How the Prevalence Rates of Male Sexual Dysfunction Vary Using Different Criteria

ABSTRACT

Objectives: This study examined the prevalence of male sexual dysfunction (MSD) and how different criteria alter prevalence rates. Methods: Five hundred seventy-three Australian men completed an online survey. Results: Of these men, 42.2% were sexually functional and 57.8% reported 1 or more sexual dysfunctions. No matter which criteria were used, the most prevalent MSD was erectile dysfunction, followed by premature ejaculation, hypoactive sexual desire disorder, and delayed ejaculation. Frequencies varied according to different definitions and measures used to diagnose MSD. More than half of the men with MSD experienced only 1 sexual dysfunction. Conclusions: These results demonstrate the high prevalence of MSD and the relatively low level of comorbidity of MSDs.     

Sexual Dysfunction,Paraphilias and their Relationship to Childhood Abuse in Men who have Sex with Men

ABSTRACT

This study aimed to examine 1) the occurrence of sexual dysfunctions and paraphilias and 2) the relationship between childhood abuse and current sexual disorders in a MSM sample. Participants were MSM in the Midwest who completed baseline surveys prior to attending a sexual health seminar. Most men reported a sexual dysfunction or paraphilia. Thirty-nine percent of the sample reported childhood abuse. Results indicated childhood abuse was associated with a significant increased risk of male erectile disorder (OR = 1.83) and secondary sexual dysfunction (OR = 2.01). The intent of the study was to generate hypotheses to guide future research efforts.     

The effect of testosterone therapy on lower urinary tract symptoms/bladder and sexual functions in men with symptomatic late-onset hypogonadism

Objective.?To prospectively investigate the effect of testosterone therapy on lower urinary tract symptoms (LUTS)/bladder and sexual functions in men with symptomatic late-onset hypogonadism (SLOH).

Methods.?The study included 25 men (age range 38 to 73 years) presented with sexual dysfunction, having SLOH, at a single university hospital. All men received testosterone replacement therapy with transdermal testosterone 50–100 mg gel per day for one year. Urodynamic studies with pressure-flow analysis, measurement of prostate volume, prostate specific antigen (PSA) and free PSA level, International Prostate Symptom Score (IPSS), Aging Male Symptom (AMS) scale and International Index of Erectile Function (IIEF-5) score were recorded in all men before and after one year of the treatment.

Results.?The mean AMS score significantly decreased from 40.4 ± 7.3 to 28.8 ± 5.31 (p = 0.001), and mean IIEF-5 score significantly increased from 8.84 ± 3.76 to 14.36 ± 3.62 (p = 0.001). The mean maximal bladder capacity and compliance significantly increased (p = 0.007 and p = 0.032, respectively), and mean detrusor pressure at Qmax significantly decreased from pre-treatment to post-treatment (p = 0.017).

Conclusion.?This study suggests that in addition to improvement in sexual functions, testosterone therapy may also improve LUTS/bladder functions by increasing bladder capacity and compliance and decreasing detrusor pressure at maximal flow in men with SLOH.     

Associations Between Sexual Abuse and Negative Health Consequences Among High-Risk Men Who Have Sex with Men

This study evaluated whether a history of sexual abuse could differentiate negative health consequences among men who have sex with men (MSM; N = 148) enrolled in a risk counseling program. More than half (51.4%) reported an experience of sexual abuse. A history of sexual abuse was associated with increased psychological distress, increased rates of alcohol (AOR = 2.91; p <.01) and/or drug abuse (AOR = 2; p <.01) treatment, increased risk of housing instability (AOR = 2.13; p <.05), and increased risk for suicidality (AOR = 4.3; p <.001). Findings demonstrate that screening for sexual abuse may be useful in determining the service needs of high-risk MSM.     

Androgens and sexual function: a placebo-controlled,randomized, double-blind study of testosterone vs. dehydroepiandrosterone in men with sexual dysfunction and androgen deficiency

Purpose.?Supplemental administration of androgens has been advocated for men with sexual dysfunction (SD) and hypoandrogenism. The preponderance of evidence indicates that most delivery forms of testosterone (T) are effective but the role of dehydroepiandrosterone (DHEA) is controversial. A placebo-controlled, randomized trial of oral androgen (T versus DHEA) supplementation was carried out to determine their efficacy.

Materials and methods.?Eighty-six men with SD and decreased levels of serum T and/or DHEA, participated in a study receiving oral T undecanoate (OTU) (n?=?29) 80?mg twice daily, DHEA (n?=?28) 50?mg twice daily, or placebo (n?=?29). Outcomes included evaluation of sexual performance by the International Index of Erectile Function (IIEF), the Androgen Deficiency in the Aging Male (ADAM), Aging Male Symtom Scale (AMS), and Global Assessment Questionnaire (GAQ) questionnaires. Biochemical evaluations included measurement of T and DHEA, prolactin, gonadotropins, and PSA.

Results.?Seventy-nine men completed the study. There were no significant differences in outcomes as assessed by four different instruments: the ADAM, IIEF, AMS, and GAQ in regard to sexual interest or erectile function. Biochemically, a significant increase in serum DHEA between baseline and final visit was documented in the group receiving DHEA. The levels of T, on the other hand, increased insignificantly between entry and final visit in the T cohort. No biochemical changes were observed in the placebo group. Levels of PSA remained stable in all three groups.

Conclusions.?This study did not suggest a clinical benefit of OTU or DHEA supplementation in men with hypoandrogenism and SD. The recommended dose of OTU may have been inadequate or poorly absorbed. Increased doses or an alternative T delivery form may result in a different response.     

The Gender Gap in Orgasms: Survey Data from a Mid-Sized Canadian City

Objective: Previous research has established a gap in orgasm frequency between men and women. This study investigates explanations for the gender gap in orgasm. Methods: Crosstab analysis and logistic regression are used to examine the gender gap in orgasms from one Canadian city: Hamilton, Ontario (N = 194). Results: We find a strong association between women’s orgasms and the type of sexual behavior in which partners engage. Women who receive oral sex are more likely to reach orgasm. Conclusion: Sexual practices focused on clitoral stimulation are important to reducing the gender gap in orgasms.     

Brief Report: Sexual Wellbeing in Heterosexual,Mostly Heterosexual,and Bisexually Attracted Men and Women

Abstract

Objective: To assess differences in sexual wellbeing among men and women with exclusively heterosexual, mostly heterosexual, and bisexual attractions. Method: An anonymous online survey in a convenience sample of 597 young adults (394 women, 203 men; average age = 20.04) assessed patterns of sexual attraction, desire, sexual functioning, and sexual satisfaction using validated questionnaires. Results: Individuals with mostly heterosexual attractions reported significantly higher solitary sexual desire than exclusively heterosexual individuals (women: d?=?0.64; men: d?=?0.68). Partnered sexual desire did not differ between groups. Women with exclusively heterosexual attractions reported significantly higher sexual functioning and satisfaction than either mostly heterosexual or bisexually attracted women (functioning: d?=?0.29; satisfaction: d?=?0.47). Men with mostly heterosexual attractions reported significantly lower sexual functioning than either exclusively heterosexual or bisexually attracted men (d?=?0.40). Conclusions: There were significant differences between exclusively vs. mostly heterosexual individuals in several aspects of sexual wellbeing, supporting the assertion that mostly heterosexual may constitute a distinct orientation. Taken together with prior research showing higher rates of sexual dysfunction in bisexual women, these findings highlight sexual health disparities among nonmonosexual women. Efforts to support the sexual wellbeing of sexual minority individuals should include consideration of mostly heterosexual individuals, as this population may have unique sexual health needs.     

Body Size and Sexual Behavior in a Community-Based Sample of Women

ABSTRACT. Women's body size is closely related to their social and sexual experiences. Clinical research has found that women's lifetime sexual behaviors may vary based on body mass index (BMI). Objectives: This study examined the relationship between BMI and recent solo and partnered sexual repertoire in a community-based, non-clinical sample of women. Methods: Two hundred thirty-eight sexually active women completed an online survey measuring age, sexual relationship status, BMI, gender of sexual partners, and engagement in sexual behaviors in the previous 4 weeks. Logistic regression analyses were conducted to determine whether BMI predicted engagement in behaviors after controlling for age and sexual relationship variables. Results: Participant age ranged from 18 to 56 years (M = 30.4, SD = 7.8). Participants were predominantly in exclusive sexual relationships (62.9%, n = 146) with men (82.8%, n = 197). Mean BMI for the sample was 29.33 (SD = 9.28). Participation in self-masturbation, masturbating a partner, performing oral sex on a partner, receiving oral sex from a partner, and penile–vaginal intercourse were not predicted by BMI after controlling for age and partner variables. Conclusions: BMI did not impact sexual repertoire during the previous 4 weeks, with the exception of an increased odds ratio for penile–anal intercourse (OR = 1.06; 95% CI [1.02, 1.10]). Researchers and practitioners working with women should not assume limitations on women's sexual repertoires because of larger body size.     

Sexual inactivity among men who have sex with men living with hiv in europe

Objectives: Most people living with HIV stay sexually active, but some remain inactive. This study investigated prevalence and correlates of sexual inactivity among European HIV-positive men who have sex with men (MSM). Methods: An anonymous sexual health questionnaire was distributed in 17 HIV outpatient clinics throughout Europe. Ninety-seven (11.6%) of 838 respondents reported absence of sexual activity. Results: Multivariable regression analysis identified older age, relationship status, and less satisfaction with general health and sexual desire as being associated with sexual inactivity. Conclusions: Prevalence of sexual inactivity has declined since the introduction of antiretroviral therapy to levels similar to those of HIV-negative MSM, suggesting a tendency toward normalization of HIV-positive MSM's sex lives.     

Seventy-Five Years Old and Still Going Strong: Stability and Change in Sexual Interest and Sexual Enjoyment in Elderly Men and Women Across Europe

Abstract

Objective: The aim of this study was to test a conceptual model of retrospectively assessed change in sexual interest and sexual enjoyment in the past 10 years among coupled older adults in Norway, Denmark, Belgium and Portugal. To which degree do structural influences, personal characteristics, and interpersonal factors predict the dynamics of sexual interest and enjoyment in partnered persons? Methods: Data were collected as a cross-sectional postal survey, with national probability-based samples of the population aged 60-75 years recruited by phone registers in Norway (676 men and 594 women), Denmark (530 men and 515 women), Belgium ( 318 men and 672 women), and Portugal (236 men and 273 women). Results: Across countries, personal characteristics—primarily general health status—were the most important predictors of change in sexual interest and sexual enjoyment in men. Change in sexual interest and enjoyment among women (except for Portuguese women) was best predicted by interpersonal factors. Conclusions: Good health, an active sex life throughout the lifespan, direction of relationship, and feeling emotionally close to partner during sex are important factors in maintaining sexual interest and enjoyment among partnered older adults in Europe.     

The Relationship Between Use of Sexually Explicit Media and Sexual Risk Behavior in Men Who Have Sex with Men: Exploring the Mediating Effects of Sexual Self-Esteem and Condom Use Self-Efficacy

ABSTRACT

Objectives: This study tests the following 3 hypotheses: (1) there is a direct association between consumption of sexually explicit media (SEM) depicting non-condom use and sexually transmitted infection (STI)-related sexual risk behavior among men who have sex with men (MSM); (2) the association between SEM consumption and STI-related sexual risk behavior is mediated by men's sexual self-esteem; and (3) the relationship between SEM consumption and sexual risk behavior is mediated by condom use self-efficacy. Methods: A cross-sectional, Internet-based survey on exposure to SEM and sexual behavior of 1,391 MSM in the United States was conducted in 2011. Results: The results confirmed Hypotheses 1 and 3, while Hypothesis 2 was rejected. Accordingly, a significant association between the use of SEM picturing condom use and STI-related sexual risk behavior among MSM was found. Likewise, we found that the association between the use of SEM and sexual risk behavior was mediated by condom use self-efficacy in an indirect path. However, SEM did not influence sexual risk behavior via sexual self-esteem. Conclusions: To promote STI prevention, the actors in SEM may be used as role models in managing condom use in sexual contexts.     

What Do Men Want?

Abstract

Men play a key role in determining good sexual health outcomes for themselves and their sexual partners. However, many interventions and much of the programmatic focus and effort in reproductive and sexual health care delivery, are focused on women. This paper shows how international goals for development (the Millennium Development Goals), and international agreements on population and development (such as that agreed at the International Conference on Population and Development, Cairo,1994) cannot be met without the full and active involvement of men. We argue that achieving international goals and targets requires more than simply encouraging men to take more responsibility for their actions, it requires a detailed understanding of men's own concerns in the field of sexual health and a commitment to address those concerns to achieve better sexual health for all.

Using examples from south Asia, the paper explores the evidence surrounding the burden of men's sexual ill-health in the Region. We find that while public health programmes are (rightly) focused on controlling HIV (and sexually transmitted infections to some degree), evidence from population-based surveys of men across south Asia shows that men are most concerned with ‘psycho-sexual conditions’ including discharge syndromes, weakness, and erectile dysfunction. There is evidence that some of these conditions may be linked to higher rates of risk-taking and gender-based violence in some men. We further review patterns of care seeking for men reporting these and other sexual health problems.

We conclude that the challenges facing public health professionals are how to ensure that men receive interventions which are appropriate (and affordable and accessible and of high quality) for addressing their own sexual health concerns whilst also meeting wider public health goals of improving population levels of sexual and reproductive health.     

Training Mental Health Professionals in Child Sexual Abuse: Curricular Guidelines

This study explored whether counseling practices with women survivors of child sexual abuse reflect the belief that women do not sexually abuse children. Canadian therapists (n?=?164) who work with women survivors of child sexual abuse were surveyed about their beliefs about what constitutes child sexual abuse, who commits child sexual abuse, and their practices regarding inquiries about abusive behavior. A majority self-reported that they ask women and think it is important to ask but most believe that clients will not spontaneously self-disclose inappropriate sexual thoughts or behaviors. How broadly or narrowly therapists defined child sexual abuse was not related to self-reported therapeutic discussion. Therapists demonstrated differential gender beliefs about child sexual abuse perpetration, but this did not relate to self-reported counseling practices. Implications for therapist education are discussed.     

Sexual Rehabilitation After Prostate Cancer Through Assistive Aids: A Comparison of Gay/Bisexual and Heterosexual Men

The use of assistive aids in sexual rehabilitation after prostate cancer (PCa) was examined in 124 gay, bisexual, and other men who have sex with men (GBM) and 225 heterosexual men. GBM were significantly more likely to use assistive aids (79% versus 56%), to try multiple assistive aids (M = 1.65 versus M = 0.83) including medication, penile injection, penile implant, vacuum pump, and nonmedical sex aids, and to seek information about sexual rehabilitation on the Internet, through counseling, or in a support group. There were no differences between the groups in satisfaction with the use of assistive aids. However, use of aids was a significant negative predictor of sexual functioning for GBM and a significant positive predictor for heterosexual men. Interview accounts described satisfaction with assistive aids in terms of maintaining erectile functioning and relationships. The majority of men in the study also described hindrances, both physical and social, resulting in discontinuation of assistive aids, including perceived artificiality, loss of sexual spontaneity, side effects, failure to achieve erectile response, cost, and lack of access to information and support. It is concluded that the specific needs and concerns of GBM and heterosexual men regarding sexual rehabilitation after PCa need to be addressed by clinicians.     

Testofen,a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease,increases testosterone levels and improves sexual function in healthy aging males in a double-blind randomised clinical study

This study examined the effect of Testofen, a specialised Trigonella foenum-graecum seed extract on the symptoms of possible androgen deficiency, sexual function and serum androgen concentrations in healthy aging males. This was a double-blind, randomised, placebo-controlled trial involving 120 healthy men aged between 43 and 70 years of age. The active treatment was standardised Trigonella foenum-graecum seed extract at a dose of 600?mg/day for 12 weeks. The primary outcome measure was the change in the Aging Male Symptom questionnaire (AMS), a measure of possible androgen deficiency symptoms; secondary outcome measures were sexual function and serum testosterone. There was a significant decrease in AMS score over time and between the active and placebo groups. Sexual function improved, including number of morning erections and frequency of sexual activity. Both total serum testosterone and free testosterone increased compared to placebo after 12 weeks of active treatment. Trigonella foenum-graecum seed extract is a safe and effective treatment for reducing symptoms of possible androgen deficiency, improves sexual function and increases serum testosterone in healthy middle-aged and older men.     

Parenting Practices and Adolescent Sexual Behavior: A Longitudinal Study

The effects of parental attitudes, practices, and television mediation on adolescent sexual behaviors were investigated in a study of adolescent sexuality and media (N = 887). Confirmatory factor analyses supported an eight‐factor parenting model with television mediation factors as constructs distinct from general parenting practices. Logistic regressions indicated that adolescents reporting greater parental disapproval and limits on viewing at Wave 1 were less likely to initiate oral sex between Waves 1 and 2. Adolescents who reported more sexual communication with parents were more likely to initiate oral sex. Results for vaginal intercourse were similar to those for oral sex. Coviewing was a significant negative predictor of initiation of sexual behavior. Parental attitudes and television mediation can delay potentially risky adolescent sexual behaviors.     

Young Adult Relationship Values at the Intersection of Gender and Sexuality

Recent decades have brought significant social changes in the industrialized West that may influence young adults' attitudes about intimate relationships, including changes in gender expectations and behaviors and changes in sexual attitudes and practices. We used data from the National Longitudinal Study of Adolescent Health (N = 14,121) to compare men to women and sexual minorities to heterosexuals on ratings of the importance of love, faithfulness, commitment, financial security, and racial homogamy for successful relationships. We found that nearly all young adults adhere to dominant relationship values inherent in the romantic love ideology; we found, however, modest but significant differences by gender and sexual identity in relationship values. Significant interactions demonstrated that gender and sexual identity intersect to uniquely influence relationship views.     

Masculine Gender-Role Congruence among Sexual Minority Men

Sexual minority men’s sexual identity may be vulnerable to feelings of masculine gender-role incongruence within heteronormative dominant cultural contexts. This study explored associations between masculine gender-role congruence/incongruence and various aspects of sexual identity development in a sample of 106 nonheterosexual men between ages 18 and 74?years (M?=?34.86, SD?=?14.32). The majority of the sample identified as gay (79%), with the rest of the sample identifying as bisexual (10%), and nonexclusively same-sex-attracted sexual identity labels (e.g., pansexual, queer; 10%). Slightly more than half of the men reported congruence between their actual self-perception of masculinity and their ideal masculine presentation. However, men who experienced greater masculine gender-role incongruence, specifically presenting with lower masculine appearance and behavior than they desired, reported higher levels of identity distress and self-consciousness. Thus, though masculine gender roles are being challenged and gender nonconformity is becoming more widely accepted, masculine gender roles are still relevant to the lives of sexual minority men. Future research and clinical implications are discussed.     

Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students

There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as “rape” or “abuse” as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general “label” questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.     

Sex life after 65: How does erectile dysfunction affect ageing and elderly men?

Introduction. We report the findings pertinent to the ageing and elderly participants of a population-based study of erectile dysfunction (ED).

Method. We examined the sociodemographic characteristics, self-reported morbidities and responses to the 5-item International Index of Erectile Function (IIEF-5) of participants aged ≥65 years and ≥80 years.

Results. Most (73%) participants were married or had partners. Among the participants aged ≥65 years, the prevalence of ED (IIEF-5 scores <22) was 67% and of severe ED (IIEF-5 scores <8) 48%. About 32% were sexually active, and 11% had regular sexual intercourse. Cardiovascular disease (CVD) was reported in 37% and diabetes mellitus (DM) in 13%, with odds of ED at 3.91 and 4.68, respectively. Among those aged ≥80 years, the prevalence of ED was 68% and of severe ED 57%. About 12% were sexually active, and 3% had regular sexual intercourse. CVD was reported in 44% and DM in 11%, with corresponding odds of ED at 2.55 and 2.90.

Conclusions. Most ageing and elderly men are in a relationship and many are sexually active. ED is prevalent and severe. Morbidities are common and significantly associated with ED, impairing the sex lives of affected men.