Showing papers on "Sexual dysfunction published in 1997"

SSRI-induced sexual dysfunction: Fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients.

Abstract: The authors analyzed the incidence of sexual dysfunction (SD) with different selective serotonin reuptake inhibitors (SSRIs; fluoxetine, fluvoxamine, paroxetine, and sertraline) and hence the qualitative and quantitative changes in SD throughout time in a prospective and multicenter study. Outpatients (192 women and 152 men; age = 39.6 +/- 11.4 years) under treatment with SSRIs were interviewed with an SD questionnaire designed for this purpose by the authors and that included questions about the following: decreased libido, delayed orgasm or anorgasmia, delayed ejaculation, inability to ejaculate, impotence, and general sexual satisfaction. Patients with the following criteria were included: normal sexual function before SSRI intake, exclusive treatment with SSRIs or treatment associated with benzodiazepines, previous heterosexual or self-erotic current sexual practices. Excluded were patients with previous sexual dysfunction, association of SSRIs with neuroleptics, recent hormone intake, and significant medical illnesses. There was a significant increase in the incidence of SD when physicians asked the patients direct questions (58%) versus when SD was spontaneously reported (14%). There were some significant differences among different SSRIs: paroxetine provoked more delay of orgasm or ejaculation and more impotence than fluvoxamine, fluoxetine and sertraline (chi 2, p < .05). Only 24.5% of the patients had a good tolerance of their sexual dysfunction. Twelve male patients who suffered from premature ejaculation before the treatment preferred to maintain delayed ejaculation, and their sexual satisfaction, and that of their partners, clearly improved. Sexual dysfunction was positively correlated with dose. Patients experienced substantial improvement in sexual function when the dose was diminished or the drug was withdrawn. Men showed more incidence of sexual dysfunction than women, but women's sexual dysfunction was more intense than men's. In only 5.8% of patients, the dysfunction disappeared completely within 6 months, but 81.4% showed no improvement at all by the end of this period. Twelve of 15 patients experienced total improvement when the treatment was changed to moclobemide (450-600 mg/day), and 3 of 5 patients improved when treatment was changed to amineptine (200 mg/day).

Childhood sexual abuse and women's substance abuse : National survey findings

Abstract: Objective: Clinical studies have found elevated rates of childhood sexual abuse (CSA) in women seeking treatment for alcohol or drug abuse, and elevated rates of alcohol and drug disorders among female psychiatric patients with histories of CSA. The present study examines the relationship of CSA to women's use of alcohol and other drugs in a large, nationally representative sample of U.S. women. Method: As part of a national survey of women's drinking, 1,099 women were asked about sexual experiences occurring before age 18. Women who reported sexual experiences classified as abusive were compared to women without histories of CSA on nine measures of substance use, self-perception of anxiousness, the occurrence of one or more lifetime depressive episodes, five measures of sexual dysfunction, and early onset of masturbation and consensual sexual intercourse. Results: Results of logit analyses, controlling for age, ethnicity and parental education, indicated that women with histories of CSA were significantl...

Long-term Effects on Sexual Function of Five Antihypertensive Drugs and Nutritional Hygienic Treatment in Hypertensive Men and Women Treatment of Mild Hypertension Study (TOMHS)

Abstract: Problems with sexual function have been a long-standing concern in the treatment of hypertension and may influence the choice of treatment regimens and decisions to discontinue drugs. The Treatment of Mild Hypertension Study (TOMHS) provides an excellent opportunity for examination of sexual function and effects of treatment on sexual function in men and women with stage I diastolic hypertension because of the number of drug classes studied, the double-blind study design, and the long-term follow-up. TOMHS was a double-blind, randomized controlled trial of 902 hypertensive individuals (557 men, 345 women), aged 45 to 69 years, treated with placebo or one of five active drugs (acebutolol, amlodipine maleate, chlorthalidone, doxazosin maleate, or enalapril maleate). All participants received intensive lifestyle counseling regarding weight loss, dietary sodium reduction, alcohol reduction (for current drinkers), and increased physical activity. Sexual function was ascertained by physician interviews at baseline and annually during follow-up. At baseline, 14.4% of men and 4.9% of women reported a problems with sexual function. In men, 12.2% had problems obtaining and/or maintaining an erection; 2.0% of women reported a problem having an orgasm. Erection problems in men at baseline were positively related to age, systolic pressure, and previous antihypertensive drug use. The incidences of erection dysfunction during follow-up in men were 9.5% and 14.7% through 24 and 48 months, respectively, and were related to type of antihypertensive therapy. Participants randomized to chlorthalidone reported a significantly higher incidence of erection problems through 24 months than participants randomized to placebo (17.1% versus 8.1%, P = .025). Incidence rates through 48 months were more similar among treatment groups than at 24 months, with nonsignificant differences between the chlorthalidone and placebo groups. Incidence was lowest in the doxazosin group but was not significantly different from the placebo group. Incidence for acebutolol, amlodipine, and enalapril groups was similar to that in the placebo group. In many cases, erection dysfunction did not require withdrawal of medication. Disappearance of erection problems among men with problems at baseline was common in all groups but greatest in the doxazosin group. Incidence of reported sexual problems in women was low in all treatment groups. In conclusion, long-term incidence of erection problems in treated hypertensive men is relatively low but is higher with chlorthalidone treatment. Effects of erection dysfunction with chlorthalidone appear relatively early and are often tolerable, and new occurrences after 2 years are unlikely. The rate of reported sexual problems in hypertensive women is low and does not appear to differ by type of drug. Similar incidence rates of erection dysfunction in placebo and most active drug groups caution against routine attribution of erection problems to antihypertensive medication.

The Perceived Effects of Smoked Cannabis on Patients with Multiple Sclerosis

Abstract: Fifty-three UK and 59 USA people with multiple sclerosis (MS) answered anonymously the first questionnaire on cannabis use and MS. From 97 to 30% of the subjects reported cannabis improved (in descending rank order): spasticity, chronic pain of extremities, acute paroxysmal phenomenon, tremor, emotional dysfunction, anorexia/weight loss, fatigue states, double vision, sexual dysfunction, bowel and bladder dysfunctions, vision dimness, dysfunctions of walking and balance, and memory loss. The MS subjects surveyed have specific therapeutic reasons for smoking cannabis. The survey findings will aid in the design of a clinical trial of cannabis or cannabinoid administration to MS patients or to other patients with similar signs or symptoms.

Circumcision in the United States: Prevalence, Prophylactic Effects, and Sexual Practice

Abstract: Objective. —To assess the prevalence of circumcision across various social groups and examine the health and sexual outcomes of circumcision. Design. —An analysis of data from the National Health and Social Life Survey. Participants. —A national probability sample of 1410 American men aged 18 to 59 years at the time of the survey. In addition, an oversample of black and Hispanic minority groups is included in comparative analyses. Main Outcome Measures. —The contraction of sexually transmitted diseases, the experience of sexual dysfunction, and experience with a series of sexual practices. Results. —We find no significant differences between circumcised and uncircumcised men in their likelihood of contracting sexually transmitted diseases. However, uncircumcised men appear slightly more likely to experience sexual dysfunctions, especially later in life. Finally, we find that circumcised men engage in a more elaborated set of sexual practices. This pattern differs across ethnic groups, suggesting the influence of social factors. Conclusions. —The National Health and Social Life Survey evidence indicates a slight benefit of circumcision but a negligible association with most outcomes. These findings inform existing debates on the utility of circumcision. The considerable impact of circumcision status on sexual practice represents a new finding that should further enrich such discussion. Our results support the view that physicians and parents be informed of the potential benefits and risks before circumcising newborns.

Sexual dysfunction in primary medical care: prevalence, characteristics and detection by the general practitioner.

Abstract: Background Despite the recent focus on sexual behaviour and AIDs, there are almost no data on the prevalence of sexual dysfunction within primary care settings. Method One hundred and seventy patients attending a general practice participated in a questionnaire survey of the prevalence and characteristics of sexual problems. The detection rate of the general practitioners (GPs) and indicators in the patient notes were also investigated. Results Thirty five per cent of the men (n = 22) reported some form of specific sexual dysfunction: premature ejaculation was identified in 31 per cent of the men; 17 per cent experienced erectile dysfunction, which was associated with current medication, a high mean annual attendance and increasing age. The prevalence of sexual dysfunction in the women was 42 per cent {n = 41); vaginismus was reported by 30 per cent of the sample; 23 per cent of the women suffered from anorgasmia. General sexual dissatisfaction was more common than specific dysfunction; 68 per cent (n = 66) of the women and 75 per cent (n = 54) of the men reported at least one problem with dissatisfaction, avoidance, infrequency or non-communication. The large majority of the sample (70 per cent) considered sexual matters to be an appropriate topic for the GP to discuss. Despite this, sexual problems were recorded in only 2 per cent of the GP notes. Conclusions This study confirms the high prevalence of sexual disorders in the population. Many of these problems are concealed from GPs. Predictors in patients' notes could help GPs to detect those patients with more serious problems.

Quality of life and treatment outcomes : Prostate carcinoma patients' perspectives after prostatectomy or radiation therapy

Abstract: BACKGROUND Of the estimated 317,000 men in the United States diagnosed with prostate carcinoma in 1996, 57% will have localized disease, and their 5-year relative survival rate will be 98%. Limited information exists on patient-reported quality of life (QOL) and the incidence and severity of treatment-related side effects. The purpose of this study was to identify and compare patients' self-reported QOL and treatment side effects 1-5 years after radical prostatectomy or radiotherapy. METHODS Data collection for this cross-sectional study included a mailed, self-administered survey with three parts: a demographic survey, the Functional Assessment of Cancer Therapy-General (FACT-G), and a newly developed Prostate Cancer Treatment Outcome Questionnaire (PCTO-Q). The FACT-G measured the effect of prostate carcinoma on overall QOL in the two treatment groups. The PCTO-Q assessed the patients' perceptions of the incidence and severity of specific changes in bowel, urinary, and sexual functions. The test-retest reliability of the PCTO-Q in a pilot study was 91.2%. RESULTS Two hundred seventy-four eligible men completed the questionnaires; 132 (48%) reported having undergone prostatectomy and 142 (52%) reported having undergone radiotherapy. After age adjustment, the radiotherapy group reported more bowel dysfunction (P = 0.001), whereas the prostatectomy group reported more urinary problems (P = 0.03) and more sexual dysfunction (P = 0.001). Scores for the FACT-G were similar in the two treatment groups. CONCLUSIONS Men undergoing treatment for clinically localized prostate carcinoma continue to experience difficulty long after treatment. In this study, the prostatectomy group fared worse in regard to sexual and urinary functions, whereas the radiotherapy group experienced more bowel dysfunction. Survivor-reported QOL and treatment outcomes can assist physicians in counseling patients in the selection of the preferred course of treatment. Cancer 1997; 79:1977-86. © 1997 American Cancer Society.

Sexuality and Fertility After Cancer

Abstract: As more people achieve long-term survival after cancer, sexual dysfunction and infertility have increasingly been recognized as negative consequences that impact quality of life. Sexual dysfunction is a frequent long-term side effect of cancer treatment, but damage to different underlying physiological systems is salient in men versus women. Men frequently have erectile dysfunction (ED) related to damage to the autonomic nervous system and/or reduced circulation of blood to the penis. Hormonal impairment of sexual function is less common. Women, in contrast, are able to overcome damage to autonomic nerves if genital tissues remain structurally intact and estrogenized. Female sexual dysfunction is frequently associated with sudden premature ovarian failure or direct effects of radiation fibrosis or scar tissue causing pain with sexual activity. The lack of validated interventions for sexual rehabilitation after cancer is a major problem, as is finding cost-effective ways of providing services. Concerns about fertility are also a major source of distress to people treated for cancer during childhood or young adulthood, yet many young survivors do not recall any discussion about future childbearing potential with their oncology team. Since fertility preservation is becoming more practical for both men and women, producing patient and professional educational materials and developing professional practice guidelines should be high priorities for oncology societies.

Response expectancy theory and application: A decennial review

Abstract: Response expectancy is the anticipation of automatic, subjective, and behavioral responses to particular situational cues. More than a decade of research in diverse laboratories indicates that response expectancies are important considerations in designing and administering treatments and prevention programs for such problems as anxiety disorders, depression, substance abuse, and sexual dysfunction. Response expectancy also plays a central role in the effects of antidepressive medication, psychotherapy, and hypnosis. In addition, studies of the effects of placebos reveal that response expectancies can produce lasting changes in pain, anxiety, depression, alertness, tension, sexual arousal, alcohol craving and consumption, aggression, asthma, warts, and contact dermatitis. The veracity of many self-reported placebo effects have been corroborated by changes in physiological function.

Sexual contact between children and adults: a life course perspective*

Abstract: We adjudicate between two competing models of the long-term effects on women of sexual contact in childhood. The psychogenic perspective conceptualizes adult-child sexual contact as a traumatic event generating intense affect that must be resolved. Behavioral attempts to deal with the trauma of adult-child sexual contact can take opposing forms-some victims will engage in compulsive sexual behavior while others withdraw from sexual activity. The more severe the sexual contact, the more adverse the long-term effects (including sexual dysfunction and diminished well-being). From our alternative life course perspective, sexual contact with an adult during childhood provides a culturally inappropriate model of sexual behavior that increases the child's likelihood of engaging in an active and risky sexual career in adolescence and adulthood. These behaviors, in turn, create longterm adverse outcomes. Using data from the National Health and Social Life Survey, we find evidence of heightened sexual activity in the aftermath of adult-child sex (predicted by both perspectives), but we find no evidence of a tendency to avoid sexual activity (predicted by the psychogenic perspective). Moreover, we find little evidence to support the hypothesis that the severity of the sexual contact increases the likelihood of long-term adverse outcomes. In contrast, we find strong evidence that sexual trajectories account for the

Intimacy and quality of life among sexually dysfunctional men and women.

Abstract: This study evaluated the associations between intimacy, quality of life, and sexual dysfunction in men and women. Participants were 145 sexually functional (43 men, 102 women) adults drawn from the general population and 198 sexually dysfunctional (114 men, 84 women) adults who came to a university sexual behavior clinic. All respondents were currently involved in a heterosexual relationship. Respondents completed a series of questionnaires to evaluate the level of intimacy in their relationships, their quality of life, and their level of sexual dysfunction. All aspects of intimacy were lower among sexually dysfunctional men than among sexually functional men for all subgroups of dysfunctionality (premature ejaculation, erectile failure, and lack of sexual desire). Levels of intimacy were less likely to discriminate between functional and dysfunctional women, with functional women only obtaining higher intimacy scores than each of the dysfunctional groups of women (inorgasmia, lack of arousal, lack of sexual desire) for social intimacy and recreational intimacy and, to a lesser extent, for sexual intimacy. Objective levels of quality of life as well as the satisfaction and importance of the quality of life domains were more likely to be lower when sexually dysfunctional women were compared with their functional counterparts than when sexually dysfunctional men were compared with their functional counterparts. The implications of these findings for an understanding of factors that contribute to sexual dysfunction, and the treatment of these disorders, is discussed.

Chronic renal failure and sexual functioning: clinical status versus objectively assessed sexual response.

Abstract: failure but largely to loss of sexual interest, subjectively ascribed to fatigue. The latter was also found in women Background. Sexual dysfunctions are common among patients with chronic renal failure. The prevalence was on haemodialysis or peritoneal dialysis. assessed in a population of 281 patients (20‐60 years), Key words: chronic renal failure; prevalence; biochemand it was attempted to determine whether their mode ical variables; psychophysiology; sexual dysfunctions of treatment (haemodialysis, peritoneal dialysis, or kidney transplantation), or biochemical and endocrine variables and neuropathy aVect sexual functioning. Patients with rheumatoid arthritis served as a compar- Introduction ison group. Methods. Assessment included clinical history, phys- Sexual dysfunctions are common in patients with ical and laboratory examinations, questionnaires chronic renal failure (CRF ). Prevalence estimates run measuring erotosexual dysfunctions, and a psycho- from 9% before starting dialysis to 60‐70% in dialysing physiological test procedure. The latter is a laboratory male and female patients [1,2]. Several somatic factors method which measures, in a waking state, subjective have been implicated in the aetiology of sexual dysfuncand physiological sexual arousal. tions in patients with CRF (for a review see Results. Men on haemodialysis or peritoneal dialysis Handelsman [3]). However, most of these factors lack suVered significantly more often from ‘Hypoactive empirical support. Severe malnutrition, and vitamin Sexual Desire Disorder’, ‘Sexual Aversion Disorder’ and zinc deficiencies were problems in the early days and ‘Inhibited Male Orgasm’ than men with kidney of dialysis, but are relatively rare now. Uraemic toxins transplantation or rheumatoid arthritis. Interestingly, and ‘middle molecules’ have not been convincingly the prevalence of ‘Male Erectile Disorder’ did not implicated. CRF is associated with disturbances of diVer significantly between the four groups and ranged reproductive hormones and prolactin, but their pharmbetween 17 and 43%. Of the women, transplanted acotherapeutic correction has not been proved benefipatients suVered significantly less from ‘Hypoactive cial. Atherosclerosis is accelerated in patients with Sexual Desire Disorder’ than the other three groups; CRF, but the rapid onset of improvement of sexual the prevalence of other sexual dysfunctions did not function following renal transplantation renders it diVer between the groups. Although ‘Male Erectile unlikely that this is an important factor. This also Disorder’ and ‘Female Sexual Arousal Disorder’ had applies to uraemic neuropathy, the progression of a relatively high prevalence there were no diVerences which is being slowed by adequate dialysis. Several in the four groups of patients in genital responses drugs used in the treatment of patients with CRF may during psychophysiological testing. Genital responses interfere with sexual functioning, but their replacement during psychophysiological assessment had no rela- with more modern drugs has not reduced sexual tionship to the duration of renal replacement treat- dysfunction. ment, biochemical/endocrine variables, or the presence/ None of the somatic mechanisms mentioned above absence of neuropathy. has satisfactorily explained the high incidence of sexual Conclusion. The prevalence of sexual dysfunction was dysfunctions in patients with CRF. Thus, psychological high. Sexual dysfunction in men on haemodialysis or mechanisms have to be taken into consideration. In peritoneal dialysis was not so much due to erectile view of the psychosomatic nature of human sexuality, these psychological studies have gained in importance

Aging and sexuality

Abstract: Recent research suggesting that a high proportion of men and women remain sexually active well into later life refutes the prevailing myth that aging and sexual dysfunction are inexorably linked. Age-related physiological changes do not render a meaningful sexual relationship impossible or even necessarily difficult. In men, greater physical stimulation is required to attain and maintain erections, and orgasms are less intense. In women, menopause terminates fertility and produces changes stemming from estrogen deficiency. The extent to which aging affects sexual function depends largely on psychological, pharmacological, and illness-related factors. In this article I review the physiological sex-related changes that occur as part of the normal aging process in men and women. I also summarize the effects on sexual function of age-related psychological issues, illness factors, and medication use. An understanding of the sexual changes that accompany normal aging may help physicians give patients realistic and encouraging advice on sexuality. Although it is important that older men and women not fall into the psychosocial trap of expecting (or worse, trying to force) the kind and degree of sexual response characteristic of their youth, it is equally as important that they not fall prey to the negative folklore according to which decreased physical intimacy is an inevitable consequence of the passage of time.

Dyspareunia: Sexual Dysfunction or Pain Syndrome?

Abstract: This study investigated the clinical attributes of dyspareunia and the variables used to classify it. A systematic clinical description of the pain symptomatology was obtained through the administration of a structured interview and standardized pain measures to 112 women suffering from dyspareunia, ranging in age from 19 to 65. Subjects also underwent three different gynecological examinations and completed standardized measures of psychopathology, marital adjustment, and sexual attitudes, the results of which were used to test the ability of three different classification systems, including the DSM-IV, to predict physical and psychosocial outcomes. Using classification analysis, temporal pattern and location of the pain were found to be the best predictors of physical diagnoses, although none of the taxa in the three classification systems tested were related to psychosocial outcomes. Sexual impairment of women suffering from dyspareunia notwithstanding, the results support the consideration of dyspareunia as primarily a pain syndrome, rather than a sexual dysfunction.

Sexuality and fertility in long-term survivors of testicular cancer

Abstract: PURPOSEWe assessed the impact of different treatment modalities on sexuality and fertility in long-term survivors of testicular cancer.MATERIALS AND METHODSThe sample consisted of 85 testicular cancer patients, of whom 19 had undergone chemotherapy with retroperitoneal lymph node dissection (RPLND), 15 had received chemotherapy only, 42 had received infradiaphragmatic radiotherapy, and nine had received surveillance therapy. The questionnaire reported sexual function, marital status, and issues related to fertility and childbearing.RESULTSOne fourth to one half reported some type of sexual impairment in each group. The only significant difference was that approximately 70% of men with RPLND reported inability of ejaculation and a greater decline in semen volume, which is expected. The most striking finding is that the rates and nature of sexual dysfunction of surveillance patients were similar to other treatment groups, except for ejaculatory function. The highest rates of infertility distress were observ...

Serotonin reuptake inhibitor-induced sexual dysfunction and its treatment: a large-scale retrospective study of 596 psychiatric outpatients.

Abstract: In the present study, a large-scale retrospective case review was undertaken to assess the incidence and type of sexual dysfunctions associated with serotonin reuptake inhibitor (SRI) therapy, in addition to the effects of three pharmacological antidotes (yohimbine, amantadine, cypoheptadine) on SRI-induced sexual dysfunctions. A retrospective chart review was conducted on 596 patients treated with SRIs in an outpatient psychiatric pactace between July 1991 and September 1994. Patients who reported newonset sexual dysfunction during this time were categorized as having SRI-induced sexual dysfunctions. Sexual diflculties were characterized by type and duration, and the background characteristics and psychiatric diagnoses of all patients were recorded. Psychiatric outcome and sexual functioning at follow-up were independently assessed by a single psychiatrist by means of a 4-point rating scale. Sexual dysfunction symptoms were clearly associated with SRIadministration in 97 (16.3%) cases. The most ...

Premature Ejaculation: A psychophysiological review

Abstract: This review examines the most common male sexual dysfunction, premature ejaculation (PE). The prevalence, classification, neurophysiology, neuropharmacology, and psychological studies that offer evidence useful for understanding and clinically evaluating PE are reviewed. It is proposed that there are two basic kinds of PE: biogenic and psychogenic. Studies reporting pharmacological aspects of ejaculation offer some suggestions regarding the mechanisms of ejaculation as well as possible pharmacologic aid for some premature ejaculators. The traditional assumption among sex therapists that PE is almost universally caused by psychological features, and easily treated with sex therapy behavioral techniques, is drawn into question. Based on the limited available results from systematic investigations, behavioral treatments for PE remain beneficial to only a minority of men three years after treatment ends, suggesting that this male dysfunction is difficult to treat effectively. The mediocre results reported in treatment outcome studies may be due, in part, to reports on heterogeneous groups of premature ejaculators, for whom treatment has been generalized rather than targeted to the specific type of PE. We propose a biological and psychological etiology. With more discriminating assessment and more specific diagnosis of PE, and with treatment designed to address the particular type of PE, long-term outcome should improve for this common sexual dysfunction.

A critical review of selective serotonin reuptake inhibitor-related sexual dysfunction; incidence, possible aetiology and implications for management

Abstract: There is a high incidence of sexual dysfunction in the general population and sexual dysfunction is often an integral symptom of a depressive disorder. In addition, all antidepressants have effects...

Treatment-emergent changes in sexual function with selective serotonin reuptake inhibitors as measured with the Rush Sexual Inventory.

Abstract: Rates of antidepressant-associated treatment emergent changes in sexual function and satisfaction vary with method of ascertainment. We used the Rush Sexual Inventory (RSI) to assess the effect of SSRIs on sexual function and satisfaction. The RSI is a comprehensive, succinct, patient-rated scale designed to provide an accurate depiction of premorbid, current, and followup changes in sexual function and satisfaction. We assessed 42 outpatients, diagnosed with major depressive disorder with or without comorbid obsessive-compulsive disorder, over their first 8 weeks of treatment with paroxetine 20 mg/day, sertraline 50-200 mg/day, or fluoxetine 20-60 mg/day. Males and females were found to experience similar rates of treatment emergent sexual dysfunction at 60 percent and 57 percent, respectively. Despite the same mechanism of action, medication treatment groups experienced varying levels of changes in sexual function and satisfaction over time. No variation existed between responders and nonresponders over time.

Comparison of sexual functioning in clinical and nonclinical populations using the Changes in Sexual Functioning Questionnaire (CSFQ).

Abstract: The Changes in Sexual Functioning Questionnaire (CSFQ), a structured interview/questionnaire designed to measure illness- and medication-related effects on sexual functioning, is presented with initial evidence of its clinical usefulness in differentiating between those who have sexual dysfunction and those who have no dysfunction. Individuals from clinical and nonclinical samples completed the CSFQ. The sample groups were compared on mean scores on the CSFQ and its subscales. Comparative findings indicate that psychiatric patients diagnosed with a mood disorder have significantly lower sexual functioning when compared with nonpsychiatric outpatients, medical students, and psychiatry residents combined. The CSFQ is a useful measure for assessing medication- or illness-related effects on sexual functioning in a systematic way.

Preliminary evaluation of sexual problems in combat veterans with PTSD.

Abstract: This study evaluated the potential relationship between posttraumatic stress disorder (PTSD) and sexual problems. The Golombok Rust Inventory of Sexual Satisfaction was mailed to combat veterans currently in treatment at an outpatient PTSD clinic. Completed questionnaires were received from 90 patients. Results indicated that over 80% of subjects were experiencing clinically relevant sexual difficulties. Impotence and premature ejaculation were the most frequently reported problems that have corresponding psychological diagnoses. The rates of sexual problems for this sample of veterans with PTSD was similar to those reported in other studies and exceeded rates of similar problems found in samples from community samples. These data suggest that PTSD may be a risk factor for sexual problems.

Sexual difficulties, concerns, and satisfaction in homosexual men: An empirical study with implications for HIV prevention

Abstract: Minimal research has investigated the prevalence of sexual disorders in homosexual men. We examined sexual performance concerns, problems, and satisfaction in a convenience sample of 197 homosexual men who attended a health seminar. Sexual dysfunction and sexual concerns were found to be common problems. Almost all men reported some sexual difficulty over their lifetime, and more than half reported a current sexual difficulty. A further 25% of the sampled men identified other sexual concerns as well. Despite these figures, most participants-whether single, dating, or in a relationship-reported average to above-average sexual satisfaction. Correlates of sexual satisfaction included more liberal attitudes toward human sexuality, greater comfort with men's sexual attractions to other men, lower levels of internalized homophobia, and greater satisfaction with one's relationship status. Painful receptive anal intercourse appeared to be a common, yet previously underacknowledged, difficulty. Almost half of the respondents described HIV/AIDS as having a negative impact on their sexual functioning, with most reporting an increase in fear of sex as the major negative outcome.

Bupropion Treatment of Serotonin Reuptake Antidepressant-Associated Sexual Dysfunction

Abstract: Serotonin reuptake inhibitor (SRI)-induced sexual dysfunction is common, and a number of pharmacologic adjunctive strategies have been employed to treat this vexing problem. This open label study tested the efficacy of adjunctive bupropion across several measures of sexual function. Patients taking SRIs for various mood or anxiety disorders who reported prospective decline in sexual function after at least 2 months on SRIs were offered treatment with bupropion, 75 mg/day. Eight patients were treated, and sexual function was measured by use of a visual analog scale at 1 month of treatment. Four of eight patients experienced marked improvement in sexual dysfunction following adjunctive bupropion treatment. Bupropion may be a pharmacologic option for treating SRI-associated sexual dysfunction, though controlled clinical trials are needed.