Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Orgasm”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,027 records · Page 57Linked to original sources

Sexuality in head and neck cancer patients.

OBJECTIVE: To describe sexual functioning and its relationship with age, extent of disfigurement, performance status, and psychological functioning in head and neck cancer patients following radiation therapy with or without surgery. DESIGN: Descriptive study, self-report survey, convenience sample. SETTING: Academic tertiary care Veterans Administration Medical Center. PATIENTS: Fifty-five of 101 consenting patients responded to the questionnaire. Mean age of the patients was 65.1 years (range 48 to 76); 54 were men. The mean duration since diagnosis was 30.6 months (range 3 to 216). All patients received radiation therapy and 26 also underwent surgery. MAIN OUTCOME MEASURES: Instruments included were: The Derogatis inventory of Sexual Functioning, Multidimensional Health Locus of Control. The Center for Epidemiological Studies Depression Scale, Hopkins Symptom Check List, and List Performance Status Scale. RESULTS: Eighty-five percent showed interest in sex. Fifty-eight percent were satisfied with their current sexual partner and 49% were satisfied with their current sexual functioning. Most of them were able to fantasize: however, a majority reported arousal problems, 58% did not participate in sexual intercourse, and 58% had orgasmic problems. Most patients were not depressed. As a group these patients reported significantly more somatic distress but significantly less generalized feeling of distress when compared with a group of nonpatient nurses. Patients with "powerful others" locus of control showed significantly worse sexual functioning. There was no correlation between sexual functioning and performance status or severity of disfigurement. Patients younger than 65 years of age had more advanced disease, lower performance status and significantly poorer sexual functioning; those older than 65 years were more satisfied with their sexual partner and current sexual functioning. CONCLUSION: Despite experiencing sexual problems, sexuality continues to be a priority in the majority of patients studied.

Aged↗

A multicenter study of women's self-reported reproductive health after spinal cord injury.

OBJECTIVE: Little attention has been given to women's reproductive health issues in the disabled population. This study documents the unique reproductive health conditions, complications, and behaviors in women with spinal cord injury (SCI). SUBJECTS: A total of 472 women at least 18 years of age who were at least 1 year post-SCI. Their average age at injury was 32 years. DESIGN: An extensive questionnaire regarding gynecologic, sexual, obstetric, and menopausal health issues was developed and piloted. The questionnaire was then administered by a trained woman health care clinician to women who agreed to participate in the study. SETTING: Private outpatient clinics at 10 regional model SCI systems of care. RESULTS: Women reported similar gynecologic problems in both preinjury and postinjury time periods. Exceptions were urinary tract infections and vaginal yeast infections. Sexually transmitted infections appear to be less common after injury, but the difference was not statistically significant. The number of hysterectomies was similar both before and after injury, but reasons differed greatly. Women with SCI were less likely to have routine mammograms. They reported similar preventive practices such as performing self-breast examinations and obtaining Papanicolaou smears. Almost 14% of women with SCI became pregnant after injury (101 pregnancies). Complications from pregnancy, labor, and delivery were reported to be more frequent in their postinjury than in their preinjury obstetric experiences. They tended to have babies of lower birth weight and with more complications at time of delivery. Of the sample, 87% reported having sexual intercourse before injury, with only 67% having intercourse after injury. Years postinjury and level of injury were predictive of intercourse; extent of injury was not. Experience of orgasms and methods of contraception varied among the two groups. There were significant complaints of dysreflexia and bladder incontinence with sexual function. Menopause after injury was reported by 14.6% of the women. Postinjury menopausal symptoms were of low frequency, but more than those reported by women who had undergone menopause before injury. Only 19% of women who had menopause after SCI were placed on hormone replacement therapy. Almost one third of the women who had menopause after injury reported new bone fractures. CONCLUSION: This study illustrates the unique reproductive health concerns of women with SCI. Many pregnancy, labor, and delivery experiences in these women are different. Sexual activity and function have several disability-related consequences and the effects of menopause are still unknown, but may be more problematic than for able-bodied women.

Adolescent↗

Androgen deficiency in the oophorectomized woman.

Women experience a significant decline in circulating androgen concentrations after bilateral oophorectomy. Despite several limitations, studying women after oophorectomy remains a good model for investigating the effects of both androgen deficiency and androgen replacement. Current data show that most women experience satisfying sexual lives after hysterectomy and bilateral oophorectomy. This is reassuring since elective oophorectomy at the time of hysterectomy is an appropriate option for many women. Oophorectomized women, however, are more likely to report a worsening of sexual function after hysterectomy compared with women who retain their ovaries. Specifically, adverse changes in libido and orgasmic response are more likely in oophorectomized women. After bilateral oophorectomy, women also appear more likely to experience decreased positive psychological well-being. Studies of both the consequences of oophorectomy and the effects of testosterone replacement are consistent with an important role for androgens in female sexual function and psychological well-being.

Androgens↗

Randomized clinical trials of combined estrogen-androgen preparations: effects on sexual functioning.

OBJECTIVE: To review the randomized controlled trials of the efficacy of combined estrogen-androgen (E-A) preparations on sexual functioning in postmenopausal women. PATIENT(S): Naturally and surgically menopausal women. MAIN OUTCOME MEASURE(S): Changes in aspects of sexual functioning. RESULT(S): In general, a high degree of agreement exists among the findings of these well-controlled trials that combined E-A preparations enhance psychological well-being as well as sexual desire and interest and, sometimes, increases the frequency of sexual intercourse and orgasm compared with estrogen-alone treatment in both naturally and surgically postmenopausal women. CONCLUSION(S): In selected cases, combined E-A therapy can enhance the quality of life for both naturally and surgically postmenopausal women.

Androgens↗

Retrograde ejaculation: etiology and treatment via the use of a new noninvasive method.

Retrograde ejaculation (RE) is not a common infertility problem, but has increased in incidence recently due to surgical aggressiveness in pelvic and genital malignancies. However, RE is the most common cause of aspermia, or absence of ejaculate at orgasm. Meanwhile, surgical or drug therapy methods have not been very promising in regaining normal antegrade ejaculation. As yet, the standard procedures for treatment of RE involve the artificial insemination of either nonprocessed or processed (via centrifugation and resuspension) postcoital voided bladder contents. RE specimens in this study were collected after postcoital voiding into a TEST buffer and resuspended in TEST-yolk buffer. The urine effects on the voided spermatozoa were studied. The technique employed in this study assists in the recovery and reconstitution of RE fit for artificial insemination.

Adult↗

Idiopathic anejaculation treated by vibratory stimulation.

Idiopathic anejaculation is a rare cause of infertility usually treated by psychotherapy. However, electrovibration may be a simple, noninvasive adjunct to the treatment of this disorder. In our two cases, we obtained ejaculate adequate for insemination in one patient and noted some gain in orgasmic sensation in the other. The success in these two infertile patients who had already undergone lengthy psychotherapy is promising. Nevertheless, psychotherapy will continue to be the standard of therapy until we have more experience with penile electrovibration.

Adult↗

Nigerian male sexual activity during pregnancy.

OBJECTIVES: To determine the prevalence of extra-marital sexual affairs as well as other aspects of male sexual behavior during pregnancy in Nigeria. METHODS: A questionnaire survey of the husbands of consecutive women who delivered in three tertiary care centers in south-eastern Nigeria within an 8-week period. The data were analyzed by means of simple percentages and descriptive and inferential statistics, using t-tests, chi-square tests and regression equations at the 95% confidence level. RESULTS: 279 (88.3%) of the 316 eligible husbands responded to the questionnaire. A total of 78 (28.0%) of the respondents engaged in extra-marital sexual relationships during pregnancy. Of the respondents, 36.6% and 32.3% experienced a decrease in achievement of erection and orgasm, respectively. While libido decreased in 41.9%, coital frequency declined in 72.4% of the respondents. On univariate analysis, respondent's age > or = 40 years, duration of marriage > or = 5 years, having an extra-marital sexual partner and beliefs that coitus during pregnancy should be less frequent or can cause miscarriage were significant predictors of reduced coital frequency while a belief that coitus enhances fetal well-being was a significant predictor of increased coital frequency during pregnancy (P<0.05 for each variable). On multivariate logistic regression, three factors were statistically significant predictors of reduced coital frequency - age > or = 40 years (OR=2.3; 95% C.I., 1.9-2.3) and beliefs that coitus during pregnancy can cause miscarriage (OR=1.9; 95% C.I., 1.5-2.3) and should be less frequent (OR=1.9; 95% C.I., 1.8-2.5). CONCLUSIONS: Personal beliefs significantly affect sexual relationships between Nigerian husbands and their pregnant wives, making approximately one-third of husbands engage in extra-marital relationships as a way to satisfy their unmet sexual need during pregnancy. There is a need to educate husbands and their pregnant wives on sexual matters during pregnancy.

Extramarital Relations↗

Mirtazapine, yohimbine or olanzapine augmentation therapy for serotonin reuptake-associated female sexual dysfunction: a randomized, placebo controlled trial.

BACKGROUND: Many agents have been proposed as potential treatments for SSRI-associated sexual dysfunction, but few placebo-controlled trials have been reported. METHOD: After a 1-month baseline evaluation, pre-menopausal women with moderate to severe sexual dysfunction associated with the institution of fluoxetine therapy were randomized to augmentation therapy with placebo (N=39), mirtazapine (N=36), yohimbine (N=35) or olanzapine (N=38) for a 6-week period. Outcomes were measured using a daily diary, a biweekly self-report assessment, and a computer assisted structured interview. RESULTS: At baseline, orgasm was most severely impaired. After 6 weeks, there was statistically significant improvement on most measures for the overall group of patients, however there were few differences between treatment groups. Isolated treatment differences were observed for the patient self-report of overall sexual function (olanzapine superior to placebo) and the structured interview sexual satisfaction item (mirtazapine inferior to placebo). CONCLUSION: No drug assessed was consistently associated with differences from placebo. The results of the study do not support uncontrolled reports of efficacy for these agents in premenopausal women.

Adrenergic alpha-Antagonists↗

Sexual dysfunction after treatment for testicular cancer: a systematic review.

OBJECTIVES: We aimed to assess the nature and risk of sexual dysfunction in men after treatment for testicular cancer. METHOD: Systematic review of sexual dysfunction in men treated for testicular cancer. The odds ratio or proportions of subjects with reduced sexual drive, erectile dysfunction or orgasmic/ejaculatory dysfunction was calculated. RESULTS: A detailed review of 79 of the 227 citations was conducted. The highest level of evidence found, were controlled studies. Six controlled studies examined sexual function in 709 patients after they had received treatment. Seven uncontrolled studies examined sexual function in 337 subjects before and after treatment for testicular cancer. Most studies were limited by low response rates, use of unvalidated questionnaires and inclusion of a variety of treatment modalities. Few assessed psychological function and none examined its possible interaction with sexual dysfunction. Meta-analysis of the controlled studies indicated significantly reduced or absent orgasm (OR=4.62, 95% CI=2.47-8.63) together with erectile (OR=2.47, 95% CI=1.54-3.96) and ejaculatory dysfunction (OR=28.57, 95% CI=1.75-464.78) up to 2 years after treatment. Effects on sexual function were less consistent in the uncontrolled studies. CONCLUSIONS: The controlled studies indicate that sexual dysfunction persists for up to 2 years after treatment. However, better evidence is needed in studies that control for the impact of the testicular cancer, the treatment modality and psychological reactions to both.

Clinical Trials as Topic↗

Prevalence and risk factors for female sexual dysfunction in Turkish women.

PURPOSE: We assessed the prevalence of and risk factors for FSD using the Turkish version of the FSFI in Turkish women. MATERIALS AND METHODS: The study consisted of 518 women 18 to 55 years old living in Ankara, who completed the FSFI for the evaluation of FSD. The women were divided into 3 groups according to age, that is 18 to 30 (273), 31 to 45 (192) and 46 to 55 years (53). Demographic characteristics and risk factors were assessed in all women. Findings were compared between women with and without FSD. RESULTS: According to the FSFI score 48.3% of women reported FSD (FSFI score less than 25). The prevalence of FSD was 41% at ages 18 to 30 years, 53.1% at ages 31 to 45 years and 67.9% at ages 46 to 55 years. FSD was detected as a desire problem in 48.3% of women, an arousal problem in 35.9%, a lubrication problem in 40.9%, an orgasm problem in 42.7%, a satisfaction problem in 45.0% and a pain problem in 42.9%. Risk factors for FSD were age, smoking (OR 2.4, 95% CI 6.8 to 18.1), menopause (OR 1.7, 95% CI 2.7 to 10.2), diet (OR 1.2, 95% CI 1.9 to 5.5) and marital status (OR 0.8, 95% CI 1.5 to 3.2) (each p <0.001). CONCLUSIONS: Overall 48.3% of women in our study had FSD according to the FSFI. Apart from age, the most important risk factors for FSD were smoking, diet based life-style changes, menopause status and marital status.

Adolescent↗

Female sexual dysfunction following vaginal surgery: a review.

PURPOSE: Depending on age it has been estimated that up to 40% of women have complaints of sexual problems, including decreased libido, vaginal dryness, pain with intercourse, decreased genital sensation and difficulty or inability to achieve orgasm. In this review we address the etiologies and incidence, evaluation and treatment of female sexual dysfunction following vaginal surgery for indications such as stress urinary incontinence and pelvic organ prolapse; anterior/posterior colporrhaphy, perineoplasty and vaginal vault prolapse. MATERIALS AND METHODS: Literature on the mechanisms by which vaginal surgery affects female sexual function are discussed along with related pathophysiology to potential causes. The anatomy, neurovascular supply of the clitoris and introitus, and intrapelvic nerve supply are discussed as related to vaginal surgery. Techniques to avoid neurovascular damage during pelvic floor surgery were corroborated by supporting literature. Literature regarding female sexual dysfunction following other procedures, such as vaginal hysterectomy, Martius flap interposition, and vesicovaginal and rectovaginal fistula repair were also discussed. RESULTS: Current literature does not support an association between vaginal length following vaginal surgery and sexual function. The proportion of women who are sexually active does not appear to be affected by vaginal surgery. Sling surgery for urinary incontinence does not appear to adversely affect overall sexual function, although individual parameters of sexual function scores may vary, eg a significant percent of women report pain during intercourse. Some patients experience improved overall sexual function due to complete relief from coital incontinence CONCLUSIONS: Symptomatic vaginal narrowing is rare even in women undergoing simultaneous posterior repair. Overall sexual satisfaction appears to be independent of therapy for urinary incontinence or prolapse. Data indicate that defect specific posterior colporrhaphy with the avoidance of levator ani plication may improve sexual function. The possible etiological factors for sexual dysfunction following vaginal surgery deserve further investigations.

Female↗

Sexual behaviors, sexual orientation and gender identity in adult intersexuals: a pilot study.

PURPOSE: Sexual preference and adjustment of intersexuals have rarely been investigated. Interview techniques were used to explore these issues. MATERIALS AND METHODS: Ten adult intersexuals (average age 34.2 years) were randomly selected from Intersex Society of North America members. Of the 10 subjects 8 had initially been gender assigned as female and 2 as male. A structured telephone interview was used to assess sexual orientation, sexual activity and satisfaction with gender assignment. RESULTS: Sexual debut occurred at age 18.1 years (range 15 to 22). At debut, 4 females and 2 males engaged in heterosexual intercourse, and 4 females engaged in gynephilic (female) sexual contact. Despite female gender assignment of 8 and initial heterosexual activity by 4 subjects, the final choice of a sexual partner was female in all 8. Both males had initial heterosexual contact but only 1 continued to prefer female partners. Current number of sexual partners averaged 0.9 (range 0 to 2) and total number of sexual partners ranged from 1 to 300. Currently, 9 subjects are in a committed sexual relationship and 8 are able to achieve orgasm. Of the subjects 8 preferred being identified as intersexual, 1 male as male and 1 female as female. Two intersexuals with initial female gender assignment were undergoing male reassignment. CONCLUSIONS: Most intersexuals preferred being identified as intersexual and had female partners. Most reported being satisfied with overall physical appearance but satisfaction with genitalia was highly variable. Based on these results, further study of a larger population is warranted.

Adult↗

Prosthesis placement after total phallic reconstruction.

Total reconstruction of the phallus is now technically feasible. The successful reestablishment of sexual function in these patients is possible using the neurosensory radial forearm flap. The innervated neophallus develops tactile and erogenous sensation within 4 to 6 months of neurorrhaphy. Unperceived chronic pressure with subsequent tissue ischemia is the leading cause of delayed prosthesis extrusion. The development of protective sensation within this reconstructed neophallus allows for the safe placement of a penile prosthesis permitting intromission. The development of erogenous sensation allows for orgasm. We report on the successful implantation and long-term retention of penile prostheses in 4 patients after total phallic reconstruction.

Adult↗

Through the eyes of women: the sexual and psychological responses of women to their partner's treatment with self-injection or external vacuum therapy.

We prospectively delineated and contrasted the sexual, marital and psychological responses of women to their partner's use of 2 treatments for erectile dysfunction: 1) self-injection of papaverine and phentolamine, and 2) vacuum tumescence therapy. The women were assessed at 5 points during a 12-month period with psychometric questionnaires and clinical interviews. Statistical analysis indicated that the women responded equally well to both treatments. They demonstrated significant increases in frequency of intercourse, sexual arousal, coital orgasm and sexual satisfaction. No significant changes were noted on the psychometric questionnaires. The women reported feeling more at ease in their relationships and characterized sex as more leisurely, relaxed and assured. Negative responses focused on the lack of spontaneity and hesitation about initiating sex. Self-injection and vacuum pump therapy restore potency in men and secondarily facilitate improved sexual function in women.

Coitus↗

Followup observations of operated male-to-female transsexuals.

We performed an in-depth interview to ascertain the psychosocial and functional status in 10 of 22 male-to-female transsexuals who underwent vaginoplasty from May 1985 to December 1988. Followup from 5 to 48 months was available for 14 patients. Our patients comprised a well educated, mostly employed, law abiding group with a low incidence of drug use. Most patients were able to develop strong support systems and showed a marked decrease in suicidal tendencies postoperatively. Functionally, the majority of the patients were able to lubricate the neovagina and have painless intercourse with a potential for orgasm. The cosmetic result was judged to be good, with no patient reporting being discovered of having had a prior operation by the sexual partner. We experienced a 21% rate of vaginal stenosis with 40% of these patients fully functional after a corrective operation.

Adaptation, Psychological↗

Evaluation of patients and partners 1 to 4 years after penile prosthesis surgery.

One to 4 years after penile prosthesis implantation 52 men and 22 partners were interviewed personally. All except 4 patients were having intercourse on a regular basis. A quarter of the patients reported restriction in intercourse positions, possibly because of a smaller penis postoperatively, and 15 per cent reported decreased orgasm intensity. Six men had an undiagnosed prosthesis malfunction or they used an inadequate pumping technique, suggesting that prosthesis patients should be followed on a continuing basis. The 52 men had experienced 10 malfunctions with the prosthesis. Partial erections were reported by 69 per cent of the patients but this could be confirmed in only 1 of 10 with visual sexual stimulation testing. It is suggested that differences between prosthesis models are more a result of psychological, relationship and health factors than mechanical factors. Of the patients 79 per cent would undergo the operation again but only 59 per cent of the partners had no hesitations. The longer the postoperative period the more hesitations. A satisfaction score was used to measure patient satisfaction.

Coitus↗

Penile prosthesis: adjunct to treatment in patients with neurogenic bladder.

During the last 4 years we have implanted penile prostheses in 33 patients with neurogenic bladders, primarily to manage bladder dysfunction but also to correct impotence in some cases. Although complications occurred in 6 patients urinary problems did not increase postoperatively. The 10 patients who wore condom catheters indicated that the penile prosthesis helped to keep the catheter in place and the 8 who used intermittent self-catheterization reported that the urethral meatus was more accessible with the insertion of the prosthesis. Of the 24 patients who were sexually active 19 experienced orgasm postoperatively.

Adult↗