Psychogenic Sexual Dysfunction Research Articles

(226) Wearable Devices for Monitoring Sexual Encounter Physiology in Patients with Psychogenic Erectile Dysfunction

Abstract Introduction Understanding the physiological changes during sexual arousal and function in males with psychogenic erectile dysfunction remains an area of limited comprehension, despite a well-established understanding of erection physiology. To bridge this gap, we conducted a prospective study employing both qualitative and quantitative methods, to investigate the utility of wearable devices in measuring and identifying the physiological changes among males diagnosed with psychogenic sexual dysfunction. Objective This study aims to leverage wearable device technology to precisely measure and analyze physiological parameters, including heart rate, during sexual encounters in individuals diagnosed with psychogenic erectile dysfunction. Methods Individuals diagnosed with psychogenic erectile dysfunction were asked to wear a FitBit Versa 3 for a period of six weeks. Encrypted, de-identified data from the Fitbit was sent via the Fitbit app on subject’s smartphones to a single member of the research team. Subjects were asked to log the number, type (penetrative/oral/erogenous touch/masturbation), and timing of sexual encounters. Subjects also logged whether orgasm was achieved, and their satisfaction with the encounter. Results Over the course of the study, data from twenty unique sexual encounters were analyzed. Patients’ heart rate during both masturbation and sexual intercourse were recorded and normalized to their resting heart rate. During both sexual intercourse and masturbation, patterns of heart rate variability emerged, with an excitement phase (initial rise in heart rate), plateau phase, orgasm (peak heart rate), and resolution phase (decrease back to baseline heart rate), in line with our previous findings in individuals without sexual dysfunction. The data also indicate that these physiologic responses are similar regardless of if the patient is engaging in intercourse with a partner, or engaging in masturbation via self-stimulation. Conclusions We have previously shown that wearable device technology can be used to delineate patterns of heart rate variability during sexual encounters in healthy patients without sexual dysfunction. Data from our current study further highlights the feasibility of wearable device technology for conveniently and accurately measuring physiological parameters during sexual activity in patients with psychogenic erectile dysfunction. Furthermore, our data is the first to show that heart rate variability is consistent between masturbation and sexual activity with a partner in patients diagnosed with psychogenic erectile dysfunction. These findings contribute to the limited existing literature on objective physiologic measurements during sexual activity and emphasize the potential of wearable technology in monitoring physiological changes in sexual encounters. This study has further implications for both research and clinical settings for psychogenic erectile dysfunction. In research, Fitbits and other wearable devices may provide a convenient and non-invasive method for studying sexual satisfaction and further characterizing psychogenic erectile dysfunction, while in a clinical setting these devices may help healthcare professionals Disclosure No.

Assessment of the effect of mindfulness monotherapy on sexual dysfunction symptoms and sex-related quality of life in women.

Mindfulness-based therapies (MBTs) are frequently used in the treatment of sexual dysfunctions. So far, there has not been sufficient evidence for the effectiveness of interventions based on mindfulness monotherapy. The aim of the study was to assess the effect of mindfulness monotherapy on the reduction of sexual dysfunction symptoms and sex-related quality of life. We conducted 4 weeks of MBT for 2 groups of heterosexual females: 1 with psychogenic sexual dysfunction (WSD) and 1 with no sexual dysfunction (NSD). Overall 93 women were recruited for the study. We collected data via an online survey regarding sexual satisfaction, sexual dysfunctions, and mindfulness-related features at baseline, 1 week after MBT, and follow-up 12weeks after MBT. Research tools included the Female Sexual Function Index, Five Facet Mindfulness Questionnaire, and Sexual Satisfaction Questionnaire. Participating in the mindfulness program had a positive effect on women with and without sexual dysfunction. The overall risk for sexual dysfunction decreased from 90.6% at baseline to 46.7% at follow-up in the WSD group and from 32.5% at baseline to 6.9% at follow-up in the NSD group. Participants in the WSD group reported a significant increase in levels of sexual desire, arousal, lubrication, and orgasm between measurements, although not in the pain domain. Participants in the NSD group reported a significant increase in the level of sexual desire between measurements but not in levels of arousal, lubrication, orgasm, and pain. A significant increase in sex-related quality of life was observed in both groups. The results of the study have a chance to translate into an introduction of a new therapeutic program for specialists and more effective help offered to women experiencing sexual dysfunctions. This mindfulness monotherapy research project, which included assessment of meditation "homework," is the first to verify the potential of MBT in reducing symptoms of psychogenic sexual dysfunctions among heterosexual females. Major limitations include the lack of randomization, an adequate control group, and a validated measure of sexual distress. The applied training was beneficial in the treatment of sexual dysfunctions in terms of increasing desire and arousal as well as the ability to reach orgasm. However, this approach needs more investigation before it can be recommended in the treatment of sexual dysfunction. The study should be replicated under a more rigorous research design, including adequate control groups and random allocation of participants to study conditions.

Effects of tadalafil on sexual behavior of male rats induced by chronic unpredictable mild stress.

Few studies have investigated psychogenic sexual dysfunction including psychogenic erectile dysfunction (pED); the effect of tadalafil on sexual behavior of male rats induced by chronic unpredictable mild stress (CUMS) remains unclear. The aim was to explore the influence of CUMS on sexual behavior of male rats and the effects of tadalafil on that. Adult male rats were divided into 3 groups, including the normal group without CUMS, the model group with 6weeks' CUMS, and the tadalafil group with treatment of tadalafil during CUMS. CUMS consists of water deprivation, food deprivation, stroboscopic lightning, white noise, cage tilting, weeding packing, and housing 2 unfamiliar rats. The apomorphine test and vaginal smear test were conducted with the aim to screen out male rats with good erectile function and make preparation for the sexual behavior test, respectively. At the end of the study period, the level of anhedonia and sexual function were evaluated by the sucrose preference test, sexual behavior test, and measurement of serum testosterone, dopamine, and 5-HT. Sucrose preference showed significant decrease in rats after CUMS. The intromission ratio and total intromission frequency decreased significantly, while the mount latency and ejaculation latency prolonged significantly in CUMS-induced rats when compared with normal rats. Meanwhile, the treatment of tadalafil reversed the level of anhedonia and sexual function in CUMS-induced rats. However, there were no statistical differences in the levels of serum testosterone, dopamine, and 5-HT among groups. The study constructed an animal model that can provide clinical insights into the mechanism of psychogenic sexual dysfunction and supports the application of tadalafil in pED therapy. We found that CUMS-induced rats exhibited anhedonia and poor sexual function that could be prevented by tadalafil administration. Future research needs to construct the standard of pED model and explore the mechanism of tadalafil on central nervous system. Tadalafil could prevent the changes of depression and poor sexual function in rats induced by CUMS, and the method of CUMS and the sexual behavior test should be used in the future for pED modeling.

Sexual Health Problems among Service Men: The Influence of Posttraumatic Stress Disorder

ABSTRACT Military operational stressors, such as combat exposure, may increase the risk of sexual health problems. This study examined factors associated with sexual health problems, and tested the mediating effect of probable posttraumatic stress disorder (PTSD) on the association between stressors (i.e., combat deployment and sexual assault) and sexual health problems among U.S. service men. Using multivariable logistic regression (n = 16,603) and Cox proportional hazards models (n = 15,330), we estimated the risk of self-reported sexual health difficulties and sexual dysfunction medical encounters, respectively. Mediation analyses examined the effect of probable PTSD as an intermediate factor between high combat deployment and sexual assault on sexual health problems. Approximately 9% endorsed sexual health difficulties and 8% had a sexual dysfunction. Risk factors for these sexual health problems included older age, lower education level, enlisted rank, disabling injury, certain medical conditions, and higher body mass index. Probable PTSD significantly mediated the associations between high combat with sexual health problems and sexual assault with sexual dysfunction. Additionally, high combat was directly associated with sexual health difficulties. These findings indicate a relationship between these stressors and sexual health problems which suggests that treatment options should be expanded, especially to include psychogenic sexual dysfunctions.

Clinical Practice Guidelines for management of Sexual Disorders in Elderly.

Clinical Practice Guidelines for management of Sexual Disorders in Elderly.

Structural insights into aberrant cortical morphometry and network organization in psychogenic erectile dysfunction.

Functional neuroimaging studies have revealed abnormal brain dynamics of male sexual arousal (SA) in psychogenic erectile dysfunction (pED). However, the neuroanatomical correlates of pED are still unclear. In this work, we obtained cortical thickness (CTh) measurements from structural magnetic resonance images of 40 pED patients and 39 healthy control subjects. Abnormalities in CTh related to pED were explored using a scale space search based brain morphometric analysis. Organizations of brain structural covariance networks were analyzed as well. Compared with healthy men, pED patients showed significantly decreased CTh in widespread cortical regions, most of which were previously reported to show abnormal dynamics of male SA in pED, such as the medial prefrontal, orbitofrontal, cingulate, inferotemporal, and insular cortices. CTh reductions in these areas were found to be significantly correlated with male sexual functioning degradation. Moreover, pED patients showed decreased interregional CTh correlations from the right lateral orbitofrontal cortex to the right supramarginal gyrus and the left angular cortex, implying disassociations between the cognitive, motivational, and inhibitory networks of male SA in pED. This work provides structural insights on the complex phenomenon of psychogenic sexual dysfunction in men, and suggests a specific vulnerability factor, possibly as an extra "organic" factor, that may play an important role in pED.

1266 – The role of media in shaping sexual disorders in youth

Introduction The existence of age-normal are causes the special features of sexual dysfunction. At a young age (18-30 years) is characterized by the development and formation of the sexual function. It is for this age period is characterized by the influence of media on the psycho-emotional state - admass, and as a consequence, the development of psychogenic sexual dysfunctions. Propaganda regular and undying of male strength is cause the formation of personality conflict. Methods 35 patients were examined in this age range. Analysis of the data revealed that most patients were observed ejaculation disorder, (which was associated with increased sexual arousal) and erectile dysfunction, due to a number of reasons (personal characteristics, the nature of psychological trauma). Results At a young age, there is an active search for a regular sexual partner. Unsuccessful attempts to prove their sexual viability leads to the formation of non-adaptive systems of personality that was the cause of sexual dysfunction. Is aggravated sexual dysfunction picture of perfectionism. The emergence of sexual dysfunction was also due to misconceptions about the norm of sexual activity. Thus formed resistant obsessive fear of impotence. Patients in this group rarely share their problems in sexual life with a partner, because they fear for their dignity and fear seem weak, vulnerable. Conclusions The development of sexual dysfunction is largely determined by personality traits of the individual. Thus, in patients aged under 30 years at the base of sexual disorders lying psychogenic factor. The degree of which depends on the personality characteristics.

Somatoform and Psychoform Dissociation Among Women with Orgasmic and Sexual Pain Disorders

Since the 20th century, psychogenic female sexual dysfunctions (FSD), like some somatoform and conversion disorders, have been considered an expression of somatoform dissociation. Several studies have reported dissociative symptoms in different somatoform and conversion disorders, but limited data are available on dissociation among patients with FSD. The aim of this study was to assess somatoform and psychoform dissociation among patients with women's orgasmic disorder, dyspareunia, and vaginismus. A battery of self-administered questionnaires (Somatoform Dissociation Questionnaire, Dissociative Experiences Scale, Hospital Anxiety and Depression Scale, Impact of Event Scale–Revised) was given to 200 gynecological outpatients to assess psychoform and somatoform dissociation and their association with FSD. A strong association between somatoform dissociation and FSD was observed (adjusted odds ratio [OR] = 5.39, 95% confidence interval [CI] = 1.15–25.32), the association between somatoform and psychoform dissociation being estimated by an adjusted OR of 4.83 (95% CI = 1.17–19.91). Our results are compatible with the idea that some forms of FSD could be regarded as somatoform dissociative disorders.

A P300 Event Related Potential Technique for Assessment of Sexually Oriented Interest

Despite all of the modern, sophisticated tests that exist for diagnosing and assessing male and female sexual disorders, to our knowledge there is no objective psychophysiological test to evaluate sexual arousal and interest. We provide preliminary data showing a decrease in auditory P300 wave amplitude during exposure to sexually explicit video clips and a significant correlation between the auditory P300 amplitude decrease and self-reported scores of sexual arousal and interest in the clips. A total of 30 healthy subjects were exposed to several blocks of auditory stimuli administered using an oddball paradigm. Baseline auditory P300 amplitudes were obtained and auditory stimuli were then delivered while viewing visual clips with 3 types of content, including sport, scenery and sex. Auditory P300 amplitude significantly decreased during viewing clips of all contents. Viewing sexual content clips caused a maximal decrease in P300 amplitude (p <0.0001). In addition, a high correlation was found between the amplitude decrease and scores on the sexual arousal questionnaire regarding the viewed clips (r = 0.61, p <0.001). In addition, the P300 amplitude decrease was significantly related to the sexual interest score (r = 0.37, p = 0.042) but not to interest in clips of nonsexual content. The change in auditory P300 amplitude during exposure to visual stimuli with sexual context seems to be an objective measure of subject sexual interest. This method might be applied to assess therapeutic intervention and as a diagnostic tool for assessing disorders of impaired libido or psychogenic sexual dysfunction.

Male psychogenic sexual dysfunction: the role of masturbation

The role of masturbation in male psychogenic sexual dysfunction (MPSD) has been neglected by researchers and practitioners; this qualitative study explores that link through individual interviews with a clinic population by using grounded theory as a methodological approach and analytical style. Although a preference for functional sex with a partner was expressed by participants, our data suggest that masturbation dependence develops as a result of their sexual response having become conditional on a discrete set of behaviours, and is reinforced by cognitive components displaying different characteristics during masturbation and partner sex. The interrelation of both cognitive and behavioural components of sexual response is explored, and a theoretical model presented. Proposals for further study are suggested, and recommendations made for expansion of the formulation and treatment planning for MPSD.

Round Table 3 - Management of Psychogenic Sexual Dysfunction

Round Table 3 - Management of Psychogenic Sexual Dysfunction

Sexual dysfunction in gay and bisexual men with HIV infection: Evaluation, treatment and implications

Sexual dysfunction problems are common in people with HIV infection, but their relevance has been recently highlighted in response to the increased survival shown by many individuals with HIV, and the publicity surrounding the development of new treatments for male sexual dysfunction. Thirty-four gay/bisexual men with HIV infection presenting with sexual dysfunction were assessed. Antiretroviral combination therapy including protease inhibitors was taken by 44%, other combinations not including protease inhibitors by 24%, while 32% were not taking any antiretrovirals. Primarily psychogenic sexual dysfunction was thought to be present in 44%, primarily organic dysfunction in 22% and a mixed aetiology in 34%. Treatments offered included psychological interventions and physical methods of treatment, alone or in combination. Treatment was effective, with 76% reporting resolution of the problems, 14% reporting improvement and only 10% reporting no change. Practical and ethical issues raised by the findings are discussed.

Cross-Cultural Aspects of Sexual Anxieties and the Associated Dysfunction

Sociocultural influence on sexual behavior is beyond doubt. It is difficult to attribute the wide range of different sexual behaviors in different societies to constitutional predisposition only. This study represents an open longitudinal prospective to collect sociodemographics as well as relevant medical data from all patients, attending a psychiatric clinic in a general psychiatric hospital, complaining of psychogenic sexual dysfunctions in a period of one year. Patients were selected only if organic causes for their dysfunctions were excluded and positive psychogenic factors were identified. A total of 38 male and 5 female patients were seen during this period. Twenty-five males had erectile disorder and the remaining 13 had premature ejaculation. Among the females, 2 had vaginismus and 3 had dyspareunia. Eighty-eight percent of the male patients were younger than 40 years and married for less than 5 years. The premature ejaculators were relatively older than the impotents (85% older than 40 years). T...

Cognitive Hypnotherapy With Sexual Disorders

Research has found that in psychogenic sexual disorders, cognitive processes are more important than physiological ones. Negativistic “thinking” about one’s sexual activity aggravates the symptom and perpetuates it. Therefore, as vital as a differential diagnosis of sexual dysfunction is, the uncovering of Negative Self-Hypnosis (NSH) becomes essential for the successful resolution of the sexual problem. NSH constitutes the “hidden symptom” in all psychogenic sexual dysfunctions. After explicating NSH, the paper offers specific hypnotic techniques for different sexual disorders.

Gonadal steroid and gonadotropin response to dexamethasone: a study in sexual dysfunction and normal controls.

Numerous investigations have reported an alteration of hormonal response to dexamethasone in depressive disorder. No such data are available in psychogenic sexual dysfunction. Pre- and postdexamethasone levels of testosterone, estradiol, LH and FSH were studied in 20 male patients with sexual dysfunction and 20 male healthy controls. Dexamethasone had no influence on testosterone, estradiol, LH and FSH in normal controls. The patients showed an increase in testosterone and LH but not in FSH levels in the morning after dexamethasone administration. When compared with basal levels, the increase in postdexamethasone levels in sexual dysfunction was significant for testosterone (delta T) but not for LH (delta LH). The altered gonadal steroid and gonadotropin response to dexamethasone in sexual dysfunction might be due to disturbances of dexamethasone metabolism and glucocorticoid receptor density comparable to similar findings in depressive disorder.

Pre- and postdexamethasone cortisol and prolactin levels in sexual dysfunction and normal controls

Initially, the Dexamethasone Suppression Test (DST) was reported to be a specific marker for endogenous depression (Carroll 1982). Recent studies however suggest that supposedly abnormal DST results may also occur in healthy controls (Stokes et al. 1985) and in a number of other psychiatric disorders (Holsboer and Benkert 1985), though the rate of nonsuppressors is higher in major depressive disorder (Stokes et al. 1985). Dexamethasone has also been shown to decrease prolactin levels, an effect that is more often found in normal controls and in nonendogenous depression than in endogenous depression (Rupprecht et al. 1987). Hyperprolactinemia may induce sexual dysfunction (Braunstein 1983), whereas in psychogenic sexual dysfunction, Benkert and Witt (1980) and Miller et al. (1980) reported normal prolactin levels, and others even lowered prolactin levels (Natoli et al. 1985). As no data are available

The reliability of nocturnal vaginal blood flow

Fourteen subjects participated in a sleep study designed to document the reliability of measurements of REM-related vaginal blood-flow changes. Several standard sleep parameters were also examined for comparison with vaginal measures. The most reliable vaginal measure was the maximal change in disengorgement for a given REM period averaged across a night of REM periods. The reliability of this measure compared favorably with that of a highly reliable computerized measure of REM density. It is suggested that nocturnal vaginal blood-flow measures have sufficient reliability to be useful in the differential diagnosis of organic and psychogenic sexual dysfunction.

Evaluation of nocturnal penile tumescence with potentest

PotenTest is a standardized, hygienically packaged, and reliable stamp test, useful for differentiating organic from psychogenic sexual dysfunction. Fifteen potent control patients wore a PotenTest band on three separate nights, and during a selfinduced erection, while PotenTest reliably induced nocturnal erections and penile rigidity. PotenTest and Snap-Gauge were used to evaluate pre- and postoperative potency in twelve cystectomy patients. The result with each test was essentially the same.

Uses of Hypnosis in the Treatment of Psychogenic Sexual Dysfunctions

Uses of Hypnosis in the Treatment of Psychogenic Sexual Dysfunctions

A taxonomy of subjective meanings in male sexual dysfunction

In the present paper the literature on male sexual dysfunction, with specific reference to subjective dispositions, is reviewed. On the basis of an examination of psychoanalytic, cognitive, behavioral, and systemically oriented literature, six generic themes in subjective meaning are isolated and depicted via the presentation of “covert statements.” Regardless of theoretical orientation, the concept of subjective meaning is central to an understanding of psychogenic sexual dysfunction. The manner in which subjective meaning is considered from each perspective and the general form of explanation utilized is addressed. Implications for research and treatment are discussed