Showing papers on "Sexual dysfunction published in 1994"

Sexuality and body image in younger women with breast cancer.

Abstract: Breast cancer has the potential to be most devastating to the sexual function and self-esteem of premenopausal women. Nevertheless, not one study has systematically compared the impact of breast cancer treatment on sexual issues across age groups. Research shows that younger women with breast cancer have more severe emotional distress than older cohorts. In a group of patients seeking sexual rehabilitation in a cancer center, younger couples were more distressed, but also had the best prognosis with treatment. In theory, loss of a breast or poor breast appearance would be more distressing to women whose youth gives them high expectations for physical beauty. Seeking new dating relationships after breast cancer treatment is a special stressor for single women. Potential infertility also may impact on a woman's self-concept as a sexual person. Systemic treatment disrupts sexual function by causing premature menopause, with estrogen loss leading to vaginal atrophy and androgen loss perhaps decreasing sexual desire and arousability. Research on mastectomy versus breast conservation across all ages of women has demonstrated that general psychological distress, marital satisfaction, and overall sexual frequency and function do not differ between the two treatment groups. Women with breast conservation do rate their body image more highly and are more comfortable with nudity and breast caressing. There is some evidence that breast conservation offers more psychological "protection" for younger women. Research on the impact of breast reconstruction is sparse, but reveals similar patterns. Future studies should use rigorous methodology and focus on the impact of premature menopause and the effectiveness of sexual rehabilitation for younger women.

Psychotropic medications and their effects on sexual function: Diagnosis, biology, and treatment approaches.

Abstract: Background The recognition and treatment of sexual side effects caused by psychotropic agents have become topics of increasing clinical concern. Gaps in our understanding of the biology of sex and in our knowledge of the effect of Axis I disorders on sexual functioning have made both recognition of sexual side effects and a coherent treatment approach to these side effects difficult. Method The author reviews case reports, case series, and animal studies derived from a MEDLINE search for English language articles on the topics of the effects of psychiatric disorders on sexual functioning, the biology of sex, rates of sexual dysfunction associated with each medication class, and treatment approaches when these side effects occur. Results In evaluating sexual function in patients taking psychotropic medications, clinicians should first consider other potential causes of sexual dysfunction. In general, dopamine increases sexual behavior, serotonin inhibits it, while norepinephrine has conflicting effects. Sexual side effects have been described in association with all the major classes of psychotropic medications. Neuroleptics are often associated with sexual side effects. Priapism, seen with neuroleptics and trazodone, should be treated as a urological emergency. Anxiolytics cause mild, nonspecific sexual side effects as do the mood stabilizers. Among the antidepressants, the more powerful serotonergic medications--e.g., the serotonin selective reuptake inhibitors (SSRIs), clomipramine, and MAO inhibitors--may cause more sexual side effects than the tricyclics. Potential strategies to treat antidepressant-induced sexual side effects include lowering the dose, waiting, and switching to another agent. A number of specific antidotes, such as cyproheptadine and yohimbine, have been reported to reverse these side effects in a limited number of cases. Conclusion Clinicians must be aware of and specifically ask about medication-induced sexual side effects. More effective treatments of these side effects must await much needed double-blind studies of various approaches, especially those to treat SSRI-induced sexual dysfunction.

Effects of childhood trauma on psychological functioning in adults sexually abused as children

Abstract: Standardized symptom measures were used to determine the effect of childhood trauma experiences on adults sexually victimized as children. One hundred eighty-eight sexually abused individuals were tested for mean scores for depression, self-esteem, general levels of trauma symptoms, sexual dysfunction, posttraumatic stress disorder symptoms, and dissociation. Childhood traumatic experiences (parents fighting, physical abuse by father or by mother, other childhood traumas) of a nonsexual nature correlated with increased symptom levels and accounted for significant changes in percentage of variance ranging from 5.2% (general trauma symptoms) to 12.3% (posttraumatic stress disorder). Even after controlling for nonsexual-abuse trauma, sexual trauma in childhood continued to contribute significantly to increased adult symptom levels. Variables tested included number of perpetrators; incest; age of first abuse; whether force, bribes, or threats were used by the perpetrator; and penetration. The use of force was the single most significant individual sexual abuse variable. Sexual abuse as a whole contributed significantly to all the symptom measures with the most change in variance noted for dissociation (20.5%). Gender contributed significant differences only for sexual dysfunction when men scored significantly worse.

The social organization of sexuality : sexual practices in the United States

Abstract: This representative survey of sexual behaviour in the general population of America offers basic information about topics such as the transmission of AIDS and other sexually transmitted diseases, unwanted pregnancies, child abuse, sexual harassment and sexual violence. Conducted by a research team centred at the University of Chicago, the National Health and Social Life Survey (NHSLS) was designed to determine not only incidence and prevalence of sexual practices, but also the social and psychological contexts in which they occur. Based on personal interviews with a probability sample of 3432 American women and men between the ages of 18 and 59, this study explores the extent to which sexual conduct and general attitudes toward sexuality are influenced by gender, age, marital status and other demographic characteristics. Some of the questions the researchers address include: how do social factors such as education, race, and religion affect sexual conduct?; how have American sexual patterns been changing?; how do women's and men's sexual lives and attitudes differ?; and how is sexual behaviour organized across the life course? Other topics covered by the survey include early sexual experiences, masturbation, contraception and fertility, sexual abuse, coercion, sexual health, satisfaction and sexual dysfunction. A wide variety of sexual practices and preferences are also explored in the questionnaire, including specific questions on homosexual desire, identity, and behaviour, the appeal of various sexual practices, and their frequency and incorporation into sexual lives. With many charts, graphs and tables, and a copy of the complete survey questionnaire, this work is intended to be of use as a reference for scientists, analysts and researchers seeking reliable information on the sexual practices of American adults.

Sexual dysfunction in partial epilepsy: A deficit in physiologic sexual arousal

Abstract: Men and women with epilepsy frequently complain of sexual dysfunction. We studied the sexual response in men and women with partial epilepsy of temporal lobe origin (TLE) by measuring genital blood flow (GBF) during sexual arousal. Nine women and eight men with TLE and 12 women and seven men as controls completed inventories for symptoms of depression, sexual experience, and sexual attitude and underwent measurement of digital pulse and GBF during alternating segments of sexually neutral and erotic videotape. Subjective ratings of arousal to the videotape were obtained. We calculated digital pulse and GBF response as the percentage increase in pulse amplitude during the erotic compared with the preceding sexually neutral film. No subject group reported symptoms of significant depression on the inventory. However, men and women with epilepsy had fewer sexual experiences than subjects without epilepsy, and women with epilepsy imagined specific sexual activities to be more anxiety-producing and less arousing than did women without epilepsy. Men and women with TLE had a diminished GBF response. The mean increase in GBF in men with TLE was 184% versus 660% for controls (p = 0.01). Women with TLE had a mean increase of 117% versus 161% for controls (p < 0.01). Digital pulse did not vary across stimulus conditions. Subjective ratings for all groups indicated moderate sexual arousal. We conclude that there is a diminution in one aspect of physiologic sexual arousal in some men and women with TLE.

Sexuality in patients treated for penile cancer: patients' experience and doctors' judgement

Abstract: Objective To evaluate sexuality after successful treatment of penile cancer. Patients and methods Post-therapy sexuality was evaluated in 30 men (median age 57 years; range 28–75) treated for cancer of the penis 80 months previously (median; range: 11–225 months). Treatment regimes were: local excision/laser beam treatment, 5; definitive radio-therapy, 12; partial penectomy, 9; total penectomy, 4. Patients underwent a semi-structured interview and completed three self-administered questionnaires (psychosocial adjustment to severe illness [PAIS], mental symptoms [GHQ], quality of life [EORTC QLQ C-30]). A global score of overall sexual functioning was constructed consisting of sexual interest, sexual ability, sexual satisfaction, sexual identity, partner relationship and frequency of coitus. Results In 10 of 12 patients treated by irradiation the sexual global score was not or only slightly reduced compared with two of nine patients after partial penectomy and one of five patients with local surgery/laser beam treatment. All four patients who had undergone total penectomy recorded a severely reduced sexual global score. Of the six single domains, sexual identity and partner relationship did not change with increasing age, whereas the other scores of sexual life deteriorated as the patient became older. In the patients treated by irradiation doctors evaluated the patients' post-treatment sexuality to be more impaired than that experienced by the patients. Conclusion Within the limitations due to the small number of patients studied, radiotherapy seems to be the treatment of choice in limited cancer of the penis if preservation of sexuality is a major therapeutic aim. Physicians counselling patients with this rare malignancy need more information about treatment-related problems of sexuality after different therapeutic modalities.

Sexual dysfunction in advanced HIV disease

Abstract: Although there is an emerging body of literature on quality of life in persons with human immunodeficiency virus (HIV) disease (Barker et al., 1990; Wu et al., 1990; Wachtel et al., 1992), there is a paucity of published data on the prevalence of sexual dysfunction in HIV-infected persons or on the impact of such dysfunction on quality of life. One previous study has reported that 67% of homosexual men with acquired immunodeficiency syndrome (AIDS) reported a decreased libido and 33% reported impotency (Dobbs et al., 1993). We here describe the findings from an investigation of sexual dysfunction in a large group of homosexual men with severe HIV disease.

Buspirone treatment of sexual dysfunction associated with selective serotonin re-uptake inhibitors

Abstract: A retrospective study was done of sixteen patients treated with adjunctive buspirone in the context of sexual dysfunction associated with the use of selective serotonin re-uptake inhibitors (SSRls). Sexual functioning was rated as much or very much improved in 11 patients (69%). Treatment was generally very well tolerated. However, several patients who had become less irritable after treatment with an SSRI, reported increased irritability. The results suggest adjunctive buspirone may be useful in the management of sexual dysfunction associated with SSRIs; possible mechanisms of action are discussed. Depression 2:109–112 (1994). © 1994 Wiley-Liss, Inc.

Sexual dysfunction with antihypertensive drugs.

Abstract: The relationship of antihypertensive drugs have a long history of association with sexual dysfunction; however, this relationship is poorly documented. There appears to be a higher rate of sexual dysfunction in untreated hypertensive men compared with normotensive men. Sexual dysfunction increases with age and is associated with physical and emotional symptoms. There are few studies assessing sexual dysfunction with female and African-American hypertensive patients. Sexual dysfunction is associated with impairment of quality of life and noncompliance. Since group data may hide individual drug effects, baseline data should be collected on all patients before initiating therapy with any antihypertensive agent. Although questionnaires may not provide objective information on sexual dysfunction, the response rate to direct questioning may be less than the response rate on a questionnaire and may be affected by the gender or race of the interviewer. Research protocols using a double-blind, placebo-controlled design should assess sexual dysfunction in men and women in a standardized fashion. (Arch Intern Med. 1994;154:730-736)

Treatment of Fluoxetine-Induced Sexual Dysfunction with Bupropion: A Case Report

Abstract: Antidepressant-induced sexual dysfunction is a common and significant cause of patient distress and noncompliance with treatment. A number of adjunctive pharmacologic strategies, including yohimbine, cyproheptadine, bethanechol, and amantadine, have been employed previously. We report a case of using bupropion to treat fluoxetine-induced sexual dysfunction in a 50-year-old man with a history of recurrent major depression. This is the first case of such treatment we know. Sexual dysfunction induced by fluoxetine is thought secondary to effects on the serotonin system. Bupropion is an antidepressant with minimal sexual side effects. The mechanism by which bupropion resolved this sexual dysfunction is unknown, but it may be related to its mild dopamine uptake blockade.

The sexual attitudes, behavior, and relationships of women with histrionic personality disorder

Abstract: To examine the sexual attitudes, behaviors, and intimate relationships of individuals with histrionic personality disorder, this study compared a sample of women with histrionic personality disorders to an adequately matched sample of women without personality disorders (aged 24-31 years) using various measures. As compared to the control group, women with histrionic personality were found to have significantly lower sexual assertiveness, greater erotophobic attitudes toward sex, lower self-esteem, and greater marital dissatisfaction. Women in the histrionic group were also found to evidence significantly greater sexual preoccupation, lower sexual desire, more sexual boredom, greater orgasmic dysfunction, and were more likely to enter into an extramarital affair than their counterparts. Despite these findings, a higher sexual esteem was noted among the histrionic group. This pattern of sexual behavior noted among histrionic women appears consistent with those behaviors exhibited in sexual narcissism. These findings and treatment considerations are explored.

Sexual sequelae of antihypertensive drugs: treatment effects on self-report and physiological measures in middle-aged male hypertensives.

Abstract: Antihypertensive drugs are commonly associated with adverse side effects in both clinical and laboratory studies. We investigated the sexual sequelae of several major classes of antihypertensive drugs (e.g., beta blockers, central alpha agonists, diuretics) in normal males and in hypertensive patients. We compared the effects of four widely used agents (methyldopa, propranolol, atenolol, hydrochlorothiazide-triamterene) and placebo, in a selected sample of 21 sexually dysfunctional male hypertensives, 13 of whom completed all five phases of the study. Each study drug was administered for a 1-month treatment period, followed by a 2-week, single-blind washout phase, according to a randomized, Latin square crossover design. Dependent variables for the study included a broad range of hormonal, NPT, and self-report measures of sexual response. Results indicated a lack of consistent drug effects on measures of sexual response, although more frequent sexual and nonsexual side effects were observed with methyldopa and propranolol. As in our previous studies, age was negatively correlated with both hormonal and NPT measures, whereas changes in blood pressure were not significantly related to sexual function scores. Results do not support the hypothesis that sexually dysfunctional males are at greater risk for adverse sexual sequelae when treated with centrally active agents or diuretics.

Alcohol and Female Sexuality: A Look at Expectancies and Risks.

Abstract: Despite public perceptions that alcohol consumption enhances sexual experiences and indicates sexual permissiveness, there is no simple correlation between alcohol consumption and sexual behavior in women. It has been shown, however, that alcohol negatively affects female sexuality, leading to sexual dysfunction and sexual victimization of women.

Penile prostheses for the management of the neuropathic bladder and sexual dysfunction in spinal cord injury patients: long term follow up

Abstract: During the last 10 years, 90 penile prostheses were implanted in 82 patients with spinal cord injury. Surgery was done 1 month to 25 years (average 4.8 years) after the injury. The follow up period ranged from 1 to 10 years (average 4 years). A prosthesis was implanted for urinary management in 51 patients (62%), for sexual dysfunction in 10 patients (12%) and for both purposes in 21 patients (26%). Ninety-three per cent of the patients who used the implant for urinary management and 64% of the patients who used it for sexual dysfunction were satisfactory. We experienced three extrusions and nine surgical removals due to pain, difficulty of catheterisation and infection (the complication rate was 13.3%). Generally speaking, a penile prosthesis improves the quality of life of patients with spinal cord injury significantly; however, extrusion and infection are still significant problems.

Sexual function after pelvic surgery in women

Abstract: EDITORIAL COMMENT: We accepted this paper for publication since it will remind readers to discuss the possibility of postoperative sexual dysfunction. It should go without saying that sexual function before surgery should also be discussed, particularly since it may determine the type of surgery selected for genital prolapse with or without associated urinary incontinence. Our reviewer stressed the point that in spite of the oft-quoted opinion of Francis and Jeffcoate (reference 4 in this paper), posterior colporrhaphy will not cause dyspareunia if excessive narrowing of the vagina is avoided. Narrowing in the mid-vagina is caused either by excessive excision of vaginal epithelium or by excessive approximation of paravaginal connective tissue. Moreover failure to perform posterior colporrhaphy after anterior colporrhaphy, with or without vaginal hysterectomy, can accentuate weakness of the vaginal vault and posterior vaginal wall and result in rapid development of an enterocele or even eversion of the vagina. A final comment is that it should be routine to review women 6 months or so following pelvic floor surgery to review the anatomical and physiological results. The 4–6 week postoperative visit is too soon since many have not recommenced coitus at this time. Furthermore, problems with discharge or postcoital bleeding from vault granulomas are best excluded some time after resumption of coital activity. Summary: To assess the prevalence of sexual dysfunction after pelvic floor surgery for nonmalignant conditions, a retrospective survey was performed. Replies from a postal survey were received from 66 of the 200 women canvassed. Dyspareunia developed in 10 patients who had never had it before the operation, however of those who had it preoperatively the pain stopped completely in 12 of 23. Reduced libido was noted in 16 of 54 (29%), reduced lubrication in 21 (38%), and reduced genital sensation in 10 (18%). Lack of information about the potential effects of surgery on sexual function was identified as a major deficit and of considerable concern to 35 of the 66 women. Sexual function after surgery should be evaluated more intensively, and the subject discussed openly before any contemplated operation.

Psychosexual problems in people with HIV infection: Controlled study of gay men and men with haemophilia

Abstract: HIV infection can be associated with major psychological and social disturbance. Psychosexual problems would be expected to arise in the context of the infection, in view of the contribution that sexual behaviour can make to the acquisition and spread of HIV infection. Here the results of a study of the psychosexual consequences of HIV infection in gay men and men with haemophilia are presented, with the inclusion of data from control groups. Sixteen HIV-positive and 23 HIV-negative gay men, and 20 HIV-positive and 24 HIV-negative men with haemophilia with sexual partners were studied. HIV infection was found to be associated with the greater risk of development of sexual dysfunction in seropositives, in particular in relation to ejaculatory difficulties, both delayed ejaculation in the case of gay men and men with haemophilia, and premature ejaculation in the case of men with haemophilia. Possible aetiological mechanisms are considered, including the possibility of organic disease. The findings are of relevance to those involved in the care of people with HIV infection.

Symptomatic therapy of multiple sclerosis.

Abstract: Despite decades of aggressive research into the cause and cure of multiple sclerosis (MS), a direct management strategy remains lacking. As research continues, patients who strive for an improved quality of life may attain it through the improved management of symptoms. Symptoms occur in MS as a consequence of loss of myelin (primary symptoms), as the result of primary symptoms (secondary symptoms), and because of psychological dysfunction associated with MS (tertiary symptoms). This paper emphasizes the recent developments in the management of primary symptoms including visual loss, weakness, spasticity, urinary and sexual dysfunction, and fatigue. The adjective multiple emphasizes the numerous potential symptoms of MS. It is through their management that people with MS may lead happier, more productive lives until a cause and cure are found.

Impotence: Diagnosis and Management of Erectile Dysfunction

Abstract: Epidemiology of impotence anatomy and physiology of the penis endocrine factors related to impotence the diagnostic algorithm radiologic evaluation of impotence psychogenic impotence nonvascular causes of impotence impotence and chronic renal failure iatrogenic causes of impotence the pharmacology of impotence bends of the penis, Peyronie's disease and other problems sexual dysfunction and spinal-cord injury disorders of ejaculation dysfunction of venocclusive mechanism vasculogenic impotence secondary to atherosclerosis/dysplasia pelvic, perineal and penile trauma-associated arteriogenic impotence - pathophysiologic mechanisms and the role of microvascular arterial bypass surgery vasoactive pharmacotherapy vacuum therapy and other devices penile prostheses.

Intracavernous self-injection pharmacotherapy program: analysis of results and complications.

Abstract: We report our long-term results of a self-injection program, in a large number of patients, at our sexual dysfunction center. The results demonstrate the efficacy of the polydrug solution of papaverine-phentolamine-prostaglandin E1 in terms of a long-term durable response with a reduction in side-effects.

Fluvoxamine-Associated Sexual Dysfunction:

Abstract: OBJECTIVE:To report two cases of sexual dysfunction induced by fluvoxamine, a selective serotonin reuptake inhibitor (SSRI).SETTING:University teaching hospital.PATIENTS:Two depressed patients who developed ejaculation and orgasmic difficulties after initiation of fluvoxamine therapy.DISCUSSION:The literature concerning sexual dysfunction with serotonergic antidepressants is reviewed, and speculated mechanisms for this untoward effect are discussed.CONCLUSIONS:Sexual dysfunction associated with antidepressant drugs, including SSRIs, may be underreported. This troublesome adverse effect may significantly affect patient comfort and compliance. Careful evaluation of sexual function is warranted, prior to and during drug treatment, especially as more serotonergic antidepressant agents become available.

Urological and sexual problems in multiple sclerosis.

Abstract: Urologic dysfunction is a common and devastating feature of multiple sclerosis (MS). For many MS patients, urinary symptoms may be the most socially disabling features of the illness. In this chapter, we describe the urologic dysfunctions seen in MS, and discuss appropriate management for patients with MS. Sexual dysfunction is also common in MS and will be discussed in this chapter. Several safe and effective non-surgical modalities are now widely available for the treatment of erectile dysfunction.

Written consent about sexual function in men undergoing transurethral prostatectomy.

Abstract: Objective To review the written recording of consent about possible sexual dysfunction after transurethral resection of the prostate (TURP), and the incidence of sexual dysfunction in sexually active men after TURP. from a large scale audit of transurethral prostatectomy held in 12 hospital sites in the Northern Region. Patients and methods Over an 8-month period data were collected from 12 separate hospital sites within the Northern Region by two independent nurse co-ordinators who travelled to each of the sites. Information was gathered from medical records, operation lists and theatre books using a standard pro-forma. The Nottingham Health Profile (NHP) was used as a quality of life instrument in a subgroup of patients who were asked about sexual function before and after operation. Results Advice about retrograde ejaculation was recorded infrequently, with only 30% of case notes including a statement about this (inter-site variations 0–78%). The mean age of patients in whom a written record was made was lower (70 [0.44 SEM] years) than those in whom there was no recording (72 [0.25] years; P<0.001), but marital status did not appear to be a significant factor. No significant differences in NHP were found comparing men who did or who did not have written evidence about consent regarding retrograde ejaculation. In addition, in a subset of men who had been asked pre-operatively about sexual function, no significant differences were found in overall NHP measurements in those who did or who did not develop retrograde ejaculation. In men who were sexually active before operation, the incidence of major sexual problems, impotence and retrograde ejaculation were 12%, 11% and 24% respectively. Conclusion The incidence of sexual dysfunction following TURP in this audit concurred with previously reported studies (4–40%), but despite this most urologists in our audit were not recording that they had advised their patients about this possible outcome.

Psychosexual implications of gynaecological cancer.

Abstract: Sexual dysfunction is common among adults with cancer,1 and women with gynaecological cancer are no exception.2,3 Much of this is easily explained, given that most patients with cancer experience anxiety or depression after diagnosis and during treatment. To this may be added other aspects of their condition or treatment that make sex difficult - chronic fatigue, nausea, diarrhoea, altered genital appearance or loss of the vagina, tender scars, pain, malodour, alopecia, nervousness about breakdown of the wound, embarrassment about stomas, or advanced disease. What is less clear is why, after “successful” treatment, some women continue to have sexual difficulties. Most of the organic causes of this problem relate to treatments that alter the genital area. Radical vulvectomy removes the clitoris (although orgasm may still occur4), renders the tissues tight and devoid of fat “cushioning,” and may result in prolapse of the posterior vaginal wall or vaginal stenosis. Radical hysterectomy shortens the vagina, and pelvic exenteration removes it entirely. Radiotherapy renders the vaginal mucosa dry, easily traumatised, stenosed, and less distensible; to this is added the effect of ovarian failure, which in itself causes substantial sexual dysfunction.5 Both surgery and …

Sexual function in women with hypothalamo-pituitary disorders.

Abstract: The extent to which hypothalamo-pituitary disorders in women affect sexual desire and sexual functions was investigated. Sexual functions and sexual appreciation were assessed in a comprehensive interview of 48 women with well-defined hypothalamo-pituitary disorders. Data about sex life were correlated to blood hormone levels and diagnosis. In most of the women (64.8%), the first clinical symptom indicating a hypothalamo-pituitary dysfunction began in the age group 16 to 35. In 43 patients (89.6%), the initial symptom was menstrual irregularities. Altogether 45 (93.8%) of the women declared that they had or had had significant sexual problems. Two of the three women who did not report sexual problems had never had intercourse. Thirty-eight (79.2%) of the women had developed a lack of or a considerable decrease in sexual desire. Problems with lubrication or orgasm were reported by 31 (64.6%) and 33 (68.7%) of the women, respectively. Normal menstrual pattern, young age, and intrasellar tumor growth correlated better with normal sexual desire and sexual functions than did normal prolactin levels and normal testosterone levels. However, at the time of interview, only 7 women had hyperprolactinemia. Serum testosterone values correlated significantly only with masturbation.

Clonazepam-related sexual dysfunction in male veterans with PTSD.

Abstract: Medication-induced sexual dysfunction can significantly interfere with patients' quality of life and lead to poor compliance. This retrospective study examined the records of 100 male veterans with post-traumatic stress disorder (PTSD) selected in alphabetical order from an active treatment file of 230 patients. Forty-two patients had received clonazepam (mean maximum dose: 3.4 +/- 1.6 mg/day) at some point during their treatment. Of these, 18 (42.9%) complained of significant sexual dysfunction (primarily erectile dysfunction). Eighty-four patients received diazepam (mean maximum dose: 52.1 +/- 29.7 mg/day), nine received alprazolam (mean maximum dose: 5.2 +/- 2.8 mg/day) and eight received lorazepam (mean maximum dose: 3.8 +/- 2.4 mg/day). None of these patients complained of sexual dysfunction during treatment with these three other benzodiazepines. Our findings suggest that benzodiazepines, particularly clonazepam in the current study, can be a cause of sexual dysfunction in many male patients. Prospective studies comparing the overall clinical utility of various benzodiazepines are indicated in this and other clinic populations.

Compositions and methods for the diagnosis and treatment of psychogenic erectile dysfunction

Abstract: The present invention is directed to a group of linear and cyclic peptides having the structures: ##STR1## These peptides, when systemically administered to animals will bring about a sexual response and are thus useful for the diagnosis and treatment of psychogenic sexual dysfunction in the male.