No description available.

Service members and veterans of the current era, Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) are at a high risk for a variety of psychological disorders and physical health impairments. Common disorders among male service members and veterans include posttraumatic stress disorder (PTSD), substance use, and hypersexuality. Each of these disorders affect all aspects of an individual’s life and can deteriorate important interpersonal relationships or impair functioning in a variety of contexts. All these variables can affect sexual health and functioning in these service members. Sexual functioning is an important aspect of overall well-being, relationship satisfaction, and marriage satisfaction. Conversely, sexual dysfunction can create interpersonal distress in important relationships and decrease overall well-being. One of the most common forms of sexual dysfunction in males is erectile dysfunction, and rates of sexual dysfunction are higher among male service members. These rates increase for combat veterans with a posttraumatic stress disorder (PTSD) diagnosis compared to those who do not have the same diagnosis. To date sexual dysfunction has been associated with PTSD, substance use, and hypersexuality. The current study examines how each of these disorders together are associated with erectile dysfunction in a sample of OEF/OIF/OND service members and veterans (N = 213). Exploratory analysis breaks down PTS symptoms into seven separate symptom clusters in an effort to determine what types of symptoms are most strongly associated with erectile dysfunction. The study recruited a sample of service members and veterans via Facebook and asked them to complete a survey battery that covered sexual health and assessed for PTSD, substance use, and hypersexuality. PTS symptoms were significantly associated with erectile dysfunction, in particular anhedonia and dysphoric arousal symptoms accounted for the most variance in this sample. Further research with clinical samples may strengthen these results or indicate additional symptom clusters that should be targeted in treatment and screening.

Abstract available in the Annals of Behavioral Medicine.

No description available.

No / Antipsychotic drug-induced side effects of weight gain and sexual dysfunction have clinical significance adversely affecting both compliance and morbidity. This study evaluated the effects of haloperidol and the atypical antipsychotic risperidone (0.1¿1.0 mg/kg) on weight gain, food and water intake, the oestrous cycle and uterine weight in female hooded Lister rats. Haloperidol and risperidone treated rats displayed marked weight gain, although only risperidone induced significant increases in food consumption over the 21-day period. Neither haloperidol nor risperidone influenced water consumption. Marked disruption of the oestrous cycle was observed in risperidone- and haloperidol-treated animals (0.5 and 1.0 mg/kg), which was supported by significantly reduced uterine weights. The findings presented here suggest that the weight gain and sexual dysfunction induced by antipsychotics may be modelled in rodents. This model may offer insight into the mechanisms involved in mediation of such side effects.

Bakgrund: Prostatacancer är den vanligaste cancerformen i Sverige. Urininkontinens och sexuell dysfunktion är vanligt förekommande efter prostatacancerbehandling. Tidigare forskning har visat att urininkontinens och sexuell dysfunktion försämrar livskvaliteten. Syfte: Att kartlägga vilka typer av rehabilitering som finns för män med prostatacancer gällande sexuell dysfunktion och urininkontinens samt att belysa rehabiliteringsbehov som inte tillgodoses. Metod: Litteraturstudie. Tio vetenskapliga originalartiklar inkluderades; åtta med kvantitativ metod och två med kvalitativ metod. Resultat: Det fanns flera olika typer av bäckenbottenträning för att fysiskt rehabilitera urininkontinens. Bäckenbottenträningen minskade urininkontinensen i samtliga studier. Ett samband mellan minskad urininkontinens efter bäckenbottenträning och en förbättrad livskvalitet hittades. Männen hittade strategier för att psykosocialt anpassa sig till sin urininkontinens. Bäckenbottenträningen gav ingen betydande förbättring av sexuell dysfunktion.  Den psykosociala rehabiliteringen som finns vid sexuell dysfunktion är patientinformation, samtal i vården, gruppterapi, stödgrupper och par-kommunikation. Slutsats: Alla typer av bäckenbottenträning minskade urininkontinensen. På grund av den emotionella och sociala påverkan som urininkontinensen har kvarstår ett behov av psykosocial rehabilitering. Ingen evidens hittades för att bäckenbottenträning förbättrar sexuell dysfunktion. Mer forskning efterfrågas för att hitta fysiska rehabiliteringsmetoder vid sexuell dysfunktion. Psykosocial rehabilitering hjälpte männen att anpassa sig till den sexuella dysfunktionen. Dock finns ett behov av ett sammanställt program med olika typer av psykosocial rehabilitering som alla prostatacancerpatienter kan erbjudas. / Background: Prostate cancer is the most common form of cancer in Sweden. Urinary incontinence and sexual dysfunction are the general problems caused by prostate cancer treatment. Previous research has shown that quality of life is affected by urinary incontinence and sexual dysfunction. The aim: To review available rehabilitation in urinary incontinence and sexual dysfunction for men with prostate cancer, and to find rehabilitation needs that were not met in these men. Method: Literature review. Ten articles were included; eight quantitative and two with qualitative method. Results: Several types of pelvic floor muscle training were found to physically rehabilitate urinary incontinence. Pelvic floor muscle training improved urinary incontinence in all studies. A correlation between improved urinary incontinence after pelvic floor muscle training and higher quality of life was found. The men found strategies to psychosocially adjust to urinary incontinence. Pelvic floor muscle training was not effective in rehabilitating sexual dysfunction.  Patient information, consultations, group therapy, support groups and spousal communication was found to be psychosocial rehabilitation methods of sexual dysfunction. Conclusion: All pelvic floor muscle training decreased urinary incontinence. Because of the emotional and social impact of urinary incontinence a need for psychosocial rehabilitation remains. No evidence supports that pelvic floor muscle training improves sexual dysfunction. More research is required in finding physical rehabilitation methods for sexual dysfunction. Psychosocial rehabilitation helped the men to adjust to sexual dysfunction. But there is a need to assemble a program consisting of several types of psychosocial rehabilitation that can be given to all prostate cancer patients.

The comorbidity between female sexual dysfunction (FSD) and major depressive disorder (MDD) is well documented; however, the mechanism(s) underlying the relationship between these disorders has not been defined. The literature has associated the adrenal hormones cortisol and dehydroepiandrosterone (DHEA) with FSD and MDD, suggesting a biological mechanism that may elucidate the comorbidity between these disorders. Based on evidence pointing to a high cortisol/DHEA ratio (C/D Ratio) in MDD and low DHEA in FSD, this study investigated if the potential association between a high C/D Ratio and FSD would be greater for women with a history of MDD when compared to women without a history of MDD. Two groups of women (MDD history group; control group), each with a range of sexual function, collected saliva samples, completed questionnaires, and participated in a clinical interview and a psychophysiological assessment. Results did not support the hypothesis that the relationship between the C/D Ratio and sexual function would be greater for women with a history of MDD. Relevant to the effects of hormones on sexual function, a higher C/D Ratio was associated with lower frequency of sexual activity and lower sexual assertiveness. Results also showed DHEA positively associated with overall frequency of sexual activity, while cortisol was associated with lower subjective assessment of sexual desire/arousal prior to erotic stimuli. Lastly, secondary analyses revealed a positive association between DHEA and frequency of sexual activity, which was mediated by women's sexual desire. These results suggest that the effects of the C/D Ratio on FSD are not associated with a history of MDD. Results also point to contrasting roles for C/D Ratio and DHEA in FSD. In particular, a high C/D Ratio may have inhibitory effects on frequency of sexual activity and sexual assertiveness, while high DHEA may have facilitatory effects on sexual activity frequency through heightened sexual desire. Lastly, high cortisol may predispose women to have a negative assessment of sexual stimuli. These findings contribute to a further understanding of the roles of the C/D Ratio, DHEA, and cortisol in female sexuality and offer support for future studies investigating the role of these hormones in FSD.

The comorbidity between female sexual dysfunction (FSD) and major depressive disorder (MDD) is well documented; however, the mechanism(s) underlying the relationship between these disorders has not been defined. The literature has associated the adrenal hormones cortisol and dehydroepiandrosterone (DHEA) with FSD and MDD, suggesting a biological mechanism that may elucidate the comorbidity between these disorders. Based on evidence pointing to a high cortisol/DHEA ratio (C/D Ratio) in MDD and low DHEA in FSD, this study investigated if the potential association between a high C/D Ratio and FSD would be greater for women with a history of MDD when compared to women without a history of MDD. Two groups of women (MDD history group; control group), each with a range of sexual function, collected saliva samples, completed questionnaires, and participated in a clinical interview and a psychophysiological assessment. Results did not support the hypothesis that the relationship between the C/D Ratio and sexual function would be greater for women with a history of MDD. Relevant to the effects of hormones on sexual function, a higher C/D Ratio was associated with lower frequency of sexual activity and lower sexual assertiveness. Results also showed DHEA positively associated with overall frequency of sexual activity, while cortisol was associated with lower subjective assessment of sexual desire/arousal prior to erotic stimuli. Lastly, secondary analyses revealed a positive association between DHEA and frequency of sexual activity, which was mediated by women's sexual desire. These results suggest that the effects of the C/D Ratio on FSD are not associated with a history of MDD. Results also point to contrasting roles for C/D Ratio and DHEA in FSD. In particular, a high C/D Ratio may have inhibitory effects on frequency of sexual activity and sexual assertiveness, while high DHEA may have facilitatory effects on sexual activity frequency through heightened sexual desire. Lastly, high cortisol may predispose women to have a negative assessment of sexual stimuli. These findings contribute to a further understanding of the roles of the C/D Ratio, DHEA, and cortisol in female sexuality and offer support for future studies investigating the role of these hormones in FSD.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Psychiatry Melbourne, 2005 / Sexual dysfunction is a common side effect of treatment with antidepressants, particularly those with a serotonergic action. The problem has significant implications for a patient’s quality of life and their compliance with medication. Given the often longterm nature of depressive disorders and their treatment this side effect poses a potential management challenge and may have serious prognostic implications. There are currently few evidence-based treatment strategies for the management of antidepressant induced sexual dysfunction. This study was conducted to evaluate the usefulness of granisetron, a serotonin type-3 receptor antagonist, in the treatment of women experiencing sexual dysfunction due to serotonergic antidepressants. Twelve women with antidepressant induced sexual dysfunction were assigned to receive either granisetron (N=5) or placebo (N=7) in a 14-day randomised, double blind, placebo controlled drug trial. Two subjects in the granisetron group did not complete the study. Each subject’s sexual functioning was assessed at baseline, day 7 and day 14 using both the Arizona Sexual Experience Scale and the Feiger Sexual Function and Satisfaction Questionnaire. No statistical differences were measured either at baseline or at endpoint between the granisetron and placebo groups. The study did not produce evidence supporting the usefulness of granisetron as an adjunctive medication in women with antidepressant induced sexual dysfunction. Furthermore, this finding does not suggest a primary role for the serotonin type-3 receptor in the pathogenesis of this side effect.

Introdução: O hipoestrogenismo causa alteração estrutural na vaginal que pode levar a alterações na resposta sexual. Tem sido reportado o afinamento da parede vaginal após a menopausa, porém, sem comprovação morfométrica. Objetivos: Verificar a espessura da parede vaginal em condições normo e hipoestrogenicas, correlacionar disfunção sexual com espessura da parede, expressão do receptor estrogênico e estradiol sérico. Métodos: Espécimes cirúrgicos da vagina de31 mulheres, sendo 18 normoestrogênicas e 13 na pós-menopausa, submetidas a colpoperineoplastia por prolapso genital I e II. Aferidos: FSH e estradiol, prolactina e TSH. Realizou-se: tricrômico de Masson e HE, histomorfometria, imunohistoquímica para receptores estrogênicos ?, semi-quantificados pelo H-score, função sexual aferida pelo GRISS. Resultados: A parede vaginal é mais espessa no grupo menopausa em relação ao grupo menacme (2,72±0,72mm e 2,16±0,43, p=0,01 e 2,63±0,71mm e 2,07±0,49mm, p=0,01). A espessura e a fração de área da camadamuscular são maiores no grupo menopausa (parede anterior:1,54±0,44 e 1,09±0,3mm, p=0,02 e posterior 1,45±0,47 e 1,07±0,44mm, p=0,03 e 0,51±0,10 e 0,42±0,11mm 2 , p=0,03 e 0,40±0,10 e 0,49±0,08 mm 2 , p=0,02). O epitélio vaginal do segmentoproximal é mais espesso do que o segmento médio na parede posterior (0,17±0,07mm, 0,15±0,05mm, 0,24±0,09mm, p=0,02). Não houve correlação entre dor coital, espessura daparede e concentrações do estradiol nos dois grupos. Conclusão: A parede vaginal é mais espessa após a menopausa. Neste estudo, não ocorreu associação entre disfunção sexual genital concentrações estrogênicas e espessura da parede vaginal. / Hipoestrogenism causes structuralalteration on vaginal wall that can cause sexual problems. It has been reported vaginal wall thickness after menopause, however, without morphometric evidence. Objectives: To verify vaginal wall thickness in normal and hypoestrogenic conditions and to correlate sexual dysfunction with vaginal wall thickness, estrogen receptor expression and estradiol levels. Methods: Vagina surgical specimens of 18 pre and 13 post-menopausal women, submitted to surgery for genital prolapse I and II were examined. It had been surveyed: FSH and estradiol, prolactina and TSH to exclude other endocrinopatias. Masson´s tricrômico for morphometry and HE staining for histological analyses, and immunohistochemical staining for estrogen alpha receptor, quantified by H-score and the sexual function was accessed by GRISS. Results: Vaginal wall is thicker inthe post-menopausal group in relation to pre menopausal group (2,72±0,72mm e 2,16±0,43, p=0,01 e 2,63±0,71mm and 2,07±0, 49mm, p=0,01 anteriorand posterior wall, respectively). The fraction area and muscular layer thickness are bigger in the post-menopausal group (anterior: 1,54±0,44 and 1,09±0,3mm, p=0,02 and posterior wall 1,45±0,47 and 1,07±0,44mm, p=0,03 and 0,51±0,10 and 0,42±0,11mm2, p=0,03 and 0,40±0,10 and 0,49±0,08 mm2, p=0,02, respectively). Vaginal epithelium in the medium segment is thicker than the proximal one in the posterior wall (0,17±0,07mm, 0,15±0,05mm, 0,24±0,09mm, p=0,02). There is no correlation between coital pain, vaginal wall thickness and estradiol levels in the two groups. Conclusion:Vaginal wall is thicker after menopause. In this study, vaginal thickness and estrogen levels are not related to sexual dysfunction.