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PubMed1975

Sexual counseling. What the busy physician can, and cannot, do.

Patients with sexual problems often seek help first from their family physician. Before referring these patients, the physician should determine the kind of dysfunction present and whether it might successfully be treated in the general office setting. Secondary impotence can often be overcome by simple reassurance or by a program of frequent sexual foreplay and avoidance of actual intercourse. A stop-start method of reconditioning has had some success in the treatment of premature ejaculation. Anorgasmia is a commonly reported female complaint. If caused by inadequate foreplay, counseling and interpersonal discussion should lead to successful resolution. There is some evidence that anorgasmia in some cases may result from clitoral adhesion or underdevelopment of the pubococcygeus muscle. Both conditions may be simply remedied.

Coitus↗
PubMed1975

Sexual conseling of the physically disabled.

Sexual satisfaction and feelings of self-esteem play an important role in the ability to adapt to an acquired physical disability. A framework has been presented to show how sexual function is affected by different types of physical disability, and spinal cord injury has been selected as a specific example. Sexual counseling for the disabled differs little from that for the able-bodied--the same principles apply. It is appropriate to remind not only the counselor but also the disabled that (1) loss of sensation does not mean loss of feelings, (2) loss of potency does not mean loss of ability, (3) loss of urinary continence does not mean loss of penile competence, and (4) loss of genitalia does not mean loss of sexuality.

Attitude to Health↗
PubMed1976

Office gynecology. Relieving dyspareunia.

Effective treatment of dyspareunia can be a simple matter of reassuring the patient or conferring with her sexual partner. Or it may require vaginal dilation, use of lubricant or estrogenic cream, or surgery. Psychogenic dyspareunia is relatively uncommon.

Coitus↗
PubMed1976

Concurrent sex therapy and psychoanalytic psychotherapy by separate therapists: effectiveness and implications.

Since the publication of Masters and Johnson's Human Sexual Inadequacy in 1970, sex therapy has become an established, though controversial, new approach to the treatment of sexual disorders. Masters and Johnson adopted the position that any other form of psychotherapy should be avoided or suspended during the two- or three-week period of sex therapy. Helen Kaplan, in considering sex therapy to be a type of psychotherapy, has stressed that the skillful trained psychotherapist uses his awareness of the psychodynamics and unconscious conflicts of the couple in modifying and tailoring the sex therapy program to their individual needs. In the present study, sex therapy, utilizing a second therapist, was introduced into an ongoing psychoanalytic psychotherapy.

Adaptation, Psychological↗
PubMed2001

Odynorgasmia.

Painful ejaculation ("odynorgasmia") is not well recognized. When it occurs it may indicate the precise site of pathology.

Ejaculation↗
PubMedDate not supplied

The female sexual response: a different model.

Clarification of women's sexual response during long-term relationships is needed. I have presented a model that more accurately depicts the responsive component of women's desire and the underlying motivational forces that trigger it. The variety of arousal/orgasm responses is also acknowledged. The purpose is both to prevent diagnosing dysfunction when the response is simply different from the traditional human sex-response cycle and to more clearly define subgroups of dysfunction. The latter would appear to be necessary before progress in newer treatment modalities, including pharmacological, can be made.

Awareness↗
PubMedDate not supplied

A survey of sexual side effects among severely mentally ill patients taking psychotropic medications: impact on compliance.

Few studies have addressed the effects that iatrogenic sexual side effects have on compliance in the severely mentally ill. The objective of this survey was to assess the levels of self-reported iatrogenic sexual dysfunction within a sample of 51 severely mentally ill outpatients taking a variety of psychiatric medications and to assess the impact of sexual side effects on medication compliance. We found that 62.5% of males and 38.5% of females felt that their psychiatric medications were causing sexual side effects. Despite the fact that they were experiencing sexual side effects, 50% of the subjects never or infrequently spoke about sexual functioning with their primary mental health care providers. In particular, women with sexual side effects rarely discussed sex, in fact, 80% of women with sexual side effects failed to discuss sexual dysfunction with their mental health care providers. We found that the presence of sexual side effects affected compliance. We found that 41.7% of men and 15.4% of women admitted that they had stopped their medications at some point during their treatment based on a belief that they were experiencing sexual side effects.

Adult↗
PubMedDate not supplied

Communication and associated relationship issues in female anorgasmia.

Communication problems are among the most common complaints brought to couples' counseling and are believed to play a central role in the development and maintenance of many sexual dysfunctions. The present study examined self-reported communication patterns within heterosexual couples where the wife is experiencing anorgasmia and within two groups of control couples. As hypothesized, couples with an anorgasmic female partner reported more problematic communication regarding issues of sexuality than did control couples. In particular, the anorgasmic women and their male partners reported significantly more discomfort than did controls in discussing sexual activities associated with direct clitoral stimulation. The etiologic and treatment implications of these differences are discussed.

Adult↗
PubMedDate not supplied

Self-reported sexual arousability in women with congenital adrenal hyperplasia.

As part of a larger study of psychosexual development and sexual functioning in women with congenital adrenal hyperplasia (CAH), we assessed self-reported sexual arousability with the Sexual Arousability Inventory-Short Form (SAI-SF; Hoon & Chambless, 1998). Compared to their unaffected sisters/female cousins (n = 15), women with CAH (n = 30) reported significantly lower sexual arousability on the SAI, with an effect size, using Cohen's d, of 1.16. For both the CAH women alone and combined with the controls, higher self-reported sexual arousability was significantly associated with (a) relationship status (married or cohabitating with a man versus being single or not in a relationship); (b) higher levels of sexual attraction to men in fantasy in the past 12 months on the Erotic Response and Orientation Scale (Storms, 1980); (c) higher Kinsey interview ratings of a heterosexual orientation in behavior in the past 12 months; and (d) more sexual experiences with men, according to a modified version of the Zuckerman (1973) Heterosexual Experience Scale (HES), in the past 12 months and lifetime (all ps < .001-.05). CAH women who were simple virilizers (versus salt-wasters) and those assigned female at birth (versus delayed or male) tended to report higher levels of sexual arousability (p < .10). Self-reported degree of satisfaction with genital surgery and genital function was also associated with higher levels of arousability. For CAH women and both groups combined, multiple regression analysis showed that the sole predictor of self-reported sexual arousability was HES lifetime sexual experiences with men. We discuss the results in the context of assessing sexual function and dysfunction in women with CAH.

Adrenal Hyperplasia, Congenital↗
PubMedDate not supplied

Preliminary clinical experience with androgen administration for pre- and postmenopausal women with hypoactive sexual desire.

The present study examined effects of testosterone on hypoactive sexual desire in pre- and postmenopausal women (treated) compared with an age-matched reference group (reference). Treated participants received 100 mg of testosterone cypionate in oil injected intramuscularly (i.m.) monthly for 3 months. We measured salivary testosterone and scores on the Sexual Desire Inventory pretreatment and posttreatment. Treated and reference participants' baseline testosterone was equivalent, however, treated participants exhibited higher testosterone levels than did reference participants posttreatment. As expected, treated participants exhibited lower baseline sexual desire than did reference participants and showed a significant increase in sexual desire posttreatment. This research suggests that testosterone may effectively alleviate hypoactive sexual desire, even in women with normal testosterone levels.

Adult↗
PubMedDate not supplied

Persistent sexual arousal syndrome: a case report and review of the literature.

This article describes a case of persistent sexual arousal syndrome (PSAS) seen by the Gynecology Consult Service of the National Institutes of Health. This syndrome was first described in 2001 and is characterized by excessive and unrelenting sexual arousal in the absence of desire. PSAS has only recently come to the attention of the health care community, and its prevalence in the population is not completely known. It is important to report cases of this syndrome in order to help clarify its prevalence, etiology, and prognosis and to determine possible methods of treatment.

Adult↗