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Concept: Sexual function

169

Reduced libido is widely considered the most prominent symptomatic reflection of low testosterone (T) levels in men. Testosterone deficiency (TD) afflicts approximately 30% of men aged 40-79 years. This study seeks to evaluate the effect of a new natural compound “tradamixina "in order to improve male sexual function in elderly men, particularly libido and possible erectile dysfunction, versus administration of tadalafil 5 mg daily.

Concepts: Sociology, Testosterone, Group, Ageing, Erectile dysfunction, Hypogonadism, Sexual function, Sexual dysfunction

91

Research on multidimensional sexual perfectionism differentiates four forms: self-oriented, partner-oriented, partner-prescribed, and socially prescribed. Self-oriented sexual perfectionism reflects perfectionistic standards people apply to themselves as sexual partners; partner-oriented sexual perfectionism reflects perfectionistic standards people apply to their sexual partner; partner-prescribed sexual perfectionism reflects people’s beliefs that their sexual partner imposes perfectionistic standards on them; and socially prescribed sexual perfectionism reflects people’s beliefs that society imposes such standards on them. Previous studies found partner-prescribed and socially prescribed sexual perfectionism to be maladaptive forms of sexual perfectionism associated with a negative sexual self-concept and problematic sexual behaviors, but only examined cross-sectional relationships. The present article presents the first longitudinal study examining whether multidimensional sexual perfectionism predicts changes in sexual self-concept and sexual function over time. A total of 366 women aged 17-69 years completed measures of multidimensional sexual perfectionism, sexual esteem, sexual anxiety, sexual problem self-blame, and sexual function (cross-sectional data). Three to six months later, 164 of the women completed the same measures again (longitudinal data). Across analyses, partner-prescribed sexual perfectionism emerged as the most maladaptive form of sexual perfectionism. In the cross-sectional data, partner-prescribed sexual perfectionism showed positive relationships with sexual anxiety, sexual problem self-blame, and intercourse pain, and negative relationships with sexual esteem, desire, arousal, lubrication, and orgasmic function. In the longitudinal data, partner-prescribed sexual perfectionism predicted increases in sexual anxiety and decreases in sexual esteem, arousal, and lubrication over time. The findings suggest that partner-prescribed sexual perfectionism contributes to women’s negative sexual self-concept and female sexual dysfunction.

Concepts: Sexual intercourse, Longitudinal study, Cross-sectional study, Sociology, Orgasm, Sexual arousal, Sexual function, Sexual dysfunction

44

Introduction: Synaesthesia is a phenomenon in which a certain stimulus induces a concurrent sensory perception; it has an estimated prevalence of 4%. Sexual arousal as an inducer for synaesthetic perceptions is rarely mentioned in the literature but can be found sometimes in case reports about subjective orgasmic experiences. Aims: To examine whether synaesthetic perceptions during sexual intercourse have an impact on the sexual experience and the extent of sexual trance compared to non-synaesthetes. Methods: In total, 19 synaesthetes with sexual forms of synaesthesia (17 female; 2 male) were included as well as corresponding control data of 36 non-synaesthetic subjects (n = 55). Two questionnaires were used to assess relevant aspects of sexual function and dysfunction (a German adaption of the Brief Index of Sexual Functioning, KFSP) as well as the occurrence and extent of sexual trance (German version of the Altered States of Consciousness Questionnaire, OAVAV). Additionally qualitative interviews were conducted in some subjects to further explore the nature of sexual experiences in synaesthetes. Main Outcome Measures: Sexual experience and extent of sexual trance during intercourse. Results: Synaesthetes depicted significantly better overall sexual function on the KFSP with increased scores for the subscale “sexual appetence” but coevally significant lower subscale scores for “sexual satisfaction.” Sexual dysfunction was not detected in this sample. Synaesthetes depicted significantly higher levels of the subscales “oceanic boundlessness” and “visionary restructuralization” than controls using the OAVAV. Qualitative interviews revealed varying synaesthetic perceptions during the different states of arousal. Furthermore, synaesthetes reported an unsatisfactory feeling of isolation caused by the idiosyncratic perceptions. Conclusions: Synaesthetes with sexual forms of synaesthesia seem to experience a deeper state of sexual trance without, however, enhanced satisfaction during sexual intercourse.

Concepts: Sexual intercourse, Orgasm, Qualia, Sexuality, Erection, Sexual arousal, Sexual function, Sexual dysfunction

27

PURPOSE: To assess sexual function, satisfaction with life (SWL), and menopause-related symptoms among mid-aged Spanish women. MATERIALS AND METHODS: Cross-sectional study of 260 women, aged 40-59, attending the public gynecology consultations completed the 14-item Changes in Sexual Functioning Questionnaire (CSFQ-14), the SWL Scale (SWLS), the Menopause Rating Scale (MRS), and a socio-demographic questionnaire. RESULTS: Median [inter quartile range] age was 47 [8.0] years, 87.7% had a stable partner, 27.0% were postmenopausal, and 53.9% had increased body mass index (BMI). The prevalence of sexual dysfunction was 46.5% (CSFQ-14 score≤41). Postmenopausal status was associated with lower CSFQ-14 scores (worse sexual function) and severe menopausal symptoms whereas there were not significant differences in SWLS scores. CSFQ-14 scores correlated with SWLS (p<0.04), and inversely correlated with menopausal symptoms (p<0.02). Multiple linear regression analysis model predicted 26.6% of the total CSFQ-14 score variance, and higher scores (better sexual function) were correlated with better SWL, and inversely correlated to female age and worse menopausal symptoms. A second model predicted 38.4% of the SWLS score variance. The SWLS score correlated with the total CSFQ-14 score and BMI, and inversely correlated with economical problems, female tobacco use, lack of healthiness, menopausal symptoms, not having a partner, and partner's lack of healthiness. CONCLUSIONS: Lower sexual function was related to low SWL, age and menopausal symptoms while low SWLS score was related with economical problems, smoking, menopausal symptoms, and partner factors.

Concepts: Regression analysis, Linear regression, Middle age, Menopause, Econometrics, Body mass index, Sexual function, Sexual dysfunction

10

Although sexual functioning is an important facet of living donor quality of life, it has not received extensive evaluation in this population. Using data from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study, we examined donor sexual functioning across the donation process from the predonation evaluation to 3 months and 1 year postdonation. Donors (n=208) and a comparison group of non-donors (n=155) completed self-reported surveys with specific questions on sexual desire, satisfaction, orgasm, and (for men) erectile function. Across the three time points, donor sexual functioning was lower at the evaluation phase and 3 months postdonation than at one year postdonation. In the early recovery period, abdominal pain was associated with difficulty reaching orgasm (OR = 3.98, 95% CI 1.30-12.16), concerns over appearance with lower sexual desire (OR = 4.14, 95% CI 1.02-16.79), and not feeling back to normal was associated with dissatisfaction with sexual life (OR 3.58, 95% CI 1.43-8.99). Efforts to educate donors before the surgery and prepare them for the early recovery phase may improve recovery and reduce distress regarding sexual functioning. This article is protected by copyright. All rights reserved.

Concepts: English-language films, Orgasm, All rights reserved, Sexuality, Copyright, Sexual function, Sexual dysfunction, Masters and Johnson

5

Sexual dysfunction, an important determinant of women’s health and quality of life, is commonly associated with declining estrogen levels around the menopausal transition.

Concepts: Sexual intercourse, Life, Menopause, Estrogen, Sociology, Sexual health, Sexual function, Sexual dysfunction

3

Sexual dysfunction in people with cancer is a significant problem. The present clinical practice guideline makes recommendations to improve sexual function in people with cancer.

Concepts: Sexual intercourse, Erectile dysfunction, Orgasm, Sexual health, Sexual function, Sexual dysfunction

3

Information on the association between bipolar disorder (BD), sexual satisfaction, sexual function, sexual distress and quality of life (QoL) is sparse. This study aims, in women with BD, to (i) investigate sexual dysfunction, sexual distress, general sexual satisfaction and QoL; (ii) explore whether sexual distress was related to affective symptoms and (iii) investigate whether QoL was associated with sexual distress. The study is a questionnaire survey in an outpatient cohort of women with BD using: Changes in Sexual Functioning Questionnaire, Female Sexual Distress Scale, Altman Self-Rating Mania Scale (ASRM), Major Depression Inventory (MDI) and The World Health Organisation Quality of Life-Brief.

Concepts: Antidepressant, Antipsychotic, Bipolar disorder, Major depressive disorder, Depression, Suicide, Sexual function, Sexual dysfunction

3

This prospective study described the trajectory of sexual well-being from before hematopoietic cell transplantation (HCT) to 3 years after in 131 allogeneic and 146 autologous HCT recipients and identified the predictors of post-HCT sexual dysfunction. Assessments were made pre-HCT, 6 months, 1, 2, and 3 years post-HCT using the Derogatis Interview for Sexual Function-Self Report and Derogatis Global Sexual Satisfaction Index. Sixty-one percent of men and 37% of women were sexually active pre-HCT; the prevalence declined to 51% (P=.01) in men and increased to 48% (P=.02) in women at 3 years post-HCT. After HCT, sexual satisfaction declined in both sexes (P<.001), as did Orgasm (P=.002) and Drive/Relationship (P<.001) in men, but Sexual Cognition/Fantasy (P=.01) and Sexual Behavior/Experience (P=.01) improved in women. All sexual function domains were worse in women compared to men (P≤.001). Older age negatively impacted sexual function post-HCT in both sexes (P<.01). Chronic graft vs. host disease was associated with lower Sexual Cognition/Fantasy (P=.003) and Orgasm (P=.006) in men and Sexual Arousal (P=.05) and sexual satisfaction (P=.005) in women. All male sexual functions declined with exposure to total body irradiation (P<.05). Multidisciplinary interventional strategies are needed to help vulnerable sub-populations recover sexual quality of life after HCT.

Concepts: Sexual intercourse, Hematopoietic stem cell transplantation, Human sexual behavior, Orgasm, Sexuality, Sexual arousal, Sexual function, Masters and Johnson

2

Purpose The adaptation of the Cancer Care Ontario (CCO) guideline Interventions to Address Sexual Problems in People With Cancer provides recommendations to manage sexual function adverse effects that occur as a result of cancer diagnosis and/or treatment. Methods ASCO staff reviewed the guideline for developmental rigor and updated the literature search. An ASCO Expert Panel ( Table A1 ) was assembled to review the guideline content and recommendations. Results The ASCO Expert Panel determined that the recommendations from the 2016 CCO guideline are clear, thorough, and based upon the most relevant scientific evidence. ASCO statements and modifications were added to adapt the CCO guideline for a broader audience. Recommendations It is recommended that there be a discussion with the patient, initiated by a member of the health care team, regarding sexual health and dysfunction resulting from cancer or its treatment. Psychosocial and/or psychosexual counseling should be offered to all patients with cancer, aiming to improve sexual response, body image, intimacy and relationship issues, and overall sexual functioning and satisfaction. Medical and treatable contributing factors should be identified and addressed first. In women with symptoms of vaginal and/or vulvar atrophy, lubricants in addition to vaginal moisturizers may be tried as a first option. Low-dose vaginal estrogen, lidocaine, and dehydroepiandrosterone may also be considered in some cases. In men, medication such as phosphodiesterase type 5 inhibitors may be beneficial, and surgery remains an option for those with symptoms or treatment complications refractory to medical management. Both women and men experiencing vasomotor symptoms should be offered interventions for symptomatic improvement, including behavioral options such as cognitive behavioral therapy, slow breathing and hypnosis, and medications such as venlafaxine and gabapentin.Additional information is available at: www.asco.org/survivorship-guidelines and www.asco.org/guidelineswiki .

Concepts: Health care, Medicine, Oncology, Chemotherapy, Orgasm, Sexual health, Sexual function, Sexual dysfunction