Male Sexual Desire Research Articles

Clinical application of eight-zone laparoscopic dissection strategy for rectal cancer: Experience and discussion.

The incidence of rectal cancer is increasing worldwide, and surgery remains the primary treatment modality. With the advent of total mesorectal excision (TME) technique, the probability of tumor recurrence post-surgery has significantly decreased. Surgeons' focus has gradually shifted towards minimizing the impact of surgery on urinary and sexual functions. Among these concerns, the optimal dissection of the rectal lateral ligaments and preservation of the pelvic floor neurovascular bundle have become critical. To explore the optimal surgical technique for TME and establish a standardized surgical protocol to minimize the impact on urinary and sexual functions, we propose the eight-zone dissection strategy for pelvic floor anatomy. To compare the differences in surgical specimen integrity and postoperative quality of life satisfaction between the traditional pelvic floor dissection strategy and the innovative eight-zone dissection strategy. We analyzed the perioperative data of patients who underwent laparoscopic radical resection of rectal cancer at Qilu Hospital of Shandong University between January 1, 2021 and December 1, 2023. This study included a total of 218 patients undergoing laparoscopic radical surgery for rectal cancer, among whom 109 patients underwent traditional pelvic floor dissection strategy, and 109 patients received the eight-zone dissection strategy. There were no significant differences in general characteristics between the two groups. Patients in the eight-zone dissection group had higher postoperative specimen integrity (88.1% vs 78.0%, P = 0.047). At the 3-month follow-up, patients in the eight-zone surgery group had better scores in urinary issues (6.8 ± 3.3 vs 5.3 ± 2.5, P = 0.045) and male sexual desire (2.2 ± 0.6 vs 2.5 ± 0.5, P = 0.047) compared to the traditional surgery strategy group. This study demonstrates that the eight-zone dissection strategy for laparoscopic lateral ligament dissection of rectal cancer is safe and effective. Compared with the traditional pelvic floor dissection strategy, this approach can reduce the risk of nerve injury and minimize the impact on urinary and sexual functions. Therefore, we recommend the clinical application of this strategy to better serve patients with rectal cancer.

P-488 The importance of identifying and addressing sexual functioning in couples with unexplained infertility

Abstract Study question How is the sexual functioning of newly diagnosed unexplained infertile couples and which factors are associated? Summary answer At least 25% of couples are at risk of sexual dysfunction. Sexual functioning is associated with age, infertility duration, sperm quality, personal and relational wellbeing. What is known already A large proportion of unexplained infertile couples have the ability to conceive naturally over time. Sexual functioning is important for natural conception rates, but infertility is associated with reduced sexual functioning. Surprisingly, sexual functioning and its risk-factors are still understudied in unexplained infertility. Knowing the risk factors for reduced sexual functioning would enable fertility specialists to timely diagnose, prevent or treat sexual dysfunction, and in this way improve natural conception rates. The current literature is mainly based on individual-level data, neglecting the fact that observations, such as sexual functioning, arising from couples are not independent. Study design, size, duration Cross-sectional digital survey data and medical chart factors, which also served as the baseline assessment of a randomized controlled trial (Pleasure&Pregnancy, trial registration number NTR5709), were subjected to a dyadic analysis followed by linear regression. A total of 700 heterosexual couples recently diagnosed with unexplained infertility in secondary or tertiary fertility clinics were addressed between 2016 and 2021. Participants/materials, setting, methods Heterosexual couples (female age 18-38 year) with unexplained infertility and who were able to have coitus were eligible. Sexual functioning was assessed with the Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF). Determinants included demographic, lifestyle and diagnostic and wellbeing factors as assessed with the Hospital Anxiety and Depression Scale (HADS) and the Revised Dyadic Adjustment Scale (R-DAS). B represents the impact on sexual functioning when a factor changes 1 unit. Main results and the role of chance A total of 581 (83%) women and 478 (68%) men filled out questionnaires. Survey data and medical chart factors were available for 451 couples. About one in four women (24.3%) and one in fourteen men (7.3%) were at risk of respectively female sexual dysfunction and erectile dysfunction after fertility work-up. Couples had a mean coital frequency of 7 times per month (SD 2.7). Higher female and male sexual desire (B: 0.04, p<0.01 and B: 0.02, p<0.02) and satisfaction (B: 0.03, p<0.01 and B: 0.06, p<0.01), but not orgasm were significantly associated with increased coital frequency. Own age (B: -0.64), anxiety (B: -9.47), depression (B: -7.61) and relationship distress (B: -8.97), and partners’ relationship distress (B: -5.08) and total motility sperm count (B: -4.88) were associated with lower female sexual functioning. Own age (B: -0.17), anxiety (B: -5.03), depression (B: -3.65), relationship distress (B: -5.77), and partners’ age (B: -0.46) and relationship distress (B: -3.14) and couples’ duration of infertility (B: -0.24) were associated with lower male sexual functioning. Limitations, reasons for caution The study is prone to selection bias given the inclusion of couples seeking medical help, consenting to a RCT and were having coitus. Not all previous identified determinants of sexual functioning were studied due to factors as missing data, low case numbers or not being assessed in the Pleasure&Pregnancy RCT. Wider implications of the findings Clinicians advising couples with unexplained infertility to continue natural conception, need to be aware that at least 25% of couples are at risk of sexual dysfunction. Clinicians should consider risk factors of reduced sexual functioning, take a sexual anamnesis and advice sexual counselling and treatment if indicated. Trial registration number Baseline assessment of RCT (Pleasure&Pregnancy) with trial registration number NTR5709

Melukis Kembali Penggambaran Citra Gender dalam Media Massa

In Netflix’s 'Ice Cold,' which delves into the murder of Jessica by Mirna, she is often praised and forgiven for her beauty. The documentary even states that the killer is a handsome figure. Women seem to be forced to conform to the image of modern women, who should hold feminist paradigms. Digital television content, as one of the mass media platforms, often portrays women as limited to the role of 'subordinates.' The existence of women is frequently reduced solely to their physical dimensions. It is as if advertisements and television programs would feel empty without the presence of women celebrated as objects. This perspective eventually becomes ingrained in the minds of modern women, largely through the influence of mass media, while commercial demands and the race for the highest ratings are the primary reasons why women continue to be used as complementary objects in various media content.This research employs Roland Barthes' Semiotics to explore how religious education, the male gaze, mass media, and societal views interact in shaping the contemporary perception of the female body. Ironically, the excessive use of patriarchal media has made women feel more liberated to express themselves and actualize their potential in various aspects of life. In this context, elements of religious education play a crucial role, as some Abrahamic religious teachings promote gender hierarchies that can influence society's perception of women and result in gender inequality. The concept of the male gaze is also relevant in this analysis, as it refers to how the male perspective dominates the understanding and representation of women in media, often reducing women to objects of male sexual desire. This research can offer valuable insights into the interconnection of these perspectives and women's potential for increased self-expression within patriarchal-dominated environments.

(121) DISCREPANCY IN SEXUAL DYSFUNCTION, SEXUAL DESIRE, AND RELATIONSHIP SATISFACTION BETWEEN MALE AND FEMALE PARTNERS DURING THE POSTPARTUM PERIOD AND THE IMPACT OF POSTPARTUM DEPRESSION

Abstract Introduction Studies suggest that changes in sexual health and relationship satisfaction are common in women during pregnancy and postpartum, however these are often overlooked during postpartum care. Furthermore, one in seven women experience additional challenges of postpartum depression within the first postnatal yea. Studies have recognized depression as a major predictor for reduced sexual desire and satisfaction. There is little empirical data on the impact of postpartum depression on the sexual health of both male and female partners and relationship satisfaction. Objective This study assesses the relationship between postpartum depression, relationship satisfaction, and sexual satisfaction at three postpartum time points: immediate, six weeks, and twelve weeks postpartum, in postpartum patients and their partners. Methods This longitudinal study was conducted on heterosexual couples recruited from the postpartum unit, excluding patients with pregnancy complications. Each partner was consented immediately postpartum and individually surveyed to evaluate their sexual desire, relationship satisfaction, and sexual dysfunction immediately, 6 weeks, and 12 weeks postpartum. The Sexual Desire Inventory-2, Sexual Dysfunction Questionnaire, and Couples Satisfaction Index were utilized. Mothers were additionally screened for postpartum depression using the Edinburgh Postnatal Depression Scale at the three time points. We then conducted a retrospective chart review from 6 and 12 week postpartum visits to investigate delivery details and sexual dysfunction screening as reported in clinic documentation. Results This sample consisted of 89 female (54.60%), and 74 male (45.40%). 5 had postpartum depression at least 1 timepoint (8.20%). Sexual desire differed significantly between female and male partners over the entire postpartum period (p < 0.01), and relationship satisfaction differed significantly over time throughout the postpartum period across both female and male partners (p < 0.01). Across the entire postpartum period, female partner sexual desire scores were, on average, 7.02 units lower than male partner sexual desire scores (Mean Difference; 95% CI: -7.02; -11.02, -3.02), meaning that female partner sexual desire was significantly lower than male partner sexual desire throughout the postpartum period. For both female and male partners, relationship satisfaction scores were significantly lower at 12 weeks postpartum (p < 0.01) and at 6 weeks postpartum (p < 0.01) as compared to immediately postpartum, meaning that both female and male partners were significantly less satisfied with their relationships at 6 weeks postpartum and at 12 weeks postpartum as compared to immediately postpartum. 82% females were not screened for sexual dysfunction at 6 weeks postpartum and 2% were screened. Conclusions Discrepancy in relationship satisfaction and sexual desire between male and female partners was found throughout the postpartum period. Yet, a majority of patients are not screened for sexual dysfunction at their 6 week postpartum visit. These findings elucidate the need to normalize and address sexual health during the postpartum period as standard of care, including screening and treatment, in both male and female partners. Disclosure No.

Jung's Erotic Phenomenology: I. A New Translation.

In the introduction to The Psychology of the Transference (1946), Carl Jung sketched out a theory of "erotic phenomenology" which condenses his teaching about sexuality and romantic love into a very concise summary. But the meaning of this passage is obscured in the English translation given in the Collected Works of C. G. Jung. I propose here a new translation which makes Jung's meaning clearer, along with a commentary which explains it in the context of Freudian drive theory and German 19th century philosophy. Invoking the concepts of instinct, mind, and Eros (both the passion and the divine figure), Jung's theory says that male sexual desire can be cultivated or repressed in four distinct ways, each associated with a female symbolic figure or anima image: Eve, Helen, Mary and Sophia.

Can ChatGPT help patients understand their andrological diseases?

We aimed to assess the reliability of Chat Generative Pre-training Transformer (ChatGPT)'s andrology information and its suitability for informing patients and medical students accurately about andrology topics. We presented a series of systematically organized frequently asked questions on andrology topics and sentences containing strong recommendations from the European Association of Urology (EAU) Guideline to ChatGPT-3.5 and 4.0 as questions. These questions encompassed Male Hypogonadism, Erectile Dysfunction and Sexual Desire Disorder, Disorders of Ejaculation, Penile Curvature and Penile Size Abnormalities, Priapism, and Male Infertility. Two expert urologists independently evaluated and assigned scores ranging from 1 to 4 to each response based on its accuracy, with the following ratings: (1) Completely true, (2) Accurate but insufficient, (3) A mixture of accurate and misleading information, and (4) Completely false. A total of 120 questions were included in the study. Among these questions, 50.0% received a grade of 1 (completely correct) (55.4% for 4.0 version). The combined rate of correct answers (grades 1 and 2) was 85.2% for frequently asked questions (88.8% for 4.0 version) and 81.5% for questions obtained from the guideline. The rate of completely incorrect answers (grade 4) was 1.8% for frequently asked questions (0% for 4.0 version) and 5.2% for questions based on strong recommendations. The response rate of version 4.0 to questions created from sentences containing strong recommendations from the EAU guideline was the same as version 3.5. ChatGPT provided satisfactory answers to the questions asked, although some responses lacked completeness. It may be beneficial to utilize ChatGPT under the guidance of a urologist to enhance patients' comprehension of their andrology issues.

Adaptive Calibration of Dyadic Sexual Desire Is Sex Differentiated and Disrupted by Hormonal Contraceptives.

Adaptive calibration models suggest that features of people's childhood ecologies can shape their reproductive outcomes in adulthood. Given the importance of dyadic sexual desire (i.e., desire for sex with a partner) for relationships and reproduction, we examined the extent to which people's childhood ecologies-especially the unpredictability of those ecologies-adaptively calibrate such desire. Nevertheless, because female (versus male) sexual desire is presumed to be more sensitive to situational factors, and because hormonal contraceptives alter myriad aspects of female physiology that influence female sexual desire, we predicted that adaptive calibration of dyadic sexual desire would emerge more strongly for naturally cycling females (versus females who use hormonal contraceptives and versus males). In Study 1, a total of 630 participants (159 males, 203 naturally cycling females, and 268 females using hormonal contraceptives) completed questionnaires assessing the harshness and unpredictability of their childhood ecologies as well as their sexual desire. Consistent with predictions, childhood unpredictability (but not harshness) was positively associated with dyadic (but not solitary) sexual desire among naturally cycling females (but not among females using hormonal contraceptives nor among males). Study 2, which consisted of 736 females (307 naturally cycling females, 429 females using hormonal contraceptives), replicated this pattern of results for females. These findings add to a growing literature suggesting that the instability of people's early childhood ecologies can adaptively calibrate their adult reproductive motivations and behaviors, including their dyadic sexual desire. Not only is the current finding among the first to show that some adaptive calibration processes may be sex differentiated, it further highlights that hormonal contraceptives, which alter the evolved reproductive physiology of females, may disrupt adaptive calibration processes (though such disruption may not be inherently negative).

Hyperprolactinemia and male sexual function: focus on erectile dysfunction and sexual desire.

The present paper aims to analyze and discuss the available evidence supporting the relationship between male sexual function and elevated prolactin (PRL) levels (HPRL). Two different sources of data were analyzed. Clinical data were derived from a series of patients seeking medical care for sexual dysfunction at our Unit. Out of 418 studies, 25 papers were used with a meta-analytic approach to evaluate the overall prevalence of HPRL in patients with erectile dysfunction (ED) and to study the influence of HPRL and its treatment on male sexual function. Among 4215 patients (mean age 51.6 ± 13.1 years) consulting for sexual dysfunction at our Unit, 176 (4.2%) showed PRL levels above the normal range. Meta-analytic data showed that HPRL is a rare condition among patients with ED (2 [1;3]%). Either clinical and meta-analytic data confirm a stepwise negative influence of PRL on male sexual desire (S = 0.00004 [0.00003; 0.00006]; I = -0.58915 [-0.78438; -0.39392]; both p < 0.0001 from meta-regression analysis). Normalization of PRL levels is able to improve libido. The role of HPRL in ED remains inconclusive. Data from a meta-analytic approach showed that either HPRL or reduced T levels were independently associated with ED rates. The normalization of PRL levels only partially restored ED. HPRL did not significantly contribute to ED severity, in our clinical setting. In conclusion, treating HPRL can restore normal sexual desire, whereas its effect on erection is limited.

Partner responses to low desire among couples coping with male hypoactive sexual desire disorder and associations with sexual well-being.

Hypoactive sexual desire disorder (HSDD) is characterized by persistently low desire and associated distress. Low desire is one of the most common sexual complaints among men and is associated with poor well-being. Interpersonal factors are key to understanding low desire, yet there are few dyadic studies of HSDD in men. Previous work on genito-pelvic pain and low desire in women has established that greater facilitative (eg, affectionate) partner responses are associated with greater sexual satisfaction and function and that more negative (eg, critical) or solicitous (eg, sympathetic, avoidant) partner responses are associated with lower sexual satisfaction and function. Examining how partner responses are associated with adjustment to HSDD may shed light on the interpersonal dynamics of this understudied sexual dysfunction. In a cross-sectional study, we examined whether partner responses to low desire in men were associated with sexual desire, sexual satisfaction, and sexual distress for both members of the couple. Men with HSDD and their partners (N = 67 couples) completed measures of facilitative, negative, and avoidant partner responses to men's low sexual desire-as perceived by the man with HSDD and self-reported by their partner-and sexual desire, sexual satisfaction, and sexual distress. Data were analyzed using multilevel modeling guided by the actor-partner interdependence model. Outcomes included the partner-focused subscale of the Sexual Desire Inventory-2, Global Measure of Sexual Satisfaction, and Sexual Distress Scale-Revised. When men with HSDD perceived more facilitative partner responses to their low desire, they and their partners reported greater sexual satisfaction. When men with HSDD perceived and their partners self-reported more negative partner responses, they each reported lower sexual satisfaction. In addition, when men with HSDD perceived more avoidant partner responses, their partners reported greater sexual distress. Partner responses were not associated with sexual desire for either member of the couple. Findings support the importance of the interpersonal context for HSDD in men and suggest potential future targets of treatment when working with affected couples. This study is one of the only dyadic studies of HSDD in men, as assessed via clinical interview or self-report symptoms reviewed by the clinical team. Despite our best efforts to recruit this sample over 6 years, the small size limited power to detect all predicted effects. More facilitative and fewer negative or avoidant partner responses to low desire are associated with greater sexual well-being in couples coping with HSDD.

STUDY OF SOME REPRODUCTIVE PARAMETERS AND SEXUAL BEHAVIOR IN AWASSI RAMS: A REVIEW

Reproductive efficiency represented by sexual desire, semen quality, testicular dimensions, and level of sex hormones are among the main components of ram fertility, which affect the fertility and productivity of the herd. Since the development of the testicles is related to reproductive activity and the ability to fertilize, so measuring the dimensions of the testicles is important in evaluating the reproductive capacity of rams. In addition, the concentration of testosterone is reflected in most of the characteristics of male sexual behavior, as it is positively and significantly correlated with ejaculate volume, mass motility, and sperm concentration. The high level of testosterone hormone in the blood plasma during reproductive season leads to an increase in male sexual desire and an improvement in the quality of semen through direct influence in the process of sperm formation and the volume ejaculate, density and vitality of semen. In addition to reproductive traits are also affected by age, body weight, season and herd management, as well as the impact of the environmental conditions, which are temperature, humidity, level of nutrition, quantity and quality, and length of the photoperiod, which is one of the most important factors affecting the reproductive performance of rams.

Prevalence and predictors of unrecognised low sexual desire/interest in men with new onset erectile dysfunction: findings from a cross-sectional, real-life study.

The interrelationship between male sexual desire and erectile dysfunction (ED) has been scantly investigated. Thus, we aimed at investigating the prevalence of and the predictors of unrecognised low sexual desire/interest (uLSD/I) in a cohort of men with new onset ED. Complete data from 1587 men seeking for first medical help for ED between 2010 and 2021 were analysed. Comorbidities were scored with the Charlson Comorbidity Index (CCI). At entrance, all patients were asked to self-report low sexual desire/interest and completed the International Index of Erectile Function (IIEF) and the Beck Depression Inventory (BDI) (depressive symptoms scored as BDI ≥ 11). The IIEF-erectile function (IIEF-EF) domain was categorised according to Cappelleri's criteria. The median value of the IIEF-sexual desire domain (IIEF-SD) was used to dichotomise men with uLSD/I along with ED (IIEF-SD < 7) vs. ED-only (IIEF-SD ≥ 7). Circulating hormones were measured in every patient. Hypogonadism was defined as total testosterone (tT) <3.0 ng/mL. Descriptive statistics and logistic regression models tested the association between clinical variables and uLSD/I. Of 1197 patients not self-reporting LSD/I, 369 (30.8%) had IIEF-SD < 7. Patients with ED + uLSD/I were older [median (IQR) 54(41-63) vs. 49(36-59) years], had lower IIEF-EF [10.5(5-22) vs. 22(11-28)] but higher BDI [6(3-12) vs. 4(1-8)] and lower tT [4.3(3.2-5.7) vs. 4.8(3.2-6.3) ng/mL] compared to ED-only men (all p < 0.05). Overall, ED + uLSD/I men had higher rate of severe ED (49.9% vs. 23.9%), and of BDI ≥ 11 (30.6% vs. 18.2%) (all p < 0.05). At multivariable logistic regression analysis, lower tT (OR: 0.82), lower IIEF-EF scores (OR:0.95) and BDI ≥ 11 (OR:2.51) were independently associated with ED + uLSD/I, after accounting for age (all p < 0.05). Almost 30% of men seeking first medical help for ED-only had also uLSD/I. Men with both conditions were older, had higher rates of severe ED and more depressive symptoms. A detailed investigation of sexual desire should be always included in men self-complaining only of ED.

“So When We Do Have a Say?” On Sexy Selfie Making as a Standpoint for Seen-ness

As photography’s technological advancement has afforded women greater self-representational opportunity and control, new discourses of concern have emerged over women who create sexy selfies. I argue that these discourses are, in part, mired in outdated notions of the heterosexual male gaze which figure sexy selfies to be a contemporary reflection of the ongoing dominance of male sexual desire over the passive and objectified female subject. Using data from a project which involved the photographic collaborations of a professional photographer (myself) and a number of sexy-selfie taking women, I propose to promote the concept of seen-ness as a counter to male-centered gaze discourses and ideals of ‘proper’ feminine/sexual presentation. Like theories on ‘listening’ to create a to-be-heard-ness, there is an ethical imperative for viewing/gazing to create a to-be-seen-ness. I will further argue that sexy selfies have brought objectification discourses to a critical juncture where relations of power between the looker and the looked-at are much less clear and in need of new frameworks for analysis.

O-092 The ‘Pleasure&amp;Pregnancy’ eHealth programme and its effect on the sexual functioning and ongoing pregnancy rates of couples with unexplained subfertility: a randomized controlled trial

Abstract Study question Does offering the ‘Pleasure&amp;Pregnancy programme’ rather than expectant management affect sexual desire, pleasure and satisfaction, intercourse frequency and ongoing pregnancy rates in subfertile couples? Summary answer The ‘Pleasure&amp;Pregnancy programme’ limits the decline in sexual desire and intercourse frequency but does not affect sexual pleasure and satisfaction and ongoing pregnancy rates. What is known already Dutch guidelines advise six months of non-interactive expectant management, in couples with unexplained subfertility and Hunault-prognosis of minimally 30%, rather than immediately starting assisted reproduction. Adherence to this advice is limited as both couples and fertility clinic staff feel an urge for action. Underpowered studies indicated that face-to-face sex-counselling may increase the pregnancy rates of these couples. Interactive eHealth programmes proved as effective as face-to-face sex counselling in other patient populations. Our group developed the interactive six months Pleasure&amp;Pregnancy web-based programme, aiming to help couples maintain or improve sexual pleasure and activity and consequently increase chances on naturally conceived pregnancies. Study design, size, duration This multi-centre trial randomised 701 couples between six months of the Pleasure&amp;Pregnancy programme (n = 349) or expectant management, the current standard of care (n = 353) from 2016 to 2021. The Pleasure&amp;Pregnancy web-based programme contains eight modules combining psychosexual education with couple communication, mindfulness and sensate focus exercises and additionally enables couples to interact with professionals and peers. Sexual outcomes were assessed with a diary and reliable questionnaires at baseline, three and six months. Participants/materials, setting, methods Heterosexual couples with unexplained subfertility and a Hunault-prognosis of minimally 30% were included after their diagnostic work-up in 41 Dutch fertility clinics. All analyses were according to intention-to-treat principles. Differences between groups in ongoing pregnancy rates (naturally conceived within six months after randomization; primary outcome) were expressed as relative risks (RR). Linear mixed models assessed time, group and interactive effects on female/male sexual desire, pleasure and satisfaction, and intercourse frequency; mean differences (MD) are provided. Main results and the role of chance Response rates at baseline, three and six months for the diaries assessing sexual pleasure (Quality of Sexual Experience; QSE) were, respectively: 55.8%, 33.9% and 16.8%. For the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) questionnaires assessing intercourse frequency, sexual desire and satisfaction response rates were, respectively: 83.2%, 50.8% and 41.2%. The probability of a naturally conceived ongoing pregnancy within six months after randomization did not differ between the randomized groups, and was 22% (n = 78/349) in the Pleasure&amp;Pregnancy-group and 24% (n = 83/353) in the control group (RR 0.94; 95% CI 0.67 to 1.32). Neither did the groups differ in time to pregnancy (log rank p = 0.46). Both female and male sexual pleasure and satisfaction was comparable in both groups and did not change over time. Male sexual desire (scale 2-10) remained over time in the Pleasure&amp;Pregnancy-group but decreased in the control group (MD 0.47, 95%CI 0.28 to 0.67, p &amp;lt; 0.001) and a similar trend was observed in females (MD 0.16, 95%CI -0.02 to 0.33, p = 0.086). Intercourse frequency declined over time in both groups (MD over 6 months -1.05, 95% CI -1.47 to -0.62, p &amp;lt; 0.01), but less in the Pleasure&amp;Pregnancy- group (MD 0.3, 95% CI 0-0.6; p = 0.05). Limitations, reasons for caution The intended sample size of 1164 was not reached, although the inclusion period was doubled. Web-based tracking showed limited intervention adherence, indicating the need for per protocol analysis in addition to this intention-to-treat analysis. Examining user experiences with the Pleasure&amp;Pregnancy programme would be of interest and might explain adherence rate. Wider implications of the findings Clinics are advised to offer the Pleasure&amp;Pregnancy or similar programme to care for the sexual health of couples with unexplained subfertility. The Pleasure&amp;Pregnancy programme did not increase naturally conceived ongoing pregnancy rates but did help couples maintain their sexual desire and intercourse frequency, while continuing to attempt natural conception. Trial registration number NTR5709

Prevalence and predictors of unrecognized low sexual desire in men with new onset erectile dysfunction – findings from a cross-sectional, real-life study

ABSTRACT Introduction The interrelationship between male sexual desire and erectile dysfunction (ED) has been variously investigated. Objectives We aimed to investigate the prevalence of and the predictors of unrecognized low sexual desire (LSD) in a cohort of men seeking medical help for new onset ED in the real-life setting. Methods Data from 1509 men seeking first medical help for new-onset ED at a single andrology centre between 01/2010 and 01/2020 were analyzed. Patients were assessed with a thorough medical and sexual history. Comorbidities were scored with the Charlson Comorbidity Index (CCI). All participants were asked to self-report the presence of LSD. Moreover, patients completed the International Index of Erectile Function (IIEF) and the Beck Depression Inventory (BDI). Depressive symptoms were defined as BDI ≥11. The median value of the IIEF-Sexual desire domain (IIEF-SD) was used to categorize the cohort in low SD (IIEF-SD &amp;lt;7) vs. normal SD (IIEF-SD ≥7). The IIEF-Erectile function (IIEF-EF) domain was categorized according to Cappelleri's criteria. Circulating hormones were measured in every patient. Hypogonadism was defined as total testosterone (tT) &amp;lt; 3.0 ng/mL. Descriptive statistics and logistic regression models tested the association between clinical variables and unrecognized LSD. Results Overall, 312 (20.7%) patients self-reported LSD and were excluded from further analyses. Of 1197 patients not self-reporting LSD, 369 (30.8%) had IIEF-SD &amp;lt;7 (arbitrarily defined as unrecognized LSD). Patients with unrecognized LSD were older [median (IQR) 54 yrs (41-63) vs. 49 yrs (36-59), p&amp;lt;0.001], had lower IIEF-EF [10 (5-20) vs. 22 (11-28)] but higher BDI [6 (3-12) vs. 4 (1-8)] and lower tT [4.3 (3.2-5.7) vs. 4.7 (3.2-7.3) ng/ml] (all p&amp;lt;0.001) than men without LSD. Overall, men with unrecognized LSD presented a higher rate of severe ED (50% vs. 24%, p&amp;lt;0.001), and of BDI suggestive for depressive symptoms (30.6% vs. 18.3%) and of hypogonadism (19.9% vs. 10%) (all p&amp;lt;0.001). At multivariable logistic regression analysis, lower tT, despite not suggestive for hypogonadism (OR 0.91, p=0.03), lower IIEF-EF (OR 0.94, p&amp;lt;0.001) and BDI suggestive for depressive symptoms (OR 1.83, p&amp;lt;0.001) were found to be independent predictors of unrecognized LSD, after accounting for age. Conclusions One out of three men seeking first medical help for ED showed unrecognized LSD according to the IIEF-SD domain scores. Men with unrecognized LSD were older, had higher rates of severe ED and depressive symptoms and lower tT values despite not suggestive for hypogonadism than men with normal SD. A detailed investigation of sexual desire should be always included in the diagnostic work-up of men with ED, in order to better tailoring patient therapeutic management. Disclosure Work supported by industry: no.

Seed extract of Thai Mucuna pruriens (L.) DC. var. pruriens enhances sexual performance and improves male reproductive damages in ethanol-induced rats

Ethnopharmacological relevanceThai Mucuna pruriens (L.) DC. var. pruriens (T-MP) has been traditionally used in treating depressive disorders, dysuria and enhancing male sexual desire. Although T-MP seed is demonstrated to have antioxidant capacity, its aphrodisiac and protective tissue damage properties have never been documented. Recently, ethanol (Eth) is known to cause sexual behavior dysfunction and damage reproductive system. This study aimed to investigate the protective effects of T-MP seed extract on sexual behavior dysfunction and reproductive damages in male rats admisted with Eth. Materials and methodsT-MP possessing antioxidant activity was determined for L-DOPA content using NMR analysis. Thirty-six male rats were divided into four groups (9 animals/group). Control rats received DW and the ethanol (Eth) group was given with Eth (3 g/kgBW; 40%v/v). In preventive groups (T-MP150 + Eth and MP300 + Eth groups), animals were treated with T-MP extract at a dose of 150 and 300 mg/kgBW before Eth administration for consecutive 56 days. Sexual behaviors including mounting frequency (MF), intromission frequency (IF), mounting latency (ML), intromission latency (IL), ejaculation latency (EL), post-ejaculatory interval (PEI), and ejaculation frequency (EF) were evaluated. Epididymal sperm quality and daily sperm production (DSP) were examined. Testicular histology was observed using Masson's trichrome staining. The malondialdehyde (MDA) levels and expressions of androgen receptor (AR), heat shock protein 70 (HSP70), steroidogenic acute regulatory (StAR), and tyrosine-phosphorylated (TyrPho) proteins in testis were also determined. ResultsT-MP extract contained L-DOPA and improved sexual behaviors including increased MF and IF and decreased ML and IL in Eth treated rats. Significantly, sperm quality, DSP, and testicular histopathology observed in Eth group were improved after T-MP treatment. T-MP also decreased the testicular MDA levels. Additionally, T-MP could correct testicular functional proteins of AR and StAR except HSP70 expression in Eth group. Expressions of TyrPho proteins in testicular and sperm lysates were improved in co-administered groups. ConclusionsT-MP seed extract possessing L-DOPA could enhance the sexual behaviors and protect reproductive damages via improvement of testicular functional proteins.

Marking Modern Movement: Dance and Gender in the Visual Imagery of the Weimar Republic by Susan Funkenstein

Reviewed by: Marking Modern Movement: Dance and Gender in the Visual Imagery of the Weimar Republic by Susan Funkenstein Kate Kelley Marking Modern Movement: Dance and Gender in the Visual Imagery of the Weimar Republic. By Susan Funkenstein. Ann Arbor: University of Michigan Press, 2020. Pp. 330. Paper $39.95. ISBN 978-0-472-05461-9. Through a series of case studies on the visual imagery of social and professional dance, Susan Funkenstein's interdisciplinary monograph Marking Modern Movement tracks interactions and relationships between dancers and visual artists during the Weimar era. Drawing primarily on literature from gender studies, cultural history, art history, and dance history, Funkenstein fluently describes and analyzes dance and visual art. The dancing body, Funkenstein argues, was a site of cultural debate used by artists to explore, challenge, or reinforce gender norms as well as racial stereotypes. Constantly reevaluating the self-other binary in a selection of "high" and popular visual art, Funkenstein aims to show how these exchanges between dancers and visual artists, unique to the Weimar period, allowed artists to center the embodied experiences of women, shifting their status from object to subject. Through interpretations of dances and popular music associated with African American culture, this book also tracks the role of American cultural influence in Germany at this time as well as Germany's colonial imagination after losing its colonies at the end of WWI. Moreover, Funkenstein uses paintings, drawings, photographs, performances, and other art media to analyze the ways in which men and women crossed boundaries into opposite gendered spheres—just as many women entered the political sphere, so too did men find their ways into cultural realms of fashion and dance. The first chapter looks at two photomontages by artist Hannah Höch which make visible the contradictory place of women in 1919–1920. After having gained rights and workplace opportunities during the war, women were made to cede the realms of politics and the economy to men at the war's end. Combining, for example, images of early modern dancers dressed in loose-fitting white chitons with the heads of well-known suffragists, Höch's works couple women's emancipation with the celebration of their difference, especially their maternal nature, suggesting that a return to normative femininity and gender roles may have been welcome after the chaos and anxiety of wartime. In chapter 2, Funkenstein presents Mary Wigman as having more of a positive view on the role of women in politics and society than Höch, using, as she does in all the chapters, a significant amount of biographical detail. Funkenstein argues that Wigman's positioning herself as the subject through solo performances, costume choices, particular movements, and gestures, as well as her strong leadership, forced established male artists Emil Nolde and Ernst Ludwig Kirchner (both personal friends of Wigman) to rethink their portrayal of women as objects in their paintings. Funkenstein suggests that both artists, in repeatedly "marking" performances along with the dancers, were able to capture and, to some [End Page 181] degree, join their community, thus crossing the otherwise strictly gendered boundary of the all-female dance company. In a turn toward a more "low-brow" art form, the third chapter challenges dominant readings of the Weimar revue stage—specifically the kickline—as either representations of male sexual desire or as a reflection of growing capitalism and industrialization. Funkenstein looks at the revues as "women's culture filled with women's visual and performative pleasure" (93–94). Her case studies include the popular women's magazine Uhu's portrayals of women in revues as women experiencing pleasure and celebrating their physical beauty, while Hannah Höch's costume and set designs for her never-realized performance Anti-Revue used humor and androgynous characters to highlight the female performer's individuality and the possibilities for breaking down gender roles and crossing gendered boundaries. In her chapter on another well-known star, Funkenstein argues that Josephine Baker, ever aware of her public image, represented, on the one hand, the stereotypes and typology exemplified in the title of Paul Klee's portrait of Baker's Negride Schönheit and, on the other hand, the boundary-pushing notion that...

Diminished Libido, Its Manifestations and Definitions of Hypoactive Sexual Desire Disorder

The article deals with clinical manifestations of diminished libido as well as definitions of hypoactive sexual desire disorder (HSDD) in the International Classification of Diseases, 10th Revision (ICD-10), Diagnostic and Statistical Manual of Mental Disorders, Fourth and Fifth Editions (DSM-4 and DSM-5) (USA). Its corresponding code in ICD-10 is F52.0 (“Lack or loss of sexual desire”), which is common for both men and women. DSM-4 has code 302.71 (“Hypoactive Sexual Desire Disorder”), which is common for persons of both sexes too. The point to note is that the above classification considers the presence of distress or difficulties in interpersonal communication, caused by hyposexuality, as one of indicators for diagnosing this disorder. DSM-5 uses diagnosis “Male Hypoactive Sexual Desire Disorder” (code 302.71), whereas for revealing this disorder in women general diagnosis “Female Sexual Interest/Arousal Disorder” (code 302.72) is used, since in compliance with the opinion, present in the above guide, women are characterized by difficulties in differentiation and a frequent comorbidity of disorders of sexual interest and sexual excitement. Also, attention is called to the fact of substitution of the term “sexual desire” with the term “sexual interest”, thereby giving some psychological tint to the first part of the diagnosis and reducing its biological background. Both DSM-5 codes (for men and for women) also provide for a diagnostic criterion, according to which hypoactive sexual manifestations cause a clinically significant distress. The author also informs about existence of an autonomous classification of female sexual dysfunctions by two international panels of experts in sexual medicine (Nomenclature Committee of the International Society for the Study of Women’s Sexual Health and the International Consultation in Sexual Medicine), who believe that preservation of the separate diagnosis “Hypoactive sexual desire disorder” for women is reasonable. It is reported that ICD-11 will use diagnosis “Hypoactive sexual desire dysfunction” not only for men, but for women too. The given data demonstrate scientific substantiation for such a decision. Attention is called to the fact that the above classification has fully absolutized the subjective perception of hyposexuality. For example, it is reported that the proposed diagnostic guide takes aim at the absence of any norms for sexual activity. It is suggested to regard as “satisfactory” the sexual activity, which satisfies the given person. If the individual is satisfied with his/her sexual activity, the possibility of diagnosing his/her sexual dysfunction is excluded at once. Validity of such an approach is discussed. Besides the described hypoactive sexual manifestations, the article also lists the clinical phenomena, which are associated with the above manifestations and accompany them.

Effect of Foot Reflexology on Sexual Function of Patients under Hemodialysis: A Randomized Parallel Controlled Clinical Trial.

Introduction Hemodialysis patients experience sexual dysfunction due to the nature of their disease and its complications. Dialysis patients have reported sexual dysfunction as one of the most important stressors, which leads to many psychological and physiological problems. Sexual function in hemodialysis patients has been improved with pharmaceutical and nonpharmacological therapies. Foot reflexology is a complementary and alternative treatment that can be used in conjunction with contemporary care. By activating the chemical nerve system, reflexology may balance enzymes and regulate endocrine function. Objectives To determine the effect of foot reflexology on the sexual function of hemodialysis patients. Methods This randomized controlled trial was conducted on 47 patients on chronic hemodialysis referred to Imam Reza Hospital in Sirjan, Iran, who were divided into two groups of reflexology (n = 24; male = 19 and female = 5) and sham (n = 23; male = 18, and female = 5). The intervention group received foot reflexology during dialysis for four weeks, three times a week, 30 minutes each time (15 minutes per foot). The sham group received nonspecific foot massage without applying pressure on standard reflex points with the same condition and duration as the intervention group. The international index of erectile function and female sexual function index was assessed before, immediately, and one month after the intervention. Results The results showed that immediately after the intervention, male orgasm function, sexual desire, and intercourse satisfaction in the reflexology group was significantly higher than those of the sham group. There was no significant difference between the two groups regarding erectile function and overall satisfaction. Furthermore, there was no significant difference between the two groups in terms of different aspects of female sexual function. Conclusions Foot reflexology, as an effective intervention treatment, can reduce some aspects of sexual dysfunction of male patients under hemodialysis.

Psychosocial Profile Of Subjects Presenting With Sexual Dysfunctions In Psychiatry Outpatient Department Of A Teaching Hospital In Nepal

Introduction: Sexuality is way people experience and express themselves sexually. It influences psychological, physical and social well-being of both men and women. Sexual dysfunctions are believed to be among the commonly prevalent psychological disorders in the general population but there is a lack of published research papers and literature related to sexuality and sexual medicine from Nepal. The aim of the present study was to descriptively analyze the nature of sexual dysfunctions in a teaching hospital.&#x0D; Material And Method: Retrospective analysis of data from subjects attending the psychiatry outpatient department in Nepalgunj Medical College Teaching Hospital, Kohalpur over the calendar year 2019 was done. Sociodemographic and clinical parameters of the subjects were obtained from the OPD register. Diagnosis was made using the DSM-5.&#x0D; Results: Out of total 54 subjects, 92.6% were male while 7.4% were female. Married subjects constituted 79.6% while single/unmarried 20.4%. Premature ejaculation was the most common sexual dysfunction encountered (55.5%) followed by erectile disorder (33.3%) and female sexual interest/arousal disorder (5.5%). Male hypoactive sexual desire disorder was seen in 3.7% and genito-pelvic pain/penetration disorder was seen in 2%.&#x0D; Conclusion: Males more commonly seek medical help for sexual dysfunction than females. People especially females, hesitate to discuss and seek medical help for sexual dysfunctions. There is lack of research on sexual medicine and sexuality from Nepal and prevalence of various sexual dysfunctions is not known.

Unconsummated Marriage (“Honeymoon Impotence”): 25 years’ Experience with 871 Couples, in Kermanshah, Iran.

Background: Unconsummated marriage (UCM) is a condition in which the first coitus in a marriage has not occurred in “due time” and thus the bride remains a virgin. UCM, which occurs early in married life, can sometimes last for years and have significant negative effects on a couple’s sexual satisfaction. Here we report our experience with 871 couples in Kermanshah, Iran.Methods: Electronic medical records of couples with UCM, seen by Zargooshi from 1996 to 2021, were reviewed. Some patients whose data were reported in our previous articles at 2000 and 2008, were not included here. For transparency, we voluntarily sent the full identifying data of our patients to the Journal during the first submission of the manuscript.Results: Associated conditions include erectile dysfunction (49.8%), premature ejaculation (14.6%), male hypoactive sexual desire disorder (7.2%), and vaginismus (12.5%). Intracavernosal injection (ICI) was used as the treatment of choice. The consummation rate was 95.1%. We used ICI in presence of vaginismus, too. It may appear “ungentle” to approach the vaginismus this way. However, the couples preferred this expeditious treatment over a time-consuming, and ineffective alternative.Conclusions: In most cases, UCM is due to psychogenic ED, for which ICI (not psychological interventions) is the best treatment because the typical couples who present with UCM are noncompliant with time-consuming treatments. Therefore, the most effective treatment was intracavernosal injection and then the administration of type 5 phosphodiesterase drugs and the most ineffective treatment was psychological counseling.