Aphrodisiac Research Articles

The Complex Role Played by the Default Mode Network during Sexual Stimulation: A Cluster-Based fMRI Meta-Analysis.

The default mode network (DMN) is a complex network that plays a significant and active role during naturalistic stimulation. Previous studies that have used naturalistic stimuli, such as real-life stories or silent or sonorous films, have found that the information processing involved a complex hierarchical set of brain regions, including the DMN nodes. The DMN is not involved in low-level features and is only associated with high-level content-related incoming information. The human sexual experience involves a complex set of processes related to both external context and inner processes. Since the DMN plays an active role in the integration of naturalistic stimuli and aesthetic perception with beliefs, thoughts, and episodic autobiographical memories, we aimed at quantifying the involvement of the nodes of the DMN during visual sexual stimulation. After a systematic search in the principal electronic databases, we selected 83 fMRI studies, and an ALE meta-analysis was calculated. We performed conjunction analyses to assess differences in the DMN related to stimulus modalities, sex differences, and sexual orientation. The results show that sexual stimulation alters the topography of the DMN and highlights the DMN's active role in the integration of sexual stimuli with sexual schemas and beliefs.

Women in the Mix: A Critical-Pragmatic Study of the Gender Representation in Nigerian Hip-hop Music

Hip-hop music has become a popular trend in Nigeria, as it enjoys a high level of acceptance among the Nigerian youths. Thus, this study examines the representation of female gender in hip-hop music and the messages the music conveyed about female gender; it also unravels the hidden pragmatic meanings behind the content of the music. Nine (9) data from the lyrics of selected hip-hop music were randomly selected and analysed using Mey's (2001) pragmatic act theory. This paper adopted a qualitative approach which is due to the nature of the data that was analysed and the approach that was used in analysing it. Findings revealed a dominant portrayal of slangy expressions suggesting sexual overtones, female as mere edibles, women as sexual stimulants, seductive dance steps, and indecent dressing in the lyrical contents sampled. The paper also revealed that the implicit practs of exposing, seducing, luring and proposing were used in the data to show the role females play as characters in hip-hop music videos. The paper concludes that the use of vulgar expressions in the description of these female characters portrayed them mainly as sex commodities and sex workers, this questions the dignity of the African woman and the virtues she is expected to project to her fellow female folk, home and abroad.

Phantom sensation in genital gender-affirming surgery: a narrative review.

To review findings related to phantom genital sensation, emphasizing phantom sensation in the transgender and gender diverse (TGD) population. We discuss prevalence, presentation and potential implications for sensory outcomes in genital gender-affirming surgery. There is a high prevalence of phantom genital sensations in the TGD population. The prevalence varies by body part, approaching 50% in the most frequently reported transgender phantom - the phantom penis. Unlike genital phantoms that occur after trauma or surgery which are often painful, transgender phantoms are typically neutral and often erogenous in experience. Phantom sensation in the TGD population can be an affirming experience and important part of sexual well being and embodiment. Recent studies have begun to characterize the prevalence and presentations of phantom genital sensations in TGD people, informing our evolving understanding of the sensory experiences of the transgender and gender diverse population. Targeting integration of these centrally-mediated phantom genital sensations with the peripherally generated sensation from genital stimulation may represent one potential avenue to improve sensation and embodiment following genital gender-affirming surgical procedures. Additionally, emerging techniques in modern peripheral nerve surgery targeting phantom pain may offer potential treatment options for painful phantom sensation seen after cases of genital surgery or trauma.

(136) LABIA MINORA: A COMPREHENSIVE REVIEW

Abstract Introduction The labia minora (LM) is a part of the external female genitalia that varies greatly in form and appearance, and changes at each developmental stage of a woman. Its highly neurovascular nature and proximity to the clitoris allows it to play a vital role in sexual function. Along with the labia majora, it helps to protect the opening of the urethra and vagina. The perception of a normal LM is dependent on cultural and social context and influences the kinds of procedures that are done on the LM. Objective This study aims to comprehensively review labial anatomy, development, pathology, its role in sexual function, perceptions of labial appearance, and labial procedures. The goal is to understand the mechanism and purpose of the evolution of the LM and its effects on anatomical and sexual function. Methods We reviewed journal articles from 1988 to 2023 concerning labial anatomy, physiology, pathology, piercings, tattoos, and labial procedures such as labiaplasty, genital mutilation, episiotomies. We also reviewed cultural perceptions of its structure, its role in sexual function and its composition and function in the transgender population. Results The LM is highly neurovascular and engorges with blood with sexual stimulation. The structural changes are influenced by hormone levels. Perception of normal appearance varies by cultural and societal norms, influencing procedures performed in the area. Due to the histological composition of the LM, it has many manifestations of dermatological diseases. The LM is also susceptible to infectious, neoplastic, drug-induced, inflammatory, autoimmune and other systemic diseases. Limited information exists on LM piercing and tattoos. The size discrepancies of the LM may cause psychological distress, with conflicting research on its impact on sexual sensitivity or function. Labial procedures such as labiaplasty may enhance sexual satisfaction while female genital mutilation may reduce sexual satisfaction. There is a lack of comprehensive documentation of techniques of LM creation in transgender women and a lack of long-term follow-up studies post-vaginoplasty. The lymphatic structure within the LM is poorly understood, emphasizing the need for further research. Conclusions The labia minora is important for arousal and sexual function and its changes over time is dependent on hormone levels. The appearance and structure drive the kinds of labial procedures that are conducted and significantly affects sexual health. There is a need for further studies of the labia minora to understand its complexities and evolution. Disclosure No.

(082) DELAYED ORGASM CAN RESULT FROM LUMBOSACRAL DISC DISEASE DISRUPTING GENITAL SENSORY TRANSMISSION IN THE CAUDA EQUINA: A REVIEW

Abstract Introduction Delayed orgasm may be considered an unwanted, atypically long latency during most genital/sexual activity despite sexual stimulation, causing significant distress to the individual and/or partner, persisting for at least 6 months. Delayed orgasm is reported to affect 6.9% of women. It is associated with negative effects on sexual function, sexual satisfaction, and relationship satisfaction. Pharmacologic, endocrinologic, and neurobiological pathophysiological factors have been identified as possible etiologies of delayed orgasm, but an under-researched etiology is lumbosacral disc disease, specifically lumbosacral annular tear-induced sacral radiculopathy. The pelvic, pudendal, and sciatic nerves all merge at the S2-4 foramina where they coalesce to form the S2-4 nerve roots. These sacral spinal nerve roots (S2-4) ascend to the first synapse in the conus medullaris. During their ascent, they can be irritated mechanically by impingement/compression or chemically by exposure to the extruded nucleus pulposus from lumbosacral annular tears, and thereby disrupt genital sensory transmission with resultant delayed orgasm. The new evidence that delayed orgasm can be successfully treated by endoscopic spine surgery supports the association of delayed orgasm with sacral radiculopathy. There is still a paucity of research regarding delayed orgasm from lumbosacral disc disease. Objective To review the existing literature concerning the contribution of lumbosacral disc disease to delayed orgasm. Methods A literature search on delayed orgasm, its impacts and possible etiologies was performed. The following keywords were searched on Pubmed individually and in combination, related to the association between delayed orgasm and lumbosacral disc disease: delayed orgasm, delayed ejaculation, sexual dysfunction, anorgasmia, and persistent genital arousal disorder. Current definitions were compiled, and overall epidemiology, anatomy, and biopsychosocial factors of delayed orgasm were explored. Results There are a number of publications (n = 19) demonstrating the development of sexual dysfunction after damage to the sacral spinal nerve roots. Furthermore, several studies (n = 4) and case reports (n = 1) have demonstrated that treating lumbosacral disc disease reduces sexual dysfunction including improvement in delayed or reduced ejaculation. While delayed ejaculation encompasses the experience of delayed orgasm for some individuals, the literature fails to address delayed orgasm comprehensively in relation to lumbosacral disc disease, and thus fails to address treatment of lumbosacral disc disease and subsequent resolution of delayed orgasm. People with vulvas are particularly underrepresented in the literature studying the connection between lumbosacral disc disease and delayed orgasm. Conclusions While lumbosacral disc disease has many side effects that may impede daily function, sexual side effects can further detract from one’s personal life and relationship satisfaction. Thus, improving clinician awareness of sexual side effects, particularly delayed orgasm, can help improve treatment for individuals especially as they age. Further research is needed to strengthen the understanding of the effect of sacral radiculopathy on delayed orgasm as well as other sexual dysfunctions. Disclosure No.

(118) ORGASM AND HEART RATE VARIABILITY IN FEMALE BREAST CANCER SURVIVORS: RESULTS FROM A PSYCHOPHYSIOLOGY STUDY

Abstract Introduction Over 70 % of female breast cancer survivors suffer from sexual dysfunction. Sexual dysfunction can cause great amounts of stress and negatively impact overall health and well-being. Most studies focus on sexual arousal disorders and hypoactive sexual desire disorders. The research on orgasm in this specific group is limited. A better understanding of sexual function in breast cancer patients may yield potential targets for new treatment strategies for sexual dysfunction in this population. Low heart rate variability (HRV) has been shown to be predictive of erectile dysfunction and female sexual arousal as well as orgasm frequency. Reduced HRV and low cardiac vagal tone have previously been reported in breast cancer survivors during the first year post-treatment. If HRV is a reliable indicator of female sexual dysfunction, it could be used to assess and monitor it in a clinical setting. Objectives This study aimed to explore whether there is a link between HRV and both, sexual arousal and the ability to orgasm. We were expecting to find a difference in HRV between breast cancer survivors and healthy controls as well as orgasmic and anorgasmic women. Methods Participants were prescreened during a telephone interview. We included 40 premenopausal breast cancer survivors currently on hormonal treatment with an age range of 29 to 57 years (M = 43.5, SD = 6.4) and 20 healthy controls with an age range of 22 to 35 (M = 27.6, SD = 3.2). The vaginal pulse amplitude, heart rate variability (SDNN), subjective sexual arousal and self-reported number of orgasms were assessed in response to audiovisual sexual stimuli and vibrotactile clitoral stimulation in breast cancer survivors and healthy controls. Validated patient-reported outcome measures were used to assess sexual dysfunctions (Female Sexual Function Index, Female Sexual Distress Scale − Desire/Arousal/Orgasm), sexual self-esteem (Sexual Self-Esteem Inventory-Short Form), health-related quality of life (Patient-Reported Outcomes Measurement Information System 29 (PROMIS-29) profile questionnaire). Results Breast cancer survivors showed lower sexual function, health-related quality of life, sexual self-esteem and higher sexual distress than healthy controls. Preliminary results show a difference in baseline HRV scores between healthy controls and breast cancer survivors. However, this finding is likely due to age differences between our two groups and not cancer treatment effects. We could find no apparent differences in baseline HRV between anorgasmic and orgasmic women. Further analyses on the predictive value of HRV during sexual arousal for orgasm occurrence will be conducted. Conclusions Our data did not corroborate either of our hypotheses related to baseline HRV. For the evaluation of HRV as a predictor for orgasm occurrence, further exploratory analyses will follow. More research on the physiological parameters of sexual dysfunction is needed to reveal underlying mechanisms and find targets for future therapies.

(116) SUBJECTIVE AND GENITAL SEXUAL RESPONSE IN FEMALE BREAST CANCER SURVIVORS: RESULTS FROM A PSYCHOPHYSIOLOGY STUDY

Abstract Introduction Sexual dysfunction is a prevalent concern affecting more than 70% of female breast cancer survivors, casting a substantial shadow on their quality of life. Beyond the physical impact of cancer and its treatments, the emotional and psychological toll of sexual dysfunction introduces additional challenges, amplifying stress levels and undermining overall well-being. Acknowledging the profound implications of sexual dysfunction in this group and the absence of therapies, there is an urgent need to delve deeper into the intricacies of its manifestations. Objective This study aimed to gather preliminary data on psychophysiological aspects of sexual function in premenopausal breast cancer patients undergoing antihormonal therapy and compare them with a healthy control group. Exploring sexual arousal in breast cancer patients may unveil potential targets for innovative treatment strategies to address sexual dysfunction in this population. Methods Participants were prescreened during a telephone interview. We included 40 premenopausal breast cancer survivors with an age range of 29 to 57 years (M = 43.5, SD = 6.36) on current hormonal treatment and 20 healthy controls with an age range of 22 to 35 (M = 27.55, SD = 3.19). Physiological measures (VPA and HRV), subjective sexual arousal (SSA) and self-reported orgasm were assessed in response to audiovisual stimuli and vibrotactile clitoral stimulation sexual stimuli in breast cancer survivors and healthy controls. Self-reported measures like the Female Sexual Function Index (FSFI), the Sexual Self-Esteem Inventory (SSEI) und the PROMIS29 were incorporated. Data were analyzed using 2-level mixed effect models. Results No significant differences in VPA scores were observed between healthy controls and breast cancer survivors. Both groups exhibited a greater genital response to clitoral vibrator use than to visual stimuli. Group differences emerged in SSA and HRV, with higher SSA and lower HRV being detected. Breast cancer survivors climaxed less frequently than healthy controls and had significantly lower self-reported sexual function. Conclusions Physiological measures of arousal in breast cancer survivors were comparable to healthy controls and only subjective arousal differed. This finding indicates that subjective arousal should be further explored as the focus of intervention and treatment methods for breast cancer patients experiencing sexual dysfunction. Our findings underscore the importance of tailored strategies that resonate with individual narratives, acknowledging the emotional intricacies of post-cancer sexual well-being. This study not only contributes to scientific knowledge but also calls for a compassionate and personalized treatment paradigm, enriching the landscape of survivorship care. Disclosure Yes, this is sponsored by industry/sponsor: WOW Tech GmbH Clarification: No industry support in study design or execution.

Unreported Ethnomedicinal Uses of Plants as Aphrodisiac from the Folk-Lores of Uttar Pradesh Plains, India

The paper deals with unreported medicinal uses of eighteen plant species (belonging to sixteen families) exploited as aphrodisiac among the folk-lores of Uttar Pradesh plains, India. The data are outcome of ethnobotanical survey of more than 300 villages of nine districts viz., Bahraich, Gonda, Hamirpur, Jalaun, Mirzapur, Pratapgarh, Raebareli, Sidharthnagar and Sultanpur. Local name of plant, part of plant used, mode of drug preparation, administration and doses are given under each species.

Cantharidin: A Multiporpuse Beetlejuice.

Cantharidin is produced by beetles of two families, Meloidae (true blister beetles) and Oedemeridae (false blister beetles). Nevertheless, it is mainly members of the meloid family that have been widely studied in the traditional medicines and pharmacology of different cultures and countries. The meloids cantharidin's role is going to be reviewed in this paper, including the cantharidin discovery, its adaptative function, and worldwide uses. Finally, we recovered information on the implementation of this compound in South American civilizations in different therapeutic treatments as well as sexual stimulants and aphrodisiacs.

Interplay between sexual excitation and inhibition: impact on sexual function and neural correlates of erotic stimulus processing in women.

As outlined by the dual control model (DCM), individual differences in the regulation of sexual arousal following sexual stimulation depend on two distinct neurophysiological processes: sexual excitation (SE) and sexual inhibition (SI). Although associations with sexual function, behavior, and cue processing have been demonstrated in previous research, underlying neural correlates remain insufficiently explored. Moreover, interactive effects of SE/SI as proposed by the DCM, as well as factors impacting SE/SI properties, such as the use of oral contraceptives (OCs), have not received adequate attention in existing research. 90 healthy, sexually active women (n = 51 using OCs, n = 39 naturally cycling) completed an Emotional-Picture-Stroop-Paradigm (EPSP) while a 64-channel EEG was recorded. LPP amplitudes toward erotic and neutral stimuli were consecutively computed as a marker of motivational salience and approach motivation. Additionally, women provided self-reports of SE/SI and sexual function. Moderation analyses were performed to assess interactive effects of SE/SI in predicting LPP amplitudes and sexual function. Sexual function was negatively associated with SI levels but unrelated to SE. Higher SI was associated with reduced LPP amplitudes in response to erotic stimuli. This negative association was, however, attenuated for women high in SE, suggesting interactive effects of SE/SI. Furthermore, women using OCs reported lower SE compared to naturally cycling women. The observed findings provide additional psychophysiological evidence supporting the DCM and underscore the relevance of interactive SE/SI effects in stimulus processing and approach motivation. They also highlight the possible impact of OCs on psychosexual variables that warrants further research.

(285) A CASE REPORT OF MULTIMODAL APPROACH TO PGAD IN A 47 YEAR OLD WOMAN WITH ANXIETY, OBESITY AND PERIMENOPAUSE

Abstract Introduction Persistent Genital Arousal Disorder (PGAD) is characterized by spontaneous, persistent genital arousal without any sexual desire or stimulation, leading to significant distress and disruption in daily life. A process of care strategy has been developed to diagnose and treat PGAD effectively. This strategy guides clinicians to localize symptoms to one of five regions: End Organ, Pelvis/Perineum, Cauda Equina, Spinal Cord, and Brain. Clinicians can target treatments more effectively by identifying the specific region where symptoms originate. Many times, a multimodal approach is utilized, including treating underlying medical conditions such as Anxiety, Perimenopause, and Obesity and treating more than one region at a time. Objective This case report delves into the presentation of a 47-year-old female patient with a particularly challenging PGAD case linked to region 5 (Brain region). Methods A 47-year-old female with a long-standing history of Anxiety and Depression (since 2005) presented with symptoms of PGAD and Pelvic Floor Dysfunction, which seemed to correlate with a change in her anti-depressants, change in her therapist, as well as changes in her menstrual cycle with very mild vasomotor symptoms in February 2023. Since June 2023, she has developed PGAD symptoms, worsening anxiety and catastrophisation, aggravating her symptoms. Before being seen in our office, she was hospitalized for Anxiety, treated with TMS, changed her antidepressants, placed on antiseizure medications, muscle relaxers, and neuropathic medications, was treated with a bilateral pudendal nerve block (which made her symptoms worse), and pelvic floor therapy without any success. Upon our evaluation, she underwent a lumbosacral MRI, which revealed a Tarlov cyst measuring 2.3 cm in her S1-S2. She had symptoms consistent with perimenopause, including weight gain, vasomotor symptoms, musculoskeletal symptoms, and GSM-related symptoms, including provoked vestibulodynia, urinary urgency, as well as pelvic floor hypertonicity. She had a BMI of 29 and hypercholesterolemia. Results Based on all of her findings, region four was addressed with a transforaminal epidural nerve block (TFESI) performed. Unfortunately, this caused her to have persistent and worsening PGAD symptoms. At the same time, we had addressed her perimenopausal symptoms, which likely contributed to her worsening anxiety and cognitive distress, with an estradiol patch and oral micronized progesterone. She was started on vaginal DHEA and estradiol/testosterone gel, and pelvic floor physiotherapy with vaginal botox to address region 1, end-organ, and region 2, pelvis. She was started on semaglutide for her overweight status plus one other co-morbidity to improve her overall health. She was seen by a new psychiatrist and therapist and had her medications tweaked and discontinued, and pregabalin was started. Over time, with the above regimen, her symptoms improved. The observed improvement in PGAD symptoms following the introduction of hormonal therapy suggests a modulation of neuroendocrine pathways implicated in sexual arousal and reproductive function. Additionally, adding semaglutide may indirectly impact the neurobiological mechanisms associated with PGAD, given the interconnectedness between metabolic health and neurological functioning. These interventions likely influenced brain regions involved in hormonal regulation and metabolic function, ultimately alleviating symptoms. Conclusions This case underscores the treatment challenge of PGAD, particularly related to Region 5, and highlights the improvement of these symptoms with a multimodal approach, including correcting for Anxiety and perimenopausal symptoms. Additionally, the unique use of GLP-1 agonists and their possible interference with dopamine and reward pathways lead to improvement in this complex form of sexual dysfunction. Disclosure No.

(035) USE OF BREMELANOTIDE IN MEN WITH SEXUAL DYSFUNCTION AT A SEXUAL MEDICINE CLINIC

Abstract Introduction Bremelanotide (Vyleesi), a non-hormonally based CNS medication, was FDA approved for premenopausal women with generalized, acquired hypoactive sexual desire disorder (HSDD) in 2019. It modulates central dopaminergic pathways involved in sexual desire, arousal and orgasm and is reported to increase genital blood flow in women and men within hours of subcutaneous administration. Our clinic has been prescribing bremelanotide off-label to men with sexual dysfunctions (SD) since its approval. Objective To better understand the use of bremelanotide prescribed to men who underwent a biopsychosocial evaluation in our clinic, we evaluated prescribing patterns, improvements in sexual function, overall satisfaction, and side effects. Methods Bremelanotide prescription dispensing data from our facility was compiled September 2019 through June 2023 and analyzed for prescribing patterns and refill rates for all patients. A one-group study design interview trial of men with SD prescribed bremelanotide was performed. After signing consent, participants answered the Quality of Life Dimension of Sexual Quality of Life Questionnaire, Patient Global Impression of Improvement (PGI-I) and General Assessment Questions. After answering questionnaires online, participants completed a structured interview on the telephone with a single interviewer. Descriptive statistics characterized the study cohort. Adverse events were collected. Results Over the 46-month period, bremelanotide has been dispensed to men for SD 444 times; 65% of dispenses were refills. In comparison, during that same time period, the medication was prescribed 76 times to premenopausal women with 29% refills, and 104 times to postmenopausal women with 52% being refills. Over a recent 18 period, refill rates have been 73% (n = 219) for men, in contrast to 47% for premenopausal women (n = 30), 52% for postmenopausal women (n = 29). These data resulted in an interest in learning more about the experiences of the men using bremelanotide for HSDD and other SD. At the time of this interim analysis, 23 men signed consent and 22 completed online questionnaires. 76% of these men were more satisfied with their lovemaking and duration of lovemaking; 83% reported vaginal insertion was easier and 65% said it was easier to orgasm. Concerning feelings about initiating lovemaking, 76% were more at ease and 75% anticipated it would be more pleasurable and 71% more carefree. 56% believed orgasm was more pleasurable and 65% said that lovemaking was more pleasurable while 71% reported that the partner’s overall experience was more pleasurable. Using the PGI-I, 70% of participants felt that sexual function after using bremelanotide was a little better, much better, or very much better. The interview revealed that in men for whom bremelanotide worked, they had improvement in HSDD (39%), erectile dysfunction (52%), orgasm (17%), and anxiety about sexual performance (39%). Side effects included nausea (30%), flushing (22%), headache (13%), bothersome spontaneous erections without sexual stimulation for about 24 hours after injection (13%), and incontinence, cramping and abdominal burning (4% each). All adverse events were transient. Conclusions In our clinic, men prescribed centrally-acting bremelanotide off-label for SD filled and refilled their prescriptions more often than women. Our study showed that bremelanotide safely and effectively improved multiple SDs for some men. Disclosure Yes, this is sponsored by industry/sponsor: Palatin. Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: TRT, MTS.

Diagnosis and X-ray endovascular methods of treatment of arterial priapism in children

Diagnosis and X-ray endovascular methods of treatment of arterial priapism in children

Simultaneous measurement of duloxetine hydrochloride and avanafil at dual-wavelength using novel ecologically friendly TLC-densitometric method: application to synthetic mixture and spiked human plasma with evaluation of greenness and blueness

The simultaneous assay of duloxetine hydrochloride (DLX) and avanafil (AVN) in their pure forms, synthetic mixtures, and spiked human plasma was achieved using a novel, eco-friendly, sensitive, and specific HPTLC methodology that have been established and validated. Measuring the levels of co-administered antidepressants and sexual stimulants in biological fluids is an important step for individuals with depression and sexual problems. Separation was performed successfully using pre-coated silica gel 60-F254 as a stationary phase and a mobile phase composed of methanol, acetone, and 33% ammonia (8:2:0.05, v/v/v). Compact bands were produced by the optimized mobile phase that was chosen for development (Rf values were 0.23 and 0.75 for DLX and AVN, individually) after dual-wavelength detection for DLX and AVN at 232 and 253 nm, respectively. The results of polynomial regression analysis were exceptional (r = 0.9999 for both medicines) over concentration ranges of 5-800 and 10-800ng/spot for DLX and AVN, respectively. The quantitation limits were 4.69 and 9.53 ng/spot (0.31 and 0.94 µg/mL), whereas the detection limits were 1.55 and 3.15 ng/spot (0.63 and 1.91 µg/mL), for DLX and AVN, respectively. The International Council for Harmonization (ICH) criteria served as the basis for validating the established approach. Moreover, the proposed technique was evaluated in terms of greenness using four contemporary ecological metrics: The Analytical Greenness software (AGREE), the Green Analytical Procedure Index (GAPI), Eco-Scale, and the National Environmental Method Index (NEMI). Additionally, the Blue Applicability Grade Index (BAGI), a newly developed tool for evaluating the practicality (blueness) of procedures, was taken into consideration when evaluating the sustainability levels of the established approach.

Optimizing erectile function evaluation pattern in postoperative pelvic fracture-urethral injury patients: introducing PFUI pEF PROM.

To establish a psychometric validated pelvic fracture-urethral injury postoperative erectile function patient reported outcome measure (PFUI pEF PROM). We also aim to explore PFUI patients' potential classification and suitable postoperative erectile function assessment pattern. A total of 93 PFUI patients who treated by excisionandprimaryanastomotic (EPA) urethroplasty from January 2020 to August 2022 were enrolled to this study. Patients who had intercourse completed the IIEF-5, those who had sexual stimulation other than intercourse finished PFUI pEF PROM, and those who performed both completed the IIEF-5, and PFUI pEF PROM. Erection Hardness Score (EHS) was completed by all patients. This PROM was performed psychometric validation and used to find PFUI patients potential classification through latent class analysis. Then, we determined the cut-off value though receiver-operating characteristic (ROC) curve and performed univariate analysis subgroups feature. The PFUI pEF PROM demonstrated high reliability and validity with a Cronbach's alpha of 0.928. It correlated significantly with IIEF-5 (r = 0.550, p < 0.001) and EHS (r = 0.909, p < 0.001). The latent class analysis identified three patient subgroups, with 14.5 as the subgroup cut-off value. Urethral stricture length, IIEF-5, and EHS score were identified as influence factors for maximal erection potential. An assessment pattern combining IIEF-5, EHS, and the PFUI pEF PROM covered 92.5% of patients. This PROM effectively addresses the current limitation in assessing erectile function in PFUI patients. This study provides a promising tool for stratified assessment, prediction erection recovery, and treatment guidance in the PFUI Erectile dysfunction field.

Unveiling the Therapeutic Potential of Clitoria Guianensis (Aubl.) Benth Var. Guianensis: A Comprehensive Review of its AntiInflammatory and Wound Healing Properties

Introduction: This article proposes a comprehensive systematic review to analyze the potential of Clitoria guianensis as an anti-inflammatory and wound healing agent. The emphasis on diversifying research methods aims to deepen understanding of its medicinal properties, especially in the context of anti-inflammatory and wound healing activities. The plant, belonging to the genus Clitoria and native to Brazil, is recognized for its aphrodisiac properties and is used as a sexual stimulant, tonic, and energizer. Studies highlight the presence of bioactive compounds, such as isoflavones, which contribute to its medicinal properties. Methodology:The study was based on the Systematic Literature Review Protocol (SLRP), establishing a framework for comprehensively reviewing scientific literature. The objective was to identify the medicinal properties of C. guianensis in Brazil, focusing on its potential anti-inflammatory and wound healing properties. Results: The results of this scientific review aim to substantiate the consideration of C. guianensis as a potentially beneficial plant in tissue regeneration processes.

Exploring the Role of Masturbation as a Coping Strategy in Women

Objectives Recent findings suggest that individuals tend to engage in masturbation more frequently when experiencing elevated levels of psychological stress, and there appears to be distinguishable effects on stress response based on clitoral and vaginal stimulation. In this concurrent mixed-method study, we aimed to investigate this association in more detail using a convenience sample of 370 women. Methods Quantitative data were used to examine whether higher psychological distress was associated with higher levels of masturbation frequency depending on the mode of stimulation, while qualitative data gave further insight into this association. Results In regression analysis, higher levels of general and subscale-specific psychological distress were significantly associated with higher clitoral, but not combined clitoral and vaginal masturbation frequency. Qualitative content analysis showed that masturbation was used as a reliable coping strategy and self-care strategy which induced positive affective states, such as happiness and relaxation. Very few women reported negative feelings associated with masturbation. Mixed-method analysis revealed that women who indicated to use of masturbation for coping or self-care or who reported negative feelings did not differ in their level of psychological distress from women who did not report using it. The positive effects of masturbation were not related to the mode of stimulation. Conclusions Results showed the complexity of how psychological distress is related to sexual activity and point to the potential benefits of masturbation for dealing with psychological distress and for enhancing general well-being. Our results have various implications for researchers, clinicians, and society.

Genital arousal and responsive desire among women with and without sexual interest/arousal disorder symptoms.

Models depicting sexual desire as responsive to sexual arousal may be particularly apt for women experiencing arousal or desire difficulties, and the degree to which arousal triggers desire may depend on the relationship context and desire target and timing-yet, these associations have not been directly tested among women with and without sexual interest/arousal disorder (SIAD). To assess the role of SIAD status and relationship satisfaction in the associations between genital arousal and 4 types of responsive desire. One hundred women (n = 27 meeting diagnostic criteria for SIAD) in romantic relationships with men viewed a sexual film (pleasurable intimate depiction of oral sex and penile-vaginal intercourse) while their genital arousal was recorded via vaginal photoplethysmography (n = 63) or thermal imaging of the labia (n = 37). Partner and solitary desire was assessed immediately before and after the film (immediate desire) and 3days later (delayed desire). Outcomes consisted of genital response (z scored by method) and associations between genital response and responsive sexual desire. The key difference between women with and without SIAD was not in their ability to experience genital arousal but in how their genital responses translated to responsive sexual desire. Women with SIAD actually exhibited greater genital arousal than unaffected women. Associations between genital arousal and desire were significant only for women with SIAD and depended on relationship satisfaction and desire type. For women with SIAD with low relationship satisfaction, higher arousal predicted lower immediate desire for a partner; for those with high relationship satisfaction, arousal was either positively related (vaginal photoplethysmography) or unrelated (thermal imaging of the labia) to immediate desire for a partner. Associations with other desire types were not significant. Patterns of genital arousal and partner-specific responsive desire among women affected with SIAD were indicative of an avoidance model in response to heightened genital arousal, unless relationship satisfaction was high; attending to genital arousal sensations could be a means of triggering sexual desire for women with SIAD who are satisfied in their relationships. This is one of the first sexual psychophysiologic studies to connect relationship factors to patterns of sexual response. The differing arousal assessment procedures and lack of official diagnosis may have attenuated results. The homogeneous sample and in-person session requirement limit generalizability. When compared with unaffected women, women affected by SIAD may exhibit stronger arousal responses with sufficiently incentivized sexual stimuli, and the connection between their genital arousal and responsive desire for their partners may be stronger and more dependent on relationship context.

Short-Term Dorsal Genital Nerve Stimulation Increases Subjective Arousal in Women With and Without Spinal Cord Injury: A Preliminary Investigation

ObjectivesFemale sexual dysfunction (FSD) affects an estimated 40% of women. Unfortunately, FSD is understudied, leading to limited treatment options for FSD. Neuromodulation has shown some success in alleviating FSD symptoms. We developed a pilot study to investigate the short-term effect of electrical stimulation of the dorsal genital nerve and tibial nerve on sexual arousal in healthy women, women with FSD, and women with spinal cord injury (SCI) and FSD. Materials and MethodsThis study comprises a randomized crossover design in three groups: women with SCI, women with non-neurogenic FSD, and women without FSD or SCI. The primary outcome measure was change in vaginal pulse amplitude (VPA) from baseline. Secondary outcome measures were changes in subjective arousal, heart rate, and mean arterial pressure from baseline. Participants attended one or two study sessions where they received either transcutaneous dorsal genital nerve stimulation (DGNS) or tibial nerve stimulation (TNS). At each session, a vaginal photoplethysmography sensor was used to measure VPA. Participants also rated their level of subjective arousal and were asked to report any pelvic sensations. ResultsWe found that subjective arousal increased significantly from before to after stimulation in DGNS study sessions across all women. TNS had no effect on subjective arousal. There were significant differences in VPA between baseline and stimulation, baseline and recovery, and stimulation and recovery periods among participants, but there were no trends across groups or stimulation type. Two participants with complete SCIs experienced genital sensations. ConclusionsTo our knowledge, this is the first study to measure sexual arousal in response to short-term neuromodulation in women. This study indicates that short-term DGNS but not TNS can increase subjective arousal, but the effect of stimulation on genital arousal is inconclusive. This study provides further support for DGNS as a treatment for FSD.

Tickle fetishism: pleasure beyond playfulness.

Tickling is commonly perceived as juvenile play associated with laughter. However, its potential connection to adult sexual behavior has largely remained unexplored. Our online survey, primarily distributed among individuals interested in tickle fetishism, explored tickling and its association with sexual behavior. Ticklishness types, tools, preferred body parts, and partner preferences, were examined. Results revealed diverse patterns of ticklishness changes over time and distinct body-part preferences for different types of tickling. Childhood experiences and exposure to tickling content in television were found to shape individuals' affinity for tickle fetishism. A quarter of respondents reported experiencing orgasms exclusively from tickling, while around 88% expressed sexual satisfaction through tickling alone, indicating its sufficiency as a sexual stimulus among fetishists. Tickling desire decreased after orgasm, indicating an association between tickling and sexual activity. Moreover, ticklishness degree predicted preferences for being tickled rather than tickling others. Exploratory factor analysis identified three factors underlying tickling and sexual experiences: enjoyment and frequency of tickling during sexual activity; preference for intense sexual experiences; age of becoming sexually active. In conclusion, this study provides unique insights into tickling and its connections to sexual context, enhancing our understanding of diverse human sexual behavior and tickle fetishism as a distinct preference.