Hypersexuality Research Articles

Perceptions of menopause among rural women of Lahore.

The present study was undertaken to document the perceptions of Pakistani women regarding menopause. Cross-sectional descriptive study. The study was conducted in the suburb of Lahore from 1st July 2000 to 31st August 2000. The data were collected from a rural population of 28,419 individuals living in 20 villages outside Lahore. A systematic random sample of 130 women was drawn from those 1337 women, who had reached natural menopause. In-depth interviews were conducted in local dialect. The age of the population ranged from 42 to 80 years with a mean of 59.8+/-7.4 years. The mean age at menopause was 49.0+/-3.6 years. Majority of the women (82.3%) considered menopause as a positive change. According to 71.6% women, their relationship with the family had either improved or there was no change. There was an increase in libido among 70.5% women, decrease in libido among 5.7% and no change among 23.8% women. However, 16.9 % women reported dyspareunia. Seven percent of the women suffered a fracture after menopause. None of the study subjects reported postmenopausal bleeding. Three women (2.3%) had cardiac ailments. The proportion of women showing a positive attitude towards menopause was significantly higher (p<0.005) among our study subjects as compared to those from India, Thailand, USA and Australia. The majority of study subjects did not consider menopause as a negative milestone, loss of time, a partial death or a disease as seen in many western populations. On the contrary menopause is regarded as a natural phase in a woman's reproductive life

Effect of reproductive hormones and selective estrogen receptor modulators on mood during menopause.

Periods of intense hormonal fluctuations have been associated with heightened prevalence and exacerbation of underlying psychiatric illness, particularly the occurrence of premenstrual dysphoria, puerperal depression and depressive symptoms during perimenopause. It has been speculated that sex steroids such as estrogens, progestogens, testosterone and dehydroepiandrosterone (DHEA) exert a significant modulation of brain functioning, possibly through interactions with various neurotransmitter systems. It is therefore intuitive that abrupt alterations of these hormones would interfere with mood and behaviour. On the other hand, accumulating data suggest that hormonal interventions may also promote relief or even remission of depressive symptoms, as already demonstrated in studies with patients experiencing postpartum depression and perimenopausal depressive disorders. The extent to which perimenopause, alone, may increase the risk for depression is unclear. However, existing data strongly suggest that some women are particularly vulnerable to developing significant physical and psychological disturbances when entering perimenopause. This article reviews the effect of sex hormones and selective estrogen receptor modulators (SERMs) on mood among peri- and postmenopausal women. There are preliminary, though promising, data on the use of estradiol (particularly transdermal estradiol) to alleviate depression during perimenopause, use of a combination of estrogens and selective serotonin reuptake inhibitors for depression during the postmenopausal period, and the use of testosterone to improve psychological well-being and increase libido among women with induced menopause. Further studies would help to better delineate the usage of hormones as an antidepressant strategy (monotherapy or augmenting treatment) for peri- and postmenopausal women. A brief review of some nonhormonal interventions for the treatment of menopause-related symptoms that may significantly affect a woman's quality of life is also presented. There are some preliminary data suggesting the efficacy of antidepressants for the treatment of hot flushes; existing data on diet supplements and herbal products have shown more mixed results.

The World Will Do Whatever It Pleases and Energy Will Be Conserved

Accessible online at: www.karger.com/ibe A main thrust of modern journalism, it seems, is to try to worry people. Good news doesn’t sell newspapers and in the absence of catastrophe worrying people is second best to reporting disasters. Fortunately, there are always plenty of pots of worry bubbling quietly away on the back burner waiting to be pulled forward and offered as anxiety fare to the masses. Government misbehaviour, criminal activities, sex maniacs in our midst whose proclivities are weighed for maximum worry response. And the best stand-by of all: the planet earth. It’s in a bad way, they say, and it’s all our fault. The more we understand about the evolution of the solar system, the evolution of the earth, the evolution of life on the earth the less, it seems, do we use that knowledge. The recent geological record, that is just the last few million years, reveals in the rocks such things as ice ages, droughts, deluges, periods of hot and cold. This was all a long time ago and there are those who would have us believe that it’s different now, that was the past, the earth has now settled down. The same people also say that this stable state is in danger and could easily go out of control and almost certainly will unless we mend our ways and stop trashing our own backyards. Although meteorological records have only been collected more or less continuously since the late 18th century there are plenty of earlier references to the weather in the literature. These show that some years it was hot and dry and others cold and wet and that there were long periods when it was warmer than today and others when it was colder. It has been well recorded that one thing that you can rely on in this uncertain world is that the climate will vary. It always has done; it, presumably, always will. To talk as some do, and many politicians used the phrase during the recent Johannesburg Conference, of a ‘sustainable climate’ for which the Conference was a ‘blueprint’ is a nonsense. They were talking of controlling global warming and while I accept that there is an argument that the globe is indeed warming I am inclined to say – but so what, if it is, there is nothing we can do about it. Global warming comes and goes. There was a big ice age round about 20,000 years ago, a mini-ice age around 500 years ago from which we may still be emerging and another 1,000 years earlier and the alleged human-made one during which we are living. That the ice ages occurred seems certain but whatever is happening at the present time is insignificant in comparison. Note that it can get colder during global warming – it just depends where you live. One concern that is often voiced is that as it gets warmer glaciers will retreat, the ice caps melt and sea levels rise. Well, the ice caps have been melted in the past and since the last ice age 20,000 years ago, the sea level has been increasing at an average of 6 mm/year, and is currently rising 1–3 mm/year, which is a lower rate of increase than in prefossil fuel burning times. In the period between the two most recent mini-ice ages it was warmer than today. In the time known as the Medieval Warm Period, around the years 1100–1300, it has been deduced that temperatures were probably 2–3°C higher than today. From about 400 years ago after another miniice age and certainly by around 1700 temperatures were again rising, this at a time that preceded the Industrial Revolution. Perhaps human production of compounds such as carbon dioxide can raise the temperatures in previous centuries? Politically not such a silly comment since politicians barely tilt their caps to science and universally eschew all reference to and probably have no knowledge of thermodynamics. Certainly there is little rational thought in the politics of energy production or energy transfer.

A DSM-IV Axis I comorbidity study of males (n = 120) with paraphilias and paraphilia-related disorders.

One hundred and twenty consecutively evaluated outpatient males with paraphilias (PAs; n = 88, including 60 sex offenders) and paraphilia-related disorders (PRDs; n = 32) were systematically assessed for certain developmental variables and DSM-IV-defined Axis I comorbidity. In comparison with the PRDs, the PA group was statistically significantly more likely to self-report a higher incidence of physical (but not sexual) abuse, fewer years of completed education, a higher prevalence of school-associated learning and behavioral problems, more psychiatric/substance abuse hospitalizations, and increased employment-related disability as well as more lifetime contact with the criminal justice system. In both groups, the most prevalent Axis I disorders were mood disorders (71.6%), especially early onset dysthymic disorder (55%) and major depression (39%). Anxiety disorders (38.3%), especially social phobia (21.6%), and psychoactive substance abuse (40.8%), especially alcohol abuse (30%), were reported as well. Cocaine abuse was statistically significantly associated with PA males (p = .03). There was a statistically significant correlation between the lifetime prevalence of Axis I nonsexual diagnoses and hypersexual diagnoses (PAs and PRDs). The prevalence of retrospectively diagnosed attention deficit hyperactivity disorder (ADHD) was 35.8%, the third most prevalent Axis I disorder. ADHD (p = .01), especially ADHD-combined subtype (p = .009), was statistically significantly associated with PA status. ADHD was statistically significantly associated with conduct disorder, and both of these Axis I disorders were associated with the propensity for multiple PAs and a higher likelihood of incarceration. When the diagnosis of ADHD was controlled, the differences reported above between PAs and PRDs either became statistically nonsignificant or remained as only statistical trends. Thus, ADHD and its associated developmental sequellae and Axis I comorbidities was the single most common nonsexual Axis I diagnosis that statistically significantly distinguished males with socially deviant sexual arousal (PAs) from a nonparaphilic hypersexual comparison group (PRDs). Sex offender paraphiliacs were more likely to be diagnosed with conduct disorder, alcohol abuse, cocaine abuse, and generalized anxiety disorder. The prevalence of any ADHD in the sex offender paraphiliacs was 43.3%, and nearly 25% of offenders were diagnosed with ADHD-combined subtype.

Genetic and environmental influences on problematic masturbatory behavior in children: a study of same-sex twins.

Child sexual behavior problems, such as excessive or public masturbation, are often judged to result from environmental stress or trauma. We studied the relative importance of genetic and environmental factors for problematic masturbatory behavior among nonreferred prepubertal children. All twins born in Sweden in 1985-86 were identified from the Swedish Twin Registry. Parents, mainly mothers, completed Child Behavior Checklist (CBCL) ratings (Achenbach, 1991) for 401 monozygotic (MZ) and 248 dizygotic (DZ) same-sex twin pairs (male-male or female-female) at age 7-9 years. Scores of two CBCL items concerning specific sexual behavior problems (Plays with own sex parts in public and Plays with own sex parts too much) were summed and the influence of genetic and environmental factors on variability assessed. The prevalence of problematic child masturbatory behavior was low and associated with other emotional and behavioral problems. The degree of problematic child masturbatory behavior resemblance was higher within MZ twin pairs as compared to DZ same-sex twin pairs. Model fitting indicated that genetic factors substantially influenced the studied behaviors (77%, 95% CI = 9-96%), although family environment also played a role. Our results suggest that hereditary factors should be considered together with stressful experiences such as sexual victimization in the evaluation of elementary school children presenting with problematic masturbatory behaviors. When interpreting the findings, the very brief measure of sexual problem behavior and low statistical power, precluding the analysis of possible coinheritance with other symptoms or disorders, should be borne in mind.

Love that maca

There is a long history of the search for aphrodisiacs, and a wartlike growth found on plant roots in the Andes might contain the latest potency. Preliminary results come from a team of Peruvian scientists and show that the root growth known as maca can increase sperm production and virility in men aged 20 to 40. Gustavo Gonzales told the newswire Agence France Presse (16 August 2001) that within two weeks of taking the secret compound, the number of sperm in test subjects increased from 87 million to 183 million sperm. Gonzales also noted an increase in libido during the test period. Maca is already in Peruvian markets and exports are starting. TS

Masculinity and Sexuality: Selected Topics in the Psychology of Men

Masculinity and Sexuality: Selected Topics in the Psychology of Men

The Paraphilia-Related Disorders: A Proposal for a Unified Classification of Nonparaphilic Hypersexuality Disorders

This article introduces a description of a group of nonparaphilic hypersexual behavior disorders, the paraphilia-related disorders (PRDs). The rationale for the definition and characterization of these behaviors is described and empirical literature supporting the concept of PRDs is reviewed. The common paraphilia-related disorders include compulsive masturbation, protracted promiscuity, pornography dependence, cybersex dependence, telephone sex dependence, severe sexual desire incompatibility and paraphiliarelated disorder not otherwise specified. The comorbid associations and clinical characteristics supporting the evidence that PRDs are indeed related to paraphilic disorders are described. The case is made that the classification of nonparaphilic hypersexual disorders as "paraphilia-related disorders" avoids the confusing use of characterizations such as "addiction" or "compulsivity" when applied to a broad range of sexual appetitive behavior disorders.

The Differential Diagnosis of Problematic Hypersexuality

In this article, we review the diagnosis, classification, and differential diagnosis of problematic hypersexuality. The estimated frequency, morbidity, comorbidity, mortality, and the associated societal issues underscore the necessity for improved recognition, better understanding, and more effective treatment for this disorder. In general, hypersexual behavior does not seem to be evaluated, classified, or monitored in the same manner as other innate behaviors like feeling, thinking, sleep, or eating, despite the fact that hypersexual behavior is among the criteria for several psychiatric disorders. More widespread clinical use of acceptable diagnostic criteria for problematic hypersexuality would further elucidate the relationships among problematic hypersexuality and other psychiatric disorders.

Excessive Sexual Desire Disorder Among Sexual Offenders: The Development of a Research Project

This article describes our research to date and our plans to extend this research to sexual offenders who have the features of what has variously been called sexual addiction, sexual compulsivity, sexual impulsivity, sexual obsessive compulsive disorder, or excessive sexual desire disorder. We use the latter descriptor for convenience. To date our research has revealed some differences between sexual offenders with and without ESD. We describe these findings and then outline our future research plans.

What's in a Name? Terminology for Designating a Syndrome of Driven Sexual Behavior

Most clinicians and researchers would agree that a condition exists in which a person's driven sexual behavior causes either subjective distress or functional impairment. However, questions remain about how this condition should be designated. This article considers the designations that are most often employed--sexual compulsivity, sexual impulsivity, and sexual addiction--and concludes that sexual addiction is the most suitable. Arguments against the concept of sexual addiction are then reviewed and addressed. Finally, the implications of the proposed terminology for treatment are explored.

The role of medications in the treatment of paraphilia-related disorders

The role of medications in the treatment of paraphilia-related disorders

A hundred years of narcolepsy research.

The emergence of a clinical syndrome: The first convincing descriptions of narcolepsy-cataplexy were reported in Germany by Westphal (1877) (100) and Fisher (1878) (25). The unique association of episodes of muscle weakness triggered by excitement and sleepiness were described in these two reports. In both cases, hereditary factors were noted, with the mother of Westphal’s patient and one sister of Fisher’s patient presenting narcolepsy symptoms. The leading hypothesis to explain narcolepsy at the time was to refer to the well publicized case of von Zastrow. Von Zastrow was a recently arrested pathological rapist widely believed to experience pathological sleepiness as a result of repressed homosexuality and excessive masturbation. Gelineau (1880) (28, 29) is widely recognized for giving narcolepsy its name and for recognizing the disorder as a specific clinical entity. Its description of a wine cask maker with narcolepsy in la Gazette des hopitaux de Paris was classical but Gelineau did not strictly differentiate muscle weakness episodes and sleep attacks triggered by emotions. Rather, Gelineau suggested a common physiology for these two symptoms. Loewenfeld (1902), was the first to give a name to muscle weakness episodes triggered by emotions or “cataplexy” (53). The 1917-1927 epidemic of encephalitis lethargica led to a renewed interest in narcolepsy and sleep research but also added much confusion to the nosological definition of narcolepsy. Encephalitis lethargica often presented initially with somnolence and the term “narcolepsy” was often used to describe any form of daytime sleepiness. The association of somnolence and occulomotor paralysis also led to the pioneer work of Von Economo (1930) and the recognition of the posterior hypothalamus as a critical region for the promotion of wakefulness (98). In fact, Von Economo should be credited as being one of the first investigators to correctly propose that a region in the posterior hypothalamus was lesioned in human narcolepsy. In 1930, he wrote: “it is very probable, though not proved, that the narcolepsy of Gelineau, Westphal and Redlich has its primary cause in an yet unknown disease of that region” (98). As narcolepsy with cataplexy was also observed in some cases of encephalitis lethargica, clinicians long debated the existence of idiopathic narcolepsy and the importance of cataplexy for defining the clinical entity. Large case series of narcolepsy-cataplexy were reported by Addie (1926) (1), Wilson (1927) (101) and Daniels (1934) (17). The review by Daniels is considered by many as one of the most insightful clinical reviews published to this date. Further work at the Mayo Clinic, by Yoss and Daly (103) and in Prague by Bedrich Roth (91), then led to the classic description of the narcolepsy tetrad. Various methods were initially proposed in the treatment of narcolepsy, including intrathecal injection of air, cerebrospinal fluid removal and X-ray irradiation of the hypothalamic region. Ephedrine treatment was generally used as the only marginally effective treatment for daytime sleepiness until Prinzmetal and Bloomberg introduced amphetamines in 1935 (87). Yoss and Daly introduced methylphenidate in the 1960s (104). Shortly after the discovery of t r icycl ic antidepressants in 1957, Akimoto, Honda and Takahashi used imipramine in the treatment of human cataplexy (2), e s t a b l i s h i n g t h e d u a l stimulant/antidepressant pharmacological treatment most commonly used in narcoleptic patients to this date.

Another Dietary Supplement, Another Drug of Abuse

The industrial solvent, 1,4-butanediol, has become an abused substance. Touted as a dietary supplement to promote euphoria, the development of muscles, loss of fat, and increase in libido, it is rapidly converted to gamma hyroxybutyrate, a metabolite of GABA. 1,4-Butanediol apparently is widely available under …

A study of male sexual health problems in a Mumbai slum population

Conducted in a Mumbai slum population, this study examines the vocabulary men use to describe sexual health problems, cultural views about categorization, and the views of local health practitioners. Structured qualitative methods including free-listing, pile sorting and ratings were used. In addition to sexually transmitted infections, men are equally or more concerned about the quality and quantity of semen and 'impotence', which includes erectile deficiencies and premature ejaculation. A number of problems that may be indicative of the presence of STIs are thought to be transmitted through both sexual contact and other means subsumed under the category garmi. Men, as well as untrained non-allopathic sexual health practitioners, perceived the indiscreet wastage of semen through excessive masturbation, wet dreams or excessive sexual desire to be a major cause of these problems. A comprehensive reproductive health programme should address these male sexual health problems in order to motivate men to play more active and positive roles in reproductive health and family planning.

Treatment of Paraphilia with Luteinizing Hormone-Releasing Hormone Agonists

Up to now there have been no published results of therapy of paraphilia (for example, pedophilia or sadism) and sexual aggressive impulsiveness with luteinizing hormone-releasing hormone (LHRH) agonists in the German-speaking countries. After a short intoduction about physiologic features and the present state of investigations in treatment of paraphilia with LHRH agonists we describe 11 patients who were treated with the LHRH agonist Leuprolide Acetate over a period of 12 months. The patients showed no tendency toward sexually aggressive behavior and reported an evident reduction of penile erection, ejaculation, masturbation, sexually deviant impulsiveness, and fantasies. One patient died from suicide. In combination with other treatments, LHRH Agonists seem to be a very promising alternative to cyproterone acetate and its possible carcinogene effects.

Disorders of sexual impulse control in neuropsychiatric conditions.

This article reviews hypersexuality in individuals with neuropsychiatric disorders and its psychopharmacologic treatment. A brief review of the neurology, neuroendocrinology, and neuropharmacology of sexual behavior is presented. Literature describing the occurrence and treatment of hypersexuality in individuals with neuropsychiatric disorders is reviewed along with literature which discusses the pharmacologic treatment of individuals with hypersexual disorders in nonneuropsychiatric populations. Finally, a clinical algorithm for approaching and treating such disorders in a neuropsychiatric population is presented.

Childhood Abuse and Platelet Tritiated-Paroxetine Binding in Bulimia Nervosa

Co-occurrence of bulimia nervosa and borderline personality disorder has been attributed to shared factors, including childhood abuse and disturbances in central serotonin (5-hydroxytryptamine; 5-HT) mechanisms. To explore this notion, we conducted a controlled assessment of childhood abuse and 5-HT function in bulimics with and without borderline personality disorder. Forty patients with bulimia nervosa, confirmed with the Eating Disorders Examination interview (14 with borderline personality disorder and 26 without), and 25 normal-eater controls were assessed for clinical symptoms (eating disturbances, mood lability, impulsivity, and dissociation) and childhood sexual and physical abuse. We also conducted tests of platelet tritiated-paroxetine binding in blood samples from 27 of the bulimics (11 with borderline personality disorder and 16 without) and 16 of the controls. Relative to normal eaters, bulimics showed greater affective instability, overall impulsivity, and a history of physical abuse. However, borderline bulimics alone showed elevated motor impulsivity, dissociation, and rates of sexual abuse. Paroxetine-binding tests indicated no differences attributable to comorbid borderline personality disorder, instead linking bulimia nervosa with or without borderline personality disorder to substantially reduced 5-HT transporter density. Results suggest relatively autonomous pathologic entities: one, relevant to bulimia nervosa, being associated with abnormal 5-HT transporter function and affective instability, but relatively independent of childhood sexual abuse; another, relevant to borderline personality disorder, onto which sexual abuse, dissociative symptoms, and behavioral impulsivity converge. We propose that abnormal 5-HT function may, however, constitute one basis for the frequent co-occurrence of bulimic and borderline disturbances.

Psychopharmacologic Treatments for Nonparaphilic Compulsive Sexual Behaviors

This article reviews the use of pharmacologic agents to treat nonparaphilic compulsive sexual behaviors (paraphilia-related disorders). Recent data suggest that serotonergic antidepressants, especially serotonin reuptake inhibitors (SRIs), may be effective in treating nonparaphilic sexual behaviors characterized by hypersexuality. The rationale, prescriptive use, and limitations of SRIs are reviewed, as are the proposed mechanisms of action, prescriptive use, and side effects of medications that lower serum testosterone (including triptorelin and the antiandrogens medroxyprogesterone acetate and cyproterone acetate).The potential use of psychostimulants, mood stabilizers, and atypical antipsychotics for paraphilia-related disorders in specific clinical situations is discussed. Practical guidelines, augmentation strategies with adjunctive psychopharmacologic agents, and indications regarding pharmacologic combinations of the above medications are suggested.

Muscular strength, body composition and health responses to the use of testosterone enanthate: a double blind study

To determine the effect the steroid, testosterone enanthate (TE) had on upper body strength, body composition and health. Twenty one male weight training subjects were randomly assigned in a double blind method to either a 3.5 mg(-1) x kg(-1) TE (n=11) or placebo (n=10) weight training group. The subjects were monitored during a 12 week administration phase and a subsequent 12 week follow up phase. Subjects were tested on a number of strength and size measurements, whilst having their health monitored. The results from the study revealed that the testosterone/weight training group improved significantly (p<0.05) more than the placebo/weight training group during and immediately after the administration phase on a 1 repetition maximum bench press. With regards to body composition, body weight, arm girth and rectus femoris circumference all increased significantly greater in the TE group compared to the placebo. Furthermore, the abdomen skinfold showed significant decreases in the TE group compared to the placebo group at post testing, follow up mid testing and the follow up post testing occasions. With the exception of the abdomen skinfold no within or between group differences were evident following a cycling off period of 12 weeks. Changes to baseline health indicators were reported in some subjects following testosterone usage. This included an average elevation in systolic blood pressure in all TE subjects by 10 mm Hg, a mild increase in hereditary frontal alopecia, increased muscle tightness (hamstrings and pectorals), a mild increase in libido over the first two weeks with a subsequent fall to normal, mild acne, subjective changes to personality including an increase in aggression, irritability and positive mood responses. Consequently, moderate doses of TE combined with weight training can result in short term significant changes in upper body strength and body composition, with corresponding changes to baseline health in some individuals.