Development of palliative medicine in the United Kingdom and Ireland
Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita in Textbook of Palliative Medicine and Supportive Care, 2015
Sexual dysfunction is failure of any aspect of the sexual response cycle to function properly. Goldstein et al. report that sexual dysfunction is 90% psychological and 75% physiological so there can be a lot of overlap between the two causes [24]. When a person with cancer has sexual dysfunction, it is usually physiological. Causes of sexual dysfunction include psychosocial/interpersonal stressors, medical illness, depressive illness, medication, and sexual disorders (DSM-IV) [25]. What constitutes a sexual problem? Physiological dysfunctionAltered experiencesOwn perceptions and beliefsPartner's perceptions and expectationsAltered circumstancesPast experiences [13]
Erectile Dysfunction in Diabetes Mellitus
Jack L. Leahy, Nathaniel G. Clark, William T. Cefalu in Medical Management of Diabetes Mellitus, 2000
Sexual dysfunction can include difficulties with libido, penile erections, and ejaculations, with erectile difficulties constituting the vast majority of this group. Previously, the term impotence was used interchangeably for all aspects of sexual dysfunction, leading to confusion. In 1992, the National Institutes of Health (NIH) Consensus Conference recommended that the term erectile dysfunction (ED) be used to described problems relating to penile erections. This statement defined ED as the inability to achieve or maintain an erection long enough to permit satisfactory sexual intercourse. Decades before, Masters and Johnson gave a definition that may be preferable. It was the inability to achieve or maintain an erection long enough to complete intercourse in more than 25% of cases. This definition seems more clinically relevant, as it conveys the fact that men will occasionally fail and still be considered normal.
Quantitative Imaging for Assessing and Predicting Toxicity
Tiziana Rancati, Claudio Fiorino in Modelling Radiotherapy Side Effects, 2019
Radiation-induced sexual dysfunction in women was not covered by QUANTEC, though it also involves multiple organs and symptoms (e.g., vaginal decreased elasticity, dryness, and pain) (Agarwal et al. 2017). In a case-control study (N = 24), Yang et al. (2013) observed that all four investigated transvaginal US parameters (vaginal wall thickness, intensity, Nakamagi shape, and probability density function) significantly increased in the cases with mild-moderate vaginal fibrosis when compared to controls (p range: < 0.001–0.03). In a recently published study by Agarwal et al. (2017), various T1- and T2-weighted MRI sequences together with diffusion-weighted MRI were suggested to improve visualization of the anatomy of the female perineum. The foregoing imaging techniques could also have implications in the setting of quantifying sexual dysfunction following RT.
“I Want to Feel Like a Full Man”: Conceptualizing Gay, Bisexual, and Heterosexual Men’s Sexual Difficulties
Published in The Journal of Sex Research, 2018
Lorraine K. McDonagh, Elly-Jean Nielsen, Daragh T. McDermott, Nathan Davies, Todd G. Morrison
Sexual difficulties, or reduced sexual function (Rowland, 2007), have the potential to negatively affect a man’s social and psychological well-being and quality of life (e.g., Althof, 2002; Laumann, Paik, & Rosen, 1999). Traditionally, sexual functioning refers to the human sexual response cycle, which is the sequence of physiological responses that occurs during sexual stimulation (including intercourse and masturbation; Basson, 2015; Masters & Johnson, 1966). The term sexual dysfunction refers to a persistent or recurrent disturbance in sexual function that causes distress; it is also used to describe sexual difficulties when a clinical diagnosis has been made (Wincze & Weisberg, 2015). The term sexual difficulty, on the other hand, refers to the more general concept of low sexual function, where the presence of distress is not clear and has not been clinically diagnosed (Hayes, Bennett, Fairley, & Dennerstein, 2006). Over time, however, a sexual difficulty may develop into a sexual dysfunction and can play a role in the maintenance of a sexual dysfunction (Brotto et al., 2016).
Persistent sexual dysfunction after SSRI withdrawal: a scoping review and presentation of 86 cases from the Netherlands
Published in Expert Opinion on Drug Safety, 2022
Katherine Chinchilla Alfaro, Florence van Hunsel, Corine Ekhart
Sexual dysfunction (SD) is defined as disorders in sexual desire and/or in the psychophysiological changes associated with the sexual response cycle [1]. The etiology of sexual dysfunction is multifactorial, encompassing biological, psychological, relational, and sociocultural factors. Chronic illnesses, such as vascular disease, diabetes mellitus, neurological disease, and malignancy, can impact sexual function. Aging itself is associated with decreased sexual function. However, similar symptoms can also be caused by different groups of drugs, e.g. anticholinergics, cardiovascular and antihypertensive medications, hormonal preparations, or psychotropics [2,3]. Sexual dysfunction can take many forms, not only erectile dysfunction or low libido but also pain, discomfort and orgasm or ejaculation disorders [4]. Sexual dysfunction is common in both sexes. Studies show that the prevalence is between 10% and 52% in men, versus 25% and 63% in women. The wide spread of these values is due to differences in criteria, methods, and definitions between the studies [2,3,5]. Sexual dysfunction is still a ‘taboo,’ which usually makes people who suffer from it feel ashamed to talk about it with caregivers and family members [4].
Safety concerns when using novel medications to treat alopecia
Published in Expert Opinion on Drug Safety, 2018
Hind M. Almohanna, Marina Perper, Antonella Tosti
Persistent sexual adverse events following finasteride use were also reported in 2 uncontrolled studies. Irwig and Kolukula interviewed 71 males with androgenetic alopecia (aged 21–46 years) who reported new-onset sexual adverse events that continued for more than 3 months after cessation of finasteride. The mean duration of finasteride use was 28 months and the mean duration of persistent sexual adverse events was 40 months [109,110]. Sexual dysfunction increased after treatment with finasteride. The incidence of sexual dysfunction was as follows: low libido, 94%, decreased arousal, 92%, erectile dysfunction, 92%, and problems with orgasm, 69%. The majority of subjects noted sexual side effects during treatment with finasteride, although some patients reported onset after discontinuing treatment [109]. In another study by Irwig, 54 patients from the prior study with persistent sexual adverse events associated with finasteride were reevaluated after a mean of 14 months following the last interview. A total of 89% of these subjects had scores of sexual dysfunction, raising the possibility of the long-lasting sexual side effects associated with finasteride [111].
Related Knowledge Centers
- Hypoactive Sexual Desire Disorder
- Paraphilia
- Sexual Arousal Disorder
- Stress
- Orgasm
- Sexual Activity
- Sexual Arousal
- Guilt
- Worry
- Sexual Response Cycle