Orgasmic Difficulties Research Articles

Distressing Problems with Sexual Function and Symptoms of Attention-Deficit/Hyperactivity Disorder.

Cognitive models of sexual dysfunction situate distraction as a core mechanism underlying difficulties with sexual function. It follows that individuals who have difficulties with inattention and distractibility (e.g., attention-deficit/hyperactivity disorder; ADHD) may be at increased risk of problems with their sexual function, though previous research is mixed, and no research has examined links with sexual distress despite distress being a necessary criterion for sexual dysfunction. The goals of the current study were to: (1) examine associations between ADHD symptoms, sexual function, and sexual distress; (2) examine group differences in sexual function and sexual distress as a function of presumptive ADHD diagnosis; and (3) establish whether individuals with presumptive ADHD are at greater risk of distressing problems with sexual function relative to controls. In a large mixed-gender community sample (N = 943: controls n = 837, presumptive ADHD n = 106), we found that ADHD symptoms were positively correlated with worse overall sexual function, as well as orgasm difficulties and greater sexual distress. Relative to controls, individuals with presumptive ADHD reported worse sexual function and greater sexual distress, controlling for age, biological sex, and sexual orientation. Individuals with presumptive ADHD were significantly more likely (OR = 2.16) to have distressing problems with sexual function than controls. Core difficulties related to ADHD, including inattention, distractibility, and emotion dysregulation, may make individuals more vulnerable to experiencing problems with sexual function and sexual distress, putting them at risk for developing sexual dysfunction. Taken together, these data support associations between ADHD and distressing sexual function problems, including possible mechanisms explaining these links such as difficulties with emotion regulation.

Sexual Dysfunction with Risperidone in Male and Female Patients of Schizophrenia

Background: Sexual side-effects due to use of Antipsychotic drugs have become one of the most important determinants of treatment compliance. Studies regarding sexual side-effects associated with antipsychotics comprise only a handful in the Indian population, especially so in this north-eastern part of the country. Aims and Objectives 1. To assess the sexual dysfunction associated with Risperidone in male and female patients of Schizophrenia. 2. To compare the sexual dysfunction associated with Risperidone between male and female patients of Schizophrenia. Materials and Methods: This was a hospital based comparative study conducted on 50 clinically stable male and female patients of Schizophrenia on Risperidone only. A Sexual Functioning Questionnaire (SFQ) was administered after assessing the clinical stabilities with the Brief Psychiatric Rating Scale (BPRS). Sexual dysfunction was assessed by calculating the mean scores on all the domains of sexual functioning in SFQ which were then compared across the study groups using the Chi square test . The results were analysed using SPSS Version 16.0 setting the significance threshold at p <0.05. Results: From this study, we inferred that with Risperidone, impairment is seen in desire disorders (12%), arousal disorders (14%), orgasmic difficulties (26%) and overall sexual dysfunction (20%) although not statistically significant. It was also found that in females, Risperidone caused more desire disorders, more arousal disorders and a more overall sexual dysfunction; whereas in case of males, Risperidone caused more arousal disorders, more orgasmic difficulties, more sex related pain problems and a more overall sexual dysfunction; Conclusion: Sexual dysfunction is an important side-effect of Antipsychotic drugs. So clinicians should try to address these side-effects to help patients’ attain a better compliance.

Assessment of the effect of cannabis use before partnered sex on women with and without orgasm difficulty.

Up to 41% of women face challenges achieving orgasm, a statistic unchanged for 50years. To evaluate the effect of cannabis use before partnered sex on women with and without difficulty achieving orgasm. This observational study evaluated responses from female study participants relating to their demographics, sexual activities, mental well-being, cannabis usage, and orgasm-related questions from the Female Sexual Function Index (FSFI). Outcomes included orgasm frequency, difficulty, and satisfaction related to cannabis use or lack of use before partnered sex, largely based on the FSFI orgasm subscale. Of the 1037 survey responses, 410 were valid and complete. Twenty-three surveys (5.6% returned) were excluded due to failure to meet the study's criteria. Of the valid surveys, most women (52%, n = 202) reported difficulty achieving orgasm during sexual activity with a partner. These women were primarily between 25 and 34years of age (45%, n = 91); 75% identified their race as White (n = 152/202); 52% (n = 105) identified as LGBTQI+ (lesbian, gay, bisexual, transgender, queer/questioning, intersex, or other); and 82% (n = 165) were married or in a relationship. Among participants who experienced challenges in achieving orgasm, 72.8% (n = 147, P < .001) reported that cannabis use before partnered sex increased orgasm frequency, 67% stated that it improved orgasm satisfaction (n = 136, P < .001), and 71% indicated that cannabis use made orgasm easier (n = 143, P < .001). The frequency of cannabis use before partnered sex correlated with increased orgasm frequency for women who experienced difficulties achieving orgasm (n = 202, P < .001). The reasons for cannabis use before partnered sex resulted in a more positive orgasm response (n = 202, P = .22). Cannabis may be a treatment for women with difficulty achieving orgasm during partnered sex. The researchers examined the challenge of achieving orgasm and considered the covariates reported in the literature, including the FSFI orgasm subscale. The findings may not be generalizable to women who rarely or never use cannabis before sex, women who have never experienced an orgasm, or women who do not have female genitalia. Additionally, the specific type of cannabis used, its chemical composition, the quantity used, and whether or not the partner used cannabis were not assessed in this study. Cannabis-related treatment appears to provide benefit to women who have female orgasm difficulties or dysfunction.

Advancing a critical postmodern approach to stigma management communication (SMC) theory in the context of difficulty orgasming

ABSTRACT Addressing calls for increased communication scholarship that interrogates power in stigma processes, we develop a critical postmodern approach to stigma management communication (SMC) theory and demonstrate how it can be used in the context of difficulty orgasming. Semi-structured interviews with mostly white, cisgender women experiencing orgasm difficulties in mixed-sex relationships (N = 31) revealed how dominant discourse creates an idealized standard of sexual behavior that stigmatizes women with orgasm difficulties, and how stigma management strategies act as discursive practices that reify, resist, and transform the status quo. We extend SMC theory by articulating a critical postmodern approach that can be used to interrogate power in stigma processes, and by illuminating how stigma management strategies are enacted in varied ways and toward different ends. Practically, our findings underscore the need for multifaceted interventions aimed at addressing the underlying causes of stigma and offer recommendations for reducing stigma through health campaigns, programming, and care.

(010) Assessment of Cannabis Use Before Partnered Sex on Women who Experience Orgasm Difficulty

Abstract Introduction Up to 41% of women experience female orgasm disorder/difficulty (FOD), a statistic unchanged for 50 years. Despite this, there is a paucity of validated treatments. Research has suggested cannabis as a treatment for female sexual disorders for more than 50 years. Yet a literature review revealed no studies evaluating cannabis as a treatment specifically for FOD and no studies comparing women with and without FOD. This study is the first to evaluate cannabis as a treatment for FOD specifically in women with and without FOD. Objective Evaluate the effect of cannabis use before partnered sex on women with and without FOD. Methods This IRB-approved observational study conducted between March 24, 2022, and November 18, 2022, evaluated baseline demographics, sexual behavior, mental health, cannabis use, and the orgasm subscale questions of the Female Sexual Function Index (FSFI), evaluating orgasm frequency, orgasm satisfaction, and orgasm ease, with and without cannabis before partnered sex. Results Of 1,037 survey responses, the researchers received 410 valid, completed surveys; failure to meet the study’s criteria required excluding 23 (5.6%) surveys. Among the 387 valid survey participants, the majority of women, 52% (n = 202) reported orgasm difficulty, were between the ages of 25–34 (45%, n = 91), reported their race as white (75%, n = 152), and were married or in a relationship (82%, n = 165). Among respondents reporting orgasm difficulty (n = 202), cannabis use before partnered sex increased orgasm frequency (72.8%, n = 147/202, p &amp;lt; .001), improved orgasm satisfaction (67%, n = 136/202, p &amp;lt; .001) or made orgasm easier (71%, n = 143/202, p &amp;lt; .001). Frequency of cannabis use before partnered sex correlated with increased orgasm frequency for women with FOD (n = 202, p&amp;lt; .001). Orgasm response to cannabis depended on the reasons for use (n = 202, p = .022). Women with FOD reported 24% more mental health issues, 52.6% more PTSD, 29% more depressive disorders, 13% more anxiety disorders, and 22% more prescription drug use than women without FOD. Women with FOD were more likely to report sexual abuse history than women without FOD (38.6%, n=74/202). Conclusions Fifty years of sexuality research support use of cannabis for sexual difficulties. This is the first study to look at FOD specifically, demonstrating significant benefit. Randomized controlled studies are needed to evaluate cannabis’ efficacy on FOD sub-types, mental health and physical health conditions and other clinical implications; evaluating dosage, strain, timing, and method of intake. References Laumann et al., 2005 Kontula &amp; Miettinen, 2016 Keiman &amp; Meston, 1997 Dawley et al., 1979 Gorzalka et al., 2010 Klein et al., 2012 Lewis, 1970 Moser et al., 2023. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: inhaleMD.

(235) Use of Bremelanotide (Vyleesi) in Men with Sexual Dysfunctions

Abstract Introduction Bremelanotide (Vyleesi) is an FDA approved medication for the safe and efficacious treatment of hypoactive sexual desire disorder in premenopausal women, however phase 3 trials revealed it improved arousal and orgasm as well. As a centrally acting drug it was expected to be effective to treat sexual dysfunctions in men and has been prescribed off label routinely in our practice. Objective The primary aim of this study was to evaluate the use of bremelanotide in men with various sexual dysfunctions, the reasons why the medication was prescribed, improvements in sexual function and overall satisfaction, and side effects experienced. Methods This one-group study design involved men from a single clinic with various sexual dysfunctions prescribed bremelanotide beginning May 1, 2021. After signing consent participants answered the Quality of Life (QOL) Dimension of Sexual Quality of Life Questionnaire, the Patient Global Impression of Improvement (PGI-I) and the General Assessment Questions (GAQ) online. After confirming they had used the medication at least twice, participants completed a structured interview over the telephone with a single interviewer. Descriptive statistics were used to characterize the study cohort. Adverse events were collected. Results To date a total of 21 men signed consent and 19 completed the online questionnaires. 80% of these men were more satisfied with their lovemaking and duration of lovemaking; 93% reported vaginal insertion was easier and 71% said it was easier to orgasm. With regard to feelings about initiating lovemaking, 86% were more at ease and 79% anticipated it would be more pleasurable and more carefree. 69% believed orgasm was more pleasurable and 73% said that lovemaking was more pleasurable while 79% reported that the partner’s overall experience was more pleasurable. Using the PGI-I, 53% of participants felt that sexual function after using bremelanotide was a little better, much better, or very much better. Additional questions online revealed similar results. Twelve men completed the one-on-one interview: 69% of participants were prescribed bremelanotide for erectile dysfunction. 64% had at least other one sexual health issue, including anxiety about sex (54%), low sexual desire (45%), not enjoying sex (36%), orgasm difficulties (18%), and ejaculation difficulties and sensation loss (9% each). A total of 91% experienced improvements in sexual function, all with improved erectile function. 100% of those with complaints of low sexual desire and/or complaints of anxiety around sex reported improvement; 64% had decreased anxiety around sex; 55% had more enjoyment with sex; and orgasm improved for 36% of participants. Men reported longer erection and ability for additional erection for 18-24 hours after bremelanotide injection, better connection between genitals and brain, improved sensitivity, and increased confidence. Side effects included flushing (36%), nausea (36%), headache (27%), bothersome spontaneous erections without sexual stimulation for about 24 hours after injection (27%), and incontinence, cramping and abdominal burning (9% each). All adverse events were transient. Conclusions While bremelanotide is approved for hypoactive sexual desire disorder in premenopausal women, it has been prescribed and used successfully for men with erectile dysfunction and other concomitant sexual health issues. Disclosure Yes, this is sponsored by industry/sponsor: Palatin Technologies. Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: Palatin Technologies.

And how do LGB adults rate their orgasms in a relational context?

Subjective orgasm experience (SOE) refers to the perception, assessment, and/or sensation of orgasm on a psychological level, with the particularity that the study of SOE in nonheterosexual populations is currently very scarce. The study sought to analyze differences in SOE dimensions, comparing the intensity of each adjective of the Orgasm Rating Scale (ORS) and creating a ranking of the adjectives that better represent it in LGB men and women. In a sample of 1475 adults organized into 4 groups according to the type of sexual relationships reported, comparisons were made using multivariate analysis of variance and chi-square tests. Differences were obtained in the intensity of all the SOE dimensions, and in 23 of the 25 ORS adjectives. Lesbians and bisexual women reported higher intensity in SOE compared with bisexual and gay men. Because the ORS has been established as a good tool for detecting orgasmic difficulties in nonheterosexual populations, this study could provide LGBT affirmative psychotherapy with evidence on how these individuals evaluate their orgasms in a relational context. This study extends prior limited knowledge about how LGB people evaluate their orgasmic experiences in the context of sexual relationships. Despite this, the study poses limitations such as nonprobability sampling or the inclusion of exclusively cisgender and young individuals, making it difficult to generalize the results. Although significant differences were found between LGB men and women, all groups agree on the adjectives they use to describe the subjective experience of orgasm in the context of sexual relationships; therefore, evidence is provided about how LGB people evaluate their orgasmic experiences in this context.

"O" no: a Reddit analysis of orgasmic dysfunction.

Female Reddit users frequently discussed potential causes of orgasm difficulties and its implications on mental health and relationships. This study aimed to evaluate the experiences of women discussing orgasms on the Internet site Reddit. We sought to qualitatively analyze the topics that arose in users' discussions to better understand the potential causes of orgasm difficulties and its implications on quality of life. Posts on the subreddit r/TwoXChromosomes containing the keywords "orgasm" and "climax" were included in the dataset. Posts and their associated comments were qualitatively analyzed using the grounded theory approach. Two independent researchers coded each thread to identify dominant themes and emergent concepts. The most frequently coded primary topics included: (1) orgasm (32.2% [n = 337]), (2) psychological (17.8% [n = 186]), (3) relationships (15.4% [n = 161]), and (4) treatment (10.7% [n = 112]). Qualitative analysis of 107 threads and approximately 6300 comments resulted in 5 major categories: psychological aspect of orgasms, difficulty orgasming with partners, partners' responses to orgasmic dysfunction, types of orgasms, and treatments for orgasmic dysfunction. Preliminary themes included (1) the presence of an emotional component or history of trauma related to orgasmic difficulty, (2) difficulty orgasming with a partner regardless of ability to orgasm during masturbation and a variety of stimulation required to orgasm, (3) mixed partner responses to orgasmic dysfunction, (4) the definition of a normal orgasm, and (5) self-motivated treatment for orgasmic dysfunction, including clitoral stimulation devices and masturbation techniques. Notably, few posters discussed their orgasmic dysfunction with healthcare providers. The study reveals insights into the possible causes, psychosocial implications, and treatment of orgasm difficulties from a patient perspective, and can guide future research on female orgasms in a more precise, patient-oriented direction. The anonymous nature of the forum allowed for insight into sensitive topics related to female orgasms and sexual trauma. Limitations include the demographic distribution of Reddit users, which was primarily younger women in their 20s and 30s, which restricts generalizability. Reddit provides a medium for individuals with orgasm difficulties to discuss their experiences. Posts addressed users' inability to orgasm, their mental health and relationships, the stimulation required for orgasm, and treatments for orgasmic dysfunction. Interestingly, very few posts discussed healthcare, potentially suggesting that women do not classify their orgasmic dysfunction as a health issue.

Effect of chronic skin disease on female sexual function (FSF) among married Egyptian women

Background Female sexual dysfunction (FSD) is a term used to describe various sexual problems, such as low desire or interest, diminished arousal, orgasmic difficulties, and dyspareunia. Objectives The aim of the present study was to determine the effect of chronic skin disease on female sexual function among married Egyptian females as well as the prevalence of FSD among them and its effect on their husbands. Patients and methods The study was conducted on 300 sexually active married Egyptian women attending the Dermatology Outpatient Clinic of Minia University Hospital and Kom Elshokafa Clinic (Alexandria). All women were asked to fill out the female sexual function index sheet using the Arabic validated translated version of it. Those with FSD were asked about its effect on their husbands. Results We reported that 234 (78%) women with chronic skin disease had sexual dysfunction. Despite dysfunction being more common among those who had skin disease, compared with nondysfunction, it was not statistically significantly different among most skin diseases. There was a positive correlation between female’s age and percentage of dysfunction. It was found that only 15.9% of those with FSD showed an effect on their partners in the form of decreased libido. Limitations Limitations include the lack of a control group; the standardization of data, which may not be representative of the community, as they related to specific areas; and being a cross-sectional hospital-based study. Conclusion Our study revealed a high prevalence of FSD (78%) among Egyptian married women with chronic skin disease in both Minia and Kom Elshokafa (Alexandria) districts. However, it was not statistically significantly different among most skin diseases, with affection of only 15.9% of their partners.

Managing Concealable Sexual Health Stigma Through Disclosure

ABSTRACT Individuals with concealable stigma continually decide whether, and if so, how to disclose to others. These complex decision-making processes are evident across various stigmatized sexual health contexts, including sexually transmitted diseases and infections, LGBTQ+ identities, and sexual trauma, among others. One context that has received less attention within communication scholarship is difficulty orgasming among women. Due to the stigma associated with this experience, women are often reluctant to disclose their orgasm difficulties to others, especially their sexual and/or relational partners. However, the motivations women have for, and the factors they consider prior to disclosure have yet to be identified. Building upon extant sexual health communication, concealable stigma, and disclosure research, this study used semi-structured interviews (N = 31) to examine how women disclose orgasm difficulties within their sexual and/or romantic relationships. Our findings highlight several motivations women have for (non)disclosure, and various contextual and situational factors that complicate their disclosure processes. This study contributes to our theoretical understanding of the disclosure processes model (DPM) and the disclosure of concealable (sexual health) stigma. This study also offers practical insights for improving disclosure and experiences with stigma within this context.

Identifying an optimal ejaculation latency for the diagnosis of men reporting orgasmic/ejaculation difficulty.

Criteria for the definition and diagnosis of delayed ejaculation (DE) are yet under consideration. This study sought to determine an optimal ejaculation latency (EL) threshold for the diagnosis of men with DE by exploring the relationship between various ELs and independent characterizations of delayed ejaculation. In a multinational survey, 1660 men, with and without concomitant erectile dysfunction (ED) and meeting inclusion criteria, provided information on their estimated EL, measures of DE symptomology, and other covariates known to be associated with DE. We determined an optimal diagnostic EL threshold for men with DE. The strongest relationship between EL and orgasmic difficulty occurred when the latter was defined by a combination of items related to difficulty reaching orgasm and percent of successful episodes in reaching orgasm during partnered sex. An EL of ≥16minutes provided the greatest balance between measures of sensitivity and specificity; a latency ≥11minutes was the best threshold for tagging the highest number/percentage of men with the severest level of orgasmic difficulty, but this threshold also demonstrated lower specificity. These patterns persisted even when explanatory covariates known to affect orgasmic function/dysfunction were included in a multivariate model. Differences between samples of men with and without concomitant ED were negligible. In addition to assessing a man's difficulty reaching orgasm/ejaculation during partnered sex and the percent of episodes reaching orgasm, an algorithm for the diagnosis of DE should consider an EL threshold in order to control diagnostic errors. This study is the first to specify an empirically supported procedure for diagnosing DE. Cautions include the use of social media for participant recruitment, relying on estimated rather than clocked EL, not testing for differences between DE men with lifelong vs acquired etiologies, and the lower specificity associated with using the 11-minute criterion that could increase the probability of including false positives. In diagnosing men with DE, after establishing a man's difficulty reaching orgasm/ejaculation during partnered sex, using an EL of 10 to 11minutes will help control type 2 (false negative) diagnostic errors when used in conjunction with other diagnostic criteria. Whether or not the man has concomitant ED does not appear to affect the utility of this procedure.

A systematic review examining alcohol dependence and sexual dysfunction across genders

This systematic review examines the impact of alcohol dependence on sexual function amongst cisgender men and women, intersex, transgender, and gender-nonconforming individuals. Electronic searches using PubMed, PsycInfo, Web of Science, and registered clinical trials, yielded 22 relevant studies. Research looking at alcohol dependence and sexual dysfunction in cisgender women, and even more so intersex, transgender and gender non-conforming people has received comparatively less attention than for cisgender men, with a 1:5 ratio. Consensus of the included literature indicated that alcohol dependence does impact sexual functioning, which includes erectile dysfunction and premature ejaculation for cisgender men and sexual desire and orgasmic difficulties for cisgender women. With an overall general shortage of research on alcohol dependence and sexual dys/function, psychosexual services remain limited when supporting dual-diagnosed and sex and gender diverse groups.

Motives that Mediate the Associations Between Relationship Satisfaction, Orgasmic Difficulty, and the Frequency of Faking Orgasm.

Faking orgasm by women reportedly occurs quite frequently, with both relationship characteristics and orgasmic difficulty being significant predictors. We explored women's motives that might mediate the associations between orgasmic difficulty and relationship satisfaction on the one hand, with the frequency of faking orgasm on the other. In a study of 360 Hungarian women who reported "ever" faking orgasm during partnered sex, we assessed the direct and indirect (mediated) associations between orgasmic difficulty, relationship satisfaction, and the frequency of faking orgasm. Determination of motives that mediate the association between orgasmic difficulty and the frequency of faking orgasm, and the association between relationship satisfaction and the frequency of faking orgasm. Increased orgasmic difficulty was directly related to increased frequency of faking orgasm (β=0.37; P < .001), and each variable itself was related to a number of motives for faking orgasm. However, the only motive assessed in our study that mediated the relationship between orgasmic difficulty and the frequency of faking orgasm was insecurity about being perceived as abnormal or dysfunctional (indirect effect: β=0.13; P < .001). A similar pattern emerged with relationship satisfaction and frequency of faking orgasm. These two variables were directly related in that lower relationship satisfaction predicted higher frequency of faking orgasm (β=-0.15; P=.008). Furthermore, while each variable itself was related to a number of motives for faking orgasm, the only motive assessed in our study that mediated the relationship between the 2 variables was insecurity about being perceived as abnormal or dysfunctional (indirect effect: β=-0.06; P=.008). Insecurity related to being perceived as abnormal or deficient, along with sexual communication, should be addressed in women with a history of faking orgasm but who want to cease doing so. The sample was relatively large and the online survey adhered to best practices. Nevertheless, bias may result in sample characteristics when recruitment is achieved primarily through social media. In addition, the cross-sectional sample prevented causal determination and represented Western-based values. The associations between orgasmic difficulty and faking orgasm, and between relationship satisfaction and faking orgasm, are both direct and indirect (mediated). The primary motive for mediating the indirect association between the predictor variables and the frequency of faking orgasm was the insecurity about being perceived as deficient or abnormal. Hevesi K, Horvath Z, Miklos E, et al. Motives that Mediate the Associations Between Relationship Satisfaction, Orgasmic Difficulty, and the Frequency of Faking Orgasm. Sex Med 2022;10:100568.

“O” No: A Reddit Analysis of Orgasmic Dysfunction

ABSTRACT Introduction Orgasmic dysfunction includes reduced orgasmic intensity, decreased orgasm frequency and inability to achieve orgasm. Issues with orgasming are often multi-factorial in origin and can cause significant distress to patients. Objective We aimed to evaluate the experience of women with orgasmic dysfunction on Reddit, an anonymous forum-based platform that allows users to interact with a global audience. Methods The subreddit “TwoXChromosomes” was queried using the Reddit Application Programming Interface (API) for posts using the keywords “orgasm” and “climax”. Posts that were deleted, archived or unrelated to themes of orgasm were excluded. Threads were qualitatively analyzed using the grounded theory approach. Five independent researchers read and coded each thread identifying dominant themes and emergent concepts. Results Qualitative analysis of 108 threads and approximately 6,300 comments resulted in 5 major categories: psychological aspect of orgasms, difficulty orgasming with partners, partners’ response to orgasmic dysfunction, types of orgasms, and treatments for orgasmic dysfunction. Preliminary themes included (1) the presence of an emotional component or history of trauma resulting in orgasmic difficulty, (2) difficulty orgasming with a partner regardless of ability to orgasm during masturbation, and mixed partner responses to orgasmic dysfunction, with approximately half of posters reporting a supportive sexual partner who was interested in their sexual satisfaction while the remainder of posters reported partner dissatisfaction. (3) variety of stimulation required to orgasm, (4) the definition of a “normal orgasm and (5) self-motivated treatment for orgasmic dysfunction, including clitoral stimulation devices and masturbation techniques, with few posters discussing their orgasmic dysfunction with health care providers. Conclusions Overall, Reddit provides a medium for individuals with orgasmic dysfunction to discuss their experiences. Posts addressed users’ inability to orgasm, the interplay with their mental health and relationships, types of stimulation and treatments. Interestingly, very few posts discussed seeking out medical care for orgasmic dysfunction, potentially suggesting that women do not classify their orgasmic dysfunction as a health issue. The obvious prevalence of orgasmic dysfunction with little discussion surrounding healthcare reveals a large gap in sexual health counseling, indicating the need for expanded sexual health screening and detailed clinician-patient counseling. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Sprout (Raliegh, NC), Absorption Pharmaceuticals, Urovant Sciences, Inc.

Masturbation parameters related to orgasm satisfaction in sexual relationships: Differences between men and women.

ObjectiveMasturbation is a behavior that can enhance sexual functioning. This study aims to analyze differences between men and women in different masturbation parameters, and to examine their relation with orgasm satisfaction in sexual relationships.MethodOne thousand three hundred and thirty-fifth men and women from the Spanish population aged 18–83 years (M = 36.91; SD = 11.86) participated in an online survey. A questionnaire was used to collect socio-demographic. Sexual history data, negative attitude toward masturbation, solitary sexual desire and orgasm subjective experience upon masturbation were assessed. Given the differences between men and women, independent regression models are proposed to explain orgasm satisfaction in the sexual relationships context.FindingsMen, compared to women, masturbated at a younger age (p < 0.001), and reported higher current masturbation frequency (p < 0.001) and more solitary sexual desire (p < 0.001). Women reported greater intensity in the subjective orgasm experience on its Affective (p < 0.001), Sensory (p < 0.001) and Intimacy (p < 0.001) dimensions. Regarding regression models, the Affective dimension of orgasm was a common parameter in men (β = 0.36; p < 0.001) and women (β = 0.24) to explain orgasm satisfaction during sexual relationships. In men, solitary masturbation frequency (β = −0.10; p = 0.027) acquired a significant role. In women, the model also included age (β = 0.09; p = 0.038), negative attitude toward masturbation (β = −0.12; p = 0.005) and solitary sexual desire (β = −0.19; p = 0.001).ConclusionWhen dealing with men and women's orgasm difficulties in the sexual relationships context, it is important to consider the role of masturbation. In men and women, the Affective dimension of the orgasm experience explain the orgasm satisfaction in sexual relationship. Also, in men, the solitary masturbation frequency is negatively related with orgasm satisfaction in sexual relationship, supporting the compensatory hypothesis of masturbation. In women, in addition to the Affective dimension, the orgasm satisfaction in sexual relationship is explained, negatively, by the negative attitude toward masturbation, and positively, by the solitary sexual desire, which could be associated with more sexual self-knowledge. The relevance of masturbation in understanding sexual functioning is highlighted.

Prevalence and Correlates of Sexual Aversion: A Canadian Community-Based Study

BackgroundSexual aversion (SA) is a chronic difficulty impacting sexual, relational and psychological wellbeing. Yet, there is a dearth of studies exploring its prevalence and associated factors. AimTo estimate the prevalence of SA and examine its correlates among a community sample of Canadian adults. MethodsA large web-based sample of the Quebec (Canada) adult population (n = 1,935) completed an online survey on sexual wellbeing. Prevalence rates were estimated for SA and other sexual difficulties. Multivariate logistic regression analyses were used to identify correlates of SA. OutcomesDemographics (eg, gender, employment status), self-reported experiences of sexual difficulties (low sexual desire and arousal, vaginal dryness, pain during sexual intercourse, erectile difficulties, premature or delayed ejaculation, and orgasm difficulties), and markers of psychosexual wellbeing (eg, psychological distress, performance anxiety) according to the presence or absence of SA were assessed. ResultsThe prevalence of SA was 9.7% (95% CI: 8.5–11.2) in the present sample (6.9% [95% CI: 5.1–8.9] in men, 11.3% [95% CI: 9.4–13.4] in women and 17.1% [95% CI: 9.4–27.4] in nonbinary and/or trans individuals). The multivariate logistic regression model explained 31% of the likelihood of experiencing SA. SA was related to psychological distress (aOR: 1.77, 95% CI: 1.33–2.38), sexual satisfaction (aOR: .59, 95% CI:.49–0.70), sexual performance anxiety (aOR: 2.08, 95% CI: 1.45–2.98), and discomfort with sex-related information (aOR: 1.02, 95% CI: 1.01–1.04) Clinical implicationsSeveral psychosexual correlates of SA were documented and could be targeted by practitioners during the assessment and treatment of individuals living with SA. Strengths and limitationsThe study's strengths include its large, gender diverse sample and use of comprehensive diagnostic criteria for SA. Probability-based sampling methods and longitudinal studies should be conducted to address the current study's limitations. ConclusionSA research is critical to document its prevalence in different sociodemographic groups, explore additional intrapersonal and interpersonal mechanisms involved in SA etiology, and ensure that the needs of people living with SA are met with tailored interventions.David Lafortune, Éliane Dussault, Mathieu Philibert, Natacha Godbout. Prevalence and Correlates of Sexual Aversion: A Canadian Community-Based Study. J Sex Med 2022;19:1269–1280.

The role of cognitive distraction in sexual dysfunction in female medical resident doctors

Introduction: Studies have shown a high prevalence of sexual dysfunction in Medical residents. Psychological, interpersonal, and sociocultural factors play an important role in sexual vulnerability. In addition, distraction or interference in the cognitive process of the erotic stimulus plays an important role in the development of sexual dysfunction. The aim of our study was to determine the prevalence of sexual dysfunctions among a sample of married female medical resident doctors and to explore its relation with cognitive distraction during sex. Subjects and methods: This was a cross-sectional study, which was carried out in October 2017 with 70 married female medical resident doctors. We used the Female Sexual Function Index (FSFI) for sexual functioning assessment and the cognitive distraction during sex scale. Results: The mean age of women was 30.52 years. They had been married for 6.04 years on the mean. The majority (74%) had children. According to the FSFI, 40% of resident doctors had sexual dysfunction. The mean cognitive distraction during sex score was 4.37. In our study, women with female sexual dysfunction reported significantly lower sexual desire score = 3.2 vs. 4.1 and p = 0.03) and arousal (score = 3.è vs. 4.7 and p = 10-3), decreased lubrication (score = 3.8 vs. 5.1; p = 10-3), less sexual satisfaction (score = 3.9 vs. 5.8; p = 10-3) and higher orgasm difficulties (score = 3.4 vs. 5.1; p = 10-3). Yet, our results highlighted that women with female sexual dysfunction presented significantly more cognitive distraction during sex (score = 3.9 vs. 4.6; p = 0.03). Conclusion: According to our study, it appears that the prevalence of FSD in medical resident doctors is considerable. Besides, intrusive thoughts and cognitive distraction during sexual intercourse are importantly associated with sexual functioning. Therefore, several measures should be implemented in this population to prevent or act on these factors.

0711 Do postmenopausal women with insomnia and obstructive sleep apnea have deterioration in sexual function?

Abstract Introduction Sleep problems and sexual dissatisfaction are among the most common complaints during and after the menopause transition. The prevalence of insomnia and obstructive sleep apnea (OSA) reach 31% and 44% of postmenopausal women, respectively. The sexual dissatisfaction is frequently caused by a decline in hormonal levels and urogenital atrophy, resulting in inadequate lubrication and pain during intercourse, with orgasm difficulties and low sexual. Both behaviors – sleep and sexual function - play an important part in women’s wellness. The objective of this study was to investigate whether insomnia in association with OSA would increase climacteric and sexual symptoms compared with women with only insomnia or OSA. Methods Our sample comprised 47 postmenopausal women distributed into 3 groups: 1) insomnia, 2) OSA, and 3) OSA+insomnia. All participants completed the questionnaires: Insomnia Severity Index, Female Sexual Function Index, and Blatt-Kupperman menopausal index. Of the 47 participants, 34 women undergone polysomnography. The 3 groups were compared in respect of climacteric symptoms, sexual function score, and sleep. Results Our results showed that 85.1% of the postmenopausal women were classified with insomnia, 46.8% were diagnosed with OSA, and 82.9% had low sexual function. All groups had sleep efficiency of &amp;lt;80%, wake after sleep onset of &amp;gt;65 min, and a total sleep time of &amp;lt;6h, indicating poor sleep quality. There were no statistically significant differences among the groups in all sexual domains. The group of OSA+insomnia reported more climacteric symptoms (27.1±9.7) when compared to OSA group (15.7±9.6, P=0.03). Conclusion In our sample, the presence of insomnia and OSA associated with postmenopause revealed a low score for sexual function. Climacteric symptoms were higher in the groups with insomnia, and the association with low sexual function can lead to worsening of clinical condition. Support (If Any) Support: AFIP and CNPq. ACKNOWLEDGEMENTSOur studies are supported by the following funding agencies: AFIP (Associação Fundo de Incentivo à Pesquisa), CNPq (fellowships to LL, MLA, HH and ST). This study received indirect funding from AFIP and CNPq.

Prevalence and factors of sexual dysfunctions among military men: A systematic review

ABSTRACT Background Military men are at a higher risk of developing sexual dysfunction (SD) as compared to the general population because military deployment exposes soldiers to stressful situations (e.g., death of comrades, combat stress, war inflicted injuries, severe environment, lack of sleep, mental distress, isolation, post-traumatic stress disorder (PTSD), polluted environment and substance abuse, etc.) that may alter their psychological and underlying biological processes. Understanding mechanisms and estimating the burden of SD in military men would also be helpful for the implication in the general population of men exposed to such harsh conditions. Objective To systematically review published reports on SD in military men. Methods Medline was searched for original articles published between 2008 and 2020 by using the search terms “sexual dysfunction in military personnel,” and “sexual dysfunction in veterans”. Quality evaluation and data extraction were done by two authors. Studies that reported the sexual dysfunction in newly inducted or interviewed men in recruitment centres or specific disease cohorts, and that reported the effect of different drugs on sexual health under controlled conditions were excluded. Information related to the sampling duration, sampling method, sample size, methods of diagnosis, cut off values, the prevalence of different sexual dysfunctions and associated factors were extracted. All discrepancies were resolved by discussion. Results A total of 8211 studies were identified initially. After the removal of duplicates, 5186 studies were screened based on titles and abstracts. The full articles were downloaded for 54 studies, of which 27 studies were finally included in the qualitative study. Among the included studies 16 were conducted in North America (US=15 and Canada=01), 4 in Europe (Netherlands=1, France=1 and Croatia=2) and 7 in Asia (Israel=3, Iran=1, South Korea=1 and Taiwan=2). All the studies included in the present review had variable sample sizes (n=53 - 456,340). Sampling methods included mailed questionnaires, in-person interviews, medical chart reviews and secondary data taken from large surveys and patients from outpatient clinics. The studies reported a wide range of prevalence of overall SD (5.6% - 88.7%), erectile dysfunction (ED) (2% - 83.4%), ejaculatory dysfunction (0.1% - 25.5.0%), orgasmic dysfunction (0.2% - 15.4%) sexual desire disorders (0.3% - 74.0%) and sexual dissatisfaction (11.8% - 73.5%). The prevalence of mild ED (16.7% - 30.3%) was highest followed by mild to moderate ED (3.4% - 20.5%), moderate ED (1.1% - 9.3%) and severe ED (0.3% - 10%). Prevalence of premature and delayed ejaculation was 0.1% - 25.5% and 18.0%, respectively. Prevalence of quick orgasms and difficulty in orgasm was reported in 15.4% and 13.8%, respectively. Orgasmic anhedonia was also reported in 11 % of men. The prevalence of SD was positively associated with PTSD, depression and anxiety, using nicotine and antidepressants, physical health (infections, cardiovascular diseases), and being non-white race. However, age, alcohol, body weight and education had no association with SD in military men. Conclusion A considerably variable number of military men had SD due to different factors. Studies in Asian and European countries were limited in number and magnitude. Disclosure Work supported by industry: no.

MP20-13 QUANTIFYING TIME TO ORGASM AFTER GENDER AFFIRMING VAGINOPLASTY

You have accessJournal of UrologyCME1 May 2022MP20-13 QUANTIFYING TIME TO ORGASM AFTER GENDER AFFIRMING VAGINOPLASTY Gaines Blasdel, Elijah Castle, Carmen Kloer, Augustus Parker, Rachel Bluebond-Langner, and Lee Zhao Gaines BlasdelGaines Blasdel More articles by this author , Elijah CastleElijah Castle More articles by this author , Carmen KloerCarmen Kloer More articles by this author , Augustus ParkerAugustus Parker More articles by this author , Rachel Bluebond-LangnerRachel Bluebond-Langner More articles by this author , and Lee ZhaoLee Zhao More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002553.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Many transgender and nonbinary (henceforth, “trans”) patients have goals related to sexual health when seeking gender affirming vaginoplasty, and previous investigations have only studied ability to orgasm at cross-sectional timepoints. Our aim is to quantify the time to orgasm postoperative primary robotic peritoneal gender affirming vaginoplasty and describe potential correlative factors, including pre-operative orgasm to better inform preoperative counseling. METHODS: Retrospective chart review was utilized to extract factors thought to influence pre- and post-operative orgasm in patients undergoing robotic peritoneal flap vaginoplasty. Mean days to orgasm plus one standard deviation above that mean was used to define time at which patients would be considered anorgasmic. RESULTS: A total of 199 trans patients underwent surgery from September 2017 to August 2020. Median time to orgasm was 180 days. 178 patients had completed one year of follow up or greater, and of these patients, 153 (86%) were orgasmic and 25 patients (14%) were not (Figure 1). Difficulty in pre-operative orgasm was correlated only with older age (median age 45.9 years versus 31.7, p=.03). Post-operative orgasm was not significantly correlated with pre-operative orgasm. The only factor related to post-operative orgasm was smoking history: 12 of 55 patients (21.8%) who had a positive smoking history and sufficient follow up reported anorgasmia (p-value 0.046). CONCLUSIONS: Preoperative difficulty with orgasm appears to be treated with gender affirming vaginoplasty, conferring similar post-surgical orgasm rates to those who struggled with orgasm before surgery. Smoking had a negative impact on post-operative orgasm recovery despite negative cotinine test prior to surgery, signaling that prolonged smoking cessation may improve orgasmic outcomes, or that underlying exposures correlated with smoking may be the true causal factor inhibiting recovery of orgasm. The majority of patients were orgasmic at their six month follow up appointment, however patients became newly orgasmic in appreciable numbers more than one year after surgery. Interventions for anorgasmic patients include testosterone replacement, pelvic floor physical therapy, and psychotherapy. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e322 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gaines Blasdel More articles by this author Elijah Castle More articles by this author Carmen Kloer More articles by this author Augustus Parker More articles by this author Rachel Bluebond-Langner More articles by this author Lee Zhao More articles by this author Expand All Advertisement PDF DownloadLoading ...