Aphrodisiac Research Articles

Eroticism as a hormetic stimulus in health and ageing

Eroticism in later life is, on the whole, a taboo subject, and the stigma attached to expressions of sexual intent by older people is widespread in most cultures. However, sexuality and eroticism have an important role to play in maintaining healthy ageing. Sexuality is an essential aspect of our biology and its effects have repercussions in systems and organs other than the sexual. In this paper I review the importance of developing a sexual-erotic element in later life, an element that is intimately coupled with the phenomenon of hormesis. In hormesis, there is biological benefit following exposure to a mild stimulus or challenge, whereas exposure to a higher dose of the same stimulus becomes detrimental. Innovative sexual stimulation can be seen as a hormetic opportunity to initiate beneficial effects on the entire ageing human organism. The intention is to show that, health benefits may be obtained not only through physical (exercise), nutritional, mental or pharmacological challenges, but also through sexual stimulation of the appropriate magnitude and quality. By enhancing erotic stimulation it may be possible to experience many other benefits spanning several domains such as the endocrine, immune, circulatory and neurological. In addition, within an increasingly information-rich world, sexuality may play a part in improving adaptation to various cognitive external stimuli originating from our technological ecosystem.

A critical-pragmatic study of the representation of female gender in Nigerian Hip-hop music

Hip-hop music has become a popular trend in Nigeria, as it enjoys a high level of acceptance among the Nigerian youths. Thus, this study examines the representation of female gender in hip hop music and the messages the music conveyed about female gender; it also unravels the hidden pragmatic meanings behind the content of the music. Nine (9) data from the lyrics of selected hip hop music were randomly selected and analysed using Mey's (2001) pragmatic act theory. This paper adopted a qualitative approach which is due of the nature of the data that was analysed and the approach that was used in analysing it. Findings revealed a dominant portrayal of slangy expressions suggesting sexual overtimes, female as mere edibles, women as sexual stimulant, seductive dance steps, and indecent dressing in the lyrical contents sampled. The paper also revealed that the implicit practs of exposing, seducing, luring and proposing were used in the data to show the role females play as characters in hip-hop music videos. The paper concludes that the use of vulgar expressions in the description of these female characters portrayed them mainly as sex commodities and sex workers, this questions the dignity of the African woman and the virtues she is expected to project to her fellow female folk, home and abroad.

Rectal Foreign Bodies: A 10-Year Review of the National Electronic Injury Surveillance System.

Introduction Rectal foreign bodies may result in significant morbidity, potentially necessitating surgical intervention and ostomy creation. The sensitive nature of the diagnosis may lead to inaccurate patient history and possible delay in diagnosis. Currently, there is a paucity of large national studies addressing this diagnosis. Therefore, we present national data describing the demographics and incidence of patients presenting with rectal foreign bodies. Methods The National Electronic Injury Surveillance System (NEISS) was utilized to collect data regarding rectal foreign bodies. Ten years of data were collected from 2012 to 2021. Inclusion criteria focused on the diagnosis of "foreign body" coupled with pelvic and lower torso injuries. Exclusion criteria encompassed patients without a rectal foreign body clearly identified in the narrative. Patients were compared based on disposition as low severity (treated/examined and released or left without being seen) or high severity (treated and admitted/hospitalized, held for observation, or transferred to another facility). General descriptive and inferential analyses were performed regarding demographics and dispositions. Results A total of 1,806 emergency department (ED) visits were identified for inclusion. Patients ranged in age from 0 to 93 years, with a mean age of 30 years. The largest age group identified was 11-15 and 21-25 years. Most patients were male (64.6%) and white (47.1%). The most common foreign bodies were massage devices and vibrators (22.7%), jewelry (8.1%), pens and pencils (4.4%), fishing gears (activity, apparel, or equipment) (3.7%), and nonglass bottles or jars (2.6%). Patients requiring admission, observation, or transfer differed from those patients that were discharged from the ED by age, sex, race, and product involved. Discussion Rectal foreign bodies are a rare diagnosis with a growing incidence. Though the most common objects are massage devices and vibrators consistent with sexual stimulation devices, there are limited product guidelines for safe use. Further studies to help identify at-risk persons, safety precautions, and manufacturing guidelines may help prevent potential morbidity associated with rectal foreign bodies.

Toxicological Evaluations of Smilax Myosotiflora Methanol Extract and its Effect to Testosterone Level of Male in Subacute Study

Smilax myosotiflora A. DC., the horny little devil, is a tropical creeping plant which popularly consumed as a male aphrodisiac, energy booster and lumbago reliever in the old traditional medicinal. The scientific studies showed that the plant able to increase sexual behaviors and testosterone level in male rats. However, its toxicity effect is still remained unknown. Therefore, this study aimed to investigate the toxicity effects of S. myosotiflora methanol extract (SMME) through in vitro and in vivo studies. The SMME was subjected to the brine shrimp lethality test (BSLT) to determine the LC50. Acute and subacute toxicity studies according to the Limit Test of OECD guidelines no. 425 and 407 was carried out through oral gavage accordingly. It was found that the LC50 of SMME was 674.4ppm while its LD50 via acute test was more than 5000mg/kg. Neither sign of toxicity nor significant difference in food intake, weight gain, gross necropsy, the hematological and biochemical analyses and histological evaluations were recorded between the control and treated groups except for the level of AST and testosterone in male and sodium and triglycerides in female rats. The increase of testosterone in male might occur through specific pathway as the SMME did not increase the hormone level in the female. According to GHS classification, SMME in this study can be classified as Category 5 (Safe) and non-toxic. Data from this study can be served as a primary predictive guide for future research in assessing the efficiency and safety of S. myosotiflora consumption for human trial.

Avaliação reprodutiva e econômica da estimulação sexual durante o período antrópico em uma fazenda comercial com perdas neonatais de cordeiros

ABSTRACT This study was performed during the anestrous, involving 140 Akkaraman Kangal ewes whose lambs had died in the neonatal stage due to pneumonia and enteritis. Intravaginal sponge containing progesterone was placed to the animals (Group 1, n = 70) on day 0 and removed after 7 days, following which 263 µg PGF2α and 500 IU eCG were administered to the sheep. Ram introduction was performed for 7 days (days 8-14), starting from the day after the removal of the intravaginal sponge (day 8). The animals in Group 2 (n = 70) were not exposed to any treatment. Ram introduction was performed simultaneously in both the groups. To determine the reproductive response, reproductive parameters such as estrous, pregnancy, multiple pregnancy, and embryonic mortality rates, number of births, number of offspring, and fertility, as well as their economic implications, were compared between groups. Each reproductive parameter exhibited a statistical difference between groups. An economically positive trend was observed in the study group compared with the control group. It was concluded that in case of lamb losses in commercial farms that derive profit from lambing, pregnancy of ewes can be achieved via sexual stimulation without waiting for the next breeding season.

Toward a Theoretical and Analytical Framework for the Study of Sexual Humour in Chaucerian Fabliaux

The present study offers an examination of laughter in comic texts from a range of fabliau in The Canterbury Tales, framing them within discussions of medieval views of eroticism that draw from religion, medicine, philosophy, and literature. These texts feature males and females who laugh and make jokes in sexual themes and plots which involve deception and sexual misbehaviour. First, the article explores medieval attitudes toward laughter in religious, medical treatises and literature. It then discusses a number of predominant themes in the Reeve’s Tale, the Miller’s Tale, the Merchant’s Tale and the Shipman’s Tale in the context of Chaucer’s the Canterbury Tales to try to tease out how these particular themes may have worked to bring erotic pleasure to the reader of the comic texts. The comic themes discussed in this article are briefly cuckoldry, culinary humour, exposure of the genitals and farting. These subjects and how they are represented are very different from modern erotic representations. They are based both on a different understanding of the body and on a different social and cultural landscape, and their complexity resists simple interpretations about misogyny or functionality that are suggested by feminist perspectives on sexual humour. All quotations from the Canterbury Tales are taken from The Riverside Chaucer, edited by Larry D. Benson (Oxford: Oxford University Press, 1988).

Determination of the Effect of Different Doses of ECG Applications on Reproductive Parameters in Primiparous Akkaraman Kangal Sheep

To increase meat production at a level parallel to meet the demand of the increasing world population in recent years, reproductive management in farm animals must be successful. In order to reach the desired level of fertility in sheep, particularly starting with the non-prolific breeds, anoestrus period applications should be carried out effectively. In this study, different doses of equine chorionic gonadotropin were applied to determine the effective eCG dose for underwent estrus synchronization with progesterone in anoestrus Kangal ewes whose milk and wool yield has been completely abandoned by the breeder for various reasons and whose only economic benefit is lamb production. A total of 225 Kangal Akkaraman Sheep breeds, 2 years old, with a body condition score of 2.5-3.5 and an average weight of 40-50 kg, were included in the study. In line with this purpose, ewes were divided into 3 groups, containing 75 primiparous sheep. A vaginal sponge containing progesterone was inserted into the animals in all groups on day 0. Seven days after this application (on the 7th day), vaginal sponges were removed and Prostaglandin F2α (PGF2α) was applied. When the vaginal sponge was removed and the PGF2α was administered, 400 IU of eCG was given to animals in Group 1 (n:75), 500 IU of eCG was administrated to animals in Group 2 (n:75), and 600 IU of eCG was injected to the ewes in Group 3. The effectiveness of different doses of eCG application on reproductive parameters such as estrous rate, pregnancy rate, multiple pregnancy rate, and the number of offspring was evaluated. While no statistical difference could be determined between the groups in terms of the stated reproductive parameters, numerically more offspring were obtained in the group in which eCG was applied at a low rate (Group 1). In the light of this information, it is concluded that 400 IU eCG can be as effective as 600 IU eCG in sexual stimulation of Kangal ewes in anestrus.

Twig-assisted masturbation in Balinese long-tailed macaques

Abstract We documented evidence of idiosyncratic but repeated twig-assisted genital stimulation by Balinese long-tailed macaques (Macaca fascicularis), living in Ubud, Indonesia. This population is known to customarily engage in genital stone-tapping/-rubbing, a behaviour expressed by males and females of different age classes as part of a broader cultural repertoire of stone-directed and overall playful actions known as stone handling. However, genital stimulation using other objects has never been reported in this population and species. We observed repeated and extensive twig-assisted genital stimulation in one adult female and one adult male. We also recorded three instances of twig-assisted genital stimulation in three additional individuals. Our results indicate that this behaviour is not accidental and may be sexually motivated; that is, it may be another form of tool-assisted masturbation in this primate population. This report provides a valuable addition to the increasing literature on tool-assisted behavioural innovations pertaining to self-care and possibly pleasure.

(031) Bartholin Cysts Can Be Treatable Causes of Female Sexual Dysfunction: Four Year Review of Diagnosis and Treatment Principles

Abstract Introduction Bartholin glands are major vestibular androgen dependent glands that release mucus secretions during sexual arousal through a 2.5 cm duct that drains at the 5 o'clock and 7 o'clock positions of the vestibule. Bartholin's glands are innervated by a branch of the pudendal nerve; mucous secretion is activated by the efferent pelvic nerve. Unilateral or bilateral obstruction of the Bartholin's ducts may occur (e.g. from trauma, infection, surgery, or idiopathic), however as long as innervation is intact, Bartholin glands continue to produce mucus despite outlet ductal occlusion. This leads to dilation of the duct with subsequent cyst formation that can result in Bartholin cyst-associated sexual dysfunction symptoms. Objectives To review patient records of women presenting to a sexual medicine clinic over a four-year period diagnosed with and surgically treated for Bartholin cyst-associated sexual dysfunction. Methods Grayscale ultrasound was performed (see figure) using the Aixplorer and cyst dimensions were measured after visual sexual stimulation in the office. Vulvoscopy was performed with the Wallach Zoomscope. Bartholin cyst anesthesia testing was performed using benzocaine 20%, lidocaine 8% and tetracaine 6%. Marsupialization surgery was performed as an out-patient. Results We identified 11 patients (mean age 26 +/− 6 years) diagnosed with Bartholin cyst-associated sexual dysfunction between January 2019 and November. 2010 who met inclusion criteria and were surgically treated by marsupialization for unilateral (4) and bilateral (7) Bartholin cysts. Their symptoms of Bartholin cyst-associated sexual dysfunction included dryness with sexual arousal (73%), pain with sexual arousal (82%), pain with orgasm (36%), spontaneous drainage (18%), and a mass at the introitus interfering with penetration (45%). 55% had been treated previously at other facilities unsuccessfully, including cyst aspiration, Word catheter placement, and marsupialization. The mean cyst size on ultrasound was 2.9 +/− 1.5 cm. Bartholin cyst anesthesia testing was positive in all (4/4) that underwent this test. Surgical principles to encourage post-op mucin drainage through the Bartholin duct included visualization of the duct at surgery (see figure) and direct anastomosis of the duct to the inferior portion of the incision at 5 and/or 7 o’clock locations (see figure). Post-operative daily arousal was encouraged and mucin secretion through the marsupialized ducts was documented by placement of gauze in the introitus and observing the mucous (see figure). At the time of this review, with an average follow-up of 8 months, 15 of 18 (83%) cysts are still draining and 9/11 patients are somewhat better, much better and very much better with resolution of Bartholin cyst-associated sexual dysfunction symptoms. Conclusions Bartholin cysts are a sexual dysfunction that can be successfully treated. Diagnosis involves an ultrasound after sexual arousal and a positive Bartholin cyst anesthesia test. Treatment involves marsupialization with visualization and anastomosis of the Bartholin duct to the inferior portion of the incision at the 5:00 and 7:00 locations. Post-operative daily arousal is encouraged with documentation of mucinous drainage detected. Disclosure No.

Rectal Foreign Body Successfully Removed by Colonoscopic Snare Wire

Aim: The most common cause of rectal foreign bodies are objects used for sexual stimulation voluntarily by the patient. Different treatment methods are reported in the literature, and this article reports the transanal removal of the foreign body in the rectum with a snare wire without anesthesia, accompanied by colonoscopy. Case: An 80-year-old male patient was admitted to the emergency room because of the plastic rectal shower head that remained in the rectum and could not be removed while he was using a rectal douche for constipation. Contrast-enhanced abdominal computed tomograpyh (CT) showed a foreign body located in the rectosigmoid region without perforation findings. 12x1,5 cm tubular, well-circumscribed plastic foreign body embedded in the stool was removed with the help of colonoscopy in a controlled manner by holding it from its distal end with the help of endoscopic snare wire. Conclusion: Rectal foreign bodies can often be removed by the patient. However, in cases of foreign bodies in the rectum admitted to the hospital, the treatment method varies according to the type and location of the object, the occurrence of the event, and whether there are perforation findings in physical examination and imaging. Digital rectal examination is the critical first step in evaluating a patient with a rectal foreign body. Bedside extraction as the first-line treatment for low-lying anorectal foreign bodies without signs of perforation; endoscopic extraction is recommended as the first step in anorectal foreign bodies located high above the rectosigmoid junction. Because in cases without perforation, transanal removal of the foreign body is considered the first-line treatment and the success rate is approximately 75 %. The most essential condition for successful transanal removal of the foreign body in the rectum is the relaxation of the patient. Endoscopic examination is also recommended to evaluate the condition of the intestinal wall after the removal of the foreign body. In our case, we also removed the foreign body, which we found to be located in the middle rectum, in accordance with the literature, endoscopically.

Rationale and efficacy of sexual desire stimulation in mares under anaphrodisia

Data from the literature regarding the objectivity of clinical and hormonal methods of diagnosing disorders of the gonads are contradictory, because they do not always accurately reflect the state of the course of folliculo-luteogenesis. At the same time, the relationship between clinical and endocrine indicators is still insufficiently clarified, which does not allow for the development of a justified use of drugs that accelerate the manifestation of sexual hunting in mares. In this regard, our further studies were aimed at studying the dependence of hormonal indicators on the size, shape and consistency of the gonads and determining the effectiveness of stimulation of sexual hunting with prostaglandin F 2α drugs. Before conducting the experiment, it was taken into account that exogenous prostaglandin F-2 alpha has both luteolytic properties - causes lysis of the corpus luteum, and stimulating properties - affects the release of gonadotropin hormones (FSH, LH) by the hypothalamus and pituitary gland, which leads to an acceleration of the manifestation of phenomena arousal stage of the sexual cycle. From the data presented in the article, it can be seen that after the use of estrophan sexual desire was found in a larger number of animals than when bioestrophan was administered and in the control. It was observed that the effectiveness of bioestrophan compared to estrophan was lower according to some parameters: 29% of animals showed less desire for sex, its duration was 1.5 days longer (8.2±1.6 vs. 6.7±0.6), and fertilization is 19% lower. The reaction of the animals to the administration of the drugs in terms of the period from administration to the manifestation of potential libido (desire with clear signs) was almost the same (7.0±1.8 and 7.3±1.2 days). The effectiveness of prostaglandin F-2 alpha preparations, applied to mares with anaphrodisiacs to stimulate the onset of the arousal stage of the sexual cycle, depends on the value of IPRYA (the value of the integral indicator of the size of mare's ovaries), which characterizes the activity of the gonads and their refractoriness to exogenous prostaglandins. With a large value of IPRYA - 14–18 cm, compared to the control, the introduction of estrophan and bioestrophan increased the number of mares that showed sexual desire by 47.5 and 27%, accelerated the onset of sexual hunting by 9 and 8 days, contributed to an increase in fertilization by 43 and 30%. Based on the above, the PI of mare's ovaries can be used to clarify the diagnosis - hypofunction and persistence of the corpus luteum of the gonads. Key words: sexual cycle, sexual desire, exogenous prostaglandin F-2 alpha, anaphrodisia, infertility, mares.

(058) Acute Dorsal Genital Neuromodulation can Improve Subjective Arousal: A Pilot Study in Women With and Without Spinal Cord Injury

Abstract Introduction Female sexual dysfunction (FSD) is a potentially life altering condition that impacts an estimated 40% of women. Unfortunately, the few treatment options available have limited success due to adverse events and an inability to improve subjective arousal. One potential treatment option, neuromodulation, has improved female sexual function index (FSFI) scores in small studies. The underlying mechanisms of how neuromodulation may improve FSD are not understood. We hypothesize that neuromodulation provides benefits by increasing genital blood flow. Objective Our primary objective is to determine if a single period of dorsal genital nerve stimulation (DGNS) or tibial nerve stimulation (TNS) directly causes a change in vaginal blood flow (VBF). Our secondary objective is to assess if subjective arousal increases during a single period of DGNS or TNS. These interventions will be compared among three cohorts of women: women with C6–T10 spinal cord injury (SCI), women with FSD (FSFI lubrication sub-score < 4), and able-bodied women without FSD. Methods Participants attended two separate visits, one for each nerve target, randomly ordered and separated by 1–5 months. We are testing two experimental paradigms: without and with erotic audio-visual materials. The first experiments measured vaginal pulse amplitude (VPA) using a vaginal photoplethysmography transducer (VPP) before, during, and after 20 minutes of nerve stimulation. After data processing, we calculated average peak to peak (p2p) amplitudes for each time period and performed an ANOVA and post-hoc pairwise comparisons within each participant. For the second experiment we measured VPA during neutral and erotic videos both without stimulation and with stimulation. In both experiments we measured subjective arousal via a Likert-type scale at 4 timepoints and made comparisons across participants with a paired t-test. The first experiments are complete and data collection for the second experiments is ongoing. Results We recruited three participants in each cohort in the first experiments, with five participants completing both sessions. All participants saw significant changes in their p2p amplitude from before stimulation to after stimulation in DGNS trials (n = 3 increased, n = 4 decreased). Three of five participants had significant p2p increases in TNS trials and one participant had significant decreases. DGNS subject arousal scores increased significantly after stimulation, but TNS scores did not (Figure 1). Most participants reported genital sensations during DGNS (7 of 8) and TNS (3 of 6) sessions. Three participants have completed both visits in the second set of experiments, with similar trends. Conclusions Acute DGNS, but not TNS, increased subjective arousal across all participants. VPA responses to stimulation were heterogeneous and although most changes were significant, there may not be physiological or clinical relevance. It is possible that repeated stimulation sessions over time may enhance changes in VPA. Disclosure No

(129) A Neurological Excitation/Inhibition “Faucet Model” for Orgasm and Pain

Abstract Introduction A prevalent concept of neuronal inhibition in sexual response is that it opposes the effects of neuronal excitation, e.g., the classical arm balance in which excitation and inhibition are on opposite arms of the balance; when one is up, the other is down (Perelman: Curr Sex Health Rep 2018;10:38). However, there is extensive evidence that neuronal inhibition can increase jointly and concurrently with neuronal excitation. Objective To review extensive evidence of neuronal inhibition increasing concurrently with neuronal excitation in various contexts including sexual response and orgasm. Methods Review neurological evidence and propose a novel model of neuronal excitation and inhibition acting jointly to enable intense sexual response and orgasm. Results The intensity of neuronal inhibition can increase concurrently with an increase in excitation, thereby actually enabling the excitation intensity to increase, as in the most basic functions of the nervous system, i.e., the spinal reflexes, and in graceful, non-spastic movement of precision, and intense movement. Sensorially, pain activates the endogenous pain-inhibiting system. In sexual response, as the intensity of response to vaginal self-stimulation increased from pressure to pleasure to orgasm, the intensity of pain inhibition also increased. The spinothalamic tract, which transmits pain, also transmits the genital stimulation leading to orgasm. In the brain, major components that are activated by pain are also activated by orgasm, evidence of sites of inhibitory interactions between genital afferent activity and pain perception. When the intensity of excitation surpasses that of concurrent inhibition, the excitation is perceived as aversive or painful (Komisaruk & delCerro: Sex Med Rev 2022;10:481). We propose a model of this view of concurrent excitation and inhibition, both increasing in intensity jointly to orgasm, as hot (excitatory) and cold (inhibitory) water flowing from a faucet. This model differs from that of a classical balance in that it incorporates variations in intensity of excitation and inhibition independently of each other as well as concurrently and jointly, rather than just reciprocally. Thus, a low versus high flow rate of hot water would represent mild or intense pain, whereas a high flow rate of both hot and cold water would represent intense, but non-painful, comfortable excitation, as in orgasm, with perhaps the hot water intensity just exceeding the cold at orgasm. Weak, “anhedonic” orgasm, or premature ejaculation are represented by the “faucet model” as hot and cold water at a very low flow rate; anorgasmia and/or “HSDD” as cold consistently surpassing hot at any flow rate, from low to high, depending on the dynamic qualities of the anorgasmia, i.e., not “getting going”, or “getting close, but not there”, with regard to orgasm. In the latter case e.g., a titrated combination of excitatory (hot) and inhibitory (cold) pharmaceuticals might enable a more delayed and intense orgasm. Conclusions Our proposed “faucet model” of neuronal excitation and inhibition mediating sexual response and orgasm, which is based on extensive neurological evidence, we believe can account for a variety of healthy and pathological sexual responses, and provide a rational basis for therapeutic application. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Adamo Bioscience (first author); many others (last author).

(076) History of Sexual Coercion, PGAD Symptoms, and Sexual Function: Evidence for a Mediational Model

Abstract Introduction Past research on Persistent Genital Arousal Disorder (PGAD) has shown that a history of sexual abuse is common among women with PGAD (Leiblum et al., 2007; Pink et al., 2014), with higher rates of abuse among those who are most symptomatic (Leiblum et al., 2007). However, there is a need for replication and for developing a theoretical understanding of the mechanisms and developmental course of this association. Moreover, although little is known about the relation between PGAD symptoms and sexual functioning (Jackowich et al., 2016) research has suggested that women with PGAD show FSFI scores that are low but within the normal range (Leiblum & Seehuus, 2009), and that those with subthreshold PGAD symptoms associate those symptoms with positive feelings. Objective The goal of the present study was to test a mediational model in which history of sexual coercion is directly associated with PGAD symptoms, and indirectly associated with sexual functioning (desire, masturbation, lubrication), with mediational effects passing through PGAD symptoms. Methods A sample of n = 138 female university students completed questionnaires measuring past experience of sexual coercion, PGAD symptoms, sexual desire, masturbation, and lubrication. Structural equation modeling was used to test a theoretical model in which a history of sexual coercion was allowed to directly predict PGAD symptoms and all three sexual function constructs, and PGAD symptoms were allowed to predict all sexual function constructs (see Figure 1). Results The SEM model fit the data well (CFI = .96; NFI = .92; RMSEA = .07). As presented in Figure 1, past experience of sexual coercion was positively associated with PGAD symptoms and negatively associated with sexual desire, but had no direct association with masturbation or lubrication. PGAD symptoms were associated with increased desire and masturbation, but decreased lubrication, and sexual desire was positively associated with lubrication. In addition to the directs effects on PGAD symptoms and sexual desire, past experience of sexual coercion also demonstrated indirect effects on all sexual function constructs (positive effects on desire and masturbation, and negative on lubrication). Conclusions Based on these results we propose a developmental model in which the effects of PGAD symptoms on desire, arousal, and pleasure, change across time and symptom severity. Specifically, increased attention to genital and sexual sensations is expected to result from past sexual coercion. Then, in the context of this heightened genital awareness, when persistent non-painful genital stimulation is perceived, in the early stages of PGAD symptom development, the combination of those sensations and the heightened attention to them is expected to result in perceived pleasurable sensation and arousal, thus increasing desire and masturbation. This is expected to be limited to the early stages of PGAD development, whereas, during later stages, when PGAD symptoms are severe and unrelenting, this is expected to change (see Figure 2). The overall level of PGAD symptoms in this sample was low (consistent with other non-clinical samples; Jackowich & Pukall, 2020), and thus these results cannot be generalized to women who live with a diagnosis of PGAD. Disclosure No

(043) “I’m Coming!” (No, She’s Not): Inequitable Pleasure

Abstract Introduction Gendered differences in pleasure can be observed in pornography, individual pleasure (masturbation), and pleasure with partners. Objective This project intends to synthesize and review current research on gendered differences in various forms of pleasure. Methods This study is a narrative review of peer-reviewed journal articles, each of which reinforced and contextualized the existence of the pleasure gap. We considered articles that collected and analyzed data from pornography sites as well as epidemiologic data gathered from researchers studying pornography and sexual activity. Results The pleasure gap in one of pornography’s largest tube sites, Pornhub, was 60 percentage points wide: 78 percent of men were shown reaching orgasm, as compared to 18 percent of women. Regarding gender disparities in masturbation, one article found that among a sample of college students, men were twice as likely as women to have ever masturbated. Additionally, the men that had masturbated during early adolescence did so with a frequency three times higher than their female counterparts. It must be noted that, for both of these studies, the categories “men” and “women” are not clearly defined. Partnered pleasure is primarily measured by orgasm frequency within sexual partnerships. Overall, more than 90 percent of men reach orgasm during sex, as compared to 50 percent of women (note that, in this research, “men” and “women” are not defined). For self-identified men, orgasm frequency was similar across sexual orientation, whereas for self-identified women, sexual orientation dramatically influenced the occurrence of orgasms. Notably, lesbian women had a significantly higher orgasm frequency (74.7 percent), as compared to bisexual women (58 percent) and heterosexual women (61.6 percent). Conclusions This review indicates a significant gap between orgasm and masturbation rates (as proxies for pleasure) in self-identified men and women. Future directions are twofold, 1) conduct experiments on the pleasure gap to better understand its etiologies, and 2) begin to investigate pleasure beyond the constructs of orgasm, as pleasure can and does exist beyond the climax of sexual stimulation. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Blueberry Hill Strategies.

(101) Ovarian Hyperthecosis as a Cause of Hypersexualization in a Post-menopausal Female

Abstract Introduction Ovarian Hyperthecosis (OH) is a rare benign virilizing ovarian syndrome characterized by androgen overproduction due to stromal and thecal hyperplasia resulting in hirsutism and virilization(1). It is believed to be similar to polycystic ovarian syndrome (PCOS) however, presents with more robust androgen overproduction and an ovarian vein ratio of androstenedione/testosterone less than one, compared with values around 20 in pre-menopausal females and patients with PCOS(2). Specifically in post-menopausal women, the phenotypical presentation is due to unmasking of the increased thecal cell testosterone release which results from lack of granulosa cell mediated aromatization of testosterone to estradiol.(3) Some have described treatment of OH with medications that inhibit ovarian production of estrogen and progesterone especially in pre-menopausal women. However, results are mixed and oophrectomy seems to be the most effective treatment modality for OH(3). Objective Here we describe a case of OH resulting in elevated androgen levels and distressing hypersexualization in a post-menopausal female who was effectively treated with bilateral oophorectomy resulting in normalization of laboratory values and resolution of hypersexualization. Methods The patient is a 75-year-old female with past medical history significant for bipolar disorder, Sjogren’s syndrome and hypothyroidism who presented to the office for evaluation of recurrent vulvovaginitis and urinary tract infections related to vigorous and frequent sexual activity. She reported symptoms of hypersexuality developing a few years prior to presentation at which time she began engaging in sexual activity 2-3 times daily and masturbating with a variety of objects. She had also noted new heavy facial hair and scalp hair loss. There were no changes in her medical history at the time. She was bothered by the increased need for sexual stimulation and orgasm, prompting further evaluation and treatment. Her exam was notable for vulvar contact dermatitis, mild vulvovaginal atrophy, and no prolapse or urinary incontinence. Vaginal infection testing was negative. Results of an endocrine work up are summarized in Table 1. Abdominal imaging showed normal adrenal glands and ovaries. An MRI of the brain showed a normal pituitary gland. She had been started on Prozac by her psychiatrist, which reduced her libido but worsened her mania and therefore was discontinued. A diagnosis of OH was suspected and bilateral oophorectomy was planned. Results The patient underwent a laparoscopic bilateral salpingo-ophrectomy with surgical pathology confirming stromal hyperplasia and hyperthecosis. Post-operatively, her labs rapidly normalized. She noted normalization of her libido, significant improvement in vulvar contact dermatitis and increased scalp hair growth. Conclusions Bilateral oophorectomy in a post-menopausal woman with OH was an effective treatment to normalize androgen levels and restore normal libido resulting in resolution of vulvar contact dermatitis from excessive masturbation. Although an uncommon diagnosis, this disease is an important consideration in the workup of excess androgen production in post-menopausal women. Disclosure No

(039) Vaginal Orgasms: Really exists?

Abstract Introduction In 1948 Alfred Kinsey’s investigation of female and male sexuality found that 80% of women reached orgasm mainly through non-coital sexual experiences, such as oral and physical manipulation of the genitals or through sex toys. After that many peer-reviewed studies confirmed these data as well as in our practice. However, the question remains; what happened with the other 20% that reached orgasm through vaginal penetration. Objective To describe the epidemiological sexual characteristics of the 20% of women who reached orgasm mainly through vaginal penetration. Methods Over 3000 sexual histories were done in our medical center and were used to collect data regarding the reasons for the orgasm obtained through vaginal penetration. This study includes retrospective and prospective questionnaires applied to all patients seen in our centers. Results The epidemiological sexual characteristic of this specific group of women are: - 75% have had only one sexual partner in their lives - 20% of them have had two sexual partners in their life and - 5% of them have more than two. It has been very scantly found that women with a history of multiple sexual partners enjoy sexual penetration. The orgasmic response resulting from coital sex was more persistent and presently found while the number of sexual partners was less. Increased orgasmic responsiveness was also present when the initiation of the sexual activity with the partner was earlier in life. Conclusions When the sexual development of a woman is allowed to mature in the presence of a lifelong partner. Their response to penetrative vaginal stimuli is better and the obtention of sexual pleasure and orgasm reinforce this response that persists throughout life and is more attainable over any other form of vaginal stimulation. Disclosure No

(059) Comfort With Sexual Health Literacy Assessed in Urology Resident Physicians

Abstract Introduction Despite the importance of sexual health, physicians may not be adequately equipped to diagnose and treat sexual dysfunction. Topics related to healthy sexual function (pleasure, masturbation, communication, sex toys/tools, and anal sex practices) are largely omitted from medical education. It is vital that urologists are trained to ask detailed questions about sexual health, counsel on healthy sexual habits, and identify and treat sexual dysfunction. Objective To determine the level of comfort among urology residents in taking a comprehensive sexual health history, identifying sexual dysfunction, and treating patients of various gender identities and sexual orientations. Methods An anonymous electronic survey was distributed to current urology residents in the United States. The survey contained five demographics questions and twenty-three questions tied to sexual health competencies. Participants were asked to provide their education year, current age, medical school location, residency location, and estimated hours of sexual health education during training (excluding STI/STD content). Survey questions targeted previously established sexual education competency domains. Results A total of 52 urology residents participated in the study. Participant post-graduate years ranged from 1-6. 61.5% of participants stated they received only 0-3 hours of formal sex education during medical school and 46.3% reported having any formal sex education during urology residency. 80% of participants felt comfortable asking patients about self-erogenous stimulation, but only 27% of responders felt comfortable answering questions about anal stimulation devices, and 35% of responders felt comfortable answering questions about vaginal stimulation devices. Greater than 94% of residents feel “very comfortable” or “somewhat comfortable” with describing male sexual dysfunction and performing physical exam for a man with sexual dysfunction, but only 59% felt the same towards female sexual dysfunction. When describing medicines used for sexual function, 100% of residents are comfortable doing so for men, but only 63% are comfortable doing the same for women. When counseling transgender males or females on sexual practice/therapies/surgeries, only 29% of residents felt comfortable. Conclusions There are knowledge gaps in sexual medicine literacy confidence among urology residents surveyed. Lack of a comprehensive sexual health education curriculum during medical training may be affecting patient care. Women and sexual and gender minority (LGBTQ) patients may be at higher risk of being treated by a urologist without comfort in managing their sexual health. Sexual health education optimization during urology residency has the potential to promote improved understanding of the sexual health of women and sexual and gender minorities and improve the evaluation and management of sexual dysfunction in general. Disclosure No

Examining Attentional Biases Elicited by Sexual Stimuli Using MouseView.js: An Online Paradigm to Mimic Eye Movements

ABSTRACT Attention is a key mechanism underlying many aspects of sexuality, with eye-tracking studies revealing that attention is both sustained by sexual stimuli and corresponds with sexual interest. Despite its utility, eye-tracking experiments typically require specialized equipment and are conducted in a laboratory setting. The overarching objective of this research was to assess the utility of a novel online method, MouseView.js, for assessing attentional processing of sexual stimuli outside of a laboratory context. MouseView.js is an open-source, web-based application where the display is blurred to mimic peripheral vision and an aperture is directed using a mouse cursor to fixate on regions of interest within the display. Using a discovery (Study 1, n = 239) and replication (Study 2, n = 483) design, we examined attentional biases to sexual stimuli among two diverse samples with respect to gender/sex and sexual orientation. Results revealed strong attentional biases toward processing sexual stimuli relative to nonsexual stimuli, as well as dwell times that correlated with self-report sexuality measures. Results mirror those observed for laboratory-based eye-tracking research, but using a freely available instrument that mirrors gaze tracking. MouseView.js offers important advantages to traditional eye-tracking methods, including the ability to recruit larger and more diverse samples, and minimizes volunteer biases.

(529) Etiology of Erectile Dysfunction in Patients who Underwent Endourological Procedures for Prostate vs. Robotic and Open Radical Prostatectomy.

Abstract Introduction Erectile dysfunction continues to be a concern for patients and physicians after surgical treatment of prostate pathology. Objective To analyze doppler diagnosis on patients who underwent prostate surgery for benign or malignant pathology of the prostate. Methods We retrospectively analyzed all patients who underwent either robotic assisted prostatectomy (RALP), open retropubic prostatectomy (RRP), endoscopic procedures such as greenlight procedure, laser resection of the prostate or transurethral resection of the prostate (TURP); and High Intensity Focused Ultrasound (HIFU) treatment for prostate pathology and who underwent intracavernous injection followed by Color Doppler Duplex Ultrasound (CDDU) at our institution between 2005 and 2019. CDDU findings were recorded following injection of low dose alprostadil (10-20 mcg) and again after a period of privacy and visual sexual stimulation. CCDU findings including peak systolic velocities (PSV), and resistive indices (RIs) were recorded. Arterial insufficiency (AI) was defined as either a post-stimulation PSV < 25 with any RI or a PSV 25-34.9 with RI≥0.9. Cavernous Venous Occlusion Disease (CVOD) was defined as post-stimulation PSV ≥35 with RI < 0.9. Mixed was defined as post-stimulation PSV 25-34.9 with RI < 0.9. Vascular normal was defined as post-stim PSV ≥ 35 with RI ≥ 0.9. Results 380/1917 (19.8%) patients had a past surgical history of prostate surgery. 111/380 (29.2%) underwent RRP, 168/380 (44.2%) patients underwent RALP, 85/380 (22.3%) underwent endourological resection of the prostate and 2/380 (0.5%) patients underwent HIFU. Median age for the RALP group was 60.5 (IQR 23.7-82.8), RRP group was 64.2 (29.7-87.7), endourological resection of the prostate 64.6 (30.8 – 85.6) and HIFU 65.0 (46.9-79.4). 87.1% of patients who had an endoscopic procedure were using phosphodiesterase-5 inhibitors at the time of CDDU. CVOD was the most common etiology of ED in patients who underwent RRP (28.8%) and Endourological procedures of the prostate (32.9%); In patient who underwent RALP the most common etiology of ED was noted to be AI (28.6%), however none of these values were statistically significant (p=0.428). Conclusions There is no difference in etiology of ED in patients who underwent open, robotic or endoscopic manipulation of the prostate as shown by CDDU. Disclosure No