Using Three Indirect Measures to Assess the Role of Sexuality-Related Associations and Interpretations for Women's Sexual Desire: An Internet-Based Experimental Study.
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SUBMITTER: Zahler L
PROVIDER: S-EPMC8416817 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:INTRODUCTION:Although antidepressants are well known to cause sexual side effects in adults, the long-term effects of antidepressant use during development on adult sexual function is unknown. AIM:To explore differences in sexual desire and sexual behavior between adults who did vs did not use antidepressants during childhood or adolescence. METHODS:An online survey of 610 young adults (66% women) assessed childhood and current mental health and use of antidepressants and other psychiatric medications before the age of 16 years and currently, partnered and solitary sexual desire, and frequency of masturbation and partnered sexual activity. Antidepressants were coded into either selective serotonin reuptake inhibitors (SSRIs) or non-SSRI antidepressants. MAIN OUTCOME MEASURE:Scores on the Sexual Desire Inventory, and self-reported frequency of masturbation and partnered sexual activity. RESULTS:For women, childhood SSRI use was associated with significantly lower solitary sexual desire, desire for an attractive other, and frequency of masturbation. This was true even when controlling for childhood mental health concerns, current mental health, and current antidepressant use. However, there was no effect of childhood SSRI use on women's partnered sexual desire or partnered sexual activity. There was no significant effect of childhood antidepressant use on men's sexual desire or masturbation. However, in men, childhood use of non-SSRI antidepressants was associated with significantly higher frequency of partnered sexual activity. Childhood use of non-SSRI antidepressants, or nonantidepressant psychiatric medication, was not associated with adult sexual desire or behavior in either women or men. CLINICAL IMPLICATIONS:It is possible that SSRI use during childhood interrupts the normal development of sexual reward systems, which may be a risk factor for sexual desire dysfunction in adult women. STRENGTHS & LIMITATIONS:Strengths include a large sample, use of attention checks and validated measures, and careful assessment of childhood mental health history; however, generalizability is limited by a predominantly white, young adult sample. These data are cross-sectional, and therefore, causal explanations for the association between childhood SSRI use and adult sexual well-being should be considered preliminary, warranting replication. CONCLUSION:These findings point to a critical need for well-controlled, prospective research on possible long-term effects of antidepressant use, particularly SSRI use, on the development of adult sexual well-being. Lorenz TK. Antidepressant Use During Development May Impair Women's Sexual Desire in Adulthood. J Sex Med 2020;17:470-476.
| S-EPMC7197954 | biostudies-literature
Project description:Sexuality is a basic human need, which is expressed in the context of intimate personal relations. However, in studies of women's sexuality, men's attitudes are often overlooked. Health care providers can benefit from the examination of how both women and men perceive women's sexual desire and what are the most acceptable avenues for treatment for women's hypoactive sexual desire disorder (HSDD). This research aimed to explore differences between women and men on the factors affecting women's sexual desire and the appropriate avenues for treatment. Data were collected using an online questionnaire from 233 heterosexual adults who had a dyadic, steady intimate relationship over most of the previous year. A theory-based questionnaire of 28 items was developed to explore the factors associated with women's sexual desire. One quarter (7/28) of the items affecting women's sexual desire were ranked significantly differently between women and men. Among women, interpersonal issues and physical attraction, and among men, physical attraction and daily hassles were the significant predictors of women's sexual desire. Women more than men endorsed psychological help such as a sex therapist or psychologist as a more appropriate treatment for HSDD, while both men and women viewed the internet as a reasonable way to gain treatment information. Both women and men viewed gynecologists as a more acceptable source of treatment than a family doctor. Religious authorities were the least likely source of treatment advice for both women and men. The results support a multi-dimensional model of women's sexual desire and suggest that psychological interventions to treat HSDD may be preferred by women more than men.
| S-EPMC8623679 | biostudies-literature
Project description:Sexual concordance is defined as the association between genital response and self-reported sexual arousal. Though one might predict a strong association between sexual concordance and awareness of other internal physiological sensations (termed interoception), past research on sexually healthy women has not found these different domains to be related. The aim of the present study was to test the association between interoception and sexual concordance in a clinical sample of women with Sexual Interest/Arousal Disorder (SIAD). Fifty-two women with SIAD completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), a validated self-report measure of interoception, and completed a heart-beat accuracy test, an objective measure of interoception. They also participated in a laboratory-based assessment of physiological sexual arousal and self-reported sexual arousal while viewing an erotic film. Mental and physiological arousal were correlated at r = 0.27 (range -0.80 to 0.95). There was no significant association between sexual concordance and women's heartrate awareness. However, five aspects of interoceptive awareness (noticing, emotional awareness, self-regulation, body-listening, and trusting), were predictive of lower, and one aspect (not-distracting) was predictive of higher sexual concordance. We discuss the findings in relation to the role of emotions and arousal states in the interoception-sexual concordance relationship.
| S-EPMC5636106 | biostudies-literature
Project description:IntroductionCounts of satisfying sexual events (SSEs) per month have been criticized as an end point in treatment trials of women with hypoactive sexual desire disorder (HSDD) but grounding improvement in sexual desire by assessing changes in sexual behavior remains of some importance.MethodsWe conducted a literature review to find validated measurements that are specific sexual behavioral correlates of low sexual desire. We compared expert-proposed criteria for dysfunctional desire, expert-developed sets of scale items, and self-rated scales developed before issuance of, or in accordance with, the Food and Drug Administration's guidance on developing patient-reported outcomes. Behavioral measurements of HSDD were isolated from these sets of criteria or scales.Main outcome measuresWe outline a plan to evaluate such behavioral measurements of HSDD with reference to SSEs.ResultsEleven rating scales, four expert-originated and seven self-rated scales mainly derived from patient input were identified as well validated and relevant to HSDD. Three recent sets of diagnostic criteria for conditions such as HSDD were compared with the scales. Twenty-four different symptoms were found in the scales. Content found relevant to HSDD during development of the rating scales varied highly among measurements, including the self-rated scales developed in conformity with current recommendations for patient-reported outcome measurements. The only item on all sets was desire for sexual activity. Four other items were in approximately at least half the sets: sexual thoughts or fantasies, frequency of sexual activity, receptivity, and initiations. Sexual thoughts or fantasies were in every expert-derived set but in only three of the seven patient-derived sets. Receptivity was in five of the seven expert-derived sets vs two of the seven patient-derived sets. Frequency of sexual activity was in one of the seven expert-derived sets but in five of the patient-derived sets. Initiation was in approximately half the two sets. All other items were on one to three sets each. We identified three sexual behaviors of validated specificity for female HSDD: frequency of sexual activity, receptivity, and initiations. Six or seven items are relevant and informative. The item on frequency of sexual activity in the Changes in Sexual Functioning-Female scale is the only item that covers frequency of dyadic and solitary sexual activity. An item in the Female Sexual Desire Questionnaire (FSDQ) covers the intuitively relevant topic of frequency of sexual activity motivated by the woman's desire. Three FSDQ items on initiations and two items on receptivity reflect expert opinion on the sexual behaviors of most relevance to HSDD, but the FSDQ has not been validated in women with HSDD.ConclusionsSSEs have been discredited as the primary measurement in clinical trials of women with HSDD, but it would be meaningful to include at least one sexual behavioral symptom specific to HSDD as an end point. Expert-recommended sexual behaviors specifically related to HSDD are irregularly represented in self-rating scales whether developed as in the Food and Drug Administration guidance on patient-reported outcomes or not. Six or seven items on sexual behavior in self-rated scales can be recommended for relevance to women with HSDD in clinical trials. Items on female sexual behavior should be tested in comparison with SSEs in women with HSDD for relevance and for treatment sensitivity, and responder and functional and dysfunctional cutoffs should be determined before incorporation into large-scale clinical trials. Pyke R and Clayton A. What Sexual Behaviors Relate to Decreased Sexual Desire in Women? A Review and Proposal for End Points in Treatment Trials for Hypoactive Sexual Desire Disorder. Sex Med 2017;5:e73-e83.
| S-EPMC5440628 | biostudies-literature
Project description:Although numerous studies have examined sexual and substance use behaviors that put people at risk for sexually transmitted infections including HIV, most focus on an overall measure of aggregate risk or a few simple and particular subtypes of sexual acts assessed in separate analyses. In this article, we introduce a more sensitive approach to assess how the relative characteristics of sex acts may determine the level of risk in which an individual chooses to engage. Project AWARE, a randomized clinical trial conducted among 5012 patients in nine STD clinics across the U.S., is used to illustrate the approach. Our study was guided by two aims: (1) describe a new approach to examine the count of sexual acts using a disaggregated repeated measures design and (2) show how this new approach can be used to evaluate interactions among different categories of sexual risk behaviors and other predictors of interest (such as gender/sexual orientation). Profiles of different subtypes of sexual acts in the past 6 months were assessed. Potential interactions of the characteristics associated with each subtype which resulted in up to 48 distinct subtypes of sexual risk behaviors-sex with a primary/non-primary partner; partner's HIV status; vaginal/anal sex; condom use; and substance use before or during sex act-can be examined. Specifically, we chose condom use and primary and non-primary status of partner as an application in this paper to illustrate our method. There were significantly more condomless sex acts (M = 23, SE = 0.9) and sex acts with primary partners (M = 27.1, SE = 0.9) compared to sex acts with condoms (M = 10.9, SE = 0.4, IRR = 2.10, 95% CI 1.91-2.32, p < .001) and sex acts with non-primary partner (M = 10.9, SE = 0.5, IRR = 2.5, 95% CI 2.33-2.78, p < .001). In addition, there were significant differences for the count of sexual risk behaviors among women who have sex with men (WSM), men who have sex with women (MSW) and men who have sex with men (MSM) for sex acts with and without condom use, primary and non-primary partner, and their interaction (ps = .03, < .0001, and .001, respectively). This approach extends our understanding of how people make choices among sexual behaviors and may be useful in future research on disaggregated characteristics of sex acts.
| S-EPMC7688506 | biostudies-literature
Project description:IntroductionErectile function, libido, and sexual bother are incompletely correlated: a man may or may not be satisfied for a given level of erectile function; similarly, 2 men may have the same erectile function and different levels of sexual desire.AimTo explore the relationship between erectile function, sexual satisfaction and sexual desire.MethodsWe examined the Spearman correlation among erectile function (International Index of Erectile Function [IIEF-6]), sexual desire, and sexual bother in 3,944 questionnaires completed by patients after radical prostatectomy as part of routine care. IIEF-6 scores were adjusted if a patient indicated that the reason for not having intercourse was other than lack of ability of confidence (eg, lack of partner).Main outcome measurePatient-reported outcome instruments.ResultsMedian age at surgery and preoperative IIEF-6 were 63 years and 26, respectively. Among questionnaires completed after surgery, there was moderate correlation among the IIEF-6 score and both sexual desire (Spearman rho: 0.41) and sexual bother (Spearman rho: 0.30). In men who reported high or moderate bother relating to sexual function, there was a narrow distribution of erectile function scores, with most men reporting poor function (median IIEF-6: 6, interquartile range 3, 11). For men who reported small or no problem with sexual function, the distribution of erectile function scores was wide, and particularly bimodal as a function of sexual desire. Among patients with high desire, the correlation between sexual bother and erectile function was 0.61 (ie, the poorer is your function, the greater you are bothered), whereas it was -0.081 among patients with low desire, meaning that some men are not bothered by poor erections.Clinical implicationsWe provided useful insights to help physicians during sexual counselling after surgery for prostate cancer.Strength & limitationsThe study included a large number of patients and provides evidence for implementation of patient-reported outcome insturments. Limitations include the retrospective nature of our data.ConclusionSexual desire helps explain the moderate correlation between erectile function and sexual bother. Sexual desire and bother questions should be incorporated in patient-reported outcome instruments for male sexual function. Bravi CA, Tin A, Montorsi F, et al. Erectile Function and Sexual Satisfaction: The Importance of Asking About Sexual Desire. J Sex Med 2020;17:349-352.
| S-EPMC7641190 | biostudies-literature
Project description:BACKGROUND:The Elements of Desire Questionnaire (EDQ) is a patient-reported outcome (PRO) measure developed to evaluate sexual desire and was included in two identically designed phase 3 clinical trials (RECONNECT) as an exploratory endpoint. The EDQ was developed based on a literature review, qualitative research with patients with hypoactive sexual desire disorder (HSDD), and input from clinical experts. This instrument is intended to be used to collect efficacy data in clinical trials evaluating potential treatments for HSDD. The objective of this study was to evaluate the measurement properties of both the monthly and daily recall versions of the EDQ during the RECONNECT trials. METHODS:Participants completed the EDQ daily version for 7 consecutive days prior to selected monthly clinic visits. The monthly recall version was completed at each monthly clinic visit. The analysis population consisted of all subjects with Female Sexual Function Index (FSFI) data at baseline and???1 follow-up visit. RESULTS:At baseline, 1144 and 676 subjects completed the monthly and daily recall EDQs, respectively. The EDQ scores had good internal consistency and test-retest reliability. Monthly and daily recall EDQ scores were correlated with FSFI-desire domain scores at baseline and month 3. Scores from the monthly and daily recall versions were also correlated. After 6?months, there was a significantly greater improvement for bremelanotide versus placebo in both the monthly and daily recall versions (both P?<?0.0001). CONCLUSIONS:The results demonstrated that EDQ exhibited good reliability, validity, and sensitivity to change. Consistent with other validated PRO measures of sexual desire, the EDQ provides additional insights into sexual desire. TRIAL REGISTRATION:NCT02338960 and NCT02333071 (RECONNECT studies).
| S-EPMC7544783 | biostudies-literature
Project description:Objectum-sexuality (OS) is a sexual orientation which has received little attention in the academic literature. Individuals who identify as OS experience emotional, romantic and/or sexual feelings towards inanimate objects (e.g. a bridge, a statue). We tested 34 OS individuals and 88 controls, and provide the first empirical evidence that OS is linked to two separate neurodevelopmental traits - autism and synaesthesia. We show that OS individuals possess significantly higher rates of diagnosed autism and significantly stronger autistic traits compared to controls, as well as a significantly higher prevalence of synaesthesia, and significant synaesthetic traits inherent in the nature of their attractions. Our results suggest that OS may encapsulate autism and synaesthesia within its phenomenology. Our data speak to debates concerning the biological underpinnings of sexuality, to models of autism and synaesthesia, and to psychological and philosophical models of romantic love.
| S-EPMC6934473 | biostudies-literature
Project description:BACKGROUND:Psychological therapies are effective treatments for hypoactive sexual desire dysfunction (HSDD; formerly hypoactive sexual desire disorder), a common sexual dysfunction among women. Access to evidence-based treatments, however, remains difficult. Internet-based interventions are effective for a variety of psychological disorders and may be a promising means to close the treatment gap for HSDD. OBJECTIVE:This article describes the treatment protocol and study design of a randomized controlled trial, aiming to study the efficacy of cognitive behavioral and mindfulness-based interventions delivered via the internet for women with HSDD to a waitlist control group. Outcomes are sexual desire (primary) and sexual distress (secondary). Additional variables (eg, depression, mindfulness, rumination) will be assessed as potential moderators or mediators of treatment success. METHODS:A cognitive behavioral and a mindfulness-based self-help intervention for HSDD will be provided online. Overall, 266 women with HSDD will be recruited and assigned either to one of the intervention groups, or to a waitlist control group (2:2:1). Outcome data will be assessed at baseline, at 12 weeks, and at 6 and 12 months after randomization. Intention-to-treat and completer analyses will be conducted. RESULTS:We expect improvements in sexual desire and sexuality-related distress in both intervention groups compared to the waitlist control. Recruitment has begun in January 2019 and is expected to be completed in August 2021. Results will be published in 2022. CONCLUSIONS:This study aims to contribute to the improvement and dissemination of psychological treatments for women with HSDD and to clarify whether cognitive behavioral and/or mindfulness-based treatments for HSDD are feasible and effective when delivered via the internet. TRIAL REGISTRATION:ClinicalTrials.gov NCT03780751; https://clinicaltrials.gov/ct2/show/NCT03780751. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):DERR1-10.2196/20326.
| S-EPMC7556380 | biostudies-literature
Project description:Although co-occurring methamphetamine (meth) use and HIV amplify the risk for neuropsychiatric comorbidities, the underlying neuroimmune mechanisms are not well characterized. We examined whether a detectable viral load and dysregulated metabolism of amino acid precursors for neurotransmitters predicted subsequent levels of sexual compulsivity and sexual sensation seeking. This 15-month longitudinal study enrolled 110 sexual minority men (SMM) living with HIV who had biologically confirmed meth use (i.e., reactive urine or hair toxicology results). Peripheral venous blood samples collected at baseline, 6 months, 12 months, and 15 months were used to measure a detectable viral load (> 40 copies/mL), the kynurenine/tryptophan (K/T) ratio, and the phenylalanine/tyrosine (P/T) ratio. The K/T and P/T ratios index dysregulated serotonin and catecholamine (e.g., dopamine) synthesis, respectively. In a cross-lagged panel model, a detectable viral load at 6 months predicted greater sexual compulsivity at 12 months after adjusting for prior levels of sexual compulsivity and recent stimulant use (β = 0.26, p = 0.046). A greater P/T ratio at baseline predicted decreased sexual sensation seeking at 6 months (β = - 0.25, p = 0.004) after adjusting for baseline sexual sensation seeking and recent stimulant use. Taken together, HIV replication and dysregulated catecholamine synthesis could potentiate sexual compulsivity while decreasing sexual pleasure in SMM who use meth.
| S-EPMC9474700 | biostudies-literature