sodium-ethylxanthate and Sexual-Dysfunction--Physiological

Men undergoing prostatectomy can have unrealistic preoperative expectations regarding sexual function after surgery and may desire more education on recovery and symptom management.. To present contemporary data on recovery of sexual function after prostatectomy and characterize how it is impacted by perioperative patient educational interventions.. A comprehensive review of the English-language literature available by PubMed search.. Rates of sexual function recovery after prostatectomy and the impact of educational interventions on these and related outcomes.. Available studies describe heterogeneous educational and support interventions that differ by patient selection, content, method of delivery, timing, and duration. Interventions with group-based education or peer support benefitted sexual satisfaction metrics. Many studies included men and their partners in supportive interventions. However, the few randomized controlled trials directly analyzing the effect of partner attendance revealed no additional benefit to outcomes. Interventions within 6 weeks of prostatectomy variably aided measures of sexual recovery. Some studies with greater time between prostate cancer treatment and interventions revealed only temporary improvements in outcomes. Yet durable improvements in sexual satisfaction and sexual function were observed in some men enrolled years after prostate cancer treatment. At times, web-based interventions had lower completion rates, but sexual function outcomes were comparable to traditional in-person interventions within randomized trials.. Educational interventions imparted variable benefit to sexual function and satisfaction, with group-based designs mostly benefitting satisfaction outcomes. Despite standardized interventions, men reported worse-than-expected outcomes, suggesting an emphasis on counseling regarding changes in erectile function at multiple time points before surgery and during the recovery period may be helpful. Earlier interventions may help with recovery by establishing more accurate patient expectations. Regarding accessibility, future endeavors may be improved with internet-based educational content, as such interventions appeared to provide comparable benefits to in-person sessions. Faris AER, Montague DK, Gill BC. Perioperative Educational Interventions and Contemporary Sexual Function Outcomes of Radical Prostatectomy. Sex Med Rev 2019;7:293-305.

Topics: Health Education; Humans; Male; Perioperative Period; Personal Satisfaction; Prostatectomy; Recovery of Function; Sex; Sexual Dysfunction, Physiological; Treatment Outcome

Cloacal exstrophy, one of the most severe congenital anomalies compatible with life, occurs in up to 1 in 200,000 lives births. The condition affects nearly every major organ system with severe neurologic, skeletal, gastrointestinal, and genitourinary ramifications. With increased understanding of the anatomy and embryology combined with refinements in prenatal diagnosis and postnatal care, there is now near-universal survival of patients with cloacal exstrophy. Functional and cosmetic outcomes have improved with modifications in surgical technique. However, debate continues regarding the issue of gender identity, and long-term data are still accruing with respect to the best strategy for management. Despite the extensive malformations noted, many patients have gone on to live fruitful lives.

Topics: Abnormalities, Multiple; Anus, Imperforate; Digestive System Abnormalities; Female; Hernia, Umbilical; Humans; Male; Musculoskeletal Abnormalities; Nervous System Malformations; Prenatal Diagnosis; Scoliosis; Sex; Sexual Dysfunction, Physiological; Urogenital Abnormalities

The treatment of sexual dysfunction or deviancy requires an understanding of the underlying neural substrates. Neuroimaging techniques offer insight into brain regions involved in sexual arousal and inhibition. The development of robust paradigms has implications for the assessment and treatment of sexual disorder in men and women.

Topics: Adolescent; Adult; Arousal; Brain Diseases; Female; Humans; Magnetic Resonance Imaging; Male; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon

This review is designed to help the reproductive endocrinologist integrate his or her professional activity with those of other disciplines including urology, radiology, neurology, and psychology in order to successfully manage all of the inseparable aspects of male sexual and reproductive functioning. Significant advances in the field of male sexual physiology and pathophysiology and new methods of investigation and treatment of male sexual disorders are outlined. The review synthesizes available data on the following: norms of sexual organs, aging and sexuality, role of central and peripheral neurochemicals in each stage of the sexual cycle, role of corporeal smooth muscles in the hemodynamic control of erection and detumescence, influence of psychological factors, drugs, and disease on all aspects of sexual functioning, and use of nocturnal penile tumescence monitoring, imaging investigations, and neurophysiologic studies in the diagnostic workup of males with sexual dysfunction. Clinical algorithms are presented where appropriate. Extensive discussions on newly developed strategies in psychological and behavioral counseling, drug therapy, tissue engineering, nonsurgical devices, and surgical treatments for all forms of sexual disorders are also provided. Lastly, the effect of sexual dysfunction and its treatment on quality of life in affected men is addressed, along with recommendations for future research endeavors.

Topics: Humans; Male; Penis; Sex; Sexual Dysfunction, Physiological

In this review, we briefly discuss recently published data on female sexual desire, arousal, orgasm and pain, and on medical/iatrogenic factors associated with female sexual function. The studies reviewed highlight a number of important methodological and etiological issues in the study of female sexual function. Researchers are urged to use standardized methods for defining sexual disorders and for selecting patient samples. Placebo-controlled studies are essential for examining the pharmacological aspects of female sexual dysfunction. Evidence suggests that free testosterone levels may be associated with sexual desire in women. Sildenafil citrate increases genital blood flow but may not impact on subjective reports of arousal. Past research implicated the serotonin 5-hydroxytryptamine 2 and 5-hydroxytryptamine 1A receptors in female sexual function, while recent data suggest a role for the 5-hydroxytryptamine 3 receptor. Increasing attention is being paid to medical/health conditions that impact sexual function (e.g. neurological conditions, cancer, hysterectomy, and cardiovascular disease).

Topics: Female; Humans; Sex; Sexual Dysfunction, Physiological

Breast cancer has the potential to be most devastating to the sexual function and self-esteem of premenopausal women. Nevertheless, not one study has systematically compared the impact of breast cancer treatment on sexual issues across age groups. Research shows that younger women with breast cancer have more severe emotional distress than older cohorts. In a group of patients seeking sexual rehabilitation in a cancer center, younger couples were more distressed, but also had the best prognosis with treatment. In theory, loss of a breast or poor breast appearance would be more distressing to women whose youth gives them high expectations for physical beauty. Seeking new dating relationships after breast cancer treatment is a special stressor for single women. Potential infertility also may impact on a woman's self-concept as a sexual person. Systemic treatment disrupts sexual function by causing premature menopause, with estrogen loss leading to vaginal atrophy and androgen loss perhaps decreasing sexual desire and arousability. Research on mastectomy versus breast conservation across all ages of women has demonstrated that general psychological distress, marital satisfaction, and overall sexual frequency and function do not differ between the two treatment groups. Women with breast conservation do rate their body image more highly and are more comfortable with nudity and breast caressing. There is some evidence that breast conservation offers more psychological "protection" for younger women. Research on the impact of breast reconstruction is sparse, but reveals similar patterns. Future studies should use rigorous methodology and focus on the impact of premature menopause and the effectiveness of sexual rehabilitation for younger women.

Topics: Adult; Age Factors; Antineoplastic Combined Chemotherapy Protocols; Body Image; Breast Neoplasms; Emotions; Female; Humans; Infertility, Female; Mammaplasty; Mastectomy; Mastectomy, Segmental; Menopause, Premature; Middle Aged; Primary Ovarian Insufficiency; Quality of Life; Research Design; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Tamoxifen

A majority of women experience some change in sexual function during the years immediately before and after the menopause. Common sexual complaints include loss of desire, decreased frequency of sexual activity, painful intercourse, diminished sexual responsiveness, and dysfunctions of the male partner. Sexual function is influenced by biologic and nonbiologic factors. Sexual arousal, including sensory perception, central and peripheral nerve discharge, peripheral blood flow, and the capacity to develop muscle tension, as well as sexual desire and frequency of sexual activity, can all be influenced by ovarian hormone levels. Sexual function is also influenced by the interplay of psychological, sociocultural, and interpersonal factors. Health care professionals can play an important role in the evaluation, education, counseling, and treatment of the menopausal woman.

Topics: Cardiovascular System; Counseling; Estradiol; Female; Humans; Male; Menopause; Middle Aged; Nervous System; Sex; Sexual Dysfunction, Physiological

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Humans; Male; Middle Aged; Prostatectomy; Prostatic Hyperplasia; Prostatic Neoplasms; Sex; Sexual Dysfunction, Physiological

Ephebiatric sexual medicine is a specialty that still awaits its Vesalius. The age of onset of puberty has decreased by four years in the past two centuries, without a concordant change in social and legal institutions governing sexual and economic autonomy. Concomitant with the reintroduction of the ancient European betrothal system, the adolescent age of first coitus has lowered and averages two years earlier than first contraception. The hiatus is attributed to the moral sanctions against open access to contraception in adolescence. The neglect of sexual learning in teenage allows cases of suicidal and homicidal lovesickness to be undetected and likewise the mental template or "lovemap" of paraphilic pathology in adolescence lacks both preventive measures and treatment. The newest treatment of the paraphilias is with antiandrogen combined with counseling. Positive or negative preparedness for first orgasm or first coitus correlate with positive or negative outcome in subsequent sexuoerotic health. Knowing the sexology of syndromes, for example genetic and endocrine syndromes of childhood, expedites the delivery of sexological health care service in adolescence.

Topics: Adolescent; Adolescent Medicine; Age Factors; Androgen Antagonists; Contraception; Female; Humans; Love; Male; Marriage; Puberty; Sex; Sex Chromosome Aberrations; Sex Education; Sexual Dysfunction, Physiological

Topics: Adolescent; Adult; Counseling; Disabled Persons; Family; Family Planning Services; Female; Genetic Counseling; Humans; Intellectual Disability; Male; Peer Group; Physician's Role; Psychology; Rehabilitation; Sex; Sex Education; Sexual Dysfunction, Physiological; Social Behavior; Social Work; Stereotyping

Topics: Adult; Androgens; Animals; Contraceptives, Oral, Synthetic; Endocrinology; Estrogens; Female; Gender Identity; Gonadal Steroid Hormones; Gonadotropin-Releasing Hormone; Humans; Male; Menopause; Menstruation; Middle Aged; Pregnancy; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Social Behavior; Testosterone

Topics: Aged; Aging; Attitude; Disease; Female; Genitalia, Female; Genitalia, Male; Gynecology; Humans; Male; Marriage; Mental Disorders; Middle Aged; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Social Behavior

Topics: Adolescent; Adult; Arthritis, Rheumatoid; Asthma; Cardiovascular Diseases; Coitus; Counseling; Diabetes Complications; Disabled Persons; Erectile Dysfunction; Female; Humans; Kidney Diseases; Lung Diseases, Obstructive; Male; Pregnancy; Sex; Sexual Dysfunction, Physiological; Spinal Cord Injuries

Forty-eight couples who complained of female orgasmic dysfunction received one of two therapies: sex therapy and communication therapy. Each couple was treated by a team of one male and one female therapist. Pretherapeutic, posttherapeutic and follow-up measurements showed that female sexual satisfaction increased in both therapies, but that the increase came more quickly in sex therapy. Male sexual satisfaction increased in sex therapy, but diminished in communication therapy. A two-phase model of the sexual response was tested against the therapeutic results. The experience of sexual interaction and the orgasmic experience improved in males and females in sex therapy, and in females in communication therapy. The male experience of sexual interaction deteriorated in communication therapy, while the male orgasmic experience initially increased and subsequently diminished again. Satisfaction with the total relationship increased in the males in communication therapy, and in the females in sex therapy.

Topics: Adult; Behavior Therapy; Communication; Female; Humans; Male; Marital Therapy; Orgasm; Outcome and Process Assessment, Health Care; Self Concept; Sex; Sex Factors; Sexual Dysfunction, Physiological

Topics: Communication; Depression; Family Health; Fear; Habits; Humans; Nonprescription Drugs; Patient Compliance; Physician-Patient Relations; Polypharmacy; Sex; Sexual Dysfunction, Physiological; Travel

Topics: Female; Humans; Libido; Male; Sex; Sex Factors; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological

Of the estimated 317,000 men in the United States diagnosed with prostate carcinoma in 1996, 57% will have localized disease, and their 5-year relative survival rate will be 98%. Limited information exists on patient-reported quality of life (QOL) and the incidence and severity of treatment-related side effects. The purpose of this study was to identify and compare patients' self-reported QOL and treatment side effects 1-5 years after radical prostatectomy or radiotherapy.. Data collection for this cross-sectional study included a mailed, self-administered survey with three parts: a demographic survey, the Functional Assessment of Cancer Therapy-General (FACT-G), and a newly developed Prostate Cancer Treatment Outcome Questionnaire (PCTO-Q). The FACT-G measured the effect of prostate carcinoma on overall QOL in the two treatment groups. The PCTO-Q assessed the patients' perceptions of the incidence and severity of specific changes in bowel, urinary, and sexual functions. The test-retest reliability of the PCTO-Q in a pilot study was 91.2%.. Two hundred seventy-four eligible men completed the questionnaires; 132 (48%) reported having undergone prostatectomy and 142 (52%) reported having undergone radiotherapy. After age adjustment, the radiotherapy group reported more bowel dysfunction (P = 0.001), whereas the prostatectomy group reported more urinary problems (P = 0.03) and more sexual dysfunction (P = 0.001). Scores for the FACT-G were similar in the two treatment groups.. Men undergoing treatment for clinically localized prostate carcinoma continue to experience difficulty long after treatment. In this study, the prostatectomy group fared worse in regard to sexual and urinary functions, whereas the radiotherapy group experienced more bowel dysfunction. Survivor-reported QOL and treatment outcomes can assist physicians in counseling patients in the selection of the preferred course of treatment.

Topics: Age Factors; Aged; Aged, 80 and over; Carcinoma; Counseling; Cross-Sectional Studies; Defecation; Demography; Humans; Incidence; Intestinal Diseases; Male; Middle Aged; Pilot Projects; Prostatectomy; Prostatic Neoplasms; Quality of Life; Radiotherapy; Reproducibility of Results; Self-Assessment; Sex; Sexual Dysfunction, Physiological; Survival Rate; Treatment Outcome; Urination; Urologic Diseases

Topics: Aged; Aging; Disease; Female; Geriatric Nursing; Humans; Male; Sex; Sexual Dysfunction, Physiological; Sexuality

To evaluate sexuality after successful treatment of penile cancer.. Post-therapy sexuality was evaluated in 30 men (median age 57 years; range 28-75) treated for cancer of the penis 80 months previously (median; range: 11-225 months). Treatment regimes were: local excision/laser beam treatment, 5; definitive radio-therapy, 12; partial penectomy, 9; total penectomy, 4. Patients underwent a semi-structured interview and completed three self-administered questionnaires (psychosocial adjustment to severe illness [PAIS], mental symptoms [GHQ], quality of life [EORTC QLQ C-30]). A global score of overall sexual functioning was constructed consisting of sexual interest, sexual ability, sexual satisfaction, sexual identity, partner relationship and frequency of coitus.. In 10 of 12 patients treated by irradiation the sexual global score was not or only slightly reduced compared with two of nine patients after partial penectomy and one of five patients with local surgery/laser beam treatment. All four patients who had undergone total penectomy recorded a severely reduced sexual global score. Of the six single domains, sexual identity and partner relationship did not change with increasing age, whereas the other scores of sexual life deteriorated as the patient became older. In the patients treated by irradiation doctors evaluated the patients' post-treatment sexuality to be more impaired than that experienced by the patients.. Within the limitations due to the small number of patients studied, radiotherapy seems to be the treatment of choice in limited cancer of the penis if preservation of sexuality is a major therapeutic aim. Physicians counselling patients with this rare malignancy need more information about treatment-related problems of sexuality after different therapeutic modalities.

Topics: Adult; Age Factors; Aged; Attitude of Health Personnel; Attitude to Health; Follow-Up Studies; Humans; Male; Middle Aged; Penile Neoplasms; Penis; Postoperative Complications; Sex; Sexual Dysfunction, Physiological

Topics: Adolescent; Adult; Bone Marrow Transplantation; Female; Humans; Infertility; Libido; Male; Middle Aged; Nursing Care; Quality of Life; Sex; Sexual Dysfunction, Physiological

Sexual physiology, sexual behaviour and attitude to sexuality vary according to sex and age. The sexual reaction cycle is very uniform in men, but much more variable in women; at a more advanced age the reactions of this cycle are delayed in both sexes. While hormones have been proved to influence male sexuality, their influence on female sexuality has not been clarified. Sexual appetite changes with age. It reaches a climax earlier in men than women, but also declines more in men with increasing age. In the last three decades the number of women who masturbate has considerably increased. The difference between the sexes as far as attitude to sexuality is concerned is particularly evident in those with sexual difficulties: men usually see their problems in an isolated way as a purely physical disorder, whereas women are usually aware of the connection between their sexual problems and personal, partner or work problems.

Topics: Adult; Age Factors; Aged; Attitude; Female; Gonadal Steroid Hormones; Humans; Libido; Male; Middle Aged; Sex; Sex Factors; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Female; Humans; Male; Sex; Sexual Dysfunction, Physiological

283 torture victims (135 examined by the Amnesty International [AI] Danish Medical Group, and 148 by the International Rehabilitation and Research Center for Torture Victims [RCT]) were questioned about methods of torture and subsequent sexual difficulties. Overall, the prevalence of sexual torture was 61% (women 80%, men 56%), but this was higher in the RCT than in the AI group. More Latin Americans than Europeans had been sexually tortured in the AI group. Prevalence of sexual difficulties was 32%, the RCT recording a significantly higher prevalence than the AI (43% vs 20%). Sexually tortured victims were more likely to have sexual difficulties (40%) than were non-sexually tortured victims (19%). Overall, there were more cases of sexual difficulties in victims from Africa and from Turkey/Middle East/Far East than in victims from Latin America and from Europe. In the RCT subsample, prevalence of sexual difficulties and anxiety was significantly higher in sexually tortured victims than in non-sexually tortured victims; the two groups were broadly similar with respect to depression and low self-esteem. Depressed victims and victims with low self-esteem were more likely to have sexual difficulties. In the RCT group, but not overall, prevalence of sexual difficulties was significantly associated with age but was independent of low self-esteem and of depression.

Topics: Adolescent; Adult; Africa; Age Factors; Anxiety; Asia, Eastern; Depression; Europe; Evaluation Studies as Topic; Female; Genitalia; Humans; Male; Middle Aged; Middle East; Physical Examination; Prevalence; Regression Analysis; Self Concept; Sex; Sexual Dysfunction, Physiological; South America; Torture; Turkey

Topics: Female; Humans; Male; Medicine; Sex; Sexual Dysfunction, Physiological; Specialization; USSR; Venereology

Empirical research, clinical experience, and greater sophistication about the interaction of social, psychological, and biological factors have produced marked changes in the appreciation of the importance of sexuality in older persons. An earlier view linking sex exclusively with reproductive function has given way to a holistic view of sex as vital to self-concept, the maintenance of healthy interpersonal relationships, and a sense of integrity. Older adults often have difficulty communicating sexual problems, concerns, and questions because of their conflicting attitudes and perceptions. Sexual problems often are presented covertly, expressed in vague terms, or masked by embarrassment. Physicians need to be aware of the possibility of covert sexual dysfunctions, clear about their own attitudes and expectations to avoid stereotyping the elderly, and knowledgeable about pharmacological, organic, and psychosocial bases of sexual problems in older patients.

Topics: Aged; Attitude; Humans; Sex; Sex Counseling; Sexual Dysfunction, Physiological

Topics: Female; Humans; Male; Psychophysiologic Disorders; Psychosexual Development; Sex; Sexual Dysfunction, Physiological

Topics: Aged; Female; Humans; Life Style; Male; Medical History Taking; Middle Aged; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Surveys and Questionnaires

Between 1978 and 1982 the sexual functions of 54 patients with a nonseminomatous testicular tumor stage II or III were assessed before and after treatment with surgery and combination chemotherapy. Two years after completing therapy 54% of the patients experienced sexual functional disorders. Greatly reduced or absent antegrade ejaculation was reported by 26 patients; 18 of them had been treated with more or less extensive retroperitoneal lymph node dissection, whereas 8 had not. This means that the chemotherapy might be responsible for ejaculatory disorders in 30% of the patients. Only two patients reported a change in the quality of erection; seven patients experienced a decidedly diminished libido, and five patients noticed their orgasm had changed in a negative sense. The appearance of the contralateral testis changed in 21 patients, who showed "atrophy" of this testis. The findings of this study indicate that sexual and ejaculatory disorders in particular are quite common in men treated for a disseminated nonseminomatous testicular tumor. Many of these disorders seem to be owing to causes other than surgical intervention.

Topics: Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Ejaculation; Humans; Male; Sex; Sexual Dysfunction, Physiological; Testicular Neoplasms

Taking as a starting point, papers on sexuality of disabled people and papers on attitudes and representations toward their sexuality, we have demonstrated that the coping of those people is directed by an ideology of rationalisation of sexuality. This ideology is expressed in different ways, with physically disabled and mentally retarded people. This fact makes clear the importance of the handicapped referent over the coping. Procreation is strongly supported for the physically disabled people (paraplegics). Mentally retarded people are strictly forbidden to procreate: this appears especially with the sterilisation of mentally retarded women.

Topics: Adaptation, Psychological; Adult; Disabled Persons; Female; Humans; Intellectual Disability; Male; Paraplegia; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Sterilization, Tubal

Topics: Cultural Characteristics; Fantasy; Female; Gender Identity; Homosexuality; Humans; Male; Sex; Sexual Behavior; Sexual Dysfunction, Physiological

Pregnancy in the diabetic women must be well-planned since it is crucial that the conception coincide with a period of perfect glycemic equilibrium. Contraception should be suspended only when the decision to conceive is made and the metabolic control is obtained. Currently, the mechanical and hormonal means of contraception (low-dose progestogen only) are the ones most commonly used. The child of a diabetic mother is open to risk for malformations, the result of hyperglycemia in the early stages of embryonic development. Impotence can plague the diabetic male's sex life. This is seen especially in autonomic diabetic neuropathy, in particular when there are severe urinary disorders. However, nonspecific causes for impotence are frequent in the diabetic male population and should be systematically investigated. (author's modified)

Topics: Contraception; Diabetes Mellitus; Female; Genetic Counseling; Humans; Male; Pregnancy; Pregnancy in Diabetics; Sex; Sexual Dysfunction, Physiological

Forty-one women recently diagnosed with early-stage cervical or endometrial cancer and a matched group of healthy women in no gynecologic distress, participated in a detailed assessment of their sexual functioning. Data included the range and frequency of sexual behavior, level of sexual responsiveness, and the presence of sexual dysfunction. Multivariate analyses of variance indicated that prior to the onset of cancer signs/symptoms the gynecologic cancer patients reported similar patterns of sexual activity and responsiveness as the healthy sample. With the appearance of disease signs, however, the gynecologic cancer patients reported experiencing significant sexual dysfunction symptoms. While sexual morbidity is typically conceptualized as occurring after the diagnosis and treatment of cancer, these data indicate that such changes are a major source of variation in describing the prediagnosis sexual status of the gynecologic cancer patient.

Topics: Adult; Age Factors; Analysis of Variance; Female; Humans; Middle Aged; Research Design; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Uterine Cervical Neoplasms; Uterine Neoplasms

Topics: Aged; Counseling; Female; Humans; Male; Sex; Sexual Dysfunction, Physiological

Topics: Female; Humans; Male; Sex; Sex Education; Sexual Dysfunction, Physiological; Spinal Cord Injuries

A nurse in the maternity ward of a hospital helped a pregnant diabetic overcome her sexual problem. The 28-year-old woman has been diabetic for the past 9 years and has learned to monitor and control her blood sugar level. She has been married for 5 years and just gave a birth to her 2nd child. She also requested and underwent Madlener tubal sterilization to avoid future pregnancy. It was during her recent hospital stay for childbirth that she finally confided her sexual problem with the nurse in the maternity ward. She complained of a pain at the vaginal opening in copulation and attributed it to her diabetic condition. After counseling the patient and her husband separately, the nurse concluded that this was a psychosomatic condition due to many factors. Both the patient's husband and mother-in-law who lived with them were extremely secretive about their complicated family history. Consequently their home environment lacked peace, harmony, understanding, and mutual trust needed to nurture their marital relationship. In addition, the diabetic condition made the patient fearful of pregnancy and she was never relaxed at the time of sex. Because of her pain, frequency of sex was reduced to once a month. The pain was located at labia minora. Ejaculation took place only at the vaginal opening. The nurse suggested the following for solution: The couple should try to be more open and communicative toward each other. They should rebuild a relationship based on understanding and trust and have more understanding of and a positive attitude about human sexuality. The patient should use some lubricant to reduce pain.

Topics: Contraception; Female; Humans; Male; Pregnancy; Sex; Sex Education; Sexual Dysfunction, Physiological

Topics: Adult; Castration; Female; Hormones; Humans; Hysterectomy; Male; Middle Aged; Ovary; Sex; Sexual Dysfunction, Physiological

Topics: Counseling; Humans; Medicine; Sex; Sexual Dysfunction, Physiological; Specialization

Topics: Adult; Arousal; Dominance, Cerebral; Electroencephalography; Humans; Male; Middle Aged; Penis; Sex; Sexual Dysfunction, Physiological

A review of sexual dysfunction due to antihypertensive agents is presented. Sexual dysfunction is a relatively common complication of antihypertensive drug therapy and has been associated with nearly all of the antihypertensive agents. The physiology of the normal sexual response, proposed mechanisms of sexual dysfunction, and the types of disorders and relative incidence rates associated with individual agents are discussed. Since a disturbance in sexual function may lead to poor compliance with the drug regimen, it is important that the clinician be familiar with this topic. Information on the detection of antihypertensive-agent-induced sexual dysfunction, patient counseling, and therapeutic alternatives, should a disorder in sexual function occur, also is provided.

Topics: Adrenergic beta-Antagonists; Antihypertensive Agents; Benzothiadiazines; Clonidine; Diuretics; Female; Guanethidine; Humans; Hydralazine; Male; Methyldopa; Prazosin; Propranolol; Reserpine; Sex; Sexual Dysfunction, Physiological; Sodium Chloride Symporter Inhibitors; Spironolactone

Paraplegia can lead to social stigmatisation, sexual difficulties, and emotional maladjustment. The specific nature of problems experienced in these areas were investigated in an interview study of 22 male and female paraplegics. These interviews were followed up by a postal questionnaire and both qualitative and quantitative data are presented in this report. Effective counselling can only be offered on the basis of an understanding of problems as they are subjectively experienced, and with an acknowledgement of the wide differences that exist between individuals in the way that they view and react to their situation.

Topics: Adaptation, Psychological; Adult; Female; Humans; Interpersonal Relations; Interviews as Topic; Male; Paraplegia; Sex; Sexual Dysfunction, Physiological; Surveys and Questionnaires

Sexual functioning after myocardial infarction is a primary concern for patients, yet many physicians fail to discuss this part of rehabilitation. Even with instructions, more than one-fourth of previously active patients fail to resume intercourse after a coronary event. Patients with a healthy sexual relationship before the infarction have a much better chance for full recovery of sexual activity.

Topics: Counseling; Extramarital Relations; Fear; Female; Humans; Male; Masturbation; Myocardial Infarction; Self Concept; Sex; Sexual Dysfunction, Physiological

Topics: Adult; Aged; Denmark; Female; Humans; Male; Middle Aged; Sex; Sexual Dysfunction, Physiological

Topics: Coitus; Estrogens; Female; Humans; Hydrogen-Ion Concentration; Male; Menopause; Middle Aged; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Vagina

Topics: Aged; Aging; Body Image; Dependency, Psychological; Diabetes Complications; Female; Gender Identity; Guilt; Homosexuality; Humans; Male; Middle Aged; Nursing Homes; Retirement; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Substance-Related Disorders

Topics: Aged; Aging; Female; Geriatric Nursing; Humans; Male; Sex; Sexual Dysfunction, Physiological

Topics: Adult; Denmark; Female; Humans; Male; Middle Aged; Psychotherapy; Referral and Consultation; Retrospective Studies; Sex; Sex Education; Sexual Dysfunction, Physiological; Socioeconomic Factors

Topics: Body Image; Counseling; Female; Humans; Infertility; Interpersonal Relations; Male; Neoplasms; Sex; Sex Education; Sexual Dysfunction, Physiological

Topics: Attitude of Health Personnel; Female; Humans; Male; Sex; Sexual Dysfunction, Physiological

Topics: Empathy; Female; Humans; Male; Nursing Staff; Sex; Sexual Dysfunction, Physiological; United States

Topics: Adolescent; Adult; Denmark; Female; Humans; Male; Patients; Sex; Sex Education; Sex Offenses; Sexual Dysfunction, Physiological

Topics: Aged; Aging; Cultural Characteristics; Female; Humans; Male; Sex; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Female; Humans; Male; Scandinavian and Nordic Countries; Sex; Sex Education; Sexual Dysfunction, Physiological

Topics: Diabetes Mellitus; Female; Humans; Infertility, Male; Male; Sex; Sexual Dysfunction, Physiological

Topics: Age Factors; Aged; Diabetes Complications; Female; Humans; Male; Postoperative Complications; Prostatic Hyperplasia; Sex; Sexual Dysfunction, Physiological

This study investigated psychotherapists' verbal replies, affective reactions, and clinical judgments in response to audiotapes of client sexual material. The sample included 12 men and 12 women from each of the following categories: postresidency psychiatrists, Ph.D.-level clinical psychologists, and M.S.W.-level social workers. Each was presented with either a male or female case description, a photograph, and an audiotape of a client, who either discussed a mild sexual dysfunction or expressed sexual attraction to the therapist. Female therapists were more comfortable than males with client sexual material. Male therapists with liberal sexual attitudes were sexually aroused by, and verbally encouraged, the seductive female client. Conservative men were aroused by the female dysfunction tape but reacted with anxiety and verbal avoidance of the material. Therapists need more extensive and direct training in dealing with client sexual material.

Topics: Adult; Attitude of Health Personnel; Audiovisual Aids; Clinical Competence; Female; Homosexuality; Humans; Male; Middle Aged; Professional-Patient Relations; Psychiatry; Psychology, Clinical; Psychotherapy; Sex; Sex Factors; Sexual Dysfunction, Physiological; Social Work; Transference, Psychology

Sexuality was investigated in 35 males and 25 females with chronic back pain. Prior to onset of pain orgasmic dysfunction was common in 60 per cent of the females with relatively lower level of sexual frustration. Markedly less sexual dysfunction characterized the males. With back pain sexual dysfunction increased in both sexes. Frequency of coitus was reduced in half the subjects and about 50 per cent also had altered coital positions. Fatigue and pain were common and sexual enjoyment was reduced for most subjects. In many females back pain may serve to legalize previously latent sexual dysfunction. However, for both sexes back pain per se causes sexual maladaptation. Therefore, sexual counselling should be part of the rehabilitation of the back pain sufferer.

Topics: Adult; Back Pain; Coitus; Counseling; Female; Humans; Male; Middle Aged; Orgasm; Sex; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Adult; Attitude; Female; Humans; Male; Pakistan; Sex; Sexual Dysfunction, Physiological; Students; Universities

Topics: Adolescent; Adult; Aging; Attitude of Health Personnel; Counseling; Female; Homosexuality; Humans; Male; Middle Aged; Physicians, Family; Postoperative Complications; Pregnancy; Referral and Consultation; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Stress, Psychological; Substance-Related Disorders; Transference, Psychology

Topics: Female; Humans; Male; Sex; Sexual Dysfunction, Physiological

Topics: Female; Humans; Male; Psychophysiologic Disorders; Sex; Sexual Dysfunction, Physiological

Topics: Adult; Diabetes Complications; Diabetes Mellitus; Female; Humans; Male; Penis; Prostheses and Implants; Sex; Sexual Behavior; Sexual Dysfunction, Physiological

Excision of the recto-sigmoid and rectum for cancer or inflammatory disease frequently damages the autonomic nerve supply. The anatomy and function of the autonomic nervous system in the pelvis is reviewed. Thirty-two patients who underwent excision of the rectum have been studied: 28 operations were for carcinoma, 4 for ulcerative colitis. A detailed history of sexual function was obtained preoperatively together with a neurological examination of the genitalia and perineum. Biopsies were taken from the surgical specimens and examined for the presence of nerve tissue. A further sexual history was taken 3 months postoperatively. Ten sexual active men (ages 46-74) who had anterior resections or abdominoperineal excisions for carcinoma tended to show impaired sexual activity if there was excessive nerve tissue in the specimen. Two out of 3 sexually active women (ages 53-68) who had cancer operations had satisfactory sexual function postoperatively. Four patients (ages-66) all had satisfactory sexual function after panproctocolectomy for ulcerative colitis. The advantages of avoiding damages to the pelvic autonomic nerves at operation are discussed.

Topics: Adult; Aged; Colitis, Ulcerative; Female; Humans; Male; Middle Aged; Pelvis; Postoperative Complications; Postoperative Period; Prospective Studies; Rectal Neoplasms; Rectum; Sex; Sexual Dysfunction, Physiological

Topics: Female; Humans; Male; Sex; Sex Education; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Adult; Erectile Dysfunction; Female; Humans; Male; Marital Therapy; Myocardial Infarction; Sex; Sexual Behavior; Sexual Dysfunction, Physiological

Concerned professionals in the United States warn that sexuality is in danger of being dehumanized by a new frankness in the mass media as well as in sex therapy. However, with sensitivity and common sense responsible physicians realize that sexuality and moral values are inextricably interwoven for self as for patients, mandating that excellence of care take this fact into careful account. Sexual ignorance is neither innocence nor bliss. Physicians of all disciplines may make significant contributions by providing understanding leadership and sane sex education to patients as well as to communities in search of information and direction.

Topics: Adult; Child; Ethics, Professional; Female; Humans; Libido; Male; Morals; Sex; Sex Education; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Archaeology; Female; Greece; History, Ancient; History, Medieval; History, Modern 1601-; Humans; Male; Mythology; Paleography; Rome; Sex; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Disorders of Sex Development; Female; Humans; Male; Sex; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Canada; Female; Humans; Male; Research; Sex; Sexual Dysfunction, Physiological

Recent research suggests possible health benefits of sexual activity. Sexual arousal appears to increase testosterone levels in males. (Related effects in females have not been studied.) This article shows that increased testosterone has a number of health-promoting effects and that good sexual functioning is a health issue not only in itself, but also in its effects on general health as well. Both clinical and experimental evidence indicates that stress disrupts the normal sexual response. Combining this with the previous evidence, a general model of reciprural inhibition between sexual and stress effects is proposed, with the implication that sex may be an antagonist to the deleterious health effects of stress. If stress disrupts sex, the result is likely to be indirect negative effects on health. Three basic types of stress which frequently disrupt sexual functioning are described, and it is argued that sex therapy techniques are effective in large part as a result of their ability to reduce these forms of stress. The kinds of stress that lead to sexual dysfunction have clear social roots. A variety of etiological factors are identified. It is argued that movements promoting social change may in fact perform sexual preventive medicine, which may indirectly augment general health as well.

Topics: Female; Health; Humans; Male; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Social Change; Stress, Psychological; Testosterone

Topics: Education, Medical; Female; Humans; Male; Medicine; Sex; Sex Education; Sexual Dysfunction, Physiological; Specialization

Topics: Colostomy; Female; Humans; Male; Postoperative Complications; Rehabilitation; Sex; Sexual Dysfunction, Physiological

Topics: Attitude of Health Personnel; Attitude to Health; Counseling; Disabled Persons; Family Planning Services; Female; Health Services; Humans; Interpersonal Relations; Love; Male; Mental Health; Minnesota; Physician-Patient Relations; Public Opinion; Referral and Consultation; Rehabilitation; Self Concept; Sex; Sex Education; Sexual Dysfunction, Physiological; United States

Topics: Aged; Aging; Attitude; Female; Humans; Libido; Male; Middle Aged; Physician-Patient Relations; Psychophysiologic Disorders; Sex; Sex Factors; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Aggression; Attitude; Conflict, Psychological; Counseling; Courtship; Drive; Extramarital Relations; Female; Humans; Individuality; Interpersonal Relations; Male; Personal Satisfaction; Psychosexual Development; Role; Self Concept; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Social Values; Socialization

Topics: Abortion, Spontaneous; Adolescent; Attitude; Contraception; Female; Humans; Illegitimacy; Male; Marriage; Permissiveness; Pregnancy; Psychology, Adolescent; Self Concept; Sex; Sex Education; Sexual Dysfunction, Physiological; Sexual Maturation; Sexually Transmitted Diseases

Topics: Attitude to Death; Death; Education, Medical; Female; Male; Religion and Sex; Sex; Sexual Dysfunction, Physiological

Topics: Adolescent; Adult; Age Factors; Aged; Coitus; Female; Follicle Stimulating Hormone; Genitalia, Female; Genitalia, Male; Gonadotropin-Releasing Hormone; Humans; Libido; Luteinizing Hormone; Male; Menstruation; Middle Aged; Puberty; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Testosterone

Topics: Community Health Services; Female; Genital Diseases, Female; Genital Diseases, Male; Humans; Infertility; Male; Sex; Sexual Dysfunction, Physiological; Ukraine

Topics: Animals; Attitude of Health Personnel; Child Development; Conflict, Psychological; Culture; Female; Homosexuality; Humans; Male; Manuals as Topic; Mental Disorders; Psychiatry; Psychosexual Development; Role; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Social Values; Societies, Medical; Terminology as Topic; United States

Topics: Adult; Behavior Therapy; Child; Contraception; Curriculum; Disorders of Sex Development; Erotica; Female; Humans; Male; Physician-Patient Relations; Psychosexual Development; Psychotherapy; Sex; Sex Education; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Female; Humans; Male; Research; Sex; Sexual Dysfunction, Physiological

Topics: Adolescent; Adult; Body Image; Child; Ejaculation; Erectile Dysfunction; Female; Homosexuality; Humans; Interpersonal Relations; Male; Mother-Child Relations; Orgasm; Parent-Child Relations; Psychosexual Development; Reproduction; Self Concept; Sex; Sex Education; Sexual Behavior; Sexual Dysfunction, Physiological; Sibling Relations; Vaginal Diseases

Topics: Adult; Culture; Diagnosis, Differential; Female; Homosexuality; Humans; India; Male; Prisoners; Psychometrics; Role; Rorschach Test; Sex; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Attitude of Health Personnel; Coitus; Curriculum; Education, Medical; Family Planning Services; Female; Humans; Male; Masturbation; Medical History Taking; Physician-Patient Relations; Psychiatry; Sex; Sex Education; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Adult; Advertising; Erotica; Ethics; Female; Germany, West; Humans; Literature, Modern; Male; Paraphilic Disorders; Sex; Sex Education; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Female; Humans; Interpersonal Relations; Male; Psychophysiologic Disorders; Reproduction; Sex; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Biological Evolution; Clitoris; Coitus; Culture; Disorders of Sex Development; Female; Genitalia, Female; Humans; Male; Menstruation; Psychoanalytic Theory; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Vagina; Women