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PubMed2006

[Sexual functioning and information needs in women with premature menopause following breast cancer treatment].

BACKGROUND: Breast cancer is the most common malignant disease among women in Israel and the western world. Approximately 4,000 women a year are diagnosed with breast cancer in Israel and about 900 die as a result of the disease. Large numbers of women who had breast cancer are struggling to cope with sexually oriented difficulties. They feel ashamed and embarrassed in front of their doctor or nurse regarding what they might think about them, for instance if they dare to ask a question regarding a non life-threatening subject. PURPOSE: The aims of this research are: 1. To describe the changes in physiological and sexual function among young Israeli women who survived breast cancer and as a consequence experience premature menopause. 2. To understand their information needs regarding sexual functioning. 3. To examine if and to what extent these needs were met by the professional staff. This research was based on the fact that the professional staff provides the patients with information regarding the surgery, the effects of chemotherapy and nutrition but avoids providing substantial information about predicted altered sexual functions and premature menopause. Research shows that medical staff members ignore this crucial information due to personal, professional and social reasons. METHODS: In a cross-sectional convenience sample, data was collected from 82 women who had been diagnosed with grade 1-2 breast cancer and were treated by one or more of four interventions: surgery, chemotherapy, radiation and hormonal therapy. They were asked to fill out a four-part self-questionnaire. FINDINGS: 1. Premature menopause differs from physiological menopause by the symptom acuteness and intensity. 2. Women treated with chemotherapy reported more sexual function difficulties in comparison to other treatments. 3. Women treated with chemotherapy reported increased sexual pleasure and decreased dyspareunia over time following the completion of treatment. 4. Most women reported no significant influence on their ability to experience orgasm during treatments. 5. Almost all the women received a considerable amount of information about treatments and their side effects, but limited information about sexual function, and were very interested in receiving more information on this subject. CONCLUSION: Breast cancer is becoming more widespread amongst young women. Therefore, it is very important for the medical staff, despite the difficulties, to prepare women treated for breast cancer for the effects of this treatment on sexual function and premature menopause.

Antineoplastic Agents↗
PubMed2006

[Linguistic validation of the "Brief Index of Sexual Functioning for Women"].

UNLABELLED: Application to the study of sexuality in a population of 93 French women. OBJECTIVES: This study was designed to linguistically validate the French version of the BISF-W (Brief Index of Sexual Functioning for Women) which provides a quantitative and qualitative assessment of female sexuality according to 7 dimensions. This version was then used to study the impact of recognized factors of sexual dysfunction on a control population. MATERIAL AND METHOD: The BISF-W a self-administered quality of life questionnaire developed by Rosen, was translated and linguistically validated. This questionnaire comprises 22 questions in 7 dimensions investigating all aspects of female sexuality: D1 (desire), D2 (arousal), D3 (frequency of sexual activity), D4 (receptiveness), 05 (pleasure, orgasm), D6 (relational satisfaction), D7 (problems affecting sexuality), Composite Score (CS) D1+D2+D3+D4+D5+D6+07. The French version was administered to a study population of 93 women: 49 derived from gynaecology or urology departments and 44 derived from the general population. We calculated and compared the scores of the various dimensions of the BISF-W according to factors able to modify sexuality, such as menopause, age or parity. RESULTS: The results of our study show an alteration of the various dimensions of sexuality in elderly patients (D2, D5, D6, CS; p<0.05) or postmenopausal patients (D2, D5, D6, CS, p<0.05) and in multiparous women. CONCLUSION: The French version of the BISF-W gives results in line with the literature and demonstrates changes of sexuality as a function of the above mentioned variables.

Adult↗
PubMed2006

[Sexuality and body image in patients with rectal cancer].

STUDY DESIGN: Rectal cancer patients were invited to complete a questionnaire aimed at evaluating their current body image and sex life 3 and 6 months after surgical treatment. In addition, the possible impact of a stoma was investigated. The relevant pre-operative situation was determined retrospectively. RESULTS: The patient's body image was appreciably impaired in both sexes. Women tended to lament a reduction in their physical attractiveness, men a loss of virility. In the subsequent months, the body image in women tended to become more positive, but remained unchanged in men. Stoma patients were clearly less happy with their bodies. Preoperatively, already, women indicated a comparatively low level of interest in sex. Three months after surgery, sex life was clearly disturbed in both sexes. During the further course of time, sexual interest increased, in particular in women, but the level of sexual pleasure stagnated at a low level. Men continued to report erectile and orgasmic disorders, while women increasing complained of pain during intercourse. Six months after surgery, a stoma had a negative impact on sexual activity. CONCLUSION: Surgical treatment of rectal cancer has an appreciable impact on body image and sexuality in both men and women. Greater attention should be paid to this fact during pre-operative patient counseling, and in the after care of tumor patients.

Aftercare↗
PubMed2005

Sexuality in aging male.

A high percentage of men aged 60 or older have satisfactory sexual activity, even if reduced sexual desire, frequency of intercourses and erections, impaired satisfaction with sex and difficulty with orgasm, and decreased semen volume frequently occur. The present report analyses the following issues: erectile dysfunction, fertility, the role of hormones in influencing libido and erection mechanisms, and the therapeutic strategies suggested.

Aged↗
PubMedDate not supplied

[Sexual dysfunctions in selected endocrinopathies].

According to the socio-sexological reports approximately 40-45% of women and up to 30% of males may suffer from different sexual dysfunctions. The prevalence of those disorders is gradually increasing with age. Multiply numbers of endocrinopathies may influence the human sexual life. In diabetic patients all phases of the sexual responses cycle, especially orgasm, might be affected. Women diagnosed with PCOS have decreased adaptation to the sexual life, low self-esteem and perception of self sexual attractiveness. The intimacy of infertile couples has not been well described and the characteristic of particular dysfunction in sex life has not been established yet. Interdisciplinary approach, understood as treatment of the endocrinopathy accompanied with psychological and sexological counseling, seems to be the fundamental issue in the therapy of sexual dysfunctions in patients with endocrinological disorders.

Counseling↗
PubMed2006

Gynecologic symptoms and sexual function before and after liver transplantation.

OBJECTIVE: To determine gynecologic symptoms and sexual function in a group of patients awaiting liver transplantation and a second group after liver transplantation. STUDY DESIGN: A questionnaire was mailed to 524 women. Of these, 233 had had transplants, and 291 were on a waiting list. The Transplant Database was used to obtain demographic information regarding these patients, and data were analyzed based on population age, Child's classification, type of liver disease, and pretransplant or posttransplant status. RESULTS: The response rate was 53%. There was no difference in ethnic or age distribution between pretransplant and posttransplant patients. There were no significant differences in rates of amenorrhea, but there was a greater prevalence of amenorrhea in patients with hepatocellular vs. cholestatic diseases (60% vs. 19%, p = 0.009). There was a higher incidence of pad use for urinary incontinence in pretransplant vs. posttransplant patients (14% vs. 7%, p = 0.04). There was no difference in availability of a sexual partner, sexual activity, orgasm experience, dyspareunia, satisfaction with sex life, symptoms of organ prolapse or dysmenorrhea based on transplant status, disease etiology or Child's classification. CONCLUSION: Liver failure patients differed in some of their gynecologic symptoms depending on their disease etiology and transplant status, but sexuality remained unchanged.

Amenorrhea↗
PubMed2005

Sexual dysfunction after radical prostatectomy.

Sexual dysfunction associated with radical retropubic prostatectomy (RRP) may start before the surgery. Men undergoing RRP frequently have some degree of sexual dysfunction. In addition to the psychological stress of the diagnosis, the biopsy may itself have a detrimental effect. After surgery, all men will experience loss of ejaculate, because the organ responsible for ejaculate has been removed. Orgasm quality is adversely affected in many men. Erectile dysfunction is immediate and recovery from it is slow. Initially, phosphodiesterase (PDE)-5 inhibitors do not work, and they take up to 18 months for their effect to be maximized. Younger men who have had bilateral nerve-sparing procedures respond the best. Combination treatment with prostaglandin E1 or high-dose PDE-5 inhibitors may provide salvage therapy when initial PDE-5 inhibitor therapy has failed.

Journal Article↗
PubMed2006

Sexual dysfunction in the peri- and postmenopause. Status of incidence, pharmacological treatment and possible risks. A secondary publication.

The frequency of female sexual dysfunction increases with age, and the menopausal transition has a negative effect on the sexuality. Pharmacological treatment options for female sexual dysfunction during the peri- and post-menopause include hormone therapy or sildenafil. A limited number of randomized, controlled trials have been conducted and evidence suggests that systemic hormone therapy with estrogen, estrogen/progesterone, estrogen/testosterone and tibolone have a positive impact on sexual dysfunction during the peri- and postmenopause. Further, there is evidence that treatment with local estrogen relieves vaginal dryness and dyspareunia. Recent knowledge on side effects related to hormone therapy necessitates careful evaluation of the indication for hormone therapy and the duration of postmenopausal hormone therapy should be as short as possible. Long-term side effects of testosterone have not yet been fully investigated. A positive effect of sildenafil has been observed in a limited group of women; those with arousal problems but with no desire problems. The results suggest an intensified focus on new pharmaceutical products for the treatment of female sexual dysfunction in the postmenopause. For the time being the effect of testosterone therapy and tibolone on female sexual dysfunction is being investigated. Sexual dysfunction in women (Female Sexual Dysfunction, FSD) is multi-factorial and influenced by physiological, psychological, social and emotional factors. FSD is defined in four diagnostic groups: desire-, arousal-, orgasm- and pain problems. Recently, it has been suggested that the woman herself should assess the dysfunction as distressful to be diagnosed as having a sexual dysfunction [1]. There are only a limited number of well-conducted population surveys on the prevalence of FSD. Further, relatively few randomized, controlled trials of pharmacological treatment of FSD have been carried out.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed1980

[Physiology of the masculine sexual act (its aging and its inherent problems).].

The author discusses the physiology of the male sexual act and the inherent problems of aging. He begins with a review of sexual physiology then goes on to describe the three phases of the sexual act : erection, orgasm, and he then deals with impotence, the problem of the elderly man, and its organic and psychological causes.

English Abstract↗
PubMed1980

[Sexuality and medication in the elderly.].

A lot of drugs have been reported to have adverse effects on sexual functions. Interference with ejaculation in man, failure to reach orgasm in women, decreased libido can occur with any centrally acting drugs or drugs that act on the sympathetic nervous system. In fact, the incidence of adverse sexual effects of drugs is not well documented. The effects which lead to sexual dysfunction are mostly reported by patients which are themselves reluctant to discuss with their physician. Antihistaminics, antihypertensives, anticholinergics, antidepressants, antipsychotics and minor tranquilizer may have an adverse effect on sexual function. Because elderly people are prone to adverse drug effects, they arc expected to experience more side effects on their sexual life with commonly prescribed drugs than younger ones are to. Refraining drug use and attentive listening may help the patient restore his normal sexual life.

English Abstract↗
PubMedDate not supplied

Sexual functioning of women with fibromyalgia.

OBJECTIVE: To examine sexual functioning at the specific phases of the sexual response cycle among women with fibromyalgia. METHODS: The Questionnaire for screening Sexual Dysfunctions - Short Form (QSD-SF) was filled out by 63 premenopausal, heterosexual women with fibromyalgia (age: 21-54 years) who were recruited at meetings of regional patient associations. RESULTS: The women with fibromyalgia did not differ from healthy women of an age reference group with respect to functioning in the excitement and the orgasm phases, but reported more problems with sexual desire and satisfaction, more pain in their body, and insensitivity (but not pain) in their genitals before, during or after having sex. Mental distress, but not pain, was a significant predictor of virtually all aspects of sexual dysfunction. CONCLUSION: Our study generates the hypothesis that the psychological but not the physiological aspect of the sexual response cycle is more disturbed than normal in fibromyalgia. This finding needs confirmation in a more representative population.

Adult↗
PubMed2006

[Peripheral nerve injury and male sexual dysfunction].

The genital organ is innervated by autonomic and somatic nerve. The former is both sympathetic and parasympathetic nerve and the later is comprised by sensory and motor fibers. The symptoms of male sexual dysfunction are sexopathy, erectile dysfunction, disorder of ejaculation and orgasm, and pianism. Not only different symptom but the same symptom can be induced by different injured nerve. The relationship between peripheral nerve injury and male sexual dysfunction should be understood correctly.

Erectile Dysfunction↗
PubMed1991

[The reality and usefulness of Halban's fascia].

The authors, in this article, have reviewed the different proofs that confirm that Halban's fascia does exist. The authors have been able to find, separate out and use Halban's fascia in a series of 263 vaginal operations for genital prolapse taking the anatomo-surgical approach. From the histological approach, they have shown that Halban's fascia is constituted by fibro-connective tissue strips between which there are large numbers of blood vessels and muscles and nerve endings. From the point of view of embryogenesis, they believe that Halban's fascia comes from the same mesenchyme layer as that which gives rise to the corpus spongiosus of the penis. As far as sexual physiology is concerned, the authors review the various clinical experiments that have been carried out throughout the world medical literature which shows that there is an erogenous zone in the upper anterior part of the vagina and they believe that Halban's facia, which is homologous with the corpus spongiosus, is the site of origin of vaginal orgasm. Finally, as far as physiology and biology of reproduction is concerned, they believe that the vaginal fluid that is secreted by Halban's fascia during intercourse plays an important role for the survival of spermatozoa.

Fascia↗
PubMed1991

[Experiences of patients with the semi-rigid Jonas penile prosthesis].

A questionnaire was used to investigate the results of the implant of a semirigid Jonas penile prosthesis in 75 men, operated at the department of Urology of the University Hospital Leiden. The results of 31 patients were available for analysis. Sexual intercourse was possible for 77% of patients. The length of the penis was satisfactory in 52%, the rigidity of the penis in 77%. In half the patients, the frequency and the quality of the intercourse was comparable with the period before the erectile dysfunction, in the other half of the cases, both positive and negative changes were mentioned. Orgasm was possible for 3/4 of patients. The overall satisfaction was 74%, in the partner group 65%. Of the patients 87% did not regret the operation. Several patients mentioned that the implant of the prosthesis did reinforce their self-confidence.

Adult↗
PubMed1990

[Follow-up of surgically treated transsexuals: what has changed?].

The surgery for both male and female transsexuals causes great difference in the behavior of operated patients. Then it is very important to analyze the variations of three parameters before and after operation: 1) the presence and the character of sexual feeling and the modality of sexual intercourse; 2) possibility of orgasm; 3) working behavior. The authors present the results of their study on 16 male transsexuals and 4 female transsexuals.

Adult↗
PubMed1990

How cancer affects sexual functioning.

Significant sexual morbidity occurs in the majority of cancer patients. In the assessment of sexual functioning, the health-care provider needs to survey sexual behavior, sexual desire, excitement, orgasm, and resolution (i.e., the sexual response cycle), and the occurrence of sexual dysfunction(s). Data are available documenting sexual disruption for the major sites of disease, including breast, colorectal, bladder, and the genitals, as well as for those with Hodgkin's disease. The author includes a brief model (ALARM) to assist the health professional in assessing sexual functioning in cancer patients.

Female↗
PubMed1990

[Intracavernous self-injection for treatment of erectile dysfunction inpatients with spinal cord injuries].

Twelve patients (aged 18-70 years, average 41 years) with known spinal cord lesions with durations of 1-25 years and with levels of the lesions from C II incomplete to L III complete received intracavernous injection of papaverine with a commencing dose of 15 mg papaverine. Following this, nine patients could obtain usable erection lasting from 30 to 300 minutes with doses from 15-60 mg. In one patient, however, 60 mg papaverine was supplemented by 5 mg phentolamine. The patients were then trained in the technique of self-injection. On contact 1-37 months after the primary instruction, eight patients had performed a total of 40 self injections with the object of coitus, which was successful in all of the cases. Because he had no partner, one patient had no employed self-injection but would like to employ the method if the appropriate situation arose. Two patients did not want to continue self-injection. One of these considered that the method was too complicated to use and the other had had an episode of prolonged erection requiring treatment. No other side effects requiring treatment were observed. The relationship to possible partners and the experience of libido, "orgasm" and feeling of self esteem as compared to previous experiences were registered. Six out of nine patients had experienced improvement in at least one of these fields and none had experienced deterioration. A total of seven patients planned to employ the method in future. The authors conclude that self-injection of papaverine is a promising supplement in the treatment of erective dysfunction in patients with spinal cord lesions.

Administration, Topical↗