Showing papers on "Sexual dysfunction published in 1988"

Relationship of chronic pelvic pain to psychiatric diagnoses and childhood sexual abuse

Abstract: Structured psychiatric and sexual abuse interviews were administered to 25 women with chronic pelvic pain and a comparison group of 30 women with specific gynecological conditions. All 55 patients underwent diagnostic laparoscopy, and the results of the fiberoptic pelvic examination were objectively classified by the study gynecologist, who was blind to the psychiatric diagnoses. The patients with chronic pelvic pain showed a significantly higher prevalence of major depression, substance abuse, adult sexual dysfunction, somatization, and history of childhood and adult sexual abuse than the comparison group. There were no significant differences between the groups in severity or type of pelvic pathology. Language: en

Sexual dysfunction among middle aged women in the community

Abstract: In a community survey of women aged 35-59 sexual functioning was studied in the 436 women with partners. One third of these women had operationally defined sexual dysfunction: impaired sexual interest was identified in 17% of women (68/406), vaginal dryness in 17% (73/434), infrequency of orgasm in 16% (60/379), and dyspareunia in 8% (30/379). Sexual dysfunctions were statistically significantly associated with increasing age and also with psychiatric disorder, neuroticism, and marital disharmony. One in 10 women regarded themselves as having a sexual problem. These women were no older than women with sexual dysfunction who did not regard themselves as having a sexual problem. Nevertheless, they differed from the rest of the sample in having more psychiatric disorder, neuroticism, marital disharmony, and (in women still menstruating) psychological symptoms of the premenstrual syndrome. In the whole sample 16 women (4%) said that they would like help for a sexual problem. The prevalence of sexual dysfunction in this series of women suggests that general practitioners should increase their alertness to the problem in their patients.

Impotence and aging: clinical and hormonal factors.

Abstract: A cross-sectional study of 216 impotent men aged 40 to 79 years (mean age 60.9 years) was conducted to determine if there are age-related changes in clinical and hormonal parameters in an impotent population. There was a slight increase in the degree of sexual dysfunction with age, with complete erectile failure occurring in a larger percent of the 60- and 70-year-olds than in the younger patients (41% vs 27% for the 40 year olds, P less than .05). No patient above the age of 70 years reported any full erections, even of short duration. In contrast, reported levels of libido did not vary significantly with age. Abnormal penile Doppler studies diagnostic of vasculogenic impotence were found in 17.8% of the patients tested, and an additional 17.8% were found to have evidence suggestive of a vascular etiology. These abnormal vascular findings were associated with an extremely high prevalence of clinically apparent atherosclerosis in this population. In 22.9% of the subjects, an abnormal vascular response was found only on exercise, ie, a "pelvic steal", which only occurred above the age of 50 years. There was a marked age-related alteration in the concentration of testosterone (T) and bioavailable testosterone (BT), but no statistically significant change in the levels of gonadotropins with age. An increase in the prevalence of eugonadotropic hypogonadism with age was found, which suggested an increasing prevalence of hypothalamic pituitary dysfunction in this patient group. For both vascular and hormonal changes (such as low T and BT), the greatest changes appear to occur after the age of 50.(ABSTRACT TRUNCATED AT 250 WORDS)

Marital problems and sexual dysfunction: how are they related?

Abstract: In a study of 28 attenders of a sexual and marital clinic, the relationship between marital distress and both general and specific sexual dysfunctions was investigated. It was found that for men there was a much closer relationship between sexual and marital problems than for women. In particular, it was noted that the specific male sexual dysfunctions of impotence and premature ejaculation played a much larger part in marital discord than did the female dysfunctions of anorgasmia and vaginismus.

Sexual dysfunction in hypertensive men. A critical review of the literature.

Abstract: Sexual dysfunction is common in hypertensive men and often is first reported by patients while receiving hypotensive therapy, leading to a widespread belief by patients and physicians that the sexual dysfunction is caused by a specific antihypertensive medication. However, it is unclear from the literature whether this problem is related to hypertension or to its therapy. Further, whether the erectile failures reported during therapy are a result of 1) reduced penile blood flow secondary to reduction of blood pressure after antihypertensive treatment or to obstructive vascular disease (or both) or 2) specific drug effects has not been well studied. Because of these unresolved issues, this common problem is not well managed and contributes to noncompliance with therapy by hypertensive male patients, which impedes the attainment of satisfactory blood pressure control. The present article reviews the literature related to hypertension and sexual function in men and outlines a management strategy for clinicians that attempts to document normalcy of sexual function before initiating treatment in newly diagnosed hypertensive patients. Further, it does not ascribe causality to specific antihypertensive agents for the sexual dysfunction reported by treated hypertensive patients but attempts instead to delineate the pathogenesis of the dysfunction. Once the pathogenesis is established, treatment plans can be implemented to restore normotension and maintain adequate sexual function among treated hypertensive men. The article also discusses how applied research in this area may be performed.

The Role of Aging and Chronic Disease in Sexual Dysfunction

Abstract: Sexual dysfunction is so highly prevalent in elderly males that it is often considered an inevitable consequence of "normal aging." To determine if other factors are related to an age-associated decline in sexual function, we surveyed two groups of elderly male veterans in a geriatric ambulatory care clinic: aged 65 to 75 years ("young-old") and aged over 75 ("old-old"). We compared their survey responses with responses from a general medical clinic for unstable medical patients, aged under 65 ("old-young"). Of 347 subjects surveyed, 225 completed a health and sexual function questionnaire (response rate = 65%). Absent libido was reported by 30% of old-young, 31% of young-old, and 47% of old-old. Erectile dysfunction was reported in 26% of old-young, 27% of young-old, and 50% of old-old (P less than .01). We used ordinal logistic regression and found overall sexual dysfunction to be significantly related to subjective poor health, diabetes mellitus, and incontinence (P less than .05), while controlling for age. These data suggest that, although sexual dysfunction is more common in the aged, it is often related more to comorbid illness than aging alone.

Effects of first-line antihypertensive agents on sexual function and sex hormones

Abstract: We studied sexual dysfunction induced by antihypertensive agents in 156 male hypertensive patients. The antihypertensive agents were: trichloromethiazide, 2-4 mg; atenolol, 50-100 mg; captopril 37.5-75 mg; and slow release nifedipine 40-80 mg, administered every day for 1 year after a 2-4-week placebo period. Sexual dysfunction was checked by both a self-reporting questionnaire and a test for serum sex hormones. In the self-reporting questionnaire, the following items were requested: reduction of sexual desire, problems in obtaining and maintaining an erection, problems in ejaculation and the number of occasions of sexual intercourse. The sex hormones measured were testosterone, follicular stimulating hormone, luteinizing hormone and oestradiol. During the placebo period, 5% of the hypertensive patients complained of some sexual disturbance without any significant changes in the plasma levels of the sex hormones. In the short term (1-4 weeks) after the initiation of the antihypertensive therapy, all antihypertensive agents except captopril caused sexual dysfunction. Patients on atenolol or trichloromethiazide complained of every item listed. Those on slow-release nifedipine complained mainly about problems in ejaculation. Serum levels of both testosterone and follicular stimulating hormone were significantly decreased while there was mild elevation of oestradiol in patients on atenolol. In the long term (1 year), only patients taking atenolol experienced sexual dysfunction and mild reduction of serum levels of testosterone. Our findings show that first-line antihypertensive agents have different effects on sexual function and that only captopril may have some advantages over the other agents in terms of the quality of sexual life.

Identifying and treating the sexual repercussions of incest: A couples therapy approach

Abstract: Given the significant number of adults who were sexually victimized as children and the serious negative effects that sexual abuse can have on sexual functioning, clinicians need to be prepared to recognize and treat the intimacy concerns of adult incest survivors. Broadening the definition of incest to include nontouch sexual abuse, this paper describes types of sexual problems commonly expressed by survivors, such as sexual dysfunction, fear of sex, conditioned negative reactions to sex, flashbacks to the abuse, and mind-body dissociation. The intimate partner of the survivor is viewed as a secondary victim of the incest, who often displays a unique set of sexual and emotional concerns as well. A four-stage couples therapy approach is presented which includes identifying the problem, working together on incest resolution, changing old sexual intimacy patterns, and creating positive sexual experiences. This model is a dynamic combination of incest resolution therapy, sex therapy, and couples therapy. Therapeutic dilemmas and considerations are discussed and recommendations given for increasing the effectiveness of therapy. An argument is made as to why a couples therapy approach is the preferred method of treatment.

Is There a Reliable and Valid Self-Report Measure of Sexual Behavior?

Abstract: A psychometric analysis of the Sexual Experience Scale (SES) from the Derogatis Sexual Functioning Inventory was conducted. This sexual behavior measure was administered on four occasions to a large sample of normal, heterosexual, sexually active women and a comparable sample which underwent gynecologic treatment that resulted in a predictable and clinical level of sexual dysfunction. In terms of reliability, internal consistency estimates for the SES were in the .85 to .90 range, but the stability of the SES was lower and ranged from .55 to .85. An evaluation of the validity revealed both strengths and limitations of the SES. The content analysis reveals that a wider range of sexual behaviors is sampled by the SES than comparable measures. To examine construct validity, a factor analysis provided a five-factor solution which would account for 82% of the variance, but the solution was not stable across groups or time and the factors were not sensitive to detecting important behavior changes. As many other psychological measures, the SES was poor in predicting a criterion (i.e., the occurrence of sexual dysfunction) concurrently or at the time of follow-up. The outcome of this analysis is discussed in the context of selecting reliable and valid self-report measures of sexual behavior.

Sexual Dysfunction in Abusers of Cocaine and Alcohol

Abstract: Sexual dysfunction is not uncommon in alcoholics and in cocaine addicts. Alcohol abuse frequently develops along with cocaine dependence and the reverse is also common. We examined the sexual history of this common dually-addicted population. Sexual dysfunction was found in 62% (N = 50) of male cocaine and alcohol abusers consecutively admitted to a substance disorder treatment unit. The influence of cocaine and alcohol on commonly studied neurotransmitters and hormones along with their influence on sexual function are discussed.

Beta-blocker effects on sexual function in normal males.

Abstract: Among the antihypertensives currently in use, the sympatholytic drugs (e.g., central alpha-agonists, beta-blockers) and diuretics are most commonly associated with sexual side effects. Previous reports of sexual dysfunction associated with these drugs have been based entirely on retrospective and self-report data. This is the first study to date to investigate beta-blocker effects on sexual function by means of physiological (NPT), subjective, and hormonal measures. Four beta-blockers with different ancillary properties (atenolol, metoprolol, pindolol, propranolol) were evaluated in a placebo-controlled, double-blind, Latin-square design. Thirty healthy male volunteers received, in counterbalanced order, each of the four drugs and 1 week of placebo testing. Significant drug effects on both total and free testosterone were found during treatment with all four beta-blockers, although it appeared that the nonselective drugs (pindolol, propranolol) were associated with the greatest reduction in testosterone. No significant effects were found on measures of cortisol or cholesterol. Analysis of NPT and self-report data yielded inconclusive results, perhaps due to the confounding effects of sleep disruption and the brief duration of treatment in this study. Inspection of individual records, however, suggested that some subjects may be especially vulnerable to sexual dysfunction in association with propranolol.

Anxiety and sexual dysfunction.

Abstract: Anxiety is a major factor in the etiology of sexual dysfunction. Anxiety concerning sexual performance or relationship issues, such as intimacy and partner rejection, is also the critical element in sexual avoidance patterns. In susceptible patients the intensity of sexual anxiety can reach panic proportions. When those patients seek sexual therapy, their underlying panic disorder often goes undiagnosed and untreated. Many treatment failures with sexaphobic patients can be attributed to the failure on the part of the clinician to detect and treat underlying panic disorders. The prognosis for patients with the dual diagnosis of sexual dysfunction and panic disorder improves significantly with the combined use of psychosexual therapy and antipanic drugs that allow highly anxious patients to cooperate with and to benefit from treatment.

The frequency of sexual problems among family practice patients.

Abstract: Two hundred-twelve patients attending a family practice center participated in a questionnaire study of their sexual identity and function. Using conservative definitions of problems, 75% were identified as having at least one specific sexual problem area. Most of these problems were functional in nature and involved desire, arousal, or orgasm. While the frequency of sexual problems was high in both sexes among all age groups, identity problems were primarily seen among the young, and desire problems among older adults. The prevalence rate of reporting sexual problems did not differ significantly by sex. However, females reported more specific sexual problems than males. Only 26% of the subjects summarized their overall sexual lives as problematic and the vast majority of patients thought their family physicians were able to help with such problems. This study reaffirms the high prevalence of sexual disorders in the population. Given adequate training, family physicians may be the ideal providers of assistance for these problems.

Sexual dysfunction in the diabetic patient with hypertension

Abstract: The prevalence of diabetes mellitus and hypertension in the United States is increasing partly because of the incidence of these diseases in the growing geriatric population. Diabetes and hypertension have been associated with sexual dysfunction in both men and women. Neuropathy, vascular insufficiency and psychological problems have been implicated in impotence, impaired ejaculation and decreased libido in men and in decreased vaginal lubrication, orgasmic dysfunction and decreased libido in women. Several investigations of women with diabetes suggest fewer reports of sexual dysfunction than have been reported by diabetic men. However, there have been few evaluations of sexual dysfunction in women and no standard methods for assessment. Antihypertensive agents, especially diuretics, sympathetic inhibitors and β-blocking agents have been associated with sexual dysfunction due to autonomic and hormonal effects. An estimated 40 to 80% of diabetic hypertensives have reported sexual dysfunction in several investigations. Clearly, the diabetic hypertensive patient should be evaluated for sexual dysfunction, and appropriate therapy, including changes in medication or referral for sex counseling, should become routine in clinical care.

Sexual dysfunction among patients with arthritis

Abstract: The relationship of arthritis and sexual dysfunction was investigated among 169 patients with rheumatoid arthritis, osteoarthritis and spondyloarthropathy, 130 of whom were pair-matched to controls. Assessments of marital happiness and depressed mood were also made using the CES-D and the Azrin Marital Happiness Scale (AMHS). Sexual dysfunctions were found to be common among patients and controls, the majority in both groups reporting one or more dysfunctions. Impotence was more common among male patients than controls and was found to be associated with co-morbidity and the taking of methotrexate. Depressed mood was more common among patients and was associated with certain sexual difficulties, but not with impotence. Marital unhappiness as indicated by AMHS scores, was not associated with arthritis but was associated with sexual dysfunction, sexual dissatisfaction and being female.

The relationship between male sexual dysfunction and belief in zilbergeld' s myths: An empirical investigation

Abstract: This study examined the relationship between belief in the myths described by Zilbergeld and sexual dysfunction in males. A group of men seeking treatment for sexual problems were compared with a group of non-dysfunctional men, with regard to their belief in these myths. As predicted, the results showed significantly greater belief in the myths among the dysfunctional group.

Client attributions for sexual dysfunction

Abstract: This investigation examined attributions for sexual dysfunctions made by 63 individuals and 21 of their partners who presented at a sex therapy service for the following problems: erectile dysfunction, premature ejaculation, and female orgasmic dysfunctions. All participants completed measures of marital adjustment, locus of control, depression and a questionnaire which assessed: attributions of responsibility for the sexual problem, perceived control over sexual functioning, distress, effort made to improve the sexual relationship, and expectations about the efficacy of sex therapy for the problem. Results indicate that both identified patients and their partners, regardless of the dysfunction, blamed the sexual problem on the “dysfunctional individual” rather than on the circumstances or the partner. With respect to the partners, husbands of women with orgasmic dysfunction were more likely to blame themselves than the circumstances, while the opposite was true for wives of males with erectile d...

Biological features of women's alcohol use: a review.

Abstract: Sensitivity to gender issues in the research community has generated a modest but growing amount of data on the biological effects of alcohol consumption on women. Data generally indicate that the same amounts of alcohol have greater effects on women and that women develop more severe alcohol problems than men over shorter drinking histories. Despite a number of studies, however, there are no clear differences between women and men in the impact of alcohol consumption on cognitive processes. Although the findings are mixed, the data point toward greater physiological deterioration among women as compared with men who have similar drinking histories. These differences may be related to the differences in patterns of social recognition and reaction that occur in instances of alcoholism among women. Such differences are confirmed by other data that indicate greater social isolation and general disorganization among female alcoholics than among male alcoholics. The risks of fetal alcohol syndrome that are associated with heavy alcohol consumption among women during pregnancy have been established, and a complex of other relationships between alcohol consumption and reproductive-related systems and behaviors exists. Linkages between sexual dysfunction, sexual satisfaction, and alcohol consumption appear to exist, but have not yet become clearly understood. It appears that alcohol may be used as a self-medication to cope with perceived problems of sexuality. It also appears that heavy alcohol consumption can contribute to sexual dysfunction and dissatisfaction. A growing body of sophisticated experimental research has established relationships between patterns of alcohol metabolism and phases of the menstrual cycle, with this literature offering some of the clearest indications of distinctive differences between the sexes in the biological consequences and correlates of alcohol consumption.

Sexual dysfunction with aging and systemic hypertension

Abstract: The incidence of sexual dysfunction increases with age and in the presence of systemic hypertension. An interplay between endocrine, neurologic and vascular systems mediates normal male sexual function. Androgens primarily regulate libido and maintenance of genital tissue, while the autonomic nervous system and arterial blood flow play key roles in the physiology of the male sexual response, particularly penile erection. Vascular disease related to hypertension, diabetes mellitus and atherosclerosis may be the main factor contributing to the sexual dysfunction that occurs with aging. Hormonal alterations probably play less of a role. The importance of neurologic abnormalities remains to be determined. Although specific diagnostic testing can be useful in defining abnormalities in each of these systems, treatment of sexual dysfunction in the setting of hypertension in the elderly patient remains a challenge.