Early Maladaptive Schemas, Sexual Self-esteem, and Anxiety in Women with Orgasmic Disorders

Background: Individual factors that can lead to psychological disorders, including early maladaptive schemas, sexual self-esteem, and anxiety, and their impact on the female orgasmic disorder (FOD), has not yet been thoroughly examined. Objectives: The purpose of this study was to compare these factors in women with FOD to those without the condition. Methods: This descriptive research was causal-comparative or ex post facto study, and the statistical population was two groups of married women aged 18 to 40 years. Out of 152 women who participated, 66 cases had FOD, and 86 cases had no FOD according to the cut-off scores of the Female Sexual Function Index questionnaire and based on the DSM5 criteria. The Young Early Maladaptive Schema questionnaire (YEMSQ) (1995), Zeanah and Schwarz’s Sexual Self-esteem Inventory for Women (SSEI-W) (1996), and the Beck Anxiety inventory (BAI) (1988) were filled out by all the participants. An independent t-test at a significance level of P < 0.05 was applied to analyze the data using SPSS 24. Results: The results indicated that the mean scores of women with FOD were significantly higher in all schema areas than the mean scores of women without FOD (P < 0.001), and the mean scores of women without FOD were significantly higher on the sexual self-esteem scale and all its sub-scales than those with FOD (P < 0.001). Also, the mean anxiety scores of women with FOD were significantly higher than the mean scores of women without FOD (P < 0.001). Conclusions: These results support the differences in individual psychological factors among women with FOD and those without and can be used for education, prevention, evaluation, and treatment of orgasmic disorders.

Timed intercourse in infertile couples doing more harm than benefits in terms of sexual dysfunction and time to pregnancy: a cohort study

Objective: To study the differences in sexual dysfunction (SD) and time to pregnancy (TTP) between infertile couples pursuing timed intercourse (TI- around the time of ovulation) and regular intercourse (RI- at least twice a week). Design: Prospective cohort study Setting: Infertility clinics of Kolkata over three years Population or Sample: Infertile couples pursuing TI (n=283) or RI (n=88), having no preexisting sexual or psychiatric illness, and no medical contraindications to frequent intercourse. Methods: At the first visit, SD of both the partners was assessed using the Arizona Sexual Experiences Scale (ASEX) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). The couples for whom natural conception was possible were followed up to determine TTP using Kaplan Meier Analysis. Main Outcome Measure: Differences in SD and differences in TTP. Results: TI significantly increased the risk of SD than RI for both males (Odds ratio [OR] 15.24, 95% confidence interval [CI] 7.96-29.15) and females (OR 5.52, 95% CI 2.38- 12.78). This difference persisted even after adjusting for age, medical disorders, obesity, smoking, cause of infertility, and previous assisted reproductive techniques. TI carried a higher risk of developing ED, premature ejaculation, male hypoactive sexual dysfunction, female sexual interest-arousal disorder, and female orgasmic disorder. IIEF-5 score was significantly better in the RI group than in the TI. The TTP for natural conception was similar between them (Log-rank p= 0.1365). Conclusions: TI increased the risk of sexual dysfunction without accelerating the time to achieve pregnancy, compared with RI.

Sexual Dysfunctions

Sexuality and sexual medicine is an important and often understudied aspect of medicine and psychiatry. Often, patients and physicians avoid conversations having to do with sex. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) defines sexual dysfunctions as “a heterogeneous group of disorders that are typically characterized by a clinically significant disturbance in a person’s ability to respond sexually or to experience sexual pleasure”. This review addresses the diagnostic criteria, epidemiology, etiology, phenomenology, diagnostic work-up, treatment modalities, guidelines, and prognosis for sexual dysfunctions including male hypoactive sexual desire disorder, erectile disorder, premature and delayed ejaculation, female sexual interest/arousal disorder, female orgasmic disorder, and genito-pelvic pain/penetration disorder. The table lists sexual dysfunctions listed in DSM-5 with associated prevalence. This review contains 1 figure, 1 table and 20 references Key Words: DSM-5, erectile disorder, female orgasmic disorder, female sexual interest/arousal disorder, painful intercourse, premature ejaculation, sexual dysfunction