Journal of Sexual Medicine最新文献

{"title":"Improved psychosexual wellbeing with administration of combined Sildenafil plus Melatonin compared than either drug alone in management of women with polycystic ovarian syndrome: a 3-month randomized clinical study.","authors":"Zahra Asadi Kalameh, Maryam Abbasi, Seyed-Abdolvahab Taghavi, Fatemeh Bazarganipour","doi":"10.1093/jsxmed/qdaf028","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf028","url":null,"abstract":"<p><strong>Background: </strong>Given the significant impact of depression, sexual function, and health-related quality of life (HRQOL) in women with Polycystic Ovarian Syndrome (PCOS), it is crucial to identify scientifically supported interventions that enhance these outcomes and thereby promote HRQOL.</p><p><strong>Aim: </strong>The present study aimed to assess the effect of adjutant administration of Sildenafil plus Melatonin on psycho-sexual status in PCOS women undergoing Metformin in an Iranian population.</p><p><strong>Methods: </strong>This study was a randomized clinical trial. 216 Eligible women were assigned to four groups including Sildenafil plus Metformin, Melatonin plus Metformin, Melatonin plus Sildenafil and Metformin, and Metformin alone. The duration of intervention was 3 months.</p><p><strong>Outcomes: </strong>The Female Sexual Function Index, Hospital Anxiety and Depression Scale and modified PCOS health-related QOL questionnaire were used to evaluate sexual function, severity of depression and HRQOL, respectively.</p><p><strong>Results: </strong>Based on the results of the present study, statistically significant improvement was found in menstrual cyclicity, sexual function (desire and arousal), HRQOL concerning menstrual and emotional aspects and severity of depression between the groups before and after the intervention in Sildenafil plus Melatonin compared to other groups after 3 months (P < 0.05).</p><p><strong>Clinical implications: </strong>The present research determined administration of Sildenafil plus Melatonin enhances menstrual cyclicity status, mental well-being, sexual function, and HRQOL in women with PCOS who undergoing Metformin treatment.</p><p><strong>Strengths & limitations: </strong>The current research possesses several strengths, notably its adherence to the rigorous standards of a randomized controlled trial with well-defined initial inclusion criteria. In addition, this questionnaire is based on the previously ratified tools used. A robust sample size was maintained, enhancing the statistical power of the analysis. However, all the sample participants were sourced from a university referral clinic. Additionally, due to cultural norms, every participant in this study was married. Lastly, the absence of a post-intervention follow-up period is a notable gap; such a period could help determine the duration of the clinical effects or assess if ongoing treatment with Sildenafil plus Melatonin is necessary to sustain these effects.</p><p><strong>Conclusions: </strong>Findings from this initial randomized controlled trial indicate that a 12-week administration of Sildenafil plus Melatonin could enhance menstrual cyclicity status, reduce depression severity, and sexual function as well as HRQOL in women with PCOS who undergoing Metformin.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between perceived stress and erectile function in patients with psychogenic erectile dysfunction: the mediating role of fatigue.","authors":"Zhi Cao, Tianle Zhu, Peng Yang, Yukuai Ma, Yunlong Ge, Pan Gao, Hui Jiang, Xiansheng Zhang","doi":"10.1093/jsxmed/qdaf045","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf045","url":null,"abstract":"<p><strong>Background: </strong>Psychological stress is closely linked to psychogenic erectile dysfunction (pED). In our recent clinical work, many pED patients report high levels of stress and fatigue, leading us to hypothesize these factors may play a contributory role in the development of pED.</p><p><strong>Aim: </strong>This research aims to elucidate how fatigue may mediate the connection between perceived stress and erectile function in individuals with pED.</p><p><strong>Methods: </strong>We assessed 125 patients diagnosed with pED. Erectile dysfunction severity was measured using the International Index of Erectile Function-5 (IIEF-5) and the Nocturnal Penile Tumescence and Rigidity (NPTR) tests. Perceived stress and fatigue were evaluated with the Perceived Stress Scale-14 and the Multidimensional Fatigue Inventory-20. Data were descriptively analyzed, and correlations among the 3 variables were examined. The mediating effect was assessed using the bootstrap method within the SPSS PROCESS macro.</p><p><strong>Outcomes: </strong>The outcomes include the relationship between perceived stress and erectile function and the mediating role of fatigue in patients with pED.</p><p><strong>Results: </strong>Our findings revealed a substantial negative correlation between perceived stress and erectile function (β = -0.604, P < .001). Fatigue emerged as a mediator in this relationship (β = -0.214, P < .05). The significance of the indirect effect of perceived stress via fatigue was confirmed through non-parametric bootstrapping (95% CI = -0.426 to -0.153), with fatigue contributing 26.46% to the total effect.</p><p><strong>Clinical implications: </strong>These findings have provided new ideas for interventions in the clinical management of pED, particularly for improving erectile function by simultaneously managing fatigue and stress.</p><p><strong>Strengths and limitations: </strong>This study explores the broader context of pED and provides a new perspective on the etiology of pED. The main drawback of this study is its lack of generalizability, as it was conducted within a monocultural and specific social context.</p><p><strong>Conclusion: </strong>Our findings of this study suggest that targeting both fatigue and perceived stress may be effective strategies for improving erectile function in patients with pED, providing valuable insights for research and clinical practice.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring subjective and genital sexual response in transgender women upon addition of low-dose testosterone to feminizing gender-affirming hormone therapy: a feasibility study.","authors":"Noor C Gieles, Baudewijntje P C Kreukels, Martin den Heijer, Stephanie Both","doi":"10.1093/jsxmed/qdaf041","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf041","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Transgender women using feminizing gender-affirming hormone therapy who underwent a gonadectomy generally have lower testosterone levels than cisgender women. It is unknown if testosterone supplementation can influence subjective and genital sexual response in transgender women and whether this can be measured using vaginal photoplethysmography.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aimed to assess the feasibility of measuring changes in subjective and genital sexual response in transgender women who underwent a penile inversion vaginoplasty after testosterone supplementation to physiological female concentrations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Transgender women received daily testosterone 2% transdermal gel, aiming for serum concentrations between 1.5 and 2.5 nmol/L for 12-20 weeks. Vaginal pulse amplitude (VPA) was measured during neutral, erotic fantasy, erotic film, and genital vibration stimulus blocks before and after testosterone supplementation. After each stimulus block, subjective sexual response was assessed. Sexual function, sexual excitability, and VPA measurement experience were assessed using questionnaires.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Change in mean VPA score and subjective sexual response after testosterone supplementation during neutral film, erotic fantasy, erotic film, and genital vibration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eight participants were included of whom seven completed the study. VPA during neutral film was significantly higher after testosterone supplementation [estimated ratio 2.7 (95% confidence interval {CI} 1.7-4.3), P &lt; 0.001]. After testosterone supplementation, we observed no change in the degree of VPA response upon exposure to erotic fantasy [estimated ratio 1.4 (95% CI 0.68-2.8), P = 0.372], erotic film [estimated ratio 1.2 (95% CI 0.54-2.8), P = 0.629] and genital vibration [estimated ratio 1.2 (95% CI 0.46-2.9), P = 0.742] compared to before testosterone supplementation. After testosterone supplementation, participants reported significantly stronger feelings of sexual arousal, genital sensations, and positive affect in response to erotic fantasy and erotic film. Finally, there was a significant improvement in sexual function and sexual excitability assessed by questionnaires. VPA measurement was generally well-accepted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Vaginal photoplethysmography can be used to assess changes in neovaginal perfusion in transgender women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths & limitations: &lt;/strong&gt;This is the first study assessing genital and subjective sexual response to testosterone supplementation in transgender women. The lack of a placebo condition precludes any clinical conclusions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Vaginal photoplethysmography can be used to assess changes in neovaginal vasocongestion after testosterone supplementation in transgender women. Explorative analyses suggest promising effects on subjective sexual response and a","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical malpractice after treatment of Peyronie's disease.","authors":"Zachary Boston, Imran Khawaja, Mahima Gurushankar, Meher Pandher, Aleksandar Popovic, Kunj Jain, Rhea Prabhu, Amjad Alwaal","doi":"10.1093/jsxmed/qdaf040","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf040","url":null,"abstract":"<p><strong>Background: </strong>Peyronie's Disease is a fibrotic tunica albuginea disorder resulting in penile deformity.</p><p><strong>Aim: </strong>This analysis provides an important investigation of medical malpractice cases related to the treatment of Peyronie's Disease.</p><p><strong>Methods: </strong>The LexisNexis+ and Westlaw databases were used to access all federal and state cases as well as jury verdicts and settlements. The databases were queried for the term \"Peyronie Disease\" and \"Peyronie's Disease\" between the years 1980 and 2024. One author manually reviewed all cases to find cases involving a patient suing the urologist or medical system after treatment for Peyronie's disease. Cases that did not sue the urologist in question and cases not directly pertaining to the consequences of Peyronie's disease were ruled out. Cases were categorized into reasons the plaintiff sued the defendant: infection, pain, deformity, erectile dysfunction, dysfunction of penile prosthesis, failure of informed consent, incorrect diagnosis, and improper surgical technique.</p><p><strong>Outcomes: </strong>The main outcome was which chief allegations commonly lead to medical malpractice litigation.</p><p><strong>Results: </strong>Investigation of the LexisNexis+ database yielded 76 cases. The Westlaw database offered 165 cases. After exclusion criteria, 22 cases were included from the LexisNexis+ database and an additional seven cases not identified in LexisNexis were included from Westlaw for a total of 29 cases. Fifteen of the cases ruled in favor of the defendant. Thirteen cases ruled in favor of the plaintiff with awards ranging from $97 500 to $3 971 917. The most common cause for litigation included dysfunction of a penile prosthesis, which was a precipitating issue in 37.9% of cases. Patients experiencing post-treatment infection were alleged in 34.5% of cases. Failure of informed consent was alleged in 20.7% of cases. Improper surgical technique was alleged in 20.7% of cases. Among the cases that ruled in favor of the plaintiff, the most common chief allegations included dysfunction of penile prosthesis, failure of informed consent, infection, improper surgical technique, erectile dysfunction, deformity, and incorrect diagnosis. 37.9% of cases originated from the southern region of the United States. Of the 13 cases that ruled in favor of the plaintiff, 38.5% were from the South and 38.5% were from the West.</p><p><strong>Clinical implications: </strong>Urologists remain at risk of encountering medical malpractice litigation after treatment of Peyronie's Disease.</p><p><strong>Strengths and limitations: </strong>We used strict inclusion criteria to ensure consistency of analysis Peyronie's disease treatment.</p><p><strong>Conclusion: </strong>This analysis identified that allegations were most common in Southern states, with the primary allegation being dysfunction of the penile prosthesis.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of female sexual dysfunctions on women undergoing pipelle endometrial biopsy and endocervical curettage for abnormal uterine bleeding: a prospective cross-sectional study.","authors":"Sevim Baltali, Ayşegül Ercan, Gonca Ceylan Kavsut, Rabia Göldağı, Gülen Kavsa, Elvan Çiftçi, Mehmet Baltali","doi":"10.1093/jsxmed/qdaf037","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf037","url":null,"abstract":"<p><strong>Background: </strong>Endometrial and endocervical biopsy sampling provides critical information for diagnosing and planning treatment in cases of abnormal uterine bleeding or suspected gynecological conditions. However, documented failure rates of up to one-third due to difficulties accessing the uterine cavity or insufficient histological sampling might have considerable clinical consequences.</p><p><strong>Aim: </strong>To assess the impact of female sexual dysfunction (FSD), depression, and anxiety on additional analgesic requirements (AAR), procedure failure (PF) due to endometrial inaccessibility, and biopsy failure (BF) among women undergoing pipelle endometrial biopsy and endocervical curettage (PEB- ECC).</p><p><strong>Methods: </strong>This prospective study collected data through face-to-face interviews with 417 women who underwent PEB-ECC between November 2022 and 2023. Anxiety and depression were evaluated using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), respectively. Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria were used to assess FSD and its related components. Age, body mass index, and educational level were considered potential confounders.</p><p><strong>Outcome: </strong>Outcomes included the necessity for additional analgesics during the surgical process, PF attributed to challenges in accessing the uterine cavity, and BF resulting from inadequate histological sampling.</p><p><strong>Results: </strong>A BAI score > 9, age ≥ 55 years, and the presence of FSD were independent predictors of AAR during PEB-ECC. PEB-ECC sampling failed in 71 women (17.0%), with PF in 7 (1.7%). Univariate analysis showed that only genito-pelvic pain/penetration disorder was associated with PF. Age ≥ 55 years and FSD were significant predictors of BF. Female orgasmic disorder was associated with BF as a component of FSD.</p><p><strong>Clinical implications: </strong>Our findings highlight the significance of FSD in influencing the success of endometrial and endocervical biopsy sampling, which gynecologists and anesthesiologists should consider before and during the procedure.</p><p><strong>Strengths and limitations: </strong>This study is the first to assess the impact of FSD on the success of PEB-ECC procedures. Intercultural variation exists in the prevalence and predictors of FSD; therefore, our findings should be interpreted cautiously. Validation studies remain warranted. We evaluated the presence and components of FSD during the interviews rather than its severity; the low response rate (417 [25.3%]) might have impacted the results.</p><p><strong>Conclusion: </strong>Despite sufficient sedation/analgesia, FSD significantly influenced AAR, PF, and BF in women undergoing PEB-ECC. Anesthesiologists and gynecologists should consider additional factors to improve the success of sampling procedures.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary analysis of the Female Genital Self-Image Scale (FGIS-4) and the Male Genital Self-Image Scale (MGIA-5) in an international sample of adults with spina bifida.","authors":"Devon J Hensel, Tori Sciara, Rosalia Misseri, John S Wiener, Joshua D Roth, Konrad M Szymanski","doi":"10.1093/jsxmed/qdaf033","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf033","url":null,"abstract":"<p><strong>Introduction: </strong>Common chronic health conditions associated with spina bifida (SB) may impact sexual health among adults in this population, including genital self-image (GSI), but no studies explore this topic.</p><p><strong>Aim: </strong>The primary aim of this study was to provide a preliminary psychometric assessment of the four-item Female Genital Self-Image Scale (FGSIS-4) and the five-item Male Genital Self-Image Scale (MGSIS-5) for use among adults with SB. A secondary aim was to describe the association of GSI with key demographic, health, and sexual experience characteristics.</p><p><strong>Methods: </strong>An international online survey collecting background and clinical data was administered to adults with SB over 12 months. We assessed internal consistency, construct validity, and convergent validity for GSI. Bivariate regression was used to explore the individual associations of each variable with the FGSIS-4 and MGSIS-5.</p><p><strong>Outcomes: </strong>GSI was measured using the 4-item Female Genital Self-Image Scale (FGSIS-4) and the 5-item Male Genital Self-Image Scale (MGSIS-5); sexual function measures (sexual desire and overall satisfaction) from the Female Sexual Function Index and the International Index of Erectile Function; and health-related quality of life with Quality of Life Assessment in Spina Bifida for Adults.</p><p><strong>Results: </strong>Participants (N = 217 women and N = 146 men) were primarily heterosexual and had a median partial-to-full college education. Half of all the participants were in a relationship and living independently. A third of both men and women were community ambulators, and a quarter of both reported full genital sensation. About half of the sample (women: 47.1%; men: 46.2%) reported clean intermittent catheterization (CIC). Both scales demonstrated good internal reliability (FGSIS-4: 0.845; MGSIS-5: 0.877) and a single-factor construct structure. Higher FGSIS-4 and MGSIS-5 scores correlated positively with sexual desire overall sexual satisfaction, health-related quality of life, and urinary continence but did not vary with using CIC.</p><p><strong>Clinical implications: </strong>Because GSI negatively impacts sexual health and sexual function, clinicians treating patients with SB should consider discussing GSI as part of routine care.</p><p><strong>Strengths and limitations: </strong>Although this research measured women's and men's GSI behavior in a large international sample of adults with SB, it is limited by its cross-sectional and retrospective design, as well as by its non-clinical convenience sample.</p><p><strong>Conclusion: </strong>The FGSIS-4 and MGSIS-5 show preliminary desirable psychometric properties for the measurement of GSI in the SB population.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic pain, sexual distress and satisfaction: cross-sectional study.","authors":"Arife Büşra Karaosmanoğlu, Yasemin Erkal Aksoy, Sema Dereli Yilmaz","doi":"10.1093/jsxmed/qdaf042","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf042","url":null,"abstract":"<p><strong>Background: </strong>Pelvic pain significantly increases sexual distress and reduces sexual satisfaction in women.</p><p><strong>Aim: </strong>The aim of this study is to identify the factors that influence women's pelvic pain, sexual distress, and satisfaction.</p><p><strong>Methods: </strong>This research was designed as a descriptive cross-sectional study. The study was conducted between June and November 2024. The study has been completed with a total of 395 women.</p><p><strong>Outcomes: </strong>The data collection forms used in the study were the Personal Information Form, the Pelvic Pain Impact Questionnaire (PPIQ), the Female Sexual Distress Scale-R (FSDS-R) and the New Sexual Satisfaction Scale (NSSS).</p><p><strong>Results: </strong>The mean scores of the PPIQ, FSDS-R, and NSSS scales for women were 9.48 ± 8.27 (min = 0, max = 32), 22.94 ± 10.35 (min = 13, max = 65) and 74.20 ± 18.53 (min = 20, max = 100), respectively.A significant positive relationship was observed between participants' total PPIQ scores and total FSDS-R scores (r = 0.418, P < 0.001), while a significant negative relationship was identified between participants' total PPIQ scores and both total NSSS scores (r = -0.247, P < 0.001) and its sub-dimension scores.</p><p><strong>Clinical implications: </strong>Healthcare professionals should ask women about pelvic pain during routine examinations, as it is associated with other problems in their lives and should be carefully assessed, supported by a multidisciplinary approach if necessary.</p><p><strong>Strengths and limitations: </strong>As the data of the study was collected online, it is limited to the women who filled in the data collection forms and cannot be generalized to the universe. However, as this study deals with issues of sexuality, the use of online data collection in a conservative society allowed participants to express their thoughts more freely.</p><p><strong>Conclusion: </strong>The study revealed a positive correlation between participants' sexual distress and their level of pelvic pain, and a negative correlation between pelvic pain and sexual satisfaction, with women experiencing pelvic pain reporting higher levels of sexual distress and lower levels of sexual satisfaction.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pornography and problematic pornography use: occurrence, patterns, and associated factors in a national gender-based controlled cross-sectional study.","authors":"Rezvan Zarei, Farzane Alidost, Maryam Damghanian, Beáta Bőthe, Farnaz Farnam","doi":"10.1093/jsxmed/qdaf034","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf034","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;A study on pornography is vital due to internet accessibility, widespread pornography usage, and a lack of data, especially in non-western countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study estimates the occurrence of pornography use (PU), compares demographic, sexual, and psychological factors between users (PUs) and non-users, and identifies associated factors of PU based on gender. It examines problematic pornography use (PPU), comparing usage patterns between PPUs and non-PPUs, and identifies associated factors of PPU.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In 2021, an online cross-sectional nationwide survey was conducted among 1249 Iranians (865 women, 384 men) in all provinces except one, using a convenience sampling method through social media platforms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Participants were categorized into PUs and non-users based on their pornography use over the past year. PUs were further divided into PPUs and non-PPUs, using the Problematic Pornography Consumption Scale cutoff (&gt;20). The researcher-made questions assessed patterns of pornography use, demographic characteristics, and sexual information; sexual health variables and psychological factors were evaluated by standard scales.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;PU was reported by 30.1% of participants (n = 376), including 27.5% of women and 35.9% of men. Logistic regression identified being male, shorter marriage duration, earlier age at first sex, lower religiosity, poorer sexual communication, masturbation, substance abuse, and depression as associated factors for PU. Among PUs, 13% (n = 49) were PPUs, including 10% of women and 17.1% of men. Linear regression identified the following risk factors for PPU: being male, longer marriage duration, masturbation, sexual distress, and pornography use. Conversely, having more children was a protective factor. Compared to non-PPUs, PPUs reported higher pornography consumption, the primary motivation being masturbation, greater usage among close friends, prioritizing pornography over sex with their spouse, negative effects on their sex life, and increased use during the COVID-19 pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Healthcare providers should address modifiable factors related to PU/PPU through early sex education and support. Objective measurements of PPU should be prioritized over subjective perceptions, as many infrequent users feel moral incongruence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;The study's applicability may be limited by imbalanced gender participation, recruitment of married individuals, and a small number of PPUs. However, strengths include standardized assessment tools, gender-based data collection, and anonymous sampling to enhance response accuracy in conservative contexts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Accurate pornography occurrence measurement requires clear definitions, consideration of dropout rates, and consistent time units. Strong corre","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of blood biomarkers for neural injury with recent, frequent exposure to partnered sexual strangulation in young adult women.","authors":"Megan E Huibregtse, Isabella L Alexander, Tsung-Chieh Fu, Lillian M Klemsz, Molly Rosenberg, J Dennis Fortenberry, Debby Herbenick, Keisuke Kawata","doi":"10.1093/jsxmed/qdaf036","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf036","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;\"Choking\" or partnered strangulation is an emerging and popular sexual behavior that is more often experienced by young women, yet the neurobiological consequences of partnered sexual strangulation remain unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;The aim of the present study was to assess differences in 5 brain-injury blood biomarkers in young adult women who frequently engaged in sexual strangulation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Young adult women were recruited from a large Midwestern university and assigned to groups based on sexual strangulation experience: (1) at least 4 instances of being strangled by a partner during sexual activities in the past 30 days or (2) no prior experience being strangled by a sexual partner. Choking/strangulation history during partnered sexual activities was assessed using a self-report questionnaire. Blood samples were collected via venipuncture. Data from 32 female participants (median 21.5 years old [IQR 20-24]) were available for analysis: 15 with a history of recent, frequent partnered strangulation exposure and 17 without any history of partnered sexual strangulation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Serum levels of 5 blood biomarkers for brain injury were measured using sandwich enzyme-linked immunosorbent assay (S100B) and single-molecule array digital immunoassay (neurofilament light, tau, ubiquitin C-terminal hydrolase L1, and glial fibrillary acidic protein).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Group differences for the 5 biomarkers were examined using 1-way multivariate analysis of covariance, adjusting for age and alcohol use. We observed a significant multivariate effect of group, Pillai's trace = 0.485, F(5, 24) = 4.235, P = .007, η2 = 0.47. Univariate results indicated that female college students who were recently, frequently strangled during partnered sexual activities exhibited elevated S100B levels compared to their peers who had never engaged in this partnered sexual behavior, F(1,28) = 11.165, P = .002, η2 = 0.29.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Engaging in this partnered sexual behavior may elicit neuroinflammation, with unknown long-term consequences for brain health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;Strengths include the recruitment of a novel population, as this investigation was the first of its kind to examine neurobiological correlates of repetitive exposure to partnered sexual strangulation. Another strength is the panel of 5 blood biomarkers that were assessed, providing information from multiple cell types and pathophysiological processes. Limitations were the relatively small sample size and the cross-sectional design, which prevents causal inference.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Young adult women with a history of recent, frequent experience being strangled by a sexual partner exhibited higher serum S100B, an astrocyte-enriched protein, compared to their biomarkers, meriting future work to determine a causal mechanism","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep and Superficial Dyspareunia Questionnaire: a patient-reported outcome measure for genito-pelvic dyspareunia.","authors":"Nisha Marshall, Samantha L Levang, Yang Doris Liu, Heather Noga, Catherine Allaire, Melanie Altas, Shauna Correia, Miriam Driscoll, Kirstie Merkt-Caprile, Ria Nishikawara, Rebecca Weaver, A Fuchsia Howard, Jessica Sutherland, Lori A Brotto, Caroline F Pukall, Paul J Yong","doi":"10.1093/jsxmed/qdaf025","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf025","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Dyspareunia affects 8%-22% of women worldwide and an unknown number of gender-diverse people. Dyspareunia is commonly categorized into deep and superficial subtypes based on pain location and underlying etiology; however, current assessment tools inadequately differentiate between pain locations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aimed to develop a patient-reported outcome measure (PROM) that independently assesses deep and superficial dyspareunia and its psychosocial correlates: the Deep and Superficial Dyspareunia Questionnaire (DSDQ).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The DSDQ development stages included item construction, categorization, review/revision, focus groups, cognitive interviews, final review, and factor analysis. Items were developed by reviewing pre-existing measures related to dyspareunia. Constructs of these measures were adapted to create items for the DSDQ. Developed items were categorized according to a conceptual framework. To review items, 4 patient partners, 2 gynecologists, and 1 psychiatrist participated in a modified eDelphi process. Next, 3 patient focus groups (n = 5, n = 3, n = 4), 1 clinician focus group (n = 2), and patient cognitive interviews (n = 15) were conducted over 2 rounds. A qualitative descriptive approach guided interview analysis, which informed DSDQ modifications and generated evidence of validity. Clinician-researchers (n = 4) and patient partners (n = 2) completed the final revision. Lastly, an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) determined the most appropriate factor structure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Generated items, validity, factor structure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Fifty-nine pre-existing measures were reviewed to generate an initial pool of 163 items. Items created were categorized into domains for characteristics (pain quality, timing, location, and intensity) or psychosocial correlates (impact of pain on cognitions, affect, sexuality, and behavior). The eDelphi modified 40 items, added 23, and excluded 10. After the final review, 175 items were approved for psychometric analysis. The EFA supported a 103-item, 6-factor model. The CFA supported a 45-item, 6-factor model. Factors included: (1) Vaginal Opening Pain; (2) Deep Vaginal/Pelvic/Abdominal Pain; (3) Pain Interference; (4) Affect and Cognitions Related to Provoked Pain; (5) Sexual Distress Related to Sexual Well-being; and (6) Pain Self-efficacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;The DSDQ will aid diagnosis, treatment, and assessment of dyspareunia changes over time in research and clinical settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;Strengths of this work include DSDQ co-development with patient partners, multidisciplinary clinicians, and researchers, as well as the rigorous mixed-methods development. Limitations include demographic and clinical homogeneity of the patient samples and sample sizes for the EFA and CFA.","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}