Sexual Disturbances Research Articles

THU0592-HPR Precipitating, Predisposing and Maintenance Factors Associated with Sexual Disorders in Patients with Rheumatoid Arthritis

BackgroundSexuality is an important dimension of personality and human body, therefore any involvement in this area should be considered as important. Sexual disturbances in rheumatoid arthritis (RA) patients are poorly...

AB0336 Sexual Disturbances in Patients with Rheumatoid Arthritis and It's Relation with Disease Activity

BackgroundSexuality is an important dimension of personality and human body, therefore any involvement in this area should be considered as important. Sexual disturbances in rheumatoid arthritis (RA) patients are poorly...

Perceived Safety, Trust, and Dialog Formation Between Sexually Victimized Women and Police

Many young women in Iran experience sexual disturbance and molestation in urban public spaces, but they usually do not refer to police to report the abuse or ask for help willingly, even in critical cases like acute sexual attacks. This research was conducted among 47 young women sexually victimized in Tehran. Semistructured interviews were conducted to explore victims' experiences and postvictimization actions. RESULTS show that, although all women are aware of legal penalties for sexual disturbances and are emotionally affected by the incidents, 8.5% of interviewees have contacted the police after experiencing serious disturbances such as sexual molestation and rape. Women are highly unwilling to contact the police because they believe that dialog channels with police forces are closed. Three main explanations for reluctance to communicate with authorities are as follows: (1) perceived inculpation threat--most women believe that they might be held responsible for the disturbances because of their appearances or merely their gender; (2) distrust in male police officers--it is a common belief that male officers do not approach sexual disturbance as a serious matter or they will reabuse the victims; and (3) fear of being accused reversal of the truth--women are afraid that they would not be able to prove their claims, and if criminals are arrested, the suspects would deny their guilt and reverse the truth by condemning women for misleading behavior. Dialog is not being formed between victimized women and police forces because of the lack of three main prerequisites of communication: perceived safety, trust, and credibility. Language: en

EPA-0622 – Men's expression and experience of depression: a systematic review

Data from the American National Comorbidity Survey Replication (Martin et al., 2013; JAMA Psychiatry) - a nationally represented mental health survey - provides evidence that current diagnostic criteria for depression in men may be incomplete. To conduct and present findings of a systematic review of the biological, psychological and social depression research literature relating to men. (1) To provide a comprehensive summary of current knowledge about the expression of depression in men; (2) To examine the accuracy of current diagnostic criteria for identifying depression in men. The PRISMA statement was used to guide a multiple database search in February and July 2012 and June 2013. Search terms included: ‘men’, ‘depression’, ‘signs’ or ‘symptoms’, ‘gender’, and ‘sex differences’. Initial database searches together with forward and backward searches found 15,966 studies that were assessed for eligibility. Thirty studies met selection criteria and were included in the review. The review challenges findings that are commonly reported in the depression literature. The majority of studies in the review did not find significant differences between males and females in global depression rates, but instead, found significant differences between males and females in specific depressive symptoms that are expressed. Depressed men commonly reported alternative symptoms, including social withdrawal, functional impairment and sexual disturbance, together with maladaptive coping mechanisms. Current diagnostic criteria may not accurately identify depression in men. Targeted research needs to further clarify which symptoms are required to accurately detect depression in men.

Pelvic muscle rehabilitation: a standardized protocol for pelvic floor dysfunction.

Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR) is a noninvasive modality involving cognitive reeducation, modification, and retraining of the pelvic floor and associated musculature. We describe our standardized PMR protocol for the management of pelvic floor dysfunction syndromes. Pelvic Muscle Rehabilitation Program. The diagnostic assessment includes electromyography and manometry analyzed in 4 phases: (1) initial baseline phase; (2) rapid contraction phase; (3) tonic contraction and endurance phase; and (4) late baseline phase. This evaluation is performed at the onset of every session. PMR management consists of 6 possible therapeutic modalities, employed depending on the diagnostic evaluation: (1) down-training; (2) accessory muscle isolation; (3) discrimination training; (4) muscle strengthening; (5) endurance training; and (6) electrical stimulation. Eight to ten sessions are performed at one-week intervals with integration of home exercises and lifestyle modifications. Conclusions. The PMR protocol offers a standardized approach to diagnose and manage pelvic floor dysfunction syndromes with potential advantages over traditional biofeedback, involving additional interventions and a continuous pelvic floor assessment with management modifications over the clinical course.

Особливості статевої поведінки самиць щурів при моделюванні гіперандрогенії в пубертатний та постпубертатний періоди

The parameters of female and male sexual behavior in 3- and 6- month old female rats which were exposed to an androgen excess (subcutaneous implantation of Silastic capsules containing 5 mg of crystalline testosterone) from the beginning of pubertal period (at the age of 35 days), or within postpubertal period (at the age of 4 months). Hyperandrogenia in pubertal period had no effect on female sexual behavior formation, but it led to appearance of male behavior components in 100% of animals. In female rats which were implanted with testosterone capsules in postpubertal period, sexual disturbances were more pronounced and were characterized by masculinization and defeminization, which was due to a higher degree of androgenic saturation. The data obtained suggest a leading role of hyperandrogenemia in the pathogenesis of sexual behavior disturbances in female rats in different periods of individual development.

Role of androgen in the elderly. Clinical androgen replacement therapy for late-onset hypogonadism

Late-onset hypogonadism (LOH) is defined as the condition caused by the decline of testosterone by aging, along with various symptoms, including physical, psychological and sexual disturbance. Thus the principle of treatment for LOH is Androgen replacement therapy (ART) , and ART has been applied primarily in order to alleviate the various symptoms in LOH patients. The indication of ART for LOH is determined based on LOH symptoms assessed by aging males' symptoms (AMS) score and serum free testosterone levels. In abroad, several routes are available for the administration of testosterone, such as injection, patch, oral administration, etc. In Japan, intramuscular injection of testosterone enanthate every 2 to 4 weeks is widely indicated for treatment of LOH. It has also reported that ART using testosterone ointment once or twice a day appeared to improve those LOH symptoms. ART is a significant and safe procedure for anti-aging in male.

AB1431-HPR Factors associated with sexual disorders in patients with rheumatoid arthritis and relationship with disease activity

BackgroundSexuality is an important dimension of personality and human body, therefore any involvement in this area should be considered as important. Rheumatoid arthritis (RA) causes inability in various performance areas...

AB0828-HPR Psychological and sexual disorders in patients with rheumatoid arthritis and correlation with disease activity

BackgroundEmotional stability and sexual life are important dimensions of personality, therefore any involvement in these areas should be considered as important. Psychological and sexual disorders in rheumatoid arthritis (RA) are...

AB0419 Psychological and sexual disorders in patients with rheumatoid arthritis and correlation with disease activity

BackgroundEmotional stability and sexual life are important dimensions of personality, therefore any involvement in these areas should be considered as important. Psychological and sexual disorders in rheumatoid arthritis (RA) are...

Die Ejaculatio praecox in der urologischen Praxis

Premature ejaculation is a frequent male sexual complaint or sexual disturbance found in urological practices and outpatient units. The frequency in the individual practices varies considerably. In large studies the prevalence is strongly dependent on the definition and ranges between 3% and 25%. Subjectively, the inability to delay ejaculation and the distress resulting from it, is relevant for the patient and his partner. Intravaginal ejaculation latency time (IELT) is used as an objective parameter. Nevertheless, in the everyday routine practice this objective parameter is not practical. Clinically 2 questionnaires have asserted themselves (Premature Ejaculation Profile and Index of Premature Ejaculation). Studies have shown that the self-assessment of patients correlates relatively well with the objective IELT measured by means of a stopwatch. Beside topical anaesthetics and elective serotonin reuptake inhibitors (SSRI), especially Dapexetine which has been approved in Germany since 2009, are treatment options. These drugs differ particularly in their use (daily or on-demand) and their effectiveness (measured by x-fold increase of IELT). This article deals with the clinical approach to EP. Beside the definition, prevalence, aetiology and neurophysiology of EP, the different pharmacological therapies as well as the guidelines of the International Society for Sexual Medicine are discussed.

Minimally invasive transforaminal, thoracic microscopic discectomy: technical report and preliminary results and complications

Surgical decompression of thoracic disc herniations is technically challenging because retraction of the thecal sac in this area must be avoided. Standard open thoracic discectomy procedures require fairly extensive soft tissue dissection and vertebral resection to provide safe decompression of the spinal cord. To describe our experience using a minimally invasive, transforaminal thoracic discectomy (MITTD) technique for the treatment of thoracic disc herniation. Technical report and preliminary results and complications. Twelve patients undergoing MITTD were evaluated preoperatively and postoperatively at 1-, 3-, and 6-month intervals with neurologic examination, and were graded using the American Spinal Injury Association (ASIA) impairment scale and a pain visual analog scale (VAS). Thoracic instability and bony fusion were assessed clinically and radiographically with plain radiographs and computed tomography (CT) scans. Surgical time, blood loss, complications, and hospital length of stay were recorded. Twelve patients (seven men and five women) underwent MITTD. The median surgical time was 128 (80 to 185) minutes, the median estimated blood loss was 100 (30 to 250) mL, and the median hospital stay was 2 (1 to 4) nights. All discs were successfully removed, and a CT or magnetic resonance imaging confirmed adequate cord decompression in all cases. All patients reported easing of neurologic symptoms and improved walking ability. The median VAS scores improved from 4.5 to 2 for back pain. The ASIA score improved from D to E in the two patients who suffered from motor weakness. Preoperative sensory deficit was reduced in three of the five patients. Patients who suffered from sexual and urinary disturbances did not report improvement. Serious systemic or local complications and neurologic deterioration were not reported. The transforaminal approach enabled sufficient access to the midline of the spinal canal without extensive resection of the facet joint or the adjacent pedicle. Because most of the osseous and ligamentous structures were preserved, additional instrumentation was not required to prevent postoperative instability. Our early results suggested that minimally invasive thoracic discectomy by transforaminal microscopic technique is a valuable choice in the management of thoracic disc herniation.

Glans‐Preserving Surgery for Superficial Penile Cancer

In this study, we investigated the safety and feasibility of glans-preserving surgery for superficial penile squamous cell carcinoma. Young patients with penile primary tumors exhibiting favorable histologic features were best suited for organ-sparing procedures, enabling them to avoid sexual disturbances. The study included 12 patients, 38-53 years of age (median age 46 years), with superficial lesions involving the glans penis, coronary sulcus, or shaft skin. After clinical staging and grading, those patients were offered a glans-preserving procedure to preserve the normal appearance and functional integrity of the glans penis. Of the 12 patients referred, the tumors were TaG1 in 4 patients, TaG2 in 3, TisG1 in 1, TisG2 in 1, T1G1 in 2, and T1G2 in 1. All patients returned to normal sexual activity 1 month postoperatively. Sexual function and sexual satisfaction were well maintained after surgery. The cosmetic results were considered satisfying/very satisfying by 83% (10 of 12 patients). Follow-up data were available on 12 patients at a mean follow-up of 62.5 months. Only 1 patient had recurrence 6 months after surgery, which was managed by a second glans-preserving surgery without recurrence. With careful patient selection and vigilant follow-up, anatomically suitable superficial penile cancer can be offered this glans-preserving surgery, while preserving function of the penis wherever possible.

The side effects of hormonal therapy at the patients with carcinoma of prostate cancer

Prostate cancer is one of most frequent malignant tumours at men. The androgen-deprivation therapy is the part of cancer treatment. It could be used both in the early stage of prostate cancer and in the bone metastates. From this reason the antiandrogen drugs waste systematically grows. Unfortunately androgen-deprivation therapy has numerous side effects such as: the inferior quality of live, sexual disturbances, the fatigue, the anaemia, the bone mineral density loss and the increase of the risk of breaks the bone, the increase of body mass, insulinresistance, hypercholesterolemia, the increase risk of cardiac disorders. The aim of this article is the introduction of the reader with possibly complications androgen-deprivation therapy and with possibilities in diagnosis and treatment.

UP-03.051 How Does the Addition of Trospium Chloride to the Alpha Blocker Treatment Affect the Sexual Life of Patients with Lower Urinary Tract Symptoms and Overactive Bladder?

The frequency of sexual function disturbance is higher in men with LUTS and OAB. The aim of this study is to question the effects of trospium chloride used with alpha blokers to the sexual life of LUTS and OAB patients.

Role of Ethnicity in Family Functioning, Personality, and Depression in an Iranian Sample

The purpose of this research study was to examine the effect of ethnicity on the family functioning, personality, and depression in an Iranian sample. Participants were 600 couples of Shushtarian, Dezfulian, Bakhtiarian, and Arabic ethnics from the Khuzestan province. A demographic questionnaire, the Family Assessment Device (FAD), the Eysenck Personality Questionnaire-Revised-Abbreviated (EPQ-R-A), and the Beck Depression Inventory (BDI) used in this study. Findings indicated that ethnicity has significant role in family functioning in both spouses and wives. There were significant differences between genders in problem solving, affective communication, and sexual behavior pattern disturbance. Extroversion has a positive relationship with family functioning, and a negative relationship with sexual behavior pattern disturbance. Neuroticism has a significant negative relationship with family functioning, and a positive relationship with sexual behavior pattern disturbance. Finally, depression has significant negative and positive correlations with family functioning and sexual behavior pattern disturbance respectively.

A report of sexual meanings: Sexual disturbances from a cognitive perspective

A szexuális diszfunkciók patogenezisében kiemelkedő jelentőségűek a kognitív organizáció zavarai, amelyek mint sajátos jelentésadási módozatok alakítják az egyén szexuális öndefinícióját, továbbá közvetítő szerepük van a fiziológiai, affektív és viselkedéses válaszok létrejöttében. A szexuális információfeldolgozás folyamatában mind a kultúra által közvetített szexuális forgatókönyvek és mítoszok, mind a diszfunkcionális szexuális attitűdök, sémák és modalitások aktiválódása kitüntetett szerepet játszik.

P03-369 - Association between psychiatric symptoms and erectile dysfunction

IntroductionErectile dysfunction (ED) is often associated with a wide array of psychiatric symptoms, although few studies systematically address their specific association with ED determinants.Objectives and aimsTo explore the relationship between ED (as assessed by SIEDY Structured Interview) and different psychopathological symptoms (as assessed by the Middlesex Hospital Questionnaire).MethodsA consecutive series of 1,388 male patients with ED was studied.ResultsPsychiatric symptoms resulted differentially associated with SIEDY domains. Depressive and phobic anxiety symptoms were associated with the relational domain, somatization with the organic one, while free-floating anxiety, obsessive-compulsive, and phobic symptoms were significantly related with higher intrapsychic SIEDYscores. In addition, relevant depressive symptomatology was associated with hypogonadism, the presence of low frequency of intercourse, hypoactive sexual desire (HSD), and conflictual relationships within the couple and the family. Patients with high free-floating anxiety symptoms were younger, and complained of an unsatisfactory work and a conflictual relationship within family. Conversely, subjects with higher phobic anxious symptoms displayed a more robust relational functioning. Similar results were observed in subjects with obsessive-compulsive symptoms, who also reported a lower prevalence of HSD. Finally, subjects with somatization symptoms showed the worst erectile function.ConclusionsThe main value of this study is that it alters various clinicians’ belief that many psychiatric symptoms can be found among ED patients. Systematic testing of patients with ED, through psychiatric questionnaires, is recommended to detect even slight or moderate psychopathological distresses, which specifically associate and exacerbate sexual disturbances.

Uterine and quality of life changes in postmenopausal women with an asymptomatic tamoxifen-thickened endometrium randomized to continuation of tamoxifen or switching to anastrozole

Before the knowledge that 5 years of adjuvant tamoxifen is less efficacious than 2 to 3 years of tamoxifen followed by 2 to 3 years of anastrozole/exemestane, we designed a multicenter double-blind randomized controlled trial in women taking tamoxifen with a thickened endometrium to compare uterine and quality-of-life parameters between those switching to anastrozole and those continuing tamoxifen. Asymptomatic postmenopausal women who took adjuvant tamoxifen for 2 to 3 years for operable breast cancer with a double endometrial thickness greater than 7 mm were randomized to 20 mg tamoxifen or 1 mg anastrozole for the remaining duration, totaling 5 years. Tablets were unrecognizable for drug assignment. The primary endpoints were the differences in double endometrial thickness and uterine volume after 1 year. Uterine and quality-of-life data were analyzed using regression methods, and missing values were handled using multiple imputation. Seventy-two women (median age, 60 y) were randomized in five hospitals. Relative to women continuing tamoxifen, women switching to anastrozole experienced a decrease of 53% (95% CI, 41%-63%) in double endometrial thickness and a decrease of 51% (95% CI, 39%-60%) in uterine volume. Vaginal dryness (b = 0.064; 95% CI, 0.016-0.112) and sexual problems (b = 0.054; 95% CI, 0.007-0.102) increased in women taking anastrozole compared with women taking tamoxifen. Treatment arms did not differ regarding withdrawal rate and the experience of (serious) adverse events. Despite premature trial closure, our data provided valuable insights. Switching to anastrozole strongly decreased the endometrial thickness and uterine volume but increased sexual disturbances. Safe and effective interventions are needed to alleviate sexual dysfunction.

Coexistence of spinal teratoma of the conus medullaris and arteriovenous malformation in an adult: a case report

The coexistence of spinal teratoma of the conus medullaris and arteriovenous malformation (AVM) is exceptional, which has not been reported previously in the literature. The precise mechanism of the coexistence of these conditions is not known, however, the dysembryonic origin of spinal cord teratoma and AVM seems to play a part in this process. A 34-year-old male patient was admitted with lower back pain, bilateral lower extremity numbness and weakness, and sexual disturbance. Magnetic resonance imaging (MRI) showed an AVM extended cranially from the top of a heterogeneous expansile lesion of the conus medullaris. Surgical exploration and histopathological examination revealed a mature teratoma associated with the AVM. A literature review supported the dysembryonic origin of spinal cord teratomas and AVMs. This unique case may provide insight into the etiopathogenesis of the coexistence of spinal teratoma of the conus medullaris and AVM.