Sexual Dysfunction in Chronically Medicated Male Inpatients With Schizophrenia: Prevalence, Risk Factors, Clinical Manifestations, and Response to Sexual Arousal

BackgroundSexual dysfunction is a common symptom in patients with schizophrenia, especially in chronically medicated patients. However, the relationship between sexual dysfunction and emotional response to sexual arousal in male patients with schizophrenia remains unclear. This study aimed to assess the incidence, risk factors of sexual dysfunction in males, and their clinical correlations to sexual arousal in male patients with schizophrenia in China.MethodsA total of 162 male patients, aged 18–50 years, with schizophrenia were recruited from a psychiatric hospital in Ganzhou. The clinical symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS). The Arizona Sexual Experience Scale was utilized to evaluate sexual dysfunction. Erotic images were selected from International Affective Picture System (IAPS). Sixty-eight out of the 162 subjects completed the erotic pictures reactivity task.ResultsOverall, 48 (29.6%) patients were measured as having global sexual dysfunction, 72 (44.4%) patients as having strength of sex drive dysfunction, 51 (31.5%) patients as having sexual arousal dysfunction, 55 (34.0%) patients as having penile erection dysfunction, 60 (37.0%) patients as having reached orgasm dysfunction, and 60 (37.0%) patients as having satisfaction with orgasm dysfunction. The sexual dysfunction patients had significantly higher scores on the negative symptoms of the PANSS. The only important predictor of sexual dysfunction was the severity of PANSS negative factor. The sense of pleasure and arousal post viewing erotic images in the sexual dysfunction group were lower compared to the non-sexual dysfunction group. The sense of pleasure and approach motivation were significantly negatively correlated with the severity of sexual dysfunction.ConclusionsThis study shows that nearly one-third of young and middle-aged chronically medicated male inpatients with schizophrenia suffer from sexual dysfunction. The negative factor of the PANSS can be regarded as the risk factor of sexual dysfunction. Schizophrenia patients with sexual dysfunction experienced lower pleasure and higher avoidance motivation than non-sexual dysfunction patients when exposed to erotic stimuli.

Paris’ μαχλοσύνη, a Mistranslated Aeschylean Fragment, and the Meanings of μάχλος (Hom. Il. 24.30, Aesch. fr. 325 Radt)

An Aeschylean fragment (325 Radt) in which a grapevine is called μάχλος is twice quoted by Eustathius of Thessalonica, who explains μάχλος as meaning ῥεομένη ‘flowing’, in connection with lewdness (καταφέρεια) and specifically μαχλοσύνη ‘feminine sexual arousal’, hapax in Homer (Il. 24.30) but well attested afterwards. In modern times Aeschylean μάχλος has systematically been mistranslated, and the botanical background of ῥεομένη completely ignored. As a matter of fact, both the probable Indo-European etymology of μάχλος and Eustathius’ explanation point to an original meaning ‘wet’, which soon became specialised as a sexual term for vaginal wetness linked to sexual arousal (cf. German läufig). This means that μαχλοσύνη was more specific and disturbing than our ‘lasciviousness’ and helps explain the ancient attempts at getting rid of it at Iliad 24.30.

Orgasm consistency and its relationship to women’s self-reported and genital sexual response

According to the Incentive Motivation Model (IMM) of sexual response, the rewarding and pleasurable aspects of a sexual act strengthen its incentive value and capacity to trigger sexual motivation. One such sexual reward is orgasm consistency, the percentage of time that orgasm is experienced during a sex act. Orgasm consistency may serve to influence the incentive value of a sexual behaviour. We tested this tenet of the IMM by examining whether orgasm consistency predicted women’s sexual responses to films depicting various sex acts. Data were collected from four separate studies examining women’s genital and subjective sexual response. Participants ( N = 144, age range = 18–65) were presented with neutral and erotic film stimuli while their genital arousal was assessed using vaginal photoplethysmography or thermography. Participants reported their sexual arousal level before, during, and after each stimulus presentation, and completed questionnaires assessing sexual history and experiences, sexual interests, and sexual functioning. Orgasm consistency during penile–vaginal intercourse (PVI) significantly predicted genital arousal to films depicting PVI, but similar relationships were not observed between genital or self-reported arousal and orgasm consistency during receptive oral sex and masturbation. Findings suggest that increasing orgasm consistency to a sex act may increase its incentive value, thereby triggering greater genital response to depictions of that act. Lack of consistent orgasm or generally pleasurable and rewarding sex may limit the capacity of sex acts to trigger sexual motivation in future sexual encounters, thus contributing to low sexual arousal and desire in women.

Gender dysphoria and sexual euphoria - A Bayesian perspective on the influence of gender-affirming hormone therapy on sexual arousal

While the concept of sexual orientation is more clearly defined in cisgender, this is less so in transgender individuals. Both experienced gender and sex hormones have a relation to sexual preferences, arousal in response to erotic stimuli, and thus sexual orientation. In transgender individuals sexual orientation occasionally changes before or during transition, which may involve gender-affirming hormone therapy. Using functional magnetic resonance imaging, we investigated whether the neuronal and behavioral patterns of sexual arousal in transgender individuals moved from the given (before) to their chosen gender after 4.5 months of hormone therapy. To this aim, trans women and men as well as age-matched cisgender controls rated visual stimuli showing heterosexual, lesbian or gay intercourse for subjective sexual arousal. Utilizing a Bayesian framework allowed us to incorporate behavioral findings in cisgender individuals of different sexual orientations. The hypothesized changes in response patterns could indeed be observed in the behavioral responses to the single but not the differentiation between stimulus categories with the strongest results for trans men and lesbian scenes. Activation of the ventral striatum supported our hypothesis only for lesbian scenes in trans women. This prominent role of lesbian stimuli might be explained by their differential responses in cis women and men. We show that correlates of sexual arousal in transgender individuals might change in direction of the chosen gender. Future investigations longer into transition might resolve the discrepancy on behavioral and neuronal levels.

The Case of Atypical Sexual Attractiveness in a Male Domestic Dog—A Case Study

During the ovarian cycle in domestic dogs, females do not accept males during the first days of estrus but become attractive to males from the beginning of proestrus, with this attractiveness persisting until the end of the estrus phase. It is believed that increased estradiol is responsible for the female attractiveness to the males. In this paper we describe the case of strong, but atypical attractiveness of a castrated male to various, adult, intact males, influenced by the emitted semiochemical signals. Any significant changes in the level of hormones typically involved in the process connected with estrus and responsible for sexual arousal in the males were assessed. The case animal was a 4 year old castrated male Border Collie that was extremely attractive to various males, which presented high levels of sexual arousal, with intensive sniffing and licking of the preputial area, specific vocalization, increased salivation and, finally, mating attempts. Clinical examination of the castrated male revealed a lack of testes in the scrotum and abdominal cavity confirmed by USG. Laboratory tests indicated basal levels of estradiol, testosterone, and progesterone (15.23 pg/mL, <0.05 ng/mL, 0.25 ng/mL), and sex was confirmed via cytogenetic and molecular analysis. Chemical analysis (HS-SPME) of the urine indicated a huge similarity to the profile obtained from a bitch in estrus, with an elevated level of acetophenone, which has been previously postulated in the literature as being a characteristic of the estrus phase in female domestic dogs. This case presented very atypical sexual attractiveness, particularly when taking into account the basal levels of hormones which, according to current knowledge, are responsible for the creation of attractiveness. As a hypothesis requiring verification, we propose the idea of involvement of other hormones in the creation of incidental attractiveness or increased production of compounds responsible for attractiveness (sex pheromones) resulting from metabolic events unrelated to reproductive processes. To our knowledge it is the first described case presenting this phenomenon, which, with more detailed study, could shed new light on the process of creation of sexual attraction in the domestic dog.

Changes in the extracellular matrix of the clitoris caused by aging: a stereological and comparative study

IntroductionThe clitoris is partially responsible for sexual arousal. The integrity of the extracellular matrix is essential for clitoral erection. Sexual dysfunction is a phenomenon associated with age.Material and methodsThe clitoris of cadavers of 20- to 80-year-old women was excised and histologically processed. Stereological analysis was performed to quantify the volumetric density of collagen, elastic fibers, and smooth muscle.ResultsA significant increase in collagen and a decrease in smooth muscle and elastic fibers were observed in older women.ConclusionsIn short, these changes caused by aging could contribute to female sexual dysfunction concerning clitoral orgasm.