Causes Of Sexual Problems Research Articles

Sexual dysfunction, mental illness and quality of life: a systematic review of the literature

Sexual dysfunction can have a significant effect on quality of life, but is not reported or underdiagnosed. A review of the recent literature highlights the correlation between sexual dysfunction and poor quality of life in people with psychiatric comorbidities and explores several aspects that influence care, from patient follow-up to pharmacological and non-pharmacological treatments. Sexual dysfunction (DS) has been shown to be predominant, but underdiagnosed and often untreated due to communication barriers between patients and physicians. The pharmacogenic and morphogenic causes of sexual problems are often difficult to differentiate. Psychiatric illness may increase the risk of DS, and DS may further aggravate psychiatric problems, suggesting a two-way relationship. Their effective treatment often involves a combination of elements of psychotherapy and behavioral therapies with pharmacotherapeutic interventions, if necessary. The persistence of sexual problems has a significant negative impact on patient satisfaction and adherence to treatment, but also on the patient's quality of life. Routine assessment of sexual function needs to be integrated into ongoing care to identify and address early problems. If sexual dysfunction is ignored, the psychiatric disorder can be maintained, the outcome of treatment can be compromised, and it can lead to non-compliance with treatment schedules.

P103 A psychosexual needs assessment of patients attending five london sexual health clinics

IntroductionThe aim of this psychosexual needs assessment was to investigate the prevalence and range of sexual problems; to understand the distress, causal attributions and functional impairment associated with these; and to explore patients’ service-related needs, in a sample of patients attending sexual health clinics in London.MethodsQuestionnaires were disseminated to patients attending five sexual health clinics in London, over a one week period. Nine hundred and thirty four patients responded to the questionnaire. Patients were aged 29.4 years (SD=8.8) and predominantly female (61.4%).Results31.1% of patients indicated they were experiencing a sexual problem. Premature ejaculation, delayed ejaculation, or difficulty having an orgasm were the most prevalent problems reported by patients (13.5%). Female and male patients did not differ in their report of overall sexual problems (32.5% and 28.6%, respectively), however more women reported sexual pain (14.8%, X2=11.3,p=.001) and male patients reported difficulties with hypersexuality (9.5%, X2=25.2,p<.001). The majority of sexual problems had commenced within the past year, however orgasm, chemsex and hypersexuality problems were longer-standing (>1year). Associated distress was reported by 79.5% of patients. Emotional reasons were attributed as the most likely cause of sexual problems (21.1%). Male patients reported higher functional impairment (U=1862.0, z=2.3,p=.02). Patients were interested in a range of interventions, and expressed preference to be supported in a sexual health clinic (67.8%).DiscussionThe findings present implications for the provision of psychosexual services in sexual health clinics.

Physical examination of the female cancer patient with sexual concerns: What oncologists and patients should expect from consultation with a specialist.

Answer questions and earn CME/CNE Sexual concerns are prevalent in women with cancer or cancer history and are a factor in patient decision making about cancer treatment and risk-reduction options. Physical examination of the female cancer patient with sexual concerns, regardless of the type or site of her cancer, is an essential and early component of a comprehensive evaluation and effective treatment plan. Specialized practices are emerging that focus specifically on evaluation and treatment of women with cancer and sexual function problems. As part of a specialized evaluation, oncologists and their patients should expect a thorough physical examination to identify or rule out physical causes of sexual problems or dysfunction. This review provides oncology professionals with a description of the physical examination of the female cancer patient with sexual function concerns. This description aims to inform anticipatory guidance for the patient and to assist in interpreting specialists' findings and recommendations. In centers or regions where specialized care is not yet available, this review can also be used by oncology practices to educate and support health care providers interested in expanding their practices to treat women with cancer and sexual function concerns. CA Cancer J Clin 2016;66:241-263. © 2016 American Cancer Society.

Experiences of general practitioners in the Ga-Rankuwa and Mabopane areas in dealing with patients who have sexual problems.

BackgroundSexual problems are common. Many patients with sexual health dysfunction use self-help literature or are often managed in general practice. However, many general practitioners (GPs) find it difficult to discuss sexual health issues because they feel uncomfortable with this and lack training in these matters. These GPs are now referring patients with sexual dysfunction to specialists.AimWe sought to explore how GPs working in the Mabopane and Ga-Rankuwa areas of handle sexual problems of their patients.SettingThe setting was the Mabopane and Ga-Rankuwa areas of North-West Tshwane, in Gauteng Province.MethodsA qualitative study comprising eight free attitude interviews with purposefully selected four male and four female GPs. All interviews were conducted in English and tape-recorded. Field notes in the form of a detailed diary was kept. The tapes were transcribed verbatim, and the transcriptions were checked against the tapes for omissions and inaccuracies.ResultsSix themes emerged from the interviews: causes of sexual problems; presentation of sexual problems to the doctor; management of sexual health problems; sex is a taboo topic; society's need for sexual health discussions, and these discussions have already begun; previous limited exposure and training, and a need for more sexual health training.ConclusionThis study confirms earlier findings that patients could be either reluctant to discuss their problems or are open about them when presenting to doctors with sexual dysfunction. GPs were not exposed to sexual health training at medical school and, because of this shortcoming, felt that training in sexual medicine should be part of the curriculum.

Sexual Life and Sexual Wellness in Individuals with Complete Androgen Insensitivity Syndrome (CAIS) and Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS)

Sexual wellness depends on a person's physical and psychological constitution. Complete Androgen Insensitivity Syndrome (CAIS) and Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS) can compromise sexual well-being. To compare sexual well-being in CAIS and MRKHS using multiple measures: To assess sexual problems and perceived distress. To gain insight into participants' feelings of inadequacy in social and sexual situations, level of self-esteem and depression. To determine how these psychological factors relate to sexual (dys)function. To uncover what participants see as the source of their sexual problems. Data were collected using a paper-and-pencil questionnaire. Eleven individuals with CAIS and 49 with MRKHS with/without neovagina treatment were included. Rates of sexual dysfunctions, overall sexual function, feelings of inadequacy in social and sexual situations, self-esteem and depression scores were calculated. Categorizations were used to identify critical cases. Correlations between psychological variables and sexual function were computed. Sexually active subjects were compared with sexually not active participants. A qualitative content analysis was carried out to explore causes of sexual problems. An extended list of sexual problems based on the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision, by the American Psychiatric Association and related distress. Female Sexual Function Index (FSFI), German Questionnaire on Feelings of Inadequacy in Social and Sexual Situations (FUSS social scale, FUSS sexual scale), Rosenberg Self-Esteem Scale (RSE), Brief Symptom Inventory (BSI) subscale depression. Open question on alleged causes of sexual problems. The results point to a far-reaching lack of sexual confidence and sexual satisfaction in CAIS. In MRKHS apprehension in sexual situations is a source of distress, but sexual problems seem to be more focused on issues of vaginal functioning. MRKHS women report being satisfied with their sex life. Different conditions can affect individuals in diagnosis-specific ways despite some shared clinical features. Professionals should adopt an interdisciplinary approach and provide custom-made care in order to promote sexual well-being in patients.

Sexual Problems and Quality of Life in Women with Multiple Sclerosis

Sexual problems (SP) are often experienced by people with multiple sclerosis (MS) and severely affect their quality of life. The aim of this study is to investigate the relationship between sexual problems and quality of life subscales. 132 women with MS from Iranian MS Society completed demographic and medical history questionnaire. Quality of life was measured by Multiple Sclerosis Quality of Life-54 (MSQoL-54) and sexual problems were quantified by MSISQ-19 which includes items for primary, secondary and tertiary causes of sexual problems. The data was analyzed by using SPSS-18 and Pearson’s correlation coefficients were used to examine relationships between sexual problems and quality of life subscales. Statistically significant correlation was found between sexual problems and quality of life subscales. Physical and mental components of MSQoL-54 were strongly correlated with secondary level of SP (p < 0.001, r = 0.702 and p < 0.001, r = 0.470 respectively). Of primary SP items decreased libido showed highly significant correlation with physical and mental components of MSQoL-54 (p < 0.001, r = 0.629 and p < 0.001, r = 0.499 respectively). Sexual problems such as decreased libido are highly correlated with quality of life in women with MS. Secondary SP had most correlations with quality of life subscales. Evaluation and appropriate management of sexual problems in MS patients can lead to improving their quality of life.

THU0469-HPR Sexual perception and sexual problems in patients with ankylosing spondylitis

BackgroundAnkylosing spondylitis (AS) is a chronic, systemic inflammatory rheumatic disease affecting the axial skeleton, but may also affect peripheral joints, tendons and internal organs. This disease which begins in the...

Sexual problems in elderly male and female patients with heart failure

ObjectivesTo investigate perceived sexual problems in a large group of younger and older patients with heart failure (HF), with and without a partner, focusing on a broad range of perceived...

Prevalence and Predictors of Sexual Problems in Men Aged 75–95 Years: A Population‐Based Study

Hypogonadism is associated with impaired libido and erectile dysfunction in young men, but the causes of sexual dysfunction in older men are less well understood. To determine the prevalence and predictors of sexual problems in older men. Sexual problems, as assessed by a self-reported questionnaire. This was a population-based, cohort study of 3,274 community-dwelling men aged 75-95 years (mean 82 years) from Perth, Western Australia. Questionnaires in 2001-2004 and 2008-2009 assessed social and medical risk factors. Sex hormones were measured in 2001-2004. Predictors of sexual problems, measured in 2008-2009, were assessed cross-sectionally in the entire sample, and longitudinally in a subset of 1,744 men with sex hormone data. Sexual problems were highly prevalent, with 49.4% (95% confidence interval 47.7% to 51.1%) reporting erectile problems, 47.7% (45.9% to 49.4%) lacking interest in sexual activity, 38.7% (37.0% to 40.3%) unable to climax, and 20.4% (19.1% to 21.8%) anxious about their ability to perform sexually. Painful and unpleasurable sex were less common (<5%). Overall, 72.0% (70.5% to 73.6%) reported at least one problem. In multivariate binary logistic regression analyses, cardiovascular disease, diabetes, depression, prostate disorders, and insomnia were the factors most commonly associated with sexual problems. Low testosterone levels were associated with lack of interest in sex, but not with other complaints. Sexual problems are common in elderly men. Chronic disease, depression, and insomnia appear to be the main modifiable risk factors. Androgen deficiency is unlikely to be a major cause of sexual problems in this age group.

The D&amp;T Report

The D&amp;T Report

Factors associated with sexual problems in HIV-positive gay men

Our objective was to determine factors associated with sexual problems in a sample of HIV-seropositive gay male clinic patients. Using a cross-sectional survey design a volunteer sample of 78 outpatient HIV-seropositive gay male service users completed a self-report questionnaire. This examined sexual problems, their perceived causes and associated factors including demographics, health status, sexual behaviour, self-justifications for sexual risk-taking and mood state (Hospital Anxiety and Depression Scale). Fifty (69%) of 78 HIV-positive gay men reported one or more sexual problems. Erectile dysfunction (ED) was reported by 38% rising to 51% in the context of trying to use condoms. Loss of interest in sex was reported by 41% and 24% experienced delayed ejaculation. The presence of sexual problems affected condom use in that 33 (90%) of the 37 gay men who had ED associated with condom use were inconsistent condom users in insertive sex compared to 28% of those not having this type of ED (P < 0.001). The presence of ED did not reduce the frequency of anal intercourse but those with ED associated with condoms were significantly more likely to have had receptive anal sex in the past three months (62%) compared to men without ED with condoms (38%) (P = 0.05). Risk cognitions such as wanting to lose oneself in sex, leaving responsibility for condom use to the active partner and perceptions that condoms interfere with pleasure were significantly more likely to be endorsed by those who report ED with condoms. Other factors associated with sexual problems included low T-cell counts (i.e. < 200). Psychological explanations were the most frequently cited causes of sexual problems, whether alone or in interaction with HIV disease itself, and combination therapy. A high incidence of sexual problems was found amongst this sample of HIV-positive gay men. Untreated sexual dysfunctions may contribute to sexual risk-taking and therefore HIV clinics need to address both issues. Further research is required to better understand the role of psychological factors, HIV disease itself and combination therapy in the incidence and treatment of sexual problems.

Office evaluation of sexual function and complaints : Clin. Geriatr. Med. 1991 7/1 (15–39)

The maintenance of sexual function is becoming a concern of patients as they live longer. Because over 80% of sexual complaints can be successfully managed in the primary care setting, it is important for physicians to include an evaluation of sexual health in the routine health examination. Physicians need to appreciate the spectrum of sexual function among older patients, which includes emotional intimacy, touching, and caressing as sexual activity as well as intercourse. For the majority of older people, sexual function may continue into their ninth and tenth decades. As people age, the prevalence of sexual dysfunction increases, most often because of the unavailability of a healthy partner, the prevalence of comorbid physical and psychologic problems, and the interaction of medications and substances used; thus, common sexual complaints of the elderly are multifactorial. To evaluate the older patient effectively, physicians must overcome a number of barriers, including their lack of formal training in therapy and counseling, personal myths regarding sexual function in old age, time and financial restraints, and a lack of patient comfort in discussing sexual problems. The sexual history should be nonthreatening, include general questions followed by more specific ones to elicit specific sexual concerns, and incorporate a thorough review of medications. The physical examination should concentrate on identifying signs of androgen deficiency, estrogen excess, vascular disease, and neurologic dysfunction. Few laboratory tests are required for the routine evaluation of common complaints. This problem-oriented evaluation approach is usually sufficient to identify one or more of the causes of sexual problems: the normal aging climacteric, disuse, physiologic dysfunction or physical illness, psychologic illness, or iatrogenic causes. Initial treatment by the primary care physician often begins with general counseling and education. Counseling should focus on eliminating medications that can interfere with sexual function, granting permission to patients to express themselves sexually in a variety of ways, educating patients on more comfortable positions for sexual activity and other lifestyle changes to make sexual expression safer and more comfortable. It also is important for the primary physician to know when to refer patients for further treatment.

HCG AND HMG treatment of male infertility with pituitary problems

A case is presented of a twenty-nine-year-old acromegalic man with sexual problems and fertility disturbance due to pituitary adenoma, who successfully fathered. Various endocrinologic studies, skull x-ray film, and computerized tomography (CT) scan revealed a pituitary adenoma. Testicular biopsy specimen also supported that the cause of sexual problems and fertility disturbance was secondary in origin. One month after transsphenoidal pituitary adenectomy, administration of human chorionic gonadotropin and human menopausal gonadotropin was started. His potency was improved immediately after start of the treatment, and his wife became pregnant five months later.

On the possible prevention of sexual problems in adolescence.

The author contends that a primary cause of sexual problems is failure to teach children about sex before they reach adolescence. Physical and mental growth are nurtured and supported throughout infancy and childhood, while sexual development is stifled or distorted. As a result children reach adolescence with their natural eroticism maimed. The author pleads for a basic change in the attitudes of adults, so that parents will begin to teach their children about sexuality. By adolescence children should be prepared to understand and accept their capacity for sexual expression and be fully aware of when and how it might or might not be appropriate.

Non-organic causes of sexual problems.

Non-organic causes of sexual problems.