Showing papers on "Sexual dysfunction published in 1995"

Quality of life in colorectal cancer. Stoma vs. nonstoma patients

Abstract: PURPOSE: The bowel and sexual function of colorectal cancer patients undergoing either sphincter-saving or sphincter-sacrificing surgical procedures may be impaired. A legitimate question is how these different surgical techniques affect the patients' quality of life. METHODS: Seventeen studies were identified that compared at least one of four aspects of patient functioning (i.e.,physical, psychologic, social, and sexual) between stoma patients and non-stoma patients. RESULTS: Although the literature does not yield entirely consistent findings, some long-term effects of surgery can be identified: 1) both patient groups are troubled by frequent or irregular bowel movements and diarrhea; 2) stoma patients report higher levels of psychologic distress than do nonstoma patients; 3) although both stoma patients and nonstoma patients report restrictions in their level of social functioning, such problems are more prevalent among patients with a colostomy; 4) sexual functioning of male and female stoma patients is consistently more impaired than that of male and female patients with intact sphincters. Results of the current review were compared with those of other, related areas. CONCLUSIONS: Although nonstoma patients generally fare better than do stoma patients, they also suffer from physical impairments induced by sphincter-saving procedures (e.g.,impaired bowel and sexual function). These impairments may become more prevalent as ultralow anastomosis is more frequently applied, resulting in bowel and sexual dysfunction and related psychologic distress. Well-designed studies are needed that examine whether quality-of-life benefits are to be gained by use of ultralow anastomosis compared with colostomy.

The Stockholm spinal cord injury study: 1. Medical problems in a regional SCI population

Abstract: Out of a regional traumatic spinal cord injury population consisting of 379 individuals, 353 (93.1%) participated in the present study. Subjects were individually interviewed using semi-structured protocols. In addition, previous medical records were available for over 96% of subjects, and were used in all these cases to minimise recall bias. Cause of injury, prevalence of present medical symptoms and occurrence of medical complications in the post-acute, post-discharge phase were recorded. Neurological classification was verified by physical examination according to ASIA/IMSOP standards. Many subjects had experienced complications since discharge from initial hospitalisation, especially urinary tract infections, decubitus ulcers, urolithiasis, and neurological deterioration. Prevalence of medical symptoms was also high. More than 41% of subjects with spastic paralysis reported excessive spasticity to be associated with additional functional impairment and/or pain. Almost two-thirds of subjects reported significant pain, with a predominance of neurogenic-type pain. Bladder and bowel dysfunction were each rated by nearly 41% of subjects as a moderate to severe life problem. As expected, sexual dysfunction was also commonly reported. Prevalence of reported symptoms by general systems review was high, particularly fatigue, constipation, ankle oedema, joint and muscle problems, and disturbed sleep. However, lack of adequate normative data precludes comparison with the general population. The frequent occurrence of reported medical problems and complications support advocacy of comprehensive, life-long care for SCI patients. The commonly reported problems of neurogenic pain and neurological deterioration, in particular, require more attention, as these symptoms are not seldom ominous, either by virtue of their impact on quality of life, or because of underlying pathology.

Partial mastectomy and breast reconstruction. A comparison of their effects on psychosocial adjustment, body image, and sexuality.

Abstract: Background. This retrospective study compared psychosocial adjustment, body image, and sexual function in women who had either breast conservation or reconstruction for early stage disease. Methods. Questionnaires were completed at a mean of 4 years after surgery by 72 women who had partial mastectomy and 146 women who had immediate breast reconstruction after mastectomy. Results. In general, fewer than 20% of women reported poor adjustment on the domains measured. The two groups did not differ in overall psychosocial adjustment to illness, body image, or satisfaction with relationships or sexual life. There was a specific advantage of partial mastectomy over breast reconstruction in terms of maintaining pleasure and frequency of breast caressing during sexual activity. Women who had undergone chemotherapy had more sexual dysfunction, poorer body image, and more psychological distress. Hormonal therapy and radiation therapy, however, did not measurably affect quality of life. Factors predictive of greater psychosocial distress included a troubled marriage, a poor body image, sexual dissatisfaction, less education, and treatment with chemotherapy. Conclusions. The choice of local treatment had little psychosexual impact, whereas chemotherapy was associated with long term impairments.

Sexual dysfunction in male schizophrenic patients.

Abstract: Background Neuroleptic treatment in schizophrenic patients is associated with sexual dysfunction. However, it is not clear to what extent the psychiatric disorder and/or the pharmacologic treatment are responsible for the sexual impairment. The aim of the present study was to evaluate the sexual function of untreated and treated male schizophrenic patients in comparison with healthy subjects. Method Participants included 122 male subjects: 20 drug-free schizophrenic patients, 51 neuroleptic-treated (depot form) schizophrenic patients, and 51 normal controls. A detailed structured interview was used to quantitatively and qualitatively assess sexual function. Results A high frequency of sexual dysfunction was reported by both schizophrenic groups of patients. Impairments in arousal items (erection) and orgasm during sex were reported mainly by the treated patients. Desire parameters were reduced in both schizophrenic groups, but reduction in the frequency of sexual thoughts was confined to the untreated one. The schizophrenic patients were more involved in masturbatory activity in comparison with the control subjects. Treated patients disclosed dissatisfaction with their sexual function. Conclusion Untreated schizophrenic patients exhibit decreased sexual desire. Neuroleptic treatment is associated with restoration of sexual desire yet it entails erectile, orgasmic, and sexual satisfaction problems. Clinicians' awareness and open discussion of sexual problems with patients may improve comprehension and compliance.

Selective serotonin reuptake inhibitor-induced sexual dysfunction: efficacy of a drug holiday.

Abstract: Objective : The purpose ofthis study was to evaluate whether weekend drug holidays would improve sexual functioning in recovered depressed patients with selective serotonin reuptake inhibitor (SSRI)-induced sexual dysfunction. Method : Thirty outpatients who reported worsening of sexual functioning during SSRI treatment were instructed to discontinue their SSRIs after the Thursday morning dose and to restart the SSRIs (at their previous dosage) on Sunday at 12 :00 noon for four weekends. Results : Significant improvement in sexual functioning was reported by the patients taking sertraline and paroxetine but not by those taking fluoxetine. There were no statistically significant increases in mean Hamilton depression scores after discontinuation of the SSRIs ; two patients had increases in scores from the 4-8 range to the 10-14 range. Conclusions : For some patients taking sertraline and paroxetine who experience sexual dysfunction side effects, brief drug holidays may allow for significant improvement in sexual functioning without a significant return of depressive symptoms.

The effects of radiotherapy and surgery on the sexual function of women treated for cervical cancer

Abstract: Purpose This study investigated the short- and medium-term effects of pelvic radiotherapy and surgery on the sexual function of women treated for cervical cancer. Methods and materials Sixteen women with Stages I, II, or III disease referred for radiotherapy treatment were assessed. Six had undergone prior hysterectomy. The women were assessed with questionnaires prior to radiotherapy, at completion of radiotherapy, and at 6 weeks and 14 weeks after radiotherapy treatment. The clinical findings at routine follow-up were noted. Results The study showed significant changes in sexual activity and satisfaction as a result of treatment. This was due to a number of physical and psychological factors. The level of sexual activity was lowest at completion of radiotherapy treatment. A feeling of vaginal shortening was the most frequent reason and was more common in women who were treated with surgery and radiotherapy. Dyspareunia, bleeding, and concern of bleeding and/or recurrence were all significant factors. Conclusions The questionnaires were an effective way of assessing women's sexual function. Radiotherapy caused sexual dysfunction in one-half of women. Combined treatment with radiotherapy and surgery results in a higher risk than radiotherapy alone. Women with cervical cancer and undergoing radiotherapy treatment require considerable counseling and support.

Multiple Sclerosis: Sexual Dysfunction and Its Response to Medications

Abstract: Objective: To determine the frequency and nature of sexual dysfunction, as well as its response to medications, in a sample of patients with multiple sclerosis (MS). Design: Retrospective and prospective survey of 65 female and 36 male patients with MS. Results: Sixty-three percent of patients reported that they had less sexual activity, and 35% said that they had less interest in lovemaking than before their diagnosis of MS. Fifty-seven patients reported that they had problems with sexual dysfunction. Sexual dysfunction preceded the diagnosis of MS in only 10 of these patients. A higher percentage of men (78%) than women (45%) reported that they experienced sexual dysfunction ( P =.002). Men had prominent erectile dysfunction, women had problems with vaginal lubrication, and both sexes had problems with decreased sensation and achieving orgasm. The presence of sexual dysfunction was associated with the presence of urinary problems ( P =.02) and with a history of treatment of ( P =.04) or a current report of ( P =.02) depression. No association could be found between sexual dysfunction and duration of disease, type of disease, disability score, or presence of fatigue. Twenty of 57 patients with sexual dysfunction reported that they had associated marital problems. Forty-three of 60 patients who discussed sexual problems with their spouses and four of six who tried formal counseling found it helpful. Surprisingly, corticosteroid treatments that were started for problems other than sexual dysfunction resulted in improved sexual functioning in many patients. Conclusions: Sexual dysfunction is common in patients with MS. Determining the frequency and nature of problems allows issues of sexual dysfunction to be addressed as part of comprehensive care of patients with MS and suggests treatments that could improve their quality of life.

The Stockholm Spinal Cord Injury Study : 2. Associations between clinical patient characteristics and post-acute medical problems.

Abstract: The Stockholm Spinal Cord Injury Study (SSCIS) is an extensive evaluation of a sample of 353 subjects with traumatic SCI, constituting 93% of the known regional prevalence population with this diagnosis. In a previous analysis of this group, symptoms such as pain, incontinence, sexual dysfunction and neurological deterioration, as well as secondary complications, such as decubitus ulcers, urinary tract infections, spinal deformity and fractures, were found to be common. In the present report, we investigate associations between a few commonly used patient characteristics, ie gender, age at injury, duration of injury and extent of neurological compromise, and the occurrence of such problems, to assess differences in vulnerability in SCI subgroups. Results generally indicate an increased vulnerability in subjects with extensive neurological deficits, as well as a cumulation of complications with the increasing duration of injury. However, some exceptions are found, possibly indicating differences in temporal patterns of the occurrence of various complications, as well as certain gender-, age-, and lesion-associated variations in vulnerability. Symptoms directly related to the spinal cord lesion, eg neurogenic pain and neurological deterioration, seem to present rather soon post-injury. Males are more prone to experience excessive spasticity and sexual problems. Females experience more fractures and spinal deformity. Younger age at injury is associated with more spinal deformity but less severe pain problems. Higher age at injury is not found to be associated with more medical problems, with the exception of neurogenic pain, among post-acute, post-discharge survivors. The latter finding does not, however, preclude more such problems in the acute stage, since the present study neither addresses the pre-discharge period, nor includes information about mortality. Finally, the ASIA/IMSOP Impairment Scale Grade E-rated subjects were found to report problems to an extent that underlines the restricted sensorimotor sense in which this rating reflects recovery.

Treatment of Sexual Disorders in the 1990s: An Integrated Approach.

Abstract: Marked changes have occurred in the formulation and treatment of sexual disorders in the past 2 decades. Emphasis has shifted to the role of biomedical and organic factors in the etiology of sexual dysfunction, along with the growing use of medical and surgical treatment interventions. Multidimensional assessment models are widely used, particularly in the evaluation of male erectile dysfunction and sexual pain disorders. Integrated treatment approaches have also been developed, as cognitive-behavioral and couples' therapy procedures are increasingly combined with traditional sex therapy techniques. This article reviews existing data regarding the etiology and treatment of male and female sexual dysfunctions. Despite the conceptual and technological sophistication of current approaches, treatment outcome is less than satisfactory in several areas. Further research is needed on the etiology and treatment of sexual disorders.

Social and sexual function following ileal pouch-anal anastomosis.

Abstract: PURPOSE: Patiens who undergo surgery for ulcerative colitis are usually young and active. When surgery becomes necessary, their future social and sexual function is of major concern. This study was performed to be able to give more detailed information of what is to be expected. METHODS: Forty-nine consecutive patients (26 men and 23 women) who underwent ileal J-pouch-anal anastomosis for ulcerative colitis between November 1983 and September 1986 in the authors' institution were personally interviewed regarding details of their preoperative and postoperative social and sexual functions. RESULTS: Eighty-eight percent had reduced capacity to work preoperatively compared with 6 percent postoperatively. Thirty-one percent resumed work in the period with diverting ileostomy. Leisure time activities were reduced in 47 percent preoperatively, whereas 6 percent had limitations postoperatively. In 35 percent of women, frequency of intercourse was increased postoperatively, and none reported a decreased frequency. None of the women who were able to achieve orgasm preoperatively reported a postoperative disturbance of this ability, and 16 percent experienced an increased quality of orgasm. Postoperatively none reported dyspareunia, vaginal discharge, or changes in their menstrual cycle. Frequency of intercourse and ability to achieve orgasm remained unchanged for the majority of men; however, one developed erectile dysfunction, and one complained of retrograde ejaculation. Sexual activity in men was less affected by the presence of an ileostomy, and 69 percent had intercourse in the period with ileostomy compared with 30 percent of women. None of the patients complained of anal pain, soiling, or fecal leakage during intercourse, but one woman reported some discomfort from the pouch during intercourse. None of the patients wanted to return to a life with an ileostomy. CONCLUSION: The social and sexual function, quality of life, after ileal J-pouch anastomosis is improved when compared with the period with ulcerative colitis and the time with diverting ileostomy. In men, however, a frequency of sexual dysfunction similar to what is seen after proctectomy for benign diseases should be underlined.

Predictors of psychological distress, sexual dysfunction and physical functioning among women with upper extremity lymphedema related to breast cancer

Abstract: Sixty-nine women presenting for rehabilitation treatment for upper extremity lymphedema (UEL) were assessed by physical examination and validated self-report assessment instruments measuring demographics, psychological distress, sexual functioning, social support, coping style, pain and functional status. Statistical analyses revealed that women with UEL had high levels of psychological distress, and high levels of sexual, functional and social dysfunction. There were no linear relationships between severity of UEL and levels of distress. Women with UEL in their dominant hand, however, had more distress and less overall sexual satisfaction than those with UEL in their non-dominant limb. Women with pain of any intensity were the most distressed, and had the most significant difficulties in psychological and physical functioning. Women with pain also perceived significantly less interpersonal support than those without pain. Virtually none were receiving pain treatment. An avoidant coping style and low perceived social support were significant correlates of psychological distress. UEL poses significant functional, social and sexual functioning problems in women following breast cancer treatment. An assessment of pain, as well as social support and coping, might help identify those in need of consultation by psychiatry and pain specialists. Patients may also benefit from psychological support and sexual therapy in addition to physical rehabilitation. A psycho-educational and support group within the clinic may prevent the worsening of UEL through the adoption of preventive strategies, maximizing compliance with rehabilitative efforts, augmenting better coping methods through group support, decreasing isolation that accompanies the condition, and facilitating the identification of patients in need of formal consultation.

Male sexual side effects associated with antidepressants: A descriptive clinical study of 32 patients

Abstract: Objective:This is a retrospective study to add to the existing body of clinical information regarding male sexual side effects associated with antidepressants. From the chart review, thirty-four ou...

Erectile dysfunction in sleep apnea and response to CPAP.

Abstract: This study assessed characteristics of sexual dysfunction in sleep apnea and the efficacy of treatment with continuous positive airway pressure (CPAP). Twenty-two men with sleep apnea syndrome and also sexual dysfunction served as subjects in this study. Tests included physical, psychological, neurological, and penile vascular examinations, along with polysomnography, nocturnal penile tumescence (NPT), and penile rigidity. All patients clinically had a history of snoring and difficulty getting and maintaining erections. Results indicate that erectile dysfunction in patients with sleep apnea could be related to patient's age and chronic cerebral hypoxia due to apnea. Treatment with CPAP relieved erectile dysfunction in one-third of these patients.

Cyproheptadine treatment of sexual dysfunction induced by serotonin reuptake inhibitors.

Abstract: Treatment of serotonin reuptake inhibitors (SRIs) is associated with sexual dysfunction. The cause of this dysfunction is unclear but may be related to stimulation of the serotonergic system. In the present article, we describe seven patients in whom iatrogenic sexual dysfunction induced by SRIs was treated with cyproheptadine, a 5HT-2 antagonist with antihistaminergic and adrenolytic properties. Seven obsessive-compulsive male patients, aged 29-54 years, who developed sexual dysfunction following treatment with SRIs (fluoxetine, fluvoxamine, and clomipramine) were instructed to take cyproheptadine (4-12 mg) 1-2 h before commencing sexual activity. Five of the seven patients displayed improvement in sexual function, although the improvement was transitory in two. The two remaining patients did not respond. All patients exhibited sedation on the day following cyproheptadine administration. Our preliminary observation suggests that some patients with sexual dysfunction associated with SRI treatment, mainly decreased libido and anorgasmia, may benefit from cyproheptadine administration. The role of 5HT-2 antagonists in SRI-induced sexual dysfunction merits further investigation.

Different patterns of sexual dysfunctions associated with psychiatric disorders and psychopharmacological treatment. Results of an investigation by semistructured interview of schizophrenic and neurotic patients and methadone-substituted opiate addicts.

Abstract: Little is known about sexual dysfunctions associated with psychiatric disorders and psychopharmacological treatment. In the present study schizophrenic patients (n = 45, mostly under neuroleptic treatment), neurotic patients (n = 50, mostly treated without medication), methadone-substituted opiate addicts (n = 37), and normal controls (n = 41) were included. They were interviewed with the aid of a sex-differentiated semistructured questionnaire on sexual function. All the methadone-substituted opiate addicts and nearly all the schizophrenic patients suffered from dysfunctions in at least one criterion. The three clinical groups differed significantly from the controls in sexual interest, emotional arousal, physiological arousal (erectile function/vaginal lubrication), performance (ejaculatory function/vaginism, dyspareunia), and orgasm satisfaction. Characteristic patterns of dysfunction were found in the male patients. The schizophrenic patients had significantly more dysfunctions of interest, physiological arousal, performance, and orgasm than the controls. Emotional arousal, erectile and ejaculatory functions, and orgasm satisfaction were impaired more frequently in the male schizophrenics than in the neurotic patients. Reduced sexual interest, emotional arousal, and orgasm satisfaction were reported more frequently by the methadone-substituted opiate addicts than by the neurotic men. Emotional arousal was even more frequently reduced than in the schizophrenic men. There was no correlation between sexual dysfunction and particular neuroleptics or neuroleptic or methadone dosage. The results are compared with the literature and suggestions made for further investigations.

Female Sexual Side Effects Associated with Selective Serotonin Reuptake Inhibitors: A Descriptive Clinical Study of 33 Patients

Abstract: Objective:After the advent of selective serotonin reuptake inhibitors on the U.S. market in 1988, American psychiatrists have been faced with more choices of antidepressants for the treatment of depression. The prescribing of SSRIs has been increasing in popularity because they are easily titrated by the physicians and tolerated by patients. However, the SSRI use is frequently associated with female sexual dysfunction. The aim of this study was to describe these SSRI-associated female sexual side effects.Methods:In a retrospective series, clinic records of 110 female SSRI-treated outpatients were reviewed for loss of or decreased libido, orgasmic disturbances (anorgasmia or delayed orgasm), as well as clinical management patterns to alleviate sexual side effects.Results:Twenty-one fluoxetine-, nine paroxetine-, and five sertraline-treated cases with female sexual inhibition were identified. The fates of SSRI-associated sexual adverse effects and clinical managements of restoring these side effects were de...

Psychostimulants apparently reverse sexual dysfunction secondary to selective serotonin re-uptake inhibitors

Abstract: Sexual dysfunction secondary to selective serotonin re-uptake inhibitors (SSRIs) is an almost universal, yet pooly understood phenomenon. Not uncommonly, this unpleasant side effect leads to noncompliance. Since SSRIs have been so successful clinically, it is time to find a safe and effective treatment for this side effect. This paper reports on five cases in which low dosages of the psychostimulants, dextroamphetamine and methylphenidate, administered on a p.r.n. basis, reversed the sexually inhibiting side effects of the SSRIs fluxetine, setraline, and paroxetine in patients with and without attention deficit hyperactivity disorder. In addition, the women experienced enhanced levels of arousal, orgasmic sensation and excitement during the resolution phase (afterglow) of the sexual response cycle on psychostimulants, and the men noted firmer erections.

Treatment of sexual dysfunctions by sex therapy and other approaches.

Abstract: BACKGROUND The treatment of sexual dysfunctions underwent a great change when sex therapy was developed more than 25 years ago. Since then the treatment programme has been modified in various ways, the response to treatment evaluated and other treatment approaches introduced. METHOD A review of the literature concerning the application and outcome of sex therapy and other treatments for sexual dysfunction was conducted. RESULTS The format of effective conjoint sex therapy is now fairly clear and there is good understanding of the sexual dysfunctions that respond best to this treatment and the couples most likely to benefit. Less is known about the effects of treatment of individuals without partners, bibliotherapy and combining sex therapy with marital therapy and with physical methods of treatment. CONCLUSIONS Sex therapy is now a well-established form of treatment. It should be more widely available for patients seen in psychiatry departments.

Clinical implications of antidepressant drug effects on sexual function.

Abstract: Sexual dysfunction in a patient being treated with antidepressant medications may be due to the underlying depression, a coexisting medical illness, disruption of interpersonal relationships, or it may be a side effect of the medication. Almost all antidepressants are associated with sexual side effects that go above and beyond any symptoms that can be explained by the disease process itself. The incidence of such sexual side effects can be as high as 92% for some antidepressants. Some of the newer antidepressants currently on the market seem to have a lower incidence of sexual dysfunction as a side effect. In view of the fairly common occurrence of these unwanted effects, and their potential contribution to noncompliance, careful selection of antidepressant medications is necessary. A variety of treatment options is available, including decreasing the dosage of medication to the lowest-effective level, adjunctive medications (such as cyproheptadine, bethanechol, yohimbine, and amantadine, as well as other antidepressants) to counteract the adverse sexual effects, or switching to another antidepressant. The treatment of antidepressant-induced sexual dysfunction requires a creative approach on the part of the treating psychiatrist, and must be individualized to the patient.

Sexual functioning and attitudes of eating-disordered women: a follow-up study.

Abstract: The sexual experiences and attitudes of eating disorder patients are receiving increased professional attention. However, empirical work in this area has generally focused on these patients at the point of initial evaluation. In the current study we report the results of a follow-up questionnaire completed by women who had been treated in our clinic (N = 42) for either anorexia nervosa (restricting type) or bulimia nervosa (purging type). We found that former anorectic patients were less likely to return the questionnaire and, of those who did, there was a trend toward anorectic women's being less likely to be in a romantic/erotic relationship. Almost all of the women had engaged in sexual intercourse, and former anorectic patients did not differ from bulimics with regard to age at first coitus. Anorectics were less likely than bulimics to have engaged in masturbation and also scored lower on a measure of sexual esteem. Although there were no differences between the two groups with regard to current level of sexual functioning, erotophobia/erotophilia, or sexual satisfaction, the women in our sample exhibited less sexual interest and more negative affect during sex than did a normative sample. Also, nearly 40% of our sample indicated clinically significant levels of sexual discord with their current partner. Results are discussed with regard to prior research, interventions, and further study.

Vulvodynia ‐ a complex syndrome of vulvar pain

Abstract: Vulvodynia is a syndrome of unexplained vulvar pain, sexual dysfunction, and psychological disability. The incidence or prevalence of this condition is not known. Several subtypes of vulvodynia have been recognized. Recognition of the distinct subsets of vulvodynia is a prerequisite for successful management. Vulvar vestibulitis syndrome, cyclic vulvovaginitis, and dysesthetic vulvodynia are the most common subtypes. Other frequently misdiagnosed vulvar or vaginal conditions which can also cause culvodynia are vulvar papillomatosis, cytolytic vaginosis, lactobacillosis, and desquamative inflammatory vaginitis. In addition, many vulvar dermatoses can cause acute or chronic vulvar itching or pain, and are a frequent cause of differential diagnostic problems. In conclusion, vulvodynia is a complex multifactorial underdiagnosed clinical syndrome. Systematic epidemiologic, etiologic, and therapeutic studies of vulvodynia should be undertaken.

Factors associated with sexual functioning in women following spinal cord injury

Abstract: Research into sexuality following spinal cord injury (SCI) has tended to concentrate on male experiences and the physical capabilities for sexual intercourse. The sexuality of women following SCI has only recently been addressed and studies are limited to small numbers and the use of non-standardised measures. The present investigation utilised standard measures of affective state and body satisfaction together with pre and post-injury questionnaire information of sexual dysfunction, feelings about sex and importance of sexual activity in a group of 85 women with SCI. Sexual dysfunction increased significantly post-injury, whilst feelings about sex and it's importance were unaffected. Sexual dysfunction and the importance of sex were inversely correlated. General and Head satisfaction estimates were not significantly different to control samples, whilst Body Satisfaction was increased for women with disabilities. None of the body satisfaction measures were related to the sexual functioning measure. General dissatisfaction was associated depression. Both anxiety and depression were experienced by the same individuals, and anxiety related to current sexual dysfunction. Qualitative data supported previous findings concerning the effects of social and attitudinal barriers on sexual functioning.

Illness Stage, Concurrent Medications, and Other Correlates of Low Testosterone in Men with Hiv Illness

Abstract: Our objective was to assess whether illness stage, markers of illness progression, and use of medications believed to lower testosterone are associated with low serum testosterone in HIV+ men. Data were available for 234 HIV+ men screened for eligibility for a study of testosterone replacement therapy and/or an antidepressant trial. A screening interview was used to elicit demographic and medical information. Blood was drawn to measure markers of immunodeficiency and serum testosterone. Thirty-eight percent of the sample had testosterone levels below the normal range. Low testosterone was associated with lower CD4 cell count, later stage of illness, use of megestrol, and older age. Regression analysis showed that only age and use of such medications as megestrol were significant predictors of low testosterone. Given the prevalence of low testosterone in HIV+ men and its link to sexual dysfunction, more research is needed on treatments aimed at correcting or compensating for this hormonal deficiency as well as the study of the impact of such medications as megestrol on testosterone levels in older men.

Addressing sexual dysfunction following radiation therapy for a gynecologic malignancy.

Abstract: Purpose/objectives To review the aspects of normal sexual response, current incidence of sexual dysfunction following radiation therapy for a gynecologic malignancy, nursing interventions for each symptom that may occur, and nursing research priorities. Data sources Published articles, book chapters, American Cancer Society materials, healthcare professionals working in the field of radiation oncology, and patients. Data synthesis Radiation therapy frequently is the treatment of choice for a gynecologic malignancy. High-dose radiation to the pelvis causes varying degrees of sexual dysfunction because of its effects on the ovaries and vagina. Conclusions Sexual dysfunction resulting from the effects of radiation therapy on the ovaries and vagina can be prevented, minimized, or managed when the nurse is aware of the needs, desires, and expectations of patients receiving this treatment. Implications for nursing practice Sexuality is an important aspect of quality of life that most healthcare professionals do not address. Nursing assessment and practical care strategies for sexual dysfunction can be implemented. Additional nursing research on this subject is warranted.