Acupuncture in Premenopausal Women with Hypoactive Sexual Desire Disorder

INTRODUCTION:

Female sexual dysfunction affects up to 43% of women in the United States and hypoactive sexual desire disorder (HSDD) is the most common type; however, we lack treatment options showing improvement for this condition.

AIMS:

To investigate whether acupuncture therapy could improve HSDD.

METHODS:

Premenopausal women with a primary diagnosis of HSDD were included in a single-arm prospective pilot study that was approved by the institutional review board. After providing informed consent, subjects completed validated questionnaires. Participants underwent 25-minute twice-weekly acupuncture sessions for 5 weeks with one certified acupuncturist. Questionnaires were completed again 6 weeks after onset of treatment.

MAIN OUTCOME MEASURES:

Based on a statistically significant change in the desire domain of the Female Sexual Function Index from 2.0 (at baseline) to 2.4 (after intervention with a specialist) in our population of patients diagnosed with HSDD, a sample of 13 was determined, with 90% power and α 0.05.

RESULTS:

Fifteen women were enrolled and 13 completed the study. Mean age was 36.9 ± 11.4 years. Most were white (n = 9, 60%), heterosexual (n = 15, 100%), and non-smokers (n = 14, 93%). Most were sexually active more than four times per month (n = 8, 53%) and none had a history of sexual abuse (n = 15, 100%). Participants received a mean acupuncture needle application of 17 ± 2 at each session. Sexual function improved after intervention, particularly desire (2.1 ± 0.6 to 3.3 ± 1.2, P < .0001), arousal (P < .0001), lubrication (P = .03), and orgasm (P = .005).

CONCLUSION:

In this cohort of premenopausal women with HSDD, 5 weeks of acupuncture therapy was associated with significant improvements in sexual function, particularly desire. This supports a role for acupuncture as a therapeutic option for women with low desire.

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By:  Oakley SH¹, Walther-Liu J², Crisp CC³, Pauls RN³.

¹Female Pelvic Medicine and Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH, USA. Electronic address: susan.oakley@stelizabeth.com.

²Acupuncture and Holistic Health, TriHealth, Cincinnati, OH, USA.

³Female Pelvic Medicine and Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH, USA.

Sex Med. 2016 Mar 28. pii: S2050-1161(16)00032-5. doi: 10.1016/j.esxm.2016.02.005. [Epub ahead of print]

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Defining Pleasure: A Focus Group Study of Solitary and Partnered Sexual Pleasure in Queer and Heterosexual Women

Solitary and partnered sexuality are typically depicted as fundamentally similar, but empirical evidence suggests they differ in important ways. 

We investigated how women's definitions of sexual pleasure overlapped and diverged when considering solitary versus partnered sexuality. Based on an interdisciplinary literature, we explored whether solitary pleasure would be characterized by eroticism (e.g., genital pleasure, orgasm) and partnered pleasure by nurturance (e.g., closeness). 

Via focus groups with a sexually diverse sample of women aged 18-64 (N = 73), we found that women defined solitary and partnered pleasure in both convergent and divergent ways that supported expectations. Autonomy was central to definitions of solitary pleasure, whereas trust, giving pleasure, and closeness were important elements of partnered pleasure. Both solitary and partnered pleasure involved exploration for self-discovery or for growing a partnered relationship. 

Definitions of pleasure were largely similar across age and sexual identity; however, relative to queer women, heterosexual women (especially younger heterosexual women) expressed greater ambivalence toward solitary masturbation and partnered orgasm. 

Results have implications for women's sexual well-being across multiple sexual identities and ages, and for understanding solitary and partnered sexuality as overlapping but distinct constructs.

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By:  Goldey KL1,2, Posh AR1, Bell SN3, van Anders SM4.

• 1Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
• 2Department of Psychology and Behavioral Neuroscience, St. Edward's University, Austin, TX, USA.
• 3Departments of Psychology and Women's Studies, University of Michigan, Ann Arbor, MI, USA.
• 4Departments of Psychology and Women's Studies, Programs in Neuroscience and Reproductive Sciences, Science, Technology, and Society Program, Biosocial Methods Collaborative, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA. smva@umich.edu. 
• Arch Sex Behav. 2016 Mar 23.

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Cathinones Use in Paris

BACKGROUND:

The pattern of recreational drug use has changed over the last decade and now includes a multitude of substances sold as "research chemicals" or new psychoactive substances, "NPS". In France, synthetic cathinones emerged in 2008 (while first mentioned by the French police force in 2007 first alerts among users appeared in 2008) and have grown to be popular drugs of abuse. Under the Official Journal dated 11th June 2010, only mephedrone has been listed as narcotics but "designer drugs" have synthesized new substitute cathinones in order to avoid anti-drug laws. However, since July 2012, in France, all synthetic drugs from the cathinones family have been banned and listed as narcotics following the example of United Kingdom. Despite their recent classification and inclusion on narcotic list, they are readily available on Internet and used widely. Paris Addictovigilance Centre observed a signal of derivate cathinones abuse (21 cases over a two-year period).

OBJECTIVE:

Paris Addictovigilance Centre and Marmottan Hospital wanted to describe the use of cathinones in the Paris area and alert the health care community about the abuse identification and risk assessment problems of these compounds. After a review of derivated cathinone's chemical structure, pharmacology and toxicology, this article seeks to provide patricians with a clinical description and treatment's modality.

RESULTS:

Most users of synthetic cathinones will experience euphoria, increased energy, talkativeness, openness and increased sexual arousal. Signs and symptoms of toxicity are consistent with a sympathomimetic toxidrome. The main reasons for care access are psychiatric (hallucinations, psychotic symptoms, agitation) and addiction disorders. Somatic complications were described with various patterns of symptoms such as headache, tachycardia, confusional states, rhabdomyolysis with renal failure or serotonin syndrome. The most important fact is the apparition of the "slam" phenomenon among men who have sex with men (MSM). The "slam" is a compound of three characteristic elements: injection, sexual party and psychostimulant drug. According to users, "slam" is convenient for group sex and is used it to put them into a good mood and a disinhibition state. These compounds cause fast dependence syndrome with strong craving and prolonged psychiatric symptoms and increase infectious risk (HIV, VHC, VHB…). The cathinones family is not detected in conventional urine drug screenings. We point out the lack of confirmatory analytic testing data which remains the only way to determine the actual etiology of the clinical effects observed since drug users do not always know exactly what they took. These substances can be identified by special analyses using gas chromatography or liquid chromatography and mass spectroscopy technology.

CONCLUSION:

This injection drug is used in order to increase sexual desire, delay orgasm and decrease sexual inhibition and is prevalent in many studies on MSM samples. Cathinones would popularize the "slam". Harm reduction policy requires specific MSM interventions on both sexual and drug addiction networks.

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By:  Batisse A1, Grégoire M2, Marillier M3, Fortias M3, Djezzar S3.

• 1CEIP-Addictovigilance, hôpital Fernand-Widal, 200, rue du Faubourg-Saint-Denis, 75010 Paris cedex 10, France. Electronic address: anne.batisse@lrb.aphp.fr.
• 2Centre Marmottan, 17-19, rue d'Armaillé, 75017 Paris, France. Electronic address: murielgreg@hotmail.com.
• 3CEIP-Addictovigilance, hôpital Fernand-Widal, 200, rue du Faubourg-Saint-Denis, 75010 Paris cedex 10, France. 
• Encephale. 2016 Feb 1. pii: S0013-7006(15)00163-3. doi: 10.1016/j.encep.2015.09.002. 

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Postcoital Dysphoria: Prevalence and Psychological Correlates

Introduction

While problems related to desire, arousal, and orgasm have been subject to extensive epidemiologic research, women's postcoital reactions and feelings, and postcoital dysphoria (PCD) remains under‐researched.

Aim

The study examined the association between women's attachment anxiety and avoidance, differentiation of self, and the experience of PCD symptoms.

Methods

Two hundred and thirty female university students completed an online survey.

Main Outcome Measures

The Female Sexual Function Index, the Experiences in Close Relationships Scale, the Differentiation of SelfInventory‐Revised, and study specific questions.

Results

Forty‐six percent of respondents reported experiencing PCD symptoms at least once in their lifetime with 5.1% experiencing PCD symptoms a few times within the past 4 weeks. A small but significant inverse correlation was found between lifetime prevalence of PCD and sexual functioning (r = −0.16). While the regression model accounted for 22% of variance in lifetime prevalence of PCD, attachment and differentiation of self variables did not account for significant variance.

Conclusions

The findings confirm that PCD is under‐recognized and under‐researched. There appears to be no relationship between PCD and intimacy in close relationships. Further research is necessary to understand the subjective experience of PCD and to inform the development of a reliable measure.

Full article at:   http://goo.gl/0D9ZBG

By:  Robert D Schweitzer, PhD, 1 Jessica O'Brien, MA (Clin Psy.), 1 and Andrea Burri, PhD 2

¹School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, Queensland, Australia

²Department of Psychology, University of Zurich, Zurich, Switzerland

Corresponding author.

Corresponding Author: Robert Schweitzer, PhD, School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia. Tel: +61 7 3870 9596; Fax: +61 7 3138 0486; E‐mail: ua.ude.tuq@reztiewhcs.r

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Sexual Motives in Heterosexual Women With and Without Sexual Difficulties

Previous research indicates that women with sexual problems may have different reasons for engaging in sex than women who are not experiencing sexual problems. 

The current study investigated whether reasons for sex differed by women reporting high versus low overall sexual functioning, as assessed by the FSFI. As low desire and inability to achieve orgasm are the two most commonly reported sexual problems for women, the study also investigated whether women with and without problems specifically related to sexual desire or orgasm cited different reasons for sex. 

The sample was comprised of 446 heterosexual women between the ages of 18 and 61 who completed an online questionnaire assessing reasons for sex and sexual functioning. Women with low sexual functioning overall were more likely to endorse insecurity reasons for sex, while women with high sexual functioning overall were more likely to endorse physical reasons for sex. 

Women experiencing low desire specifically were less likely to endorse emotional and physical reasons for sex than women without desire difficulties. Women experiencing orgasm difficulties specifically were more likely to endorse insecurity reasons for sex than women without orgasm difficulties. 

The variance accounted for was low in all cases. This research offers insights into the important but limited role sexual functioning may play in the broader context of women's sexual motivations.

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By:  Watson E1, Milhausen RR2, Wood J3, Maitland S4.

• 1 University of Guelph, Family Relations and Applied Nutrition , 50 Stone Rd East, MacDonald Institute , Guelph , Ontario , Canada.
• 2 University of Guelph, Family Relations and Applied Nutrition, Macdonald Institute , 50 Stone Rd., Guelph , Ontario , N1G 2W1 Canada.
• 3 University of Guelph, Psychology, Blackwood Hall , 50 Stone Rd., Guelph , Ontario , Canada.
• 4 University of Guelph, Family Relations and Applied Nutrition, MacDonald Institute , 50 Stone Rd., Guelph , Ontario , N1G 2W1 Canada.
• J Sex Marital Ther. 2016 Jan 6:0. [Epub ahead of print] 

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'Birthgasm': A Literary Review of Orgasm as an Alternative Mode of Pain Relief in Childbirth

Childbirth is a fundamental component of a woman's sexual cycle. The sexuality of childbirth is not well recognized in Western society despite research showing that some women experience orgasm(s) during labor and childbirth. 

Current thinking supports the view that labor and childbirth are perceived to be physically painful events, and more women are relying on medical interventions for pain relief in labor. This review explores the potential of orgasm as a mode of pain relief in childbirth and outlines the physiological explanations for its occurrence. Potential barriers to sexual expression during childbirth and labor, including the influence of deeply held cultural beliefs about sexuality, the importance of privacy and intimacy in facilitating orgasmic birth experiences, and the value of including prospective fathers in the birthing experience, are discussed. 

The role of midwives and their perceptions of the use of complementary and alternative therapies for pain relief in labor are examined. While there are indications of widespread use of complementary and alternative therapies such as hydrotherapy, herbal remedies, and breathing techniques for pain relief in childbirth, orgasm was not among those mentioned. 

Lack of recognition of the sexuality of childbirth, despite findings that orgasm can attenuate the effects of labor pain, suggests the need for greater awareness among expectant parents, educators, and health professionals of the potential of orgasm as a means of pain relief in childbirth.

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By:  Mayberry L1, Daniel J2.

• 1Curtin University L.Mayberry@curtin.edu.au.
• 2Curtin University. 

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Costs of Pleasure & the Benefits of Pain: Self-Perceived Genital Sensation, Anatomy & Sexual Dysfunction

Background: Research has highlighted the complex association between female sexual dysfunction (FSD) and distress regarding sexual activity, with decreased physical pleasure being an important mediator. The current study aims to elucidate the association between pleasurable and painful genital sensitivity and FSD, and to further investigate whether FSD may be distressing because it prevents the experience of sexual pleasure, induces pain or both. 

Methods: Sexually active women (n = 256; median, 22 years; range, 18-49 years) completed web-based questionnaires, including the Self-Assessment of Genital Anatomy and Sexual Function, the Female Sexual Function Index and the Female Sexual Distress Scale.

Results: Women reported their clitoris to be more sensitive than their vagina in terms of having more pleasurable responses (P < 0.001), but not more painful responses (P = 0.49). In women with FSD (n = 36), impaired self-perceived genital sensation was found: they reported significantly less sexual pleasure and orgasm intensity, and more orgasm effort and discomfort within the clitoral and vaginal area than women without FSD (n = 220) (P-value < 0.05). The odds of having FSD were significantly greater in women with perceived increased discomfort in the vaginal area during stimulation (odds ratio = 5.59, P = 0.009, 95% confidence interval: 1.53-20.39), but not in the clitoral area. 

Conclusions: The data provide evidence of the relevance of self-perceived genital sensitivity to sexual pleasure and overall sexual experience. Enhancing the pleasurableness of genital sensations, especially during partnered sex, could decrease the likelihood of experiencing pain and concomitant FSD.

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By:  Nina Callens ^A, Guy Bronselaer ^B, Petra De Sutter ^C, Griet De Cuypere ^D, Guy T’Sjoen^D E, Piet Hoebeke ^B and Martine Cools ^A F 

^A Department of Pediatrics, Division of Pediatric Endocrinology, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. 
^B Department of Urology, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. 
^C Department of Obstetrics and Gynecology, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. 
^D Department of Sexology and Gender Problems, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. 
^E Department of Endocrinology, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. 
^F Corresponding author. Email: martine.cools@ugent.be 

 

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A Prospective Evaluation of Female External Genitalia Sensitivity to Pressure following Labia Minora Reduction and Clitoral Hood Reduction

Little research has been conducted into the effects of labiaplasty on sensitivity of external genitalia. This study aimed to determine the effect of labia minora and clitoral hood reduction using the edge resection technique on external genitalia sensitivity.

Female subjects electing to undergo labia minora and clitoral hood reduction were enrolled. Subjects underwent sensitivity testing using monofilaments at five locations (one at the clitoral hood and four labial with each labium measured 0.5 cm from the leading edge and 1.5 cm distal to the hymen) at baseline; 2 weeks; and 3, 6, and 12 months postoperatively. Self-evaluations using the Sexual Function Questionnaire were performed at baseline and 3, 6, and 12 months postoperatively.

Thirty-seven subjects undergoing labia minora and clitoral hood reduction were enrolled. Subjects experienced a median increase in sensitivity at month 6 of 0.118 mN at the 0.5-cm right labial location (p = 0.027) and 0.059 mN at the 0.5-cm left labial location (p = 0.046) compared with baseline. No change in sensitivity was demonstrated at the clitoral hood or either of the 1.5-cm labial locations. At 6 months, an increase in the number of sexual relations was observed in 44.1 percent of subjects (p = 0.011), an improvement in orgasm frequency was exhibited by 35.3 percent of subjects (p = 0.013), and an increase in orgasm strength was observed in 35.3 percent of subjects (p = 0.006).

Labia minora and clitoral hood reduction as performed by the trim/edge resection method does not result in diminished sensitivity.

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By: Placik OJ1, Arkins JP.

• 1Chicago and Arlington Heights, Ill. From Northwestern University Feinberg School of Medicine; and Associated Plastic Surgeons, S.C.

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Overweight, Obesity & Female Sexuality in Perimenopause: A Preliminary Report

Below: The relation between domain of sexual desire and BMI among women

Below: The relation between domain of sexual arousal and BMI among women

Below: The relation between lubrication domain and BMI among women

Below: The relation between orgasm domain and BMI among women

Below: The relation between domain of sexual satisfaction and BMI among women

Below: The relation between domain of sexual pain and BMI among women

Below: The relation between total Female Sexual Function Index (FSFI) and BMI among women

Material and methods

Sixty-one women during the perimenopausal period filled out the survey, with the average age of these women being 51 years. Forty-two of the examined women had an appropriate body mass index (BMI), i.e. between 18.5 and 25, while for 19 of the women, the BMI was above normal. For statistical analysis and in order to assess the differences between the two above-mentioned groups of patients, the nonparametric Mann-Whitney test was applied. A statistically significant value was assumed at p < 0.05. The results of the conducted research indicated no such difference between the women with differing BMI for the specific domains of the FSFI test.

Results

The results obtained show that research in the area needs to be continued.

Conclusions

All the hitherto existing scientific studies also seem to indicate that the influence of overweight and obesity on female sexuality during the perimenopause has not yet been unambiguously proven. Beyond any doubt, however, sexual disorders appear in women at this time of life and the factors which determine them can vary greatly. Given the character of the situation, women ought to be supported both by a team of specialists representing different branches of medicine as well as by their relatives. The whole situation also calls for more research of the important subject matter.

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