of the patients, and loss of orgasm in 61%. The frequency of cohabitation decreased in 45% of the consulted persons. 10% of the women living in sexual partnership were of the opinion that severe disturbances in partner relations resulted therefrom. The least disturbance of the intimate relationship was found in women, who had a harmonious family background in life and who were informed to a sufficient degree.

Adult↗
PubMed2006

Colpoperineoplasty in women with a sensation of a wide vagina.

BACKGROUND: In women complaining of a wide vagina and decreased sexual satisfaction we performed colporrhaphy--including perineoplasty in most cases. METHODS: Between November 2003 and October 2004, a total of 53 patients were selected for operation at the Urogynecology and Vaginal Surgery Unit, Las Condes Clinic, Chile. The patients were requested to assess the results of surgery in terms of experienced vaginal tightening and regained or enhanced sexual satisfaction. RESULTS: Six months after surgery, 94% experienced a tighter vagina and said they were able to achieve orgasm. Expectations were fulfilled in 74%, partially fulfilled in 21%, and not met in 5%. Only two patients (4%) regretted surgery, and two patients had minor surgical complications. CONCLUSION: In a selected group of women with acquired sensation of a wide vagina, colporrhaphy seems to improve symptoms and enhance sexual gratification in a majority of the women. A controlled trial with a longer follow-up is needed for a proper evaluation.

Adult↗
PubMedDate not supplied

Brain (PET) responses to vaginal-cervical self-stimulation in women with complete spinal cord injury: preliminary findings.

Our recent research provides evidence that women with complete spinal cord injury (SCI) at the midthoracic level show perceptual responses to vaginal and/or cervical self-stimulation (for example, pain suppression and sexual response, including orgasm). On the basis of studies in laboratory rats, we hypothesized that the vagus nerves provide a sensory pathway from the vagina, cervix, and uterus directly to the brain in women. To test this hypothesis, we performed a PET-MRI study on two women with complete SCI and 1 woman with no injuries. Whereas control foot stimulation of the women with SCI did not activate the somatosensory thalamus, cervical self-stimulation increased activity in the region of the nucleus of the solitary tract, which is the brainstem nucleus to which the vagus nerves project. These preliminary findings suggest that the vagus nerves can convey genital sensory input directly to the brain in women, completely bypassing SCI at any level.

Adult↗
PubMedDate not supplied

Fluoxetine-induced changes in tactile sensation and sexual functioning among clinically depressed women.

Sexual side effects resulting from serotonin specific reuptake inhibitors (SSRIs) use may be mediated by a number of peripheral mechanisms, including alterations in tactile sensitivity. It was hypothesized that sexual difficulties resulting from SSRI use arise in part from an over-sensitivity or under-sensitivity of tactile sensation. Tactile sensitivity was examined on the index finger and lower lip in clinically depressed women at baseline (pre-medication), week 1, week 4, and week 8 of drug treatment (fluoxetine group n = 12, control n = 13). Analyses indicated that fluoxetine treatment resulted in decreased orgasm functioning. Fluoxetine-induced sexual changes were not mediated by tactile sensation. An independent association was found between sexual arousal functioning and finger sensation. Novel to this study, an independent association was found between sexual desire and finger sensation.

Adult↗
PubMedDate not supplied

Psychosocial variables of sexual satisfaction in Chile.

This study analyzed psychosocial variables of sexual satisfaction in Chile using data from the COSECON survey. Participants were 5,407 subjects (2,244 min and 3,163 women, aged 18-69 years). We used a cross-sectional questionnaire with a national probability sample. Data were collected using a thorough sexual behavior questionnaire consisting of 190 face-to-face questions and 24 self-reported questions. A single item included in the COSECON questionnaire assessed sexual satisfaction. Results showed that high education level, marital status, and high socioeconomic levels were associated with sexual satisfaction in women but not in men. The results also showed important gender differences and sustain the idea that sexuality changes may be more present in middle and high social classes. The proximal variables typically used for measuring sexual satisfaction, such as the frequency of sexual intercourse and orgasm, showed a positive but smaller association with sexual satisfaction. Other important variables related to sexual satisfaction were being in love with the partner and having a steady partner. The results confirmed previous findings and are discussed in the frame of approaches like the exchange, equity, and sexual scripts theories.

Adult↗
PubMed1977

Hypoactive sexual desire.

The sex therapy literature has concentrated on disorders of the excitement and orgasm phases of the sexual response. However, disorders of sexual desire have been virtually neglected, although low-libido disorders are highly prevalent, may be extremely distressful to patients and their partners, and influence the course and prognosis of therapy. This paper focuses on this important aspect of human sexuality. Some clinical features of hypoactive sexual desire are described, and some hypotheses about etiology and prognosis are presented.

Anxiety↗
PubMed1978

Sexual dysfunction in women who were molested as children: one response pattern and suggestions for treatment.

A common pattern of women who were sexually molested as children and seek treatment for sexual dysfunction is described. The arousal, rather than the orgasmic, component is involved. The reasons for the evolution of this particular dysfunction are discussed. Treatment should extend the period of sensate focus and address the issues of the woman's anger, her need for control, and her guilt. Excellent results can be achieved in helping the patient to experience physical intimacy and the pleasure of sexual arousal.

Adult↗
PubMed1980

Structured group treatment of couples experiencing sexual dysfunctions.

This paper describes a structured, time-limited method for treating couples in which both people are experiencing sexual dysfunctions. In our previous research, we found that group treatment was as effective as single-couple treatment for treating men experiencing premature ejaculation and women experiencing secondary orgasmic dysfunction. In this article we have described our procedures for evaluating and selecting group participants, our 12-week structured group treatment format, the group process, common problems and resistances, and our methods for assessing treatment outcome. Our structured group treatment approach is a cost efficient and effective method for treating the many couples experiencing sexual dysfunctions.

Female↗
PubMed1981

A two-dimensional model of female sexual response.

On the basis of a review of previous research on orgasm consistency and sexual satisfaction in heterosexual females, a two-dimensional conceptual model of sexual responsivity is proposed as a foundation for future research and theory. Methodological problems as well as conceptual inadequacies of past research are discussed. Research evidence strongly indicates that the variable of sexual satisfaction is a long overlooked but critical concept in the full understanding of female heterosexual behavior.

Coitus↗
PubMed1982

Group treatment of sexual dysfunctions: a methodological review of the outcome literature.

This paper reviewed 36 studies which examined the effects of the group format in the treatment of sexual dysfunctions. The methodological evaluation was conducted within the following sections: subjects, therapists, treatment goals, group composition, time format, treatment, outcome measures and assessment times. Numerous methodological deficiencies were found, most notably the inadequate definitions of dysfunction and treatment success, the failure to control for therapist or expectancy factors, the failure to isolate the specific effects of different treatments, and an absence of control or comparison groups. The data tentatively suggest that a group format is effective in the treatment of female orgasmic dysfunction and secondary erectile dysfunction. Same-sex only groups and couples' groups promote comparable improvements. It is premature to make any conclusive statements regarding the relative efficacy of group and individual treatment formats. Future investigators should examine the specific and relative effects of the various treatment components and explore the potential therapeutic advantages of the group in the treatment of sexual dysfunction.

Adult↗
PubMed1984

Three-year follow-up of couples evaluated for sexual dysfunction.

The present status of 49 couples who three years previously had been evaluated but not treated at a clinic for sexual dysfunction was determined by a self-report assessment battery. The battery consisted of the Sexual Interaction Inventory, the Locke-Wallace Marriage Inventory and the Sexual History Form completed at initial evaluation and follow-up. An additional Follow-up Questionnaire was completed at post only. Approximately 52% of the men and 54% of the women reported receiving therapy during the period between initial intake and follow-up. Analysis of male data revealed that with the exceptions of estimates of mate satisfaction and marital happiness, all other variables measuring sexual behaviors and attitudes did not show significant changes over time. Men who received subsequent therapy reported significantly more erectile difficulty at both intake and follow-up than their nontreated counterparts. In contrast, women showed significant improvement over time in sexual satisfaction, acceptance of mate, and ability to achieve orgasm through a wider variety of means. These improvements were reported by women who had therapy during the interim period as well as women who had not had therapy. Repeated measured ANOVAs and t-test analyses were performed examining the effects of male dysfunction on female functioning. Interpretations of the differences in change noted over time between women and men are offered as well as suggestions for future research.

Adult↗
PubMed1986

Sexual dysfunction and disorder patterns of working and nonworking wives.

The sexual dysfunction and disorder patterns of 218 married working and nonworking women were compared in a retrospective analysis of couples presenting for sexual and marital therapy at the Masters & Johnson Institute. Results indicated that women who were pursuing careers of an ongoing, developmental nature were twice as likely to present with a primary complaint of inhibited sexual desire than women who were employed in jobs that emphasized the immediate organization of activities, or women who were unemployed outside of the home. "Career" women were also significantly more likely to present with vaginismus than the other two groups of subjects. "Job" and "Unemployed" women were more likely to complain of concerns related to orgasmic return than "Career" subjects. The results were interpreted in terms of psychological and interpersonal stressors characteristic of married couples when wives pursue careers, and also in terms of the impact of traditional values regarding sexuality when wives are not involved in careers.

Adult↗
PubMed1986

The "G spot" and "female ejaculation": a current appraisal.

In the light of the available evidence, this paper reviews two current controversial issues in the area of female sexuality: the "G spot" and "female ejaculation." It is concluded that evidence in support of the "G spot"--defined as a discrete anatomical structure located on the anterior vaginal wall, which swells upon being tactilely stimulated--is inconclusive, and, in the event of its existence, no evidence has been produced linking it to Skene's glands. However, it seems reasonable to accept that women possess a zone of tactile erotic sensitivity on the anterior vaginal wall, which in many of them may extend to the entire anterior wall and to the posterior vaginal wall. It also seems that some women emit a fluid through the urethra at orgasm, although its true nature and anatomical origin are still unclear.

Exocrine Glands↗
PubMed1987

The influence of self-efficacy expectations on the treatment of preorgasmic women.

One of the most successful treatments developed for women who never or rarely experience orgasm is Barbach's preorgasmic treatment program. We propose that Bandura's theory of self-efficacy provides a useful framework for understanding the success of Barbach's program. This pilot study was designed to determine whether treatment affects subjects' Certainty of and Comfort with Sexual Efficacy. Treatment (n = 5) and control (n = 6) subjects completed prepoint and postpoint instruments that measured sexual efficacy expectations, body satisfaction, locus of control, and assertiveness. Although most postpoint differences were nonsignificant (probably due to small sample size), intriguing trends emerged. In particular, treatment seemed to contribute to increased Certainty of Sexual Efficacy and body satisfaction.

Assertiveness↗