Changes In Sexual Interest Research Articles

The Effect of COVID-19 Vaccine on Women's Reproductive Health: A Cross-Sectional Study.

The coronavirus disease 2019 (COVID-19) vaccine was developed to stimulate acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptoms of reproductive health abnormalities have been reported following the administration of the adenovirus and mRNA-containing vaccine. Such complaints included irregular menstrual cycles, miscarriages, changes in sexual interest, vaginal bleeding, and decreased milk supply in breastfeeding mothers. This study aimed to explore the effect of the COVID-19 vaccine on the reproductive health of women attending five primary healthcare centers in the western region of Saudi Arabia. A cross-sectional study was conducted with 300 women between 15 and 50 years. Five primary healthcare centers were included from May to September 2022. Non-probability convenient sampling technique was used; data were collected via a self-administered questionnaire from women who received any number or type ofCOVID-19 vaccine. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22 (IBM SPSS Statistics, Armonk, NY, USA). Of those who responded to the questionnaire (297 participants), 74% were married, and 52% had 1-3 children. Of the pregnant women, only 4% lost their pregnancy. In addition, of the breastfeeding mothers, 10% noticed a decrease in milk production after the vaccination. The effect of the vaccination status on decreased libido was 11%. A small proportion (18%) of the participants reported worsening dietary habits after the vaccine. Less than half of the participants (44%) reported a change in the length and amount of the menstrual cycle, and 29%worsened premenstrual syndrome (PMS). There was no significant association between the type and the number of doses on the rate of miscarriage (p=0.47), breastmilk production (p=0.47), libido (p=0.11), health diet habits (p=0.15), monthly cycle (p=0.570), heavy menses (p=0.999), and PMS symptoms in the study participants. COVID-19 vaccination remains necessary to prevent severe infection and is safe for females of reproductive age, whether trying to get pregnant or lactating, and has no significant effect on the menstrual cycle. This research can be used as a basis when deciding on vaccines in case of future pandemics and remove misinformation and doubts regarding the vaccines that should be adequately addressed.

Perceived Changes in Sexual Interest and Distress About Discrepant Sexual Interest During the First Phase of COVID-19 Pandemic: A Multi-Country Assessment in Cohabiting Partnered Individuals.

Due to COVID-19 pandemic, different restrictive measures in terms of physical distancing and lockdowns have been introduced in most European countries, affecting all facets of social life. Currently, little is known about how partnered individuals perceive changes in their sexual life during this complex emergency. This study explored retrospectively assessed changes in sexual interest for one’s partner and levels of distress related to perceived sexual interest discrepancy during the first phase of the pandemic in a large-scale online sample of partnered individuals (n = 4813; Mage = 38.5 years, SD = 10.74) recruited between May and July 2020 in seven European Union countries and Turkey. We also examined the possible role of approach/avoidance motives for sex in reported changes in sexual interest and associated distress. Most participants (53%) reported no change in their sexual interest during the pandemic, followed by those who reported an increase (28.5%). The pattern was similar across the eight countries. Distress about discrepant sexual interest, which was only weakly related to changes in sexual interest, was significantly associated with relationship quality and emotional closeness with a partner, coping with and worrying about the pandemic, and specific motivation for sex. In contrast to avoidant and relationship-focused approach motivation, ego-focused approach motivation was related to stable sexual interest during the pandemic. The current study contributes to the understanding of the link between sexual interest and complex emergencies. Considering that the COVID-19 pandemic continues, the reported experiences and perceptions are prone to change.

Frontal Pole Hypometabolism Linked to Reduced Prosocial Sexual Behaviors in Frontotemporal Dementia and Corticobasal Syndrome.

Changes in sexual behaviors in frontotemporal dementia (FTD) are common and multifaceted, but not well characterized. To characterize changes in sexual behaviors and intimacy in FTD compared to corticobasal syndrome (CBS) and normal controls (NC), and to evaluate the neuroanatomical associations of these changes. Spouses of 30 FTD patients, 20 CBS patients, and 35 NC completed the Sexual Symptoms in Neurological Illness and Injury Questionnaire (SNIQ), which captures changes in sexual interest, inappropriate sexual behaviors, and prosocial sexual behaviors. 25 patients with FTD and 14 patients with CBS also received 18-flouorodeoxyglucose positron-emission topography (18FDG-PET) scans to determine the metabolic changes associated with these symptoms. FTD patients showed a greater increase in inappropriate sexual behaviors than CBS patients [p = 0.009] and NC [p < 0.001] and a greater decrease in prosocial sexual behaviors than CBS patients [p = 0.026] and NC [p < 0.001]. Groups did not differ in change in sexual interest. Among both patient groups, the most common change was decreased prosocial sexual behaviors p < 0.01. Hypometabolism in Brodmann's Area 10 (BA10), within the right frontal pole, correlated with decreased prosocial sexual behaviors [p(FWE-corr) <0.05, k = 44]. No anatomical associations were found with other sexual changes. Decreased prosocial sexual behavior was associated with hypometabolism in BA 10, an area tied to social knowledge and theory of mind, supporting the idea that changes reflect social-cognitive deficits due to frontal dysfunction.

Successful aging, change in sexual interest and sexual satisfaction in couples from four European Countries.

Although the importance of sexuality and physical intimacy for well-being of older adults has been recognized, the role of sexuality in successful aging (SA) has been largely neglected. Building on our previous work, here we further validated a three-dimensional model of SA and examined its associations with sexual satisfaction and change in sexual interest among older heterosexual couples (aged 60-75years). Participants were recruited in a probability-based survey, which was carried out in 2016-2017 in four European countries. Using structural equation modeling of the Actor-Partner Interdependence, we observed significant relationships between SA and sexual satisfaction for both male and female partners across countries. Among women, their retrospectively assessed change in sexual interest over the past 10years was consistently associated with sexual satisfaction. Partner effects were gender-specific: male partners' SA was significantly related to their female partners' change in sexual interest, which in turn was linked to male partners' sexual satisfaction. The findings point to substantial ties between successful aging and sexuality in older European couples. Taking into account the prevalent stereotypes about old age and sexuality, this study's findings can assist professionals working with aging couples.

Seventy-Five Years Old and Still Going Strong: Stability and Change in Sexual Interest and Sexual Enjoyment in Elderly Men and Women Across Europe

Objective: The aim of this study was to test a conceptual model of retrospectively assessed change in sexual interest and sexual enjoyment in the past 10 years among coupled older adults in Norway, Denmark, Belgium and Portugal. To which degree do structural influences, personal characteristics, and interpersonal factors predict the dynamics of sexual interest and enjoyment in partnered persons? Methods: Data were collected as a cross-sectional postal survey, with national probability-based samples of the population aged 60-75 years recruited by phone registers in Norway (676 men and 594 women), Denmark (530 men and 515 women), Belgium ( 318 men and 672 women), and Portugal (236 men and 273 women). Results: Across countries, personal characteristics—primarily general health status—were the most important predictors of change in sexual interest and sexual enjoyment in men. Change in sexual interest and enjoyment among women (except for Portuguese women) was best predicted by interpersonal factors. Conclusions: Good health, an active sex life throughout the lifespan, direction of relationship, and feeling emotionally close to partner during sex are important factors in maintaining sexual interest and enjoyment among partnered older adults in Europe.

Attitudes Towards Sexuality in Older Men and Women Across Europe: Similarities, Differences, and Associations with Their Sex Lives

The aim of the study was to explore attitudes towards sexuality and sexual behaviour in older adults in Norway, Denmark, Belgium, and Portugal. A cross-sectional survey with representative samples of the population aged 60–75 years recruited through phone registers in Norway (676 men and 594 women), Denmark (530 men and 515 women), Belgium (318 men and 672 women), and Portugal (236 men and 273 women) was conducted. The data collection was carried out using an anonymous postal questionnaire. Four dimensions of attitudes towards sexuality were identified: ‘sex for love’, ‘sexual pressure in society’, ‘sex for well-being’, and ‘sexual changes and ageing’. Discriminant analyses identified three discriminant attitude functions: sex for well-being, sexual changes due to ageing, and sex for love. Portuguese men had positive attitudes towards sex as good for well-being in older adults but believed ageing was an obstacle to being sexual at this stage of life. Portuguese women believed sex was good for well-being and did not consider ageing an obstacle to sexual enjoyment. Norwegian men and Danish women believed changes in sexuality due to ageing were no obstacle to being sexual but did not believe that sex was good for well-being. The attitudes of Belgian and Danish men were largely inclined in the direction that sex is not particularly important for elderly people and that changes in sexuality occur due to the ageing process. Men and women were committed to the attitude of sex for love, although this was observed most in Belgian participants and least in Danish men. Positive attitudes towards sex for well-being and towards ageing and sexual changes correlated with less change in sexual interest and sexual enjoyment, and with increased frequency of intercourse and masturbation. To tailor successful sexual health interventions, attitudes of sexuality in older people should be addressed.

Successful Aging and Changes in Sexual Interest and Enjoyment Among Older European Men and Women

IntroductionDespite the popularity and analytical relevance of the concept of successful aging, little efforts have been made to address its relationship to sexuality in older individuals. AimTo explore the relationship between successful aging and the (retrospectively assessed) change in sexual interest and enjoyment in the past 10 years, using a new multidimensional model of successful aging. MethodsThe data for this study was collected in 2016 using national probability-based surveys in four European countries (Norway, Denmark, Belgium and Portugal). In total, information from 2,461 sexually active and inactive participants aged 60–75 years was used for analyses. Multigroup structural equation analysis was employed to address the associations between key constructs. Main Outcome MeasureThe dependent variable was a composite (two-item) indicator of change in sexual interest and enjoyment in the past 10 years; a multifaceted model of successful aging predicted the change by country and gender. ResultsTested cross-culturally, the proposed model of successful aging demonstrated a good fit to the data. Furthermore, its metric characteristics enabled direct comparisons across gender and national cultures. Controlling for sociodemographic characteristics, higher successful aging scores were consistently related to lower reduction in sexual interest/enjoyment among men and women across the 4 countries. Clinical ImplicationsGiven an increased life-expectancy and focus on healthy aging in many countries, the findings about the associations between sexual expression, quality of life and aging well are valuable to professionals working in the area of healthy sexual aging. Strength & LimitationsThis is the first study to systematically address the relationship between successful aging and sexuality. Furthermore, it provides a multidimensional measure of successful aging for a wide range of sexologic studies. Among limitations, possible self-selection bias (toward more sexually permissive and sexually active participants) and the fact that the findings are restricted to older heterosexual individuals, should be considered. ConclusionWithout stigmatizing the absence of sexual expression in aging individuals, the findings from this cross-cultural study point out that sustained sexual interest and sexual enjoyment are linked to successful aging in both genders.Štulhofer A, Hinchliff S, Jurin T, Hald GM, Træen B. Successful Aging and Changes in Sexual Interest and Enjoyment Among Older European Men and Women. J Sex Med 2018;15:1393–1402.

Abstract A62: Differences in sexual dysfunction between lesbian, bisexual, and heterosexual female breast cancer survivors

Abstract Purpose: The purpose of this study was to examine (1) differences in sexual dysfunction between lesbian, bisexual, and heterosexual female breast cancer survivors including (2) patient-provider communication regarding sexual problems, and (3) receipt of treatment for sexual complaints. Methods: Dr. Susan Love Research Foundation's The Health of Women (HOW) Study™ is a cohort study of approximately 40,000 women with and without breast cancer who have responded to one or more online, self-administered surveys. This study includes data from women who completed the baseline and quality-of-life surveys. Women were included if they had a previous diagnosis of breast cancer and if they self-identified as lesbian, bisexual, or heterosexual (N=3,833). Sexual dysfunction was defined as “ever [having] significant problems with change in sexual interest.” We also examined whether women (1) thought that their cancer/cancer treatment was “the primary cause of [her] most significant problems with changes in sexual interest”, (2) “talked to [her] doctor about [her] problems with change in sexual interest”, and (3) “received treatment for [her] problems with change in sexual interest.” Analyses included chi-square test of independence and bivariate logistic regression. Differences were considered significant at p&amp;lt;0.10. Results: Distribution of sexual orientation was as follows: heterosexual (96%), lesbian (3%), and bisexual (1%). Over a third of women reported sexual dysfunction (34%); 78% of them attributed these changes in sexual interest to their breast cancer treatment. Bisexual women were most likely to report changes in sexual interest (48%) when compared to lesbian (34%) and heterosexual (34%) women. Bisexual women were 77% more likely to report changes in sexual interest compared to heterosexual women (OR=1.77; 95%CI: 0.99-3.17, p&amp;lt;0.10); however, bisexual women were less likely than heterosexual women to talk to their doctor about this (OR=0.40; 95% CI: 0.16-0.94, p&amp;lt;0.10). All women reported similar levels of bother from changes in sexual interest (62% reporting being bothered by changes in sexual interest “quite a bit” or “very much”). Irrespective of sexual orientation, less than 20% of women received treatment for changes in sexual interest. Conclusion: Sexual dysfunction was a common issue identified by women breast cancer survivors, particularly among bisexual women who were also less likely to report sexual dysfunction to their provider. Overall, treatment for sexual dysfunction was low for all women, suggesting a potential gap in survivorship care more broadly. These findings suggest that experiencing problematic changes in sexual interest was more common among bisexual breast cancer survivors, who may face unique challenges in receiving needed survivorship care. Targeted interventions for these women may be warranted to increase patient-provider communication about sexual dysfunction and to improve the burden of sexual dysfunction among bisexual women. Citation Format: Christopher W. Wheldon, Megan C. Roberts, Michelle I. Silver, Ulrike Boehmer. Differences in sexual dysfunction between lesbian, bisexual, and heterosexual female breast cancer survivors [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A62.

Keep Faith in Yourself! A Pilot Study on the Relevance of Specific Self-Efficacy for Modifying Sexual Interest in Children Among Men With a Risk to Sexually Abuse Children

ABSTRACTAmong 26 pedophilic/hebephilic men, we investigated (1) the relationship between “specific self-efficacy for modifying a sexual interest in children” (SSIC) and actual sexual interest in children and (2) whether changes in SSIC are associated with changes in sexual interest in children. Results showed that the more clients believe they are able to influence their sexual interest in children, the less strong they perceive their sexual interest in children to be. Furthermore, an increase in SSIC is associated with a decrease in sexual interest in children. We suggest avoiding generalized statements about the immutability of sexual interest in children.

Perioperative sexual interest in women with suspected gynecologic malignancies

ObjectivesFor women with gynecologic cancer, the impact of surgery on sexual interest and desire in the immediate and later postoperative period is not well characterized. The objective of this study was to report the perioperative trends of changing sexual interest and desire in a cohort of women undergoing surgery for suspected gynecologic malignancies. MethodsThis is an ancillary analysis of a cohort study analyzing health-related outcomes in women who underwent primary surgical management of a suspected gynecologic malignancy between 10/2013 and 10/2014. Subjects completed the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction Questionnaire (PROMIS-SFQ) preoperatively and questions on sexual interest and desire at one, three, and six months postoperatively. Bivariate tests and multiple linear regression were used to analyze data. ResultsOf 231 women who completed a baseline PROMIS-SFQ, 187 (81%) completed one-month, 170 (74%) three-month, and 174 (75%) six-month follow-up interviews. Following surgery, 71% of enrolled subjects were diagnosed with a malignancy. Women age <55 had a greater decrease in sexual interest from baseline to one month than women age >55 (−5.5±1.0 vs −2.3±0.9, p=0.02). In a multivariable analysis, age <55 remained associated with a larger decrease in sexual interest at one month postoperatively (−4.6, 95% CI: −1.8, −7.4), as did having cancer vs benign disease for women of all ages (−5.6, 95% CI: −9.6, −1.5). ConclusionsThis study provides new data regarding the timing and magnitude of changes in sexual interest following gynecologic oncology procedures.

A failure to demonstrate changes in sexual interest in pedophilic men: comment on Müller et Al. (2014).

Muller et al. (2014) presented data representing test–retest results from penile plethysmography testing (PPT) among 43 men diagnosed with pedophilia. They claimed to have found evidence for impressive change in PPT-measured preferences for child versus adult stimuli and asserted that ‘‘this represents a significant challenge to the hypothesis that sexual interest in men with pedophilia is unchangeable.’’ Although it would be both newsworthy and uplifting if Muller et al. had indeed shown that meaningful changes in such preferences occurred among pedophilic men, unfortunately the data presented by Muller et al. do not come close to establishing this. In this critique, I explain why the data by Muller et al. fail to show meaningful changes in PPT-measured arousal patterns. The main concern is this: PPT arousal patterns have measurement error (and there are indications that the data of Muller et al. include substantial measurement error). Thus, to show that a man’s change in PPT indices is meaningful, one must demonstrate that the change does not simply reflect measurement error, a necessary step that Muller et al. did not even attempt. I suggest some ways of accomplishing this in future research.

Nature of Sexual Dysfunctions in Major Depressive Disorder and its Impact on Quality of Life

Background:Adequate sexual expression is an essential part of many human relationships, and may enhance quality of life and provide a sense of physical, psychological, and social well-being. Epidemiological and clinical studies show that depression is associated with impairments of sexual function and satisfaction, even in untreated patients. Most antidepressant drugs have adverse effects on sexual function, but accurate identification of the incidence of treatment-emergent dysfunction has proved troublesome. However, few investigators have reported the base rate for disturbances in sexual desire, arousal, and orgasm or ejaculation in patients with major depressive disorder (MDD) prior to antidepressant treatment. The purpose of this study is to define the frequency of sexual dysfunction (SD) in 60 patients with MDD and examine the relationship between SD and quality of life enjoyment and satisfaction variables.Materials and Methods:A consecutive series of 24 male and 36 female MDD patients diagnosed by SCID-DSM IV assessment completed a series of psychometric measures including a Sexual Function Questionnaire—Arizona Sexual Experience Scale (ASEX) which asked about change in sexual interest and function as well as quality of life of life enjoyment using QLESQ-SF.Results:Over 33.33% of men and 42% of women reported decreased sexual interest. Reduced levels of arousal were more common in both men and women (8-22%) than ejaculatory or orgasm difficulties (11–16%). In women, SDs were more than males. Quality of life was more impaired in sample with SDs than those without dysfunction showing significant impact of SD on quality of life.Limitation and Conclusion:Although limited by a relatively small sample of drug-free patients with MDD, and by the absence of a non-depressed comparison sample, these results emphasize the importance of factors beyond specific drug effects in the assessment of SD in drug naive-depressed patients.

L06 Sexuality in Huntington's disease. introducing a neuro-sexological viewpoint in bio-psycho-social rehabilitation

BackgroundHuntington's disease results in a wide variety of physical, mental, and social disabling impairments that will affect sexuality. Up to 85% men and up to 75% women experience high levels...

Women's pupillary responses to sexually significant others during the hormonal cycle

Women's sexual preferences can change over the hormonal cycle, as several studies, based on responses to questionnaires, diaries, and ratings of photographs, have indicated increased sexual interests around the time of ovulation. However, fewer studies have measured changes in attention or interest to sexually significant stimuli in terms of physiological responses that are not under voluntary control and measure sexual interest indirectly (i.e., without mention of sexual feelings or activities). In the present study, we indexed changes in sexual interest in terms of changes in the eye pupil's size. Pupillary diameter is known to have a proportional relation to the observer's level of interest and attention to a visual stimulus as well as to physical pleasure. Fourteen women (7 being “pill” users) viewed photos on a computer screen while their pupil diameters were recorded using an infrared eye-tracking device. Three measures were taken for each participant during three time windows that estimated the ovulatory, luteal, and menstrual phase of the cycle. We found an increase in mean pupil diameter for sexually significant stimuli during the fertile phase and this pupillary change was also specific to pictures of the participants' actual sexual partners. Moreover, this effect was only seen for women who did not use oral contraceptives. These findings confirm that women's attention for sexually significant stimuli is higher during their fertile phase of the menstrual cycle, and that changes in sexual interest are implicitly measurable using pupillometry.

Does oral contraceptive-induced reduction in free testosterone adversely affect the sexuality or mood of women?

The aim of this study was to examine whether changes in plasma androgen levels (total testosterone (T), free testosterone (FT), and dehydro-epiandrosterone-sulfate (DHEA-S)) induced by oral contraceptive (OC) use were related to changes in sexual interest or response or in mood. Sixty-one women provided blood samples and were assessed, using interviews and standardized questionnaires, prior to starting, and after 3 months on OCs (Ortho-Tricyclen, Ortho-Tricyclen-Lo, or Ortho-Cyclen, all containing the same progestagen, norgestimate). Significant decreases in T, FT, and DHEA-S were found after 3 months, although the extent of reduction was variable across women. There was some support for a relationship between the degree of reduction in total T and FT and the frequency of sexual thoughts after 3 months on OCs. However, some women had no loss of sexual interest in spite of substantial reduction in FT, and there was overall no evidence that reduction in FT affected enjoyment of sexual activity with a partner. The findings are consistent with the idea that some women may be more sensitive to changes in T than others. No relationship was found between negative mood, as assessed by the Beck Depression Inventory, and changes in T, FT, or DHEA-S.

1.144 Changes in sexual interest and function in patients with Parkinson's disease: Focus on hypersexuality

1.144 Changes in sexual interest and function in patients with Parkinson's disease: Focus on hypersexuality

Burden and marital and sexual satisfaction in the partners of bipolar patients

Bipolar disorder can be traumatic for both patients and patients' partners. Hence, partners' stress, burden, marital and sexual satisfactions are important areas to investigate. However, there have been problems with past attempts to identify the determinants of marital satisfaction in bipolar patients and their partners. The present study aimed to address these issues and provide an accurate description of relationship functioning in these couples. The sample involved 37 partners of bipolar patients. A semi-structured interview assessed the impact of bipolar disorder on aspects of everyday functioning and partners' attributions for patients' disturbing behaviour. Standardized instruments assessed partners' sexual and marital satisfaction across the different affective states. Despite couples staying together, significant numbers of partners reported strain as a result of socioeconomic and household changes. More male partners reported premature ejaculation and female partners reported sexual infrequency when patients were depressed. Overall, partners were less sexually satisfied when the patient was ill. Marital disharmony was greater when patients were ill and worse during manic than depressed phases. Marital disharmony was also more likely when partners believed the patient could control their illness; they had increased domestic responsibilities; or were sexually dissatisfied. Reductions in sexual satisfaction during affective episodes may be the result of illness-related changes in sexual interest, responsiveness and affection. Partners who attribute control for the illness to the patient may use strategies to influence behaviour that disrupt marital harmony. Interventions involving education, problem-solving strategies and sex therapy components may help to reduce marital dissatisfaction.

Factors predicting sexual relationships in older people: an Australian study

Objectives: Sexuality in later life is now recognised to be an important issue. The present study identified the factors that predict sexual relationships and changes in sexual activity in a sample of 844 older persons living in Melbourne, Australia, who returned a self‐completed questionnaire. Method: The variables included in the two models that predicted sexual relationship status and changes in sexual activity were: sex, age, marital status, general health, incontinence, satisfaction with physical condition, knowledge of sexual issues, change in sexual interest, perceptions of sex as an important factor in general well‐being, and number of sexual partners. Results and Conclusion: Logistic regression analysis revealed that the variables used in the model produced correct prediction rates for 84% of respondents not in a sexual relationship, and 85% for those in a sexual relationship. Age, marital status, incontinence, satisfaction with physical condition, sexual knowledge, perceptions of sex as important to well‐being, and number of sexual partners were significantly related to sexual relationship status. The present study discusses how these findings can further inform research and be used to inform our knowledge on sexuality in later life.

Sexual dysfunction before antidepressant therapy in major depression

Background: Decreased sexual interest and function both occur as a consequence of antidepressant medication use, and are especially associated with serotonin reuptake inhibitors (SRIs). However, few investigators have reported the base rate for disturbances in sexual desire, arousal and orgasm or ejaculation in patients with major depression (MD) prior to antidepressant treatment. The purpose of this report is to define the frequency of sexual dysfunction (SD) in 134 patients with MD and examine the relationship between SD and demographic, clinical and personality variables. Method: A consecutive series of 55 male and 79 female MD patients diagnosed by SCID-DSM IV assessment completed a series of psychometric measures including a Sexual Function Questionnaire, which asked about change in sexual interest and function as well as sexual activity during the preceding month. Results: Only 50% of women and 75% of men reported sexual activity during the preceding month. Over 40% of men and 50% of women reported decreased sexual interest. Reduced levels of arousal were more common in both men and women (40–50%) than ejaculatory or orgasm difficulties (15–20%). In women, problems with arousal and orgasm correlated with higher neuroticism and lower extraversion. There was no relationship between SD and personality measures in men. While age at onset of depression and number of prior episodes showed a modest correlation with SD measures, there were no correlations with severity of depression or specific symptoms clusters. Limitations and Conclusions: Although limited by a relatively small sample of drug free patients with MD, and by the absence of a non-depressed comparison sample, these results emphasize the importance of factors beyond specific drug effects in the assessment of antidepressant related sexual dysfunction.

Effect of finasteride on bother and other health-related quality of life aspects associated with benign prostatic hyperplasia

Objectives. To investigate the long-term effects of finasteride on bother and health-related quality of life (HRQOL) in men with symptomatic benign prostatic hyperplasia. Methods. A large prospective 4-year placebo-controlled trial (PLESS) of 3040 men with moderate to severe lower urinary tract symptoms and an enlarged prostate was performed that included self-administered questionnaires assessing HRQOL. Results. Significantly greater reductions in bother score were seen for finasteride compared with placebo at every time point after 4 months. Analysis of bother scores by baseline serum prostate-specific antigen (PSA), as it is highly correlated with prostate volume, suggested greater differences from placebo for men with PSA 1.4 ng/mL or greater, primarily due to worsening after the first-year improvement in the placebo group. An activity interference domain score was significantly improved for finasteride over placebo at each time point ( P <0.01), with greater treatment differences in men with higher baseline PSA levels. Comparable results were seen for worry at each time point and embarrassment due to urinary symptoms in the last 2 years of the trial. Mean changes in sexual interest and satisfaction were somewhat better for the placebo group overall, as has been previously reported, but little difference between treatments was found in sexual satisfaction measures for men with PSA 1.4 ng/mL or greater. Conclusions. Compared with placebo, men receiving finasteride had significantly less bother, activity interference, and worry due to urinary symptoms, with more pronounced differences for men with baseline PSA 1.4 ng/mL or greater. As expected, sexual satisfaction and sexual drive were slightly worse for finasteride overall, but little difference in sexual satisfaction measures was found for men with a higher baseline PSA. Thus, HRQOL was improved for finasteride compared with placebo, especially for men with a baseline PSA 1.4 ng/mL or greater.