Sexual Functioning of Transgender Females Post-Vaginoplasty: Evaluation, Outcomes and Treatment Strategies for Sexual Dysfunction

2021 ◽  
Author(s):  
Jessica N. Schardein ◽  
Dmitriy Nikolavsky
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Functioning ◽  
Treatment Strategies

scholarly journals Sexuality in Ageing Male: Review of Pathophysiology and Treatment Strategies for Various Male Sexual Dysfunctions

2019 ◽  
Vol 7 (10) ◽  
pp. 98 ◽  
Author(s):  
Chung
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Function ◽  
Treatment Strategies ◽  
The Elderly ◽  
Older Men ◽  
Current Treatment ◽  
Poor Treatment ◽  
Ageing Male ◽  
Male Sexual Function ◽  
Normal Ageing

Sexual function among older men is often thought to decrease as part of normal ageing biology despite the fact that sexuality remains an important issue in the elderly. Sexual dysfunction in the aged male is likely multifactorial in nature, with the development and/or progression of medical comorbidities often resulting in decline in male sexual function and poor treatment response. At present, sexual dysfunction in the ageing male is poorly investigated and understood, and current treatment strategies aim at improving sexual desire and erectile function with limited data on ejaculatory and orgasmic dysfunctions. In addition, men are often reticent to seek help for health concerns including sexual dysfunction. The following article provides a narrative review of strategies to address various aspects of sexual dysfunction in the ageing male. Clinicians need to be educated to be sensitive when discussing sexuality issues among older men and to present practical solutions that take into account individual and cultural differences.

Sexual functioning, sexual esteem, genital self-image and psychological and relational functioning in women with Mayer–Rokitansky–Küster–Hauser syndrome: a case–control study

2019 ◽  
Vol 34 (9) ◽  
pp. 1661-1673 ◽  
Author(s):  
P T M Weijenborg ◽  
K B Kluivers ◽  
A B Dessens ◽  
M J Kate-Booij ◽  
S Both
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Functioning ◽  
Case Control Study ◽  
Case Control ◽  
Mrkh Syndrome ◽  
Sexual Esteem ◽  
Sexual Distress ◽  
Relational Functioning ◽  
Self Image ◽  
Control Study

Abstract STUDY QUESTION Do sexual functioning, sexual esteem, genital self-image and psychological and relational functioning in women with Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome differ from a comparison group of women without the condition? SUMMARY ANSWER In comparison to controls, women with MRKH with a non-surgically or surgically created neovagina did not differ in psychological and relational functioning but reported lower sexual esteem and more negative genital self-image, intercourse-related pain, clinically relevant sexual distress and sexual dysfunction, with sexual esteem levels strongly associated with sexual distress and sexual dysfunction. WHAT IS KNOWN ALREADY Studies on sexual functioning measured with standardized questionnaires in women with MRKH syndrome compared with women without the condition have yielded contradictory results. Factors associated with sexual functioning in this patient population have rarely been investigated. STUDY DESIGN, SIZE, DURATION Between November 2015 and May 2017, 54 women with MRKH syndrome with a neovagina and 79 age-matched healthy women without the condition were enrolled in this case–control study. PARTICIPANTS/MATERIALS, SETTING, METHODS All participants had to be at least 18-years old and had to live in a steady heterosexual relationship. Women with MRKH syndrome were asked to participate by their (former) gynecologists at three university hospitals and by MRKH peer support group. Controls were recruited via advertisement in local newspapers and social media. Standardized questionnaires were administered to assess sexual functioning, sexual esteem, genital self-image and psychological and relational functioning. MAIN RESULTS AND THE ROLE OF CHANCE Women with MRKH syndrome with a surgically or non-surgically created neovagina reported significantly more pain during intercourse (P < 0.05, d = 0.5), but did not differ in overall sexual functioning from control women. More women with MRKH syndrome reported clinically relevant sexuality-related distress (P < 0.05, odds ratio (OR): 2.756, 95% CI 1.219–6.232) and suffered a sexual dysfunction (P < 0.05, OR: 2.654, 95% CI: 1.088–6.471) in comparison with controls. MRKH women scored significantly lower on the sexual esteem scale (SES) (P < 0.01, d = 0.5) and the female genital self-image scale (FGSIS) (P < 0.01, d = 0.6) than controls. No significant differences were found between the two groups regarding psychological distress, anxiety and depression, global self-esteem and relational dissatisfaction. Sexual esteem was significantly associated with the presence of clinically relevant sexual distress (ß = 0.455, P = 0.001) and suffering a sexual dysfunction (ß = 0.554, P = 0.001) and explained, respectively, 40% and 28% of the variance. LIMITATIONS, REASONS FOR CAUTION Given the nature of the study focusing on sexual functioning, a potential selection bias cannot be excluded. It is possible that those women with the most severe sexual and/or psychological disturbances did or did not choose to participate in our study. WIDER IMPLICATIONS OF THE FINDINGS The study results add new data to the very limited knowledge about psychosexual functioning of women with MRKH syndrome and are of importance for more adequate counseling and treatment of these women. STUDY FUNDING/COMPETING INTEREST(S) The research was financially supported by the Dutch Scientific Society of Sexology (Nederlandse wetenschappelijke Vereniging Voor Seksuologie). The funding was unrestricted, and there was no involvement in the conduct of the research. There are no conflicts of interest to declare.

Psychotropic induced sexual dysfunction for people with a dual diagnosis

2015 ◽  
Vol 8 (4) ◽  
pp. 167-178 ◽  
Author(s):  
Ian Hamilton ◽  
Rose Pringle ◽  
Stephen Hemingway
Keyword(s):  
Sexual Dysfunction ◽  
Dual Diagnosis ◽  
Sexual Functioning ◽  
Large Scale ◽  
Single Case ◽  
Future Research ◽  
Ageing Population ◽  
Research Attention ◽  
Content Type ◽  
Psychotropic Substances

Purpose – The purpose of this paper is: first, to consider the reported problems in sexual function caused by psychotropic medication. Second, the complex undertaking of completing an assessment of sexual functioning. Third, the role of the pharmaceutical industry is explored. Finally, implications for future research and practice are suggested. Design/methodology/approach – As a commentary this paper draws on the available literature to synthesise what is already known about the relationship between psychoactive substances and sexual functioning. Findings – The limited literature and lack of research attention given to psychotropic induced sexual dysfunction limits our collective understanding of how many people are affected and in what way. Research limitations/implications – A greater focus on psychotropic induced sexual dysfunction is needed for people with a dual diagnosis. There has been an over reliance on single case studies and self-reporting. Large scale epidemiological investigation would help understand the extent and nature of the problem more fully. The demographic shift particularly in relation to an ageing population should be considered as psychotropic substances effect individuals in different ways as they grow older. Practical implications – There is scope for workers to engage more fully in a conversation with clients about their experience of using psychotropic substances and how this has impacted their sexual functioning. The literature suggests that clients want to talk about this issue but staff are unwilling or unable to discuss the topic. Originality/value – To the authors’ knowledge this is the first paper that draws on the available literature to explore the known and likely implications of psychotropic induced sexual dysfunction for this client group.

scholarly journals The use of cyproterone acetate in a forensic psychiatric cohort of male sex offenders and its associations with sexual activity and sexual functioning

2017 ◽  
Vol 23 ◽  
Author(s):  
Gian Lippi ◽  
Paul J. Van Staden
Keyword(s):  
Sexual Dysfunction ◽  
Sex Offenders ◽  
Sexual Activity ◽  
Sexual Functioning ◽  
Cyproterone Acetate ◽  
Psychiatric Patients ◽  
Background Information ◽  
Male Sex ◽  
Forensic Psychiatric ◽  
Male Sex Offenders

Background: Cyproterone acetate (CPA) is a steroidal anti-androgenic medication used in the field of psychiatry for the treatment of paraphilic disorders, hypersexuality, and inappropriate sexual behaviour which may be present in patients with disorders such as mild and major neurocognitive disorders. In the forensic psychiatric population, it is prescribed for these indications especially for patients with a history of committing a sexual offence or who are at moderate to high risk of recidivism.Objectives: To investigate the use of CPA in a forensic psychiatric cohort of male sex offenders and its associations with sexual activity and sexual functioning.Methods: Seventy-six forensic psychiatric patients from Weskoppies Hospital in Pretoria, South Africa, participated in the study which measured their sexual functioning. A specifically designed questionnaire was used to capture relevant background information. The use of CPA was studied. The Changes in Sexual Functioning Questionnaire, Male Clinical Version (CSFQ-M-C) was used to measure sexual functioning of participants. The CSFQ-M-C scores, and those of all its subscales, of participants on CPA were compared to those not on the drug. Relevant statistical analyses were performed.Results: Thirteen out of the 76 participants were being treated with CPA (17.11%). In total, 53.85% of the participants on CPA and 65.08% not on CPA had scores indicating the presence of sexual dysfunction. The total CSFQ-M-C scores for participants on CPA (mean = 40.54; median = 42) were not statistically significantly lower than those not on the drug (mean = 41.22; median = 41). More notable is that the use of CPA in this population was associated with lower levels of desire, frequency of and pleasure from sexual activity. There was an association between having intellectual disability and being treated with CPA.Conclusion: That all the participants were being treated with psychotropic medication could account for the high percentage of sexual dysfunction in any or all areas of sexual functioning and contribute to the small difference in CSFQ-M-C scores between the two groups. Only a tentative conclusion can be made that CPA may be more effective in decreasing levels of desire, frequency and pleasure related to sexual activity than other areas of sexual functioning. The indication for the use of CPA in this population should be assessed clinically according to patient circumstances and risk assessment.

Assessment and Treatment of Sexual Dysfunction in Multiple Sclerosis

2016 ◽  
Author(s):  
Frederick W. Foley
Keyword(s):  
Multiple Sclerosis ◽  
Sexual Dysfunction ◽  
Patient Population ◽  
Behavioral Interventions ◽  
Treatment Strategies ◽  
Signs And Symptoms ◽  
Assessment And Treatment ◽  
Pharmacologic Agents

This chapter discusses the signs and symptoms of sexual dysfunction that are common in persons with multiple sclerosis. The epidemiology of sexual dysfunction in this patient population is presented, along with techniques and instruments for screening for sexual dysfunction. Definitions of primary, secondary, and tertiary sexual dysfunction are reviewed, and a detailed discussion of treatment strategies is presented, including pharmacologic agents, devices, and behavioral interventions.

scholarly journals Sexual Dysfunction and Marital Relationship in Women With Schizophrenia in Comparison with Caregivers: A Hospital-based Study

2020 ◽  
Vol 2 (1) ◽  
pp. 87-92
Author(s):  
Suvarna Jyothi Kantipudi ◽  
Navina Suresh ◽  
Poornima Ayyadurai ◽  
Sathianathan Ramanathan
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Function ◽  
Sexual Functioning ◽  
Cross Sectional Study ◽  
Women Caregivers ◽  
Cross Sectional ◽  
Significant Difference ◽  
Relationship Assessment ◽  
The Impact ◽  
The Relationship

Background: Sexual dysfunction is common in females with schizophrenia and is attributed to multiple causes, including individual psychopathology and antipsychotics. Understanding the impact of relationship satisfaction on sexual functioning is not widely studied in schizophrenia. Women caregivers also experience sexual problems and were not studied in the past. Aim: To assess the nature and occurrence of sexual dysfunction in women with schizophrenia in comparison to caregivers of males without severe mental disorder. Methods: A cross-sectional study was conducted. A total of 30 women with schizophrenia were recruited as cases and 26 age-matched controls were recruited from female caregivers. All subjects were assessed using standardized tools such as Female Sexual Function Index (FSFI) and Relationship Assessment Scale along with sociodemographic questionnaire. Results: There was a significant difference in FSFI scores and relationship scores between women with schizophrenia and caregiver control subjects. The relationship quality was better in patients with schizophrenia when compared to caregivers unlike sexual functioning. Conclusion: Sexual functioning in women is a complex phenomenon. A holistic biopsychosocial approach is necessary to understand women’s sexual function.

Hysterical traits are not from the uterus but from the testis: A study in men with sexual dysfunction

2011 ◽  
Vol 26 (S2) ◽  
pp. 1540-1540
Author(s):  
E. Bandini ◽  
V. Ricca ◽  
A.D. Fisher ◽  
G. Corona ◽  
M. Maggi
Keyword(s):  
Blood Flow ◽  
Sexual Dysfunction ◽  
Sexual Functioning ◽  
Well Being ◽  
Structured Interview ◽  
Consecutive Series ◽  
Psychiatric Setting ◽  
Middlesex Hospital ◽  
Testis Volume ◽  
Male Patients

IntroductionThe relationship between testosterone (T) and psychopathology in subjects with sexual dysfunction has not been completely clarified.Objectives and aimsTo evaluate the association between T levels and different psychopathological symptoms and traits in men seeking treatment for sexual dysfunction.MethodsA consecutive series of 2,042 heterosexual male patients consulting an outpatient clinic for sexual dysfunction was retrospectively studied. Several hormonal, biochemical, and instrumental parameters were investigated, including testis volume and penile blood flow. Patients were interviewed, prior to the beginning of any treatment, with the previously validated Structured Interview on Erectile Dysfunction (SIEDY), and ANDROTEST (a structured interview for the screening of hypogonadism in patients with sexual dysfunction). They also completed the Middlesex Hospital Questionnaire (MHQ) a brief self-reported questionnaire for the screening of the symptoms of mental disorders in non psychiatric setting.ResultsT levels showed a negative correlation with depressive and anxiety symptoms. Conversely, histrionic/hysterical traits were strongly and positively associated with elevated T. Men with histrionic/hysterical traits had higher androgenization, as suggested by higher total and free T, higher testis volume and a lower ANDROTEST score. They were also characterized by better self-reported sexual functioning and penile blood flow.ConclusionsIn men consulting for sexual dysfunction, histrionic/hysterical traits are associated with higher androgenization and better sexual functioning. Hysteria, previously considered as a typically feminine psychopathological trait, should now be considered as an index of better masculine sexual well-being.

Sexual Dysfunction and Psychotropic Medications

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S9) ◽  
pp. 24-30 ◽  
Author(s):  
Glen L. Stimmel ◽  
Mary A. Gutierrez
Keyword(s):  
Sexual Dysfunction ◽  
Sexual Functioning ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Atypical Antipsychotics ◽  
Antipsychotic Drugs ◽  
Psychotropic Medications ◽  
Self Report ◽  
Dopamine Antagonist ◽  
Seizure Disorders ◽  
Rule Out

AbstractPsychotropic drugs are often associated with sexual dysfunction. The frequency of antidepressant-associated sexual dysfunction is greatly underestimated in clinical trials that rely on patient self-report of these adverse events. Direct inquiry reveals that delayed orgasm/ejaculation occurs in ≥50% and anorgasmia in at least one third of patients given selective serotonin reuptake inhibitors. Antidepressant-induced sexual dysfunction can be successfully managed. A different antidepressant without significant sexual effects, such as bupropion or mirtazapine, can often be substituted. Other strategies involve drug holidays or adjunctive therapy with drugs such as sildenafil. Dopamine antagonist antipsychotic drugs are most commonly associated with decreased libido. The newer atypical antipsychotics, with less effect on dopamine, are less commonly associated with sexual dysfunction. Sexual dysfunction is commonly reported with seizure disorders, and many anticonvulsant drugs affect levels of sex hormones. Because sexual dysfunction can be related to many factors, care must be taken to establish the patient's baseline sexual functioning before the initiation of psychotropic drug therapy and to rule out other etiologies before drugs are implicated as causative.

Sexuality within a Russian Geriatric Sample: A Pilot Study

1994 ◽  
Vol 74 (2) ◽  
pp. 491-494 ◽  
Author(s):  
Richard A. Greer ◽  
Michael J. Herkov ◽  
Laura L. Hill
Keyword(s):  
Pilot Study ◽  
Sexual Dysfunction ◽  
Physical Health ◽  
Preliminary Data ◽  
Sexual Functioning ◽  
Sexual Attitudes ◽  
Sexual Interest ◽  
Sexually Active ◽  
Research Recommendations

This paper provides preliminary data on sexual functioning within a sample of 19 Russian geriatric respondents who completed selected items from the Starr-Weiner questionnaire assessing areas such as sexual interest and frequency, sexual dysfunction, and sexual attitudes. All 8 men and 9 of the women reported being sexually active. Like American seniors, differences in activity appeared to be moderated by gender and over-all physical health. Sexual dysfunction among these Russians was less than that reported by Stern and Stern in 1979. Also, the Russian seniors reported tolerance toward sexual topics such as homosexuality. Finally, limitations of the present study and research recommendations are mentioned.

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