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Sexual Problems (sexual + problem)

Distribution by Scientific Domains

Medical Sciences	86%
Psychology	13%

Distribution within Medical Sciences

Nursing General	18%
Neurology	9%

Selected Abstracts

Prevalence of Sexual Problems and Its Association with Social, Psychological and Physical Factors among Men in a Malaysian Population: A Cross-Sectional Study

THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2008
Kia Fatt Quek PhD
ABSTRACT Introduction., Sexual problems are common in the general population. Studies have shown that most of these sexual problems are related to their social lives, medical illnesses, and psychological status. Among the sexual problems in men, premature ejaculation (PE) is one of the most frequent, yet it is the least well-understood of the sexual dysfunctions of men. Aim., To determine the prevalence of sexual problem particularly PE and erectile dysfunction (ED) among people living in urban areas and to investigate the characteristics associated with these sexual problems in a Malaysian population. Main Outcome Measure., The PE which is defined as an intravaginal ejaculation latency time less than 2 minutes was assessed in the ED and non-ED group. Methods., The Hospital Anxiety and Depression scale is used as a measure of the psychological status [30]. The ED status was assessed using the International Index of Erectile Function questionnaire. Results., The prevalence of self-reported sexual problems for ED and PE were 41.6% and 22.3%, respectively. In those subjects with ED, 33.5% reported to have PE. Of the total of 430 subjects, anxiety was present in 8.1%, while depression was 5.3%. The prevalence of PE accounted for 25% anxiety and 14.6% for depression respectively in the population. EDs were associated with diabetes and hypertension (OR [95% CI]: 5.33 [2.33, 10.16], 3.40 [1.76, 6.57], P < 0.05), respectively, while factors associated with PE were anxiety and depression (OR [95% CI]: 1.29 [0.68, 2.45], 1.39 [0.69, 2.78]), respectively. Conclusion., Prevalence of ED is associated with medical symptoms such as diabetes and hypertension and a rise in the prevalence of age while psychological distress such as anxiety and depression also contribute to a higher PE rate. Quek KF, Sallam AA, Ng CH, and Chua CB. Prevalence of sexual problems and its association with social, psychological and physical factors among men in a Malaysian Population: A cross-sectional study. J Sex Med 2008;5:70,76. [source]

Comparative study of sexuality-related characteristics in young adults with schizophrenia treated with novel neuroleptics and in normal young adults

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2002
P. Fortier
This study compared characteristics related to sexual history, sexual activities, sexual functioning and psychological tendencies associated with sexuality in 45 young adults with schizophrenia treated with novel neuroleptics and 61 control young adults. A smaller proportion of young adults with schizophrenia currently had a sexual partner or had ever engaged in sexual relations. They also had sexual relations and sexual desires less often. Whether affected by schizophrenia or not, a smaller proportion of women had ever masturbated. They felt less sexual desire and desired sexual relations less often. Compared to controls, a higher proportion of men with schizophrenia treated with Risperidone or Olanzapine had at least one sexual dysfunction, lacked sexual desire and reported problems with sexual arousal and ejaculation. Women with schizophrenia were more likely to report problems with sexual arousal and galactorrhea. Finally, young adults with schizophrenia develop more negative psychological tendencies associated with sexuality than were normal young adults. Sexual problems are highly prevalent among young adults with schizophrenia. Sexuality should occupy the space it deserves within psychosocial rehabilitation programs and the treatment of schizophrenia. [source]

QUALITY OF LIFE OF GREEK PATIENTS WITH END STAGE RENAL DISEASE UNDERGOING HAEMODIALYSIS

JOURNAL OF RENAL CARE, Issue 3 2010
Maria Kastrouni RN
SUMMARY An evaluation of the quality of life of patients with end stage kidney disease undergoing haemodialysis in the Greek population was conducted to understand whether this quality could be improved. Comparisons were made with a similar study conducted in United States in regards to the effects of kidney disease in daily life, burden of kidney disease, work status, cognitive function, quality of social interaction, sexual function, social support, physical functioning, role physical on daily routine, pain, general health perceptions, role emotional, emotional well being, social function and energy/fatigue. Any differences are discussed and analysed. Sexual problems were found to be more prominent in this study, but the emotional status has greater influence in quality of life in the US study. The results were more positive in Greece with respect to dialysis staff encouragement, patient satisfaction, as well as acceptance and the understanding of illness. The results from our study reflect the differences of the health care systems in various countries as well as population-related beliefs and values. [source]

Prevalence of Sexual Problems and Its Association with Social, Psychological and Physical Factors among Men in a Malaysian Population: A Cross-Sectional Study

Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention

ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010
G. Bronner
Bronner G, Elran E, Golomb J, Korczyn AD. Female sexuality in multiple sclerosis: the multidimensional nature of the problem and the intervention. Acta Neurol Scand: 2010: 121: 289,301. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Female sexual functioning is a complex process involving physiological, psychosocial and interpersonal factors. Sexual dysfunction (SD) is frequent (40,74%) among women with multiple sclerosis (MS), reflecting neurological dysfunction, psychological factors, depression, side effects of medications and physical manifestations of the disease, such as fatigue and muscle weakness. A conceptual model for sexual problems in MS characterizes three levels. Primary SD includes impaired libido, lubrication, and orgasm. Secondary SD is composed of limiting sexual expressions due to physical manifestations. Tertiary SD results from psychological, emotional, social, and cultural aspects. Sexual problems cause distress and may affect the family bond. Practical suggestions on initiation of discussion of sexual issues for MS patients are included in this review. Assessment and treatment of sexual problems should combine medical and psychosexual approaches and begin early after MS diagnosis. Intervention can be done by recognizing sexual needs, educating and providing information, by letting patients express their difficulties and referring them to specialists and other information resources. [source]

A multimodal behavioral approach to performance anxiety

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 8 2004
Arnold A. Lazarus
Cognitive-behavior therapy (CBT) stresses a trimodal assessment framework (affect, behavior, and cognition [ABC]), whereas the multimodal approach assesses seven discrete but interactive components,behavior, affect, sensation, imagery, cognition, interpersonal relationships, and drugs/biological factors (BASIC I.D.). Only complex or recalcitrant cases call for the entire seven-pronged range of multimodal interventions. Various case illustrations are offered as examples of how a clinician might proceed when confronted with problems that fall under the general heading of performance anxiety. The main example is of a violinist in a symphony orchestra whose career was in serious jeopardy because of his extreme fear of performing in public. He responded very well to a focused but elaborate desensitization procedure. The hierarchy that was eventually constructed contained many dimensions and subhierarchies featuring interlocking elements that evoked his anxiety. In addition to imaginal systematic desensitization, sessions were devoted to his actual performance in the clinical setting. As a homework assignment, he found it helpful to listen to a long-playing record of an actual rehearsal and to play along with the world-renowned orchestra and conductor. The subsequent disclosure by the client of an important sexual problem was dealt with concomitantly by using a fairly conventional counseling procedure. Therapy required 20 sessions over a 3-month period. © 2004 Wiley Periodicals, Inc. J Clin Psychol/In Session. [source]

Effects of Written Information Material on Help-Seeking Behavior in Patients with Erectile Dysfunction: A Longitudinal Study

THE JOURNAL OF SEXUAL MEDICINE, Issue 2 2008
Michael M. Berner MD
ABSTRACT Introduction., Neither men with erectile dysfunction (ED) nor their physicians are willing to discuss sexual problem sufficiently. Written information material could facilitate a dialogue and encourage men to seek treatment. Aim., The central task of this article was to determine the effectiveness and acceptance of patient information material for sexual dysfunction. Methods., Through an information campaign, men received informational material. Eight thousand men also received a first survey, which asked about the intention to seek treatment and to discuss the sexual problem with a physician or partner. A second follow-up questionnaire, 3,6 months after the first one, asked for the implementation of these intentions. Descriptive and regression-based analyses were applied. Main Outcome Measures., Help-seeking behavior, subjective assessment of change in disease severity and partnership quality, satisfaction. Results., Four hundred forty-three men participated in both surveys. Nearly 90% of them became active after reading the information material. More than half talked with their partner (57.8%) and a physician (65%), and one-third sought treatment (31.8%). Especially discussing the problem with the partner and receiving treatment improved erectile functioning and led to an increase in the quality of partnership (P , 0.05). The initial intention to become active was a good predictor for completing an action. The main reasons for not becoming active were inhibitions to talk about ED (46.8%) and fear of a medical examination (27.7%). Conclusions., Overall, the results demonstrate that written information material is a useful resource for men with ED, because it evokes a high help-seeking behavior. It was perceived both to improve the sexual problem as well as to increase the quality of partnership. Providing such material in the medical practice may be an appropriate way to overcome inhibitions and to initiate dialogue with affected men. However, the results must be interpreted with caution because of possible motivationally driven self-selection bias. Berner MM, Leiber C, Kriston L, Stodden V, and Günzler C. Effects of written information material on help-seeking behavior in patients with erectile dysfunction: A longitudinal study. J Sex Med 2008;5:436,447. [source]

Prevalence of Sexual Problems and Its Association with Social, Psychological and Physical Factors among Men in a Malaysian Population: A Cross-Sectional Study

A classification of risk factors in serious juvenile offenders and the relation between patterns of risk factors and recidivism

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2010
Eva Mulder
Background,There has been a lot of research on risk factors for recidivism among juvenile offenders, in general, and on individual risk factors, but less focus on subgroups of serious juvenile offenders and prediction of recidivism within these. Objective,To find an optimal classification of risk items and to test the predictive value of the resultant factors with respect to severity of recidivism among serious juvenile offenders. Method,Seventy static and dynamic risk factors in 1154 juvenile offenders were registered with the Juvenile Forensic Profile. Recidivism data were collected on 728 of these offenders with a time at risk of at least 2 years. After factor analysis, independent sample t-tests were used to indicate differences between recidivists and non-recidivists. Logistic multiple linear regression analyses were used to test the potential predictive value of the factors for violent or serious recidivism. Results,A nine-factor solution best accounted for the data. The factors were: antisocial behaviour during treatment, sexual problems, family problems, axis-1 psychopathology, offence characteristics, conscience and empathy, intellectual and social capacities, social network, and substance abuse. Regression analysis showed that the factors antisocial behaviour during treatment, family problems and axis-1 psychopathology were associated with seriousness of recidivism. Conclusions and implications for practice,The significance of family problems and antisocial behaviour during treatments suggest that specific attention to these factors may be important in reducing recidivism. The fact that antisocial behaviour during treatment consists mainly of dynamic risk factors is hopeful as these can be influenced by treatment. Consideration of young offenders by subgroup rather than as a homogenous population is likely to yield the best information about risk of serious re-offending and the management of that risk. Copyright © 2010 John Wiley & Sons, Ltd. [source]

Health-related quality of life, symptom distress and sense of coherence in adult survivors of allogeneic stem-cell transplantation

EUROPEAN JOURNAL OF CANCER CARE, Issue 2 2001
L. Edman
This is the first Swedish study to evaluate the health-related quality of life and sense of coherence in adult survivors of allogeneic, haematopoietic stem cell transplantation (HSCT). Twenty-five recipients completed three questionnaires 2,4 years after the transplantation. The questionnaires used were the Sickness Impact Profile (SIP), the Symptom Frequency Intensity and Distress (SFID-BMT) scale and the Sense of Coherence (SOC) scale measuring subjective functional status, symptom distress and coping ability. Impairments in functional status were found, as compared with a population norm. The most common impairments were found in the areas of social interaction and sleep and rest. Eye problems, dry mouth, cough, sexual problems, tiredness, anxiety and changes of taste were symptoms reported by more than half of the patients. Despite impaired functioning and a high incidence of symptoms, the general health was described as quite good or excellent by 80% (n = 20) of the patients. The majority (20/22) had also been able to return to work or to attend school. No difference in the sense of coherence was seen, as compared with the population norm. Functional impairments were significantly correlated to a lower degree of sense of coherence. [source]

Autonomic symptoms in patients and pre-manifest mutation carriers of Huntington's disease

EUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2010
N. A. Aziz
Background and purpose:, Although autonomic function tests have revealed abnormalities of the autonomic nervous system in Huntington's disease (HD), autonomic symptoms and their association with other symptoms and signs of HD have not yet been assessed in large groups of patients or pre-manifest mutation carriers. Therefore, we aimed at delineating the characteristics and correlates of autonomic symptoms in HD. Methods:, Using the scales for outcomes in Parkinson's disease-autonomic symptoms (SCOPA-AUT) and Beck Depression Inventory questionnaires, autonomic symptoms and depressed mood were assessed in 63 patients with HD, 21 pre-manifest mutation carriers, and 85 controls. The Unified Huntington's Disease Rating Scale was used to assess other HD symptoms and signs. Results:, Relative to controls, patients with HD experienced significantly more gastrointestinal, urinary, cardiovascular and, in men, sexual problems. The most prevalent symptoms were swallowing difficulties, erection and ejaculation problems, dysphagia, sialorrhea, early abdominal fullness, straining for defecation, fecal and urinary incontinence, urgency, incomplete bladder emptying, and light-headedness whilst standing. Pre-manifest mutation carriers experienced significantly more swallowing difficulties and light-headedness on standing up compared with controls. In patients with HD, autonomic symptoms were associated with a greater degree of functional disability, more severe depression, and antidepressant drugs use. However, depression was the only independent predictor of autonomic dysfunction. Conclusions:, Autonomic symptoms are highly prevalent in patients with HD and may even precede the onset of motor signs. Moreover, autonomic dysfunction is related to functional disability and depression in HD. [source]

Sexual dysfunction in subjects with Klinefelter's syndrome

INTERNATIONAL JOURNAL OF ANDROLOGY, Issue 4 2010
G. Corona
Summary While the association of Klinefelter's Syndrome (KS) with infertility is well-known, very few investigations have evaluated the prevalence of sexual dysfunction in KS. The aim of the present study was to systematically analyse the prevalence of KS in a consecutive series of adult male patients consulting for sexual problems and to investigate its specific correlates. Among a consecutive series of 1386 men (mean age 48.9 ± 12.7 years old), 23 (1.7%) subjects with KS were found. Patients with KS were younger and more often hypogonadal when compared with the rest of the sample. Among patients with KS, five (22.7%) subjects reported severe erectile dysfunction, 14 (60.9%) hypoactive sexual desire (HSD), two (9.5%) premature and two (9.5%) delayed ejaculation. Only the association between KS and HSD was confirmed after adjustment for age [HR = 3.2 (1.37,7.5)], however, when patients with KS were compared with age, smoking habit, and testosterone matched controls, even the association between KS with HSD disappeared. In comparison to matched hypogonadal controls, subjects with KS had lower levels of education, a higher frequency of cryptorchidism and poorer pubertal progression. In conclusion, our results indicate that sexual dysfunction present in KS is not specifically associated with the syndrome but is caused by the underlying hypogonadal state. Further studies are needed to evaluate the efficacy of testosterone substitution in ameliorating the hypoactive sexual desire often reported in subjects with KS. [source]

What is worse for your sex life: Starving, being depressed, or a new baby?

INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 7 2007
Dip Clin Psych, Frances A. Carter PhD
Abstract Objective: To compare the current sexual functioning of women in an intimate relationship with anorexia nervosa, with major depression, and in the postpartum period. Method: Complete data were available for 76 women who reported being in an intimate relationship (anorexia = 10; depression = 24; postpartum = 42). Sexual functioning was assessed using the Social Adjustment Scale (Weissman and Bothwell, Arch Gen Psychiatry, 33, 1111,1115, 1976). Results: Significant differences were found among groups for the frequency of sex (p =.03) and problems with sex (p < .001), but not for enjoyment of sex (p = .55). In the previous 2 weeks, women with anorexia nervosa or major depression were more likely to have had sex than postpartum women, but were also more likely to have had sexual problems than postpartum women. Most women with anorexia nervosa, women with major depression, and postpartum women reported enjoying sex. Conclusion: Women with anorexia nervosa and women with major depression who are in an intimate relationship report a similar profile of current sexual functioning that is different from postpartum women both in the frequency of sexual encounters and in reported problems with sex. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007. [source]

Twelve-year course and outcome predictors of anorexia nervosa

INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2006
Dipl-Psych, Manfred M. Fichter MD
Abstract Objective The current study presents the long-term course of anorexia nervosa (AN) over 12 years in a large sample of 103 patients diagnosed according to criteria in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Method Assessments were made at the beginning of therapy, at the end of therapy, at the 2-year follow-up, at the 6-year follow-up, and at the 12-year follow-up. Self-rating and an expert-rating interview data were obtained. Results The participation rate at the 12-year follow-up was 88% of those alive. There was substantial improvement during therapy, a moderate (in many instances nonsignificant) decline during the first 2 years posttreatment, and further improvement from 3 to 12 years posttreatment. Based on a global 12-year outcome score, 27.5% had a good outcome, 25.3% an intermediate outcome, 39.6% had a poor outcome, and 7 (7.7%) were deceased. At the 12-year follow-up 19.0% had AN, 9.5% had bulimia nervosa-purging type (BN-P), 19.0% were classified as eating disorder not otherwise specified (EDNOS). A total of 52.4% showed no major DSM-IV eating disorder and 0% had binge eating disorder (BED). Systematic,strictly empirically based,model building resulted in a parsimonious model including four predictors of unfavorable 12-year outcome explaining 45% of the variance, that is, sexual problems, impulsivity, long duration of inpatient treatment, and long duration of an eating disorder. Conclusion Mortality was high and symptomatic recovery protracted. Impulsivity, symptom severity, and chronicity were the important factors for predicting the 12-year outcome. © 2005 by Wiley Periodicals, Inc. [source]

Effectiveness of the PLISSIT model for solving the sexual problems of patients with stoma

JOURNAL OF CLINICAL NURSING, Issue 1 2009
Sultan Ayaz
Aims and objectives., This study was carried out to assess the effectiveness of the PLISSIT model in solving sexual problems of individuals with stoma. Background., Creating a stoma due to intestinal cancer may prolong the life expectancy of individuals. However, the problems resulting from stoma may cause significant changes in an individual's life and adversely affect relations with family members and social and sexual life. Design., Experimental. Methods., The study consisted of individuals with stoma, living in Ankara. The sample consisted of 60 patients. The case group consisted of 30 patients living in Ankara; and the control group consisted of 30 patients living outside Ankara. In data collection, a questionnaire form, the PLISSIT model intervention plan and Golombok,Rust Inventory of Sexual Satisfaction (GRISS) were used. The individuals in the case group were paid eight home visits. During these visits, sexual problems of individuals with stoma were assessed and solutions sought under the guidance of the PLISSIT model intervention plan. Results., Increase of mean scores of Golombok,Rust Inventory of Sexual Satisfaction and subgroups before evaluating the sexual problems by the PLISSIT model and the sixth week scores which the sexual activity is anticipated to start have been observed, but after evaluating the sexual problems by using the model, the mean scores decreased. It was determined that negative effects of concerns related to sexual life; some physical and emotional features and physiological problems have been observed and difference between the groups is significant (p < 0·05). Conclusions., As a result, it can be claimed that decreasing sexual problems can be accomplished by using the PLISSIT model. Relevance to clinical practice., People with stoma can meet sexual problems. However, nurses experience some difficulties while handling sexual problems. It is thought that an intervention plan prepared within the framework of the PLISSIT model will guide nurses in solving sexual problems of individuals with stoma and providing integrated care and help individuals to express their sexual problems. [source]

The connections between childhood sexual abuse and human immunodeficiency virus infection: Implications for interventions

JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 6 2005
Nalini Tarakeshwar
A qualitative study was conducted with 28 women who are human immunodeficiency virus (HIV),positive and have experienced childhood sexual abuse (CSA) in order to examine (1) the challenges generated by the experience of sexual abuse and related coping strategies, (2) the impact of the HIV diagnosis on their coping strategies, and (3) the links perceived by the women between their CSA and HIV infection. The interviews revealed that CSA raised challenges in four areas: disclosure of the abuse, sexual problems, relationship difficulties, and psychological distress. The women used two strategies to cope with their CSA: illicit substances to numb their emotional distress and sexual activity, and alienation to gain control in relationships. When diagnosed with HIV, the women initially coped with their illness by using these two strategies. The women reported that, over time, they were able to accept their HIV illness, seek social support, find alternative sources of significance, and use spirituality to sustain their growth. However, they continued to suffer psychological distress related to their sexual trauma. Further, most of the women did not perceive any connection between the two traumas. Implications of these findings for secondary prevention interventions with women who have HIV and experience of CSA are discussed. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 655,672, 2005. [source]

The sexual and relationship needs of people who experience psychosis: quantitative findings of a UK study

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2010
E. MCCANN phd rmn msc dippi pgdip academic practice fhea
Accessible summary ,,Distinct lack of studies exist that explore sexual and relationship issues. ,,Captures important experiences of people who use mental health services. ,,Reveals potential obstacles to the expression of sexuality. ,,Identifies a diversity of needs. ,,Presents issues that may guide mental health practice, education and research. Abstract Few studies have investigated the experiences of people regarding sexual and relationship issues in the area of mental health. This study presents the quantitative findings of a larger study that was conducted in London, UK. The aims of the study were to establish client's sexual and relationship experiences and perceived needs. A total of 30 people with a medical diagnosis of schizophrenia, living in the community, were interviewed using three questionnaires. The first related to demographics, the second used relevant parts of the Camberwell Assessment of Need (CAN) and the third looked at possible determinants of sexual behaviour. The CAN also captured keyworker responses to issues related to their clients sexual and relationship requirements. The results showed that 83% of the clients were currently experiencing sexual feelings. Some 90% of clients felt some need in relation to sexual expression and 83% for needs related to intimate relationships. Only 10% of staff recognized sexual expression as a need in clients in their care and 43% perceived a need for intimate relationships. Furthermore, most clients interviewed thought that their psychotropic medication caused sexual problems. Contrasts are made with other studies to help highlight the important issues that emerged for service users. [source]

Female Sexual Dysfunction: Knowledge Development and Practice Implications

PERSPECTIVES IN PSYCHIATRIC CARE, Issue 3 2009
Janet Ambrogne Sobczak PhD, PMHCNS
PURPOSE., Sexual dysfunctions are thought to be common in the population. However, the majority of research on sexual dysfunctions has focused on male problems. Consequently, women's sexual function is poorly understood. This article aimed to (a) provide a historical overview of the knowledge development of female sexual function, (b) describe the current state of knowledge pertaining to sexual problems in women, and (c) discuss implications for the assessment of sexual problems in women. CONCLUSIONS., A women's sexual response may differ from current conceptualizations. PRACTICE IMPLICATIONS., A sexual history should be included in routine health assessments. Information specific to contextual and relational factors is particularly important for women. [source]

Sexual function, depressive symptoms and marital status in nonseminoma testicular cancer patients: a longitudinal study

PSYCHO-ONCOLOGY, Issue 3 2010
Marrit A. Tuinman
Abstract Goal: To longitudinally investigate sexual functioning in testicular cancer patients during the first year, and examine the effect of relationship status (with a partner or single) and depressive symptoms on sexual functioning. Patients and methods: 93 testicular cancer patients (39% single) treated in two large referral centers for testicular cancer filled in the International Index of Erectile Function (IIEF) and CES-D after orchiectomy (T1) and 3 (T2) and 12 (T3) months later. Results: Orgasmic functioning, overall satisfaction and total sexual functioning decreased between T1 and T2 and increased to an above T1 level at T3. Levels of erectile functioning and intercourse satisfaction were higher at T3 than at T1 and T2. Desire remained stable. Type of treatment did not affect sexual functioning. Singles reported worse sexual functioning at all measurement times than committed patients, and comparable desire. One year after surgery, singles also reported worse sexual functioning on three domains when compared with norms. Depressive symptoms were highest and significantly but weakly related to one domain of sexual functioning at T1, to three domains at T2, and to none at T3. Early depressive symptoms had small to moderate predictive power on sexual functioning at T2, but not at T3. Conclusion: Sexual functioning, but not desire, fluctuates during the first year after testicular cancer. Type of treatment and depressive symptoms were no risk factors for sexual dysfunction in the longer term. Singles reported more sexual problems than patients in a relationship and norms, they may need more information and guidance concerning their sexuality. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Body image and sexual problems in young women with breast cancer

PSYCHO-ONCOLOGY, Issue 7 2006
Pat Fobair
Abstract Purpose: The purpose of this study was to determine the frequency of body image and sexual problems in the first months after treatment among women diagnosed with breast cancer at age 50 or younger. Background: Breast cancer treatment may have severe effects on the bodies of younger women. Surgical treatment may be disfiguring, chemotherapy may cause abrupt menopause, and hormone replacement is not recommended. Methods: A multi-ethnic population-based sample of 549 women aged 22,50 who were married or in a stable unmarried relationship were interviewed within seven months of diagnosis with in situ, local, or regional breast cancer. Results: Body image and sexual problems were experienced by a substantial proportion of women in the early months after diagnosis. Half of the 546 women experienced two or more body image problems some of the time (33%), or at least one problem much of the time (17%). Among sexually active women, greater body image problems were associated with mastectomy and possible reconstruction, hair loss from chemotherapy, concern with weight gain or loss, poorer mental health, lower self-esteem, and partner's difficulty understanding one's feelings. Among the 360 sexually active women, half (52%) reported having a little problem in two or more areas of sexual functioning (24%), or a definite or serious problem in at least one area (28%). Greater sexual problems were associated with vaginal dryness, poorer mental health, being married, partner's difficulty understanding one's feelings, and more body image problems, and there were significant ethnic differences in reported severity. Conclusions: Difficulties related to sexuality and sexual functioning were common and occurred soon after surgical and adjuvant treatment. Addressing these problems is essential to improve the quality of life of young women with breast cancer. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Cannabis Use and Sexual Health

THE JOURNAL OF SEXUAL MEDICINE, Issue 2pt1 2010
Anthony M.A. Smith PhD
ABSTRACT Introduction., Cannabis is the most commonly used illicit substance worldwide. Despite this, its impact on sexual health is largely unknown. Aim., The aim of this article is to examine the association between cannabis use and a range of sexual health outcomes. Main Outcome Measures., The main outcome measures include the number of sexual partners in the past year, condom use at most recent vaginal or anal intercourse, diagnosis with a sexually transmissible infection in the previous year, and the occurrence of sexual problems. Methods., Method used in this article includes a computer-assisted telephone survey of 8,656 Australians aged 16,64 years resident in Australian households with a fixed telephone line. Results., Of the 8,650 who answered the questions about cannabis use, 754 (8.7%) reported cannabis use in the previous year with 126 (1.5%) reporting daily use, 126 reported (1.5%) weekly use, and 502 (5.8%) reported use less often than weekly. After adjusting for demographic factors, daily cannabis use compared with no use was associated with an increased likelihood of reporting two or more sexual partners in the previous year in both men (adjusted odds ratio 2.08, 95% confidence interval 1.11,3.89; P = 0.02) and women (2.58, 1.08,6.18; P = 0.03). Daily cannabis use was associated with reporting a diagnosis of a sexually transmissible infection in women but not men (7.19, 1.28,40.31; P = 0.02 and 1.45, 0.17,12.42; P = 0.74, respectively). Frequency of cannabis use was unrelated to sexual problems in women but daily use vs. no use was associated with increased reporting among men of an inability to reach orgasm (3.94, 1.71,9.07; P < 0.01), reaching orgasm too quickly (2.68, 1.41,5.08; P < 0.01), and too slowly (2.05, 1.02,4.12; P = 0.04). Conclusions., Frequent cannabis use is associated with higher numbers of sexual partners for both men and women, and difficulties in men's ability to orgasm as desired. Smith AMA, Ferris JA, Simpson JM, Shelley J, Pitts M, and Richters J. Cannabis use and sexual health. J Sex Med 2010;7:787,793. [source]

The Relevance of Sexual Responsiveness to Sexual Function in Male Stroke Patients

THE JOURNAL OF SEXUAL MEDICINE, Issue 12 2009
Annelien Duits PhD
ABSTRACT Introduction., Stroke may have negative consequences for the patients' quality of life, including sexual function. Whereas physical impairment will influence sexual positions and movement during sex, depression and medication may reduce sexual desire. So far, data on sexual dysfunction after stroke are scant. Although some support for physical as well as psychological explanations has been shown, further research to find the remedies for those patients with sexual problems after stroke is needed. The focus of the present study is on the identification of relevant psychological factors. Aim., The aim of this study was to study the impact of anxiety, depression, and sexual responsiveness on sexual function in male stroke patients. Methods., Nineteen male stroke patients completed a number of self-report measures to assess psychological and sexual factors. Main Outcome Measures., Sexual function based on the International Index of Erectile Function, anxiety and depression based on the Symptom Checklist-90, and sexual responsiveness based on the Sexual Inhibition/Sexual Excitation Scale, including propensities for sexual excitation and sexual inhibition as a result of both performance failure and performance consequences, were assessed. Results., Sexual excitation was positively related to sexual desire, whereas inhibition because of the threat of performance failure was negatively related to orgasmic function and sexual desire (P < 0.01). Patients with high levels of inhibition because of threat of performance failure were more likely to report low scores on overall sexual function than those with low levels. Conclusions., Although the statistical power is rather low, the results show the relevance of sexual responsiveness to sexual function in male stroke patients. The present study can be considered as a first step toward building a theoretical framework of relevant psychological and physical factors, which is needed to develop adequate interventions for those patients with sexual problems after stroke. Duits A, van Oirschot N, van Oostenbrugge RJ, and van Lankveld J. The relevance of sexual responsiveness to sexual function in male stroke patients. J Sex Med 2009;6:3320,3326. [source]

Patients' Sexual Health: A Qualitative Research Approach on Greek Nurses' Perceptions

THE JOURNAL OF SEXUAL MEDICINE, Issue 8 2009
Evangelia Nakopoulou MSc
ABSTRACT Introduction., Health care professionals, especially nurses, through their contact with patients, play an important role in encouraging discussions about sexual concerns. Aim., To explore perceptions on sexual health issues and how these might inhibit or enhance Greek nurses' ability to incorporate sexual health assessment into everyday practice. Main Outcome Measures., A discussion guide was used as checklist to ensure that the basic issues would be addressed. Topics related to the areas of interest were either brought up from the participants or introduced by the moderator. Methods., The study recruited a purposive sample of 44 Greek staff nurses (SN) attending a course leading to their professional upgrading. A qualitative research design was employed using seven focus groups. Discussions started with nurses' perceived definitions of sexual health and proceeded with open-ended questions. Transcripts were analyzed using thematic analysis based on the principles of grounded theory. Results., Three central themes were identified from transcripts' thematic analysis: subjective perception of sexual health, discussing sexual problems, and educational and training needs. Participants' perceptions of sexual health centred mainly on the emotional and somatic dimensions. Regarding clinical practice, a variety of personal and contextual reasons limit nurses' willingness to talk about sexuality with patients, such as gender and age differences, familial upbringing, lack of time and privacy, and restricted perception of nursing role. All nurses stressed the need for further specialized training not only in physiology issues related to sexuality, but also most importantly in communication skills. Conclusions., Although Greek nurses acknowledge the importance of sexual health assessment, they believe that sexual history taking is not within the range of their professional tasks. Since holistic care demands sexual health assessment and intervention to be an integral part of nursing practice, it is necessary to introduce courses in their curriculum and experiential workshops addressing the multidimensionality of sexuality. Nakopoulou E, Papaharitou S, and Hatzichristou D. Patients' sexual health: A qualitative research approach on Greek nurses' perceptions. J Sex Med 2009;6:2124,2132. [source]

Sexual Function in F-111 Maintenance Workers: The Study of Health Outcomes in Aircraft Maintenance Personnel

THE JOURNAL OF SEXUAL MEDICINE, Issue 6 2009
Anthony Brown MPH
ABSTRACT Introduction., In Australia, four formal F-111 fuel tank deseal/reseal (DSRS) repair programs were implemented over more than two decades, each involving different processes and using a range of hazardous substances. However, health concerns were raised by a number of workers. The "Study of Health Outcomes in Aircraft Maintenance Personnel" was commissioned by the Australian Department of Defence to investigate potential adverse health outcomes as a result of being involved in the deseal/reseal processes. Aim., To compare measures of sexual function in F-111 aircraft fuel tank DSRS maintenance workers, against two appropriate comparison groups. Methods., Exposed and comparison participants completed a postal questionnaire which included general questions of health and health behavior, and two specific questions on sexual functioning. They also completed the International Index of Erectile Function (IIEF) questionnaire. Logistic regression was used to explore exposure status and outcome while adjusting for potential confounders. Main Outcome Measures., The three outcomes of interest for this study were the proportion of participants with erectile dysfunction (ED) according to the IIEF, the proportion with self-reported loss of interest in sex, and the proportion with self-reported problems with sexual functioning. Results., Compared with each of the comparison groups, a larger proportion of the exposed group reported sexual problems and were classified as having ED according to the IIEF. In logistic regression, the odds of all three outcomes were higher for exposed participants relative to each comparison group and after adjustment for potentially confounding variables including anxiety and depression. Conclusions., There was a consistent problem with sexual functioning in the exposed group that is not explained by anxiety and depression, and it appears related to DSRS activities. Brown A, Gibson R, Tavener M, Guest M, D'Este C, Byles J, Attia J, Horsley K, Harrex W, and Ross J. Sexual function in F-111 maintenance workers: The study of health outcomes in aircraft maintenance personnel. J Sex Med 2009;6:1569,1578. [source]

Improvement of Chronic Pain by Treatment of Erectile Dysfunction

THE JOURNAL OF SEXUAL MEDICINE, Issue 12 2008
Jalil Arabkheradmand MD
ABSTRACT Introduction., Pain specialists, who do not routinely examine patients regarding their sexual medicine problems, need to be aware that sexual problems can and do aggravate the patient's pain. Patients may refuse to admit suffering from erectile dysfunction (ED) but complain about continuous or progressive severe pain. These patients may be best managed by the combined team effort of a sexual medicine specialist and pain specialist. Aim., This report documents the management of three cases with long-term intractable pain after severe trauma. Treatment of occult ED led to significant improvement of their pain. Main Outcome Measures., The association of the treatment of uncovered ED and improvement of chronic severe pain. Methods., Three case reports of patients with severe pain who attended a pain clinic in an academic medical center. Results., Three men suffering from chronic pain due to severe trauma were observed for several years by different physicians as well as pain specialists. In spite of different treatments, including administration of several analgesics, psychotherapy, and physical therapy, pain was not alleviated. After finding ED problems, patients were referred to the family health clinic. Using different therapies such as psychosexual therapy, correction of sexual misconceptions, relaxation training, treatment of interpersonal difficulties, and pharmacological intervention ED was cured. Treatment of ED was accompanied by a significant reduction of chronic pain in all three patients. Conclusion., The present report indicates that uncovered ED in patients suffering from chronic pain may trigger their somatic pain or reduce its threshold. Significant improvement in sexual functioning may improve the pain and reduce its complications. Arabkheradmand J, Foroutan SK, Ranjbar S, Abbasi T, Hessami S, and Gorji A. Improvement of chronic pain by treatment of erectile dysfunction. J Sex Med **;**:**,**. [source]

ORIGINAL RESEARCH,PSYCHOLOGY: Age of First Sexual Intercourse and Acculturation: Effects on Adult Sexual Responding

THE JOURNAL OF SEXUAL MEDICINE, Issue 3 2008
Jane S.T. Woo MA
ABSTRACT Introduction., Although age of first intercourse and the emotional aspects of that experience are often a target in assessment because they are thought to contribute to later sexual functioning, research to date on how sexual debut relates to adult sexual functioning has been limited and contradictory. Aim., The goal of this study was to explore the association between age of first intercourse and adult sexual function in a sample of Euro-Canadian and Asian Canadian university students. In addition, culture-based comparisons of sexual complaints were made to clarify the role of culture in sexual response. Methods., Euro-Canadian (N = 299) and Asian Canadian (N = 329) university students completed the Golombok-Rust Inventory of Sexual Satisfaction and the Vancouver Index of Acculturation. Main Outcome Measures., Self-reported sexual problems and bidimensional acculturation. Results., Ethnic group comparisons revealed that Asians reported more sexual complaints including sexual avoidance, dissatisfaction and non-sensuality. Among the women, Asians reported higher scores on the Vaginismus and Anorgasmia subscales whereas the ethnic groups did not differ on the male-specific measures of sexual complaints. In the overall sample, older age of first intercourse was associated with more sexual problems as an adult, including more sexual infrequency, sexual avoidance, and non-sensuality. Among the Asian Canadians, less identification with Western culture was predictive of more sexual complaints overall, more sexual noncommunication, more sexual avoidance, and more non-sensuality. For Asian women, acculturation interacted with age of first intercourse to predict Vaginismus scores. Conclusions., Overall, these data replicate prior research that found that a university sample of individuals of Asian descent have higher rates of sexual problems and that this effect can be explained by acculturation. Earlier sexual debut was associated with fewer sexual complaints in adulthood. Woo JST, and Brotto LA. Age of first sexual intercourse and acculturation: Effects on adult sexual responding. J Sex Med 2008;5:571,582. [source]

Prevalence of Sexual Problems and Its Association with Social, Psychological and Physical Factors among Men in a Malaysian Population: A Cross-Sectional Study

Sexual Function and Obstructive Sleep Apnea,Hypopnea: A Randomized Clinical Trial Evaluating the Effects of Oral-Appliance and Continuous Positive Airway Pressure Therapy

THE JOURNAL OF SEXUAL MEDICINE, Issue 4ii 2007
Aarnoud Hoekema DMD
ABSTRACT Introduction., The obstructive sleep apnea,hypopnea syndrome (OSAHS) is associated with sexual dysfunction. Although successful treatment with continuous positive airway pressure (CPAP) has been demonstrated to improve sexual function, the effects of oral-appliance therapy are unknown. Aim., The aims of this study were to determine to what extent untreated male OSAHS patients experience sexual dysfunctions compared with control subjects, and second, to evaluate the effects of oral-appliance and CPAP therapy on sexual functioning. Methods., Sexual functioning was determined in 48 OSAHS patients with the Golombok Rust inventory of sexual satisfaction (GRISS) and a testosterone measurement. GRISS outcomes were compared with 48 age-matched male controls without any sexual problems. Patients were randomized for either oral-appliance or CPAP therapy. After 2,3 months of treatment, the GRISS and testosterone measurements were repeated. Main Outcome Measure., The outcomes on the GRISS were used as the main outcome measure. Results., Compared with controls, OSAHS patients had significantly more erectile dysfunction (mean ± standard deviation; OSAHS 8.7 ± 3.8 vs. controls 6.8 ± 2.6) and sexual dissatisfaction (mean ± standard deviation; OSAHS 9.7 ± 4.2 vs. controls 8.1 ± 2.6) as indicated by the GRISS. No significant changes in the GRISS or testosterone levels were observed in the 20 and 27 patients completing the follow-up review for oral-appliance and CPAP therapy. A correlation was demonstrated between the extent of erectile dysfunction at baseline and improvements in erectile function following treatment (r = ,0.547, P = 0.000). Conclusions., This study confirms that male OSAHS patients show more sexual dysfunctions compared with age-matched control subjects. Although significant improvements in sexual functioning in neither the oral-appliance nor CPAP-treated group could be established, our findings suggest that untreated OSAHS patients with pronounced erectile dysfunction experience some improvement following treatment. Hoekema A, Stel A-L, Stegenga B, van der Hoeven JH, Wijkstra PJ, van Driel MF, and de Bont LGM. Sexual function and obstructive sleep apnea,hypopnea: A randomized clinical trial evaluating the effects of oral-appliance and continuous positive airway pressure therapy. J Sex Med 2007;4:1153,1162. [source]

Testing Endothelial Function of Brachial and Cavernous Arteries in Patients with Erectile Dysfunction

THE JOURNAL OF SEXUAL MEDICINE, Issue 2 2006
Evsey Mazo MD
ABSTRACT Introduction., There is considerable clinical and scientific evidence that endothelial dysfunction may be an important clinical link connecting erectile dysfunction (ED) with cardiovascular diseases. Aims., To modify the method of assessment of endothelial function of cavernosal arteries, to develop a new algorithm for evaluating its results, and to investigate the relationship between postocclusive changes in the diameter of brachial and cavernous arteries. Methods., The study participants were 212 patients presenting to our department complaining of ED and 40 healthy volunteers without sexual problems, which formed the control group. All patients with ED underwent complex evaluation and ultrasound assessment of postocclusive changes in the diameter of cavernosal arteries modified by us and standard ultrasound assessment of endothelium-dependent flow-mediated dilation of the brachial artery. Main Outcome Measures., As the main outcome measure, the percent of increase of the cavernosal arteries diameter (PICAD) was recorded. Results., In the patients with arteriogenic ED, PICAD values were significantly less than in other groups (P < 0.001 for pairs of comparison). At the same time there were no differences between the control group and groups of patients with psychogenic and organic nonarterial ED. The sensitivity and specificity of a PICAD value of 50% in diagnosis of arteriogenic ED were 100% and 98.2%, respectively. In all groups and in the entire sample of patients studied we did not find a correlation between PICAD and postocclusive changes in the diameter of brachial arteries. Conclusion., The method of ultrasound assessment of postocclusive changes in the diameter of cavernosal arteries is, reliable and, a, highly informative tool for diagnosis of arteriogenic ED. It cannot be substituted by techni-cally simpler method of ultrasound examination of brachial arteries, while results of the latter could help to define the necessity of performing an examination of cavernous arteries. Mazo E, Gamidov S, Anranovich S, and Iremashvili V. Testing endothelial function of brachial and cavernous arteries in patients with erectile dysfunction. J Sex Med 2006;3:323,330. [source]

Social factors associated with Major Depressive Disorder in homosexually active, gay men attending general practices in urban Australia

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2009
Limin Mao
Abstract Objectives: Social factors associated with Major Depressive Disorder (MDD) were identified among gay men attending high HIV caseload general practices in Sydney and Adelaide. Methods: Men who visited four participating practices were invited to self-complete a survey. A self-screening tool (PHQ-9), based on the Diagnostic and Statistical Manual of Mental Disorders, version four (DSM-IV), was used to measure depressive disorders. Results: The rate of MDD (PHQ-9 score 10 or above) among the 195 HIV-positive gay men was significantly higher than that among the 314 non-HIV-positive gay men (31.8% vs 20.1%, p=0.002). Current MDD was independently associated with younger age, lower income, recent major adverse life events, adopting denial and isolation as coping strategies, less social support, less gay community involvement and recent sexual problems. HIV-status, however, was not independently associated with MDD. Conclusion: Socio-economic hardship, interpersonal isolation and personal withdrawal were significantly and independently associated with major depression in this population of gay men. Implications: The study provides further evidence of health inequity affecting gay men in Australia. Structural health promotion approaches focused on homophobia and discrimination, as well as community-engaged primary health care responses are called for to mitigate this inequity. [source]