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The scientific literature on sexuality among mentally ill patients clearly shows a higher prevalence of sexual disorders for many mental disorders, but little is known about sexuality in individuals suffering from ADHD. Clinicians will often assume that specific difficulties of ADHD are bound to affect sexual functioning. The aim of this study was to provide a review of the literature to gain better knowledge about sexuality in subjects with ADHD and to discuss screening and management of their potential sexual problems. A systematic review of the literature was performed in Pubmed, PsychInfo, and Embase databases. The main outcome measures were sexual function and sexual dysfunctions. The studies indicated that subjects with ADHD report more sexual desire, more masturbation frequency, less sexual satisfaction, and more sexual dysfunctions than the general population. Clinicians working with subjects with ADHD should explore the quality of their sexual life. This is the first systematic review of the sexuality of individuals with ADHD. However, the results are limited by the small number of studies, by the small sample size of many studies, and the potential for bias. ADHD is a mental disorder affecting sexual health. Further studies are warranted to learn more about sexuality in subjects with ADHD. Soldati L, Bianchi-Demicheli F, Schockaert P, et al. Sexual Function, Sexual Dysfunctions, and ADHD: A Systematic Literature Review. J Sex Med 2020;17:1653–1664. [ABSTRACT FROM AUTHOR]

The use of the smartphone dating application Tinder is increasingly popular and has received much media attention. However, no empirical study to date has investigated the psychological characteristics driving its adaptive or problematic use. The aim of this study is to determine whether reliable subtypes of users can be identified via a cluster analysis approach. A total of 1,159 Tinder users were recruited. Survey questions investigated user characteristics, including: motives for app use, sexual desire, attachment styles, impulsivity traits, self-esteem, problematic use, depressive mood, and patterns of use. Four reliable clusters were identified: two with low levels of problematic use ("regulated" and "regulated with low sexual desire"), one with an intermediate level of problematic use ("unregulated-avoidants"), and one with a high level of problematic use ("unregulated-highly motivated"). The clusters differed on gender, marital status, depressive mood, and use patterns. The findings provide insight into the dynamic relationships among key use-related factors and shed light on the mechanisms underlying the self-regulation difficulties that appear to characterize problematic Tinder use. [ABSTRACT FROM AUTHOR]

Abstract Introduction Vision of the human body has been shown to be key in eliciting sexual desire. However, whether the visual pattern characterizing sexual desire is different in women and men is still unclear. Aim To investigate the effect of gender on visual patterns triggered by an identical set of stimuli depicting attractive heterosexual couples. Methods Heterosexual women and men (n = 106) were tested on a picture-viewing task associated with eye tracking. The context of sexual desire was activated by asking the participant whether they perceived such desire while looking at sensual pictures of heterosexual couples. Data were analyzed using mixed-subject design analyses of variance. Main Outcome Measure Fixation durations were used to investigate visual patterns. 2 areas of interest were created to investigate visual patterns (face vs body area). Results Results showed longer fixations on body rather than face areas irrespective of participant gender. Moreover, all participants looked longer at women's than men's bodies and at the faces of the opposite sex. Clinical Implications These findings shed light on the automatic processes underlying sexual desire, which has the potential to improve the care of patients suffering from sexual disorders by optimizing interventions. Strengths & Limitations The strengths of this study are the use of an eye-tracking paradigm, the dissociation between 2 fixation areas (ie, face and body), and the use of an identical set of stimuli allowing an accurate between-gender comparison of the visual pattern. The limitations are the small sample size, the use of healthy heterosexual individuals, and the absence of measures of sexual arousal and genital response. Conclusions These findings confirm the association between the human body and sexual desire. They also reveal the unique attentional attractiveness of woman's bodies across genders. Bolmont M, Bianchi-Demicheli F, Boisgontier MP, et al. The Woman's Body (Not the Man's One) Is Used to Evaluate Sexual Desire: An Eye-Tracking Study of Automatic Visual Attention. J Sex Med 2019;16:195–202. [ABSTRACT FROM AUTHOR]

A growing body of behavioral studies has demonstrated that women’s hemispheric specialization varies as a function of their menstrual cycle, with hemispheric specialization enhanced during their menstruation period. Our recent high-density electroencephalogram (EEG) study with lateralized emotional versus neutral words extended these behavioral results by showing that hemispheric specialization in men, but not in women under birth-control, depends upon specific EEG resting brain states at stimulus arrival, suggesting that hemispheric specialization may be pre-determined at the moment of the stimulus onset. To investigate whether EEG brain resting state for hemispheric specialization could vary as a function of the menstrual phase, we tested 12 right-handed healthy women over different phases of their menstrual cycle combining high-density EEG recordings and the same lateralized lexical decision paradigm with emotional versus neutral words. Results showed the presence of specific EEG resting brain states, associated with hemispheric specialization for emotional words, at the moment of the stimulus onset during the menstruation period only. These results suggest that the pre-stimulus EEG pattern influencing hemispheric specialization is modulated by the hormonal state. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. One of the most difficult dilemmas in relationship science and couple therapy concerns the interaction between sexual desire and love. As two mental states of intense longing for union with others, sexual desire and love are, in fact, often difficult to disentangle from one another. Aim. The present review aims to help understand the differences and similarities between these two mental states using a comprehensive statistical meta-analyses of all functional magnetic resonance imaging (fMRI) studies on sexual desire and love. Methods. Systematic retrospective review of pertinent neuroimaging literature. Main Outcome Measures. Review of published literature on fMRI studies illustrating brain regions associated with love and sexual desire to date. Results. Sexual desire and love not only show differences but also recruit a striking common set of brain areas that mediate somatosensory integration, reward expectation, and social cognition. More precisely, a significant posterior-to-anterior insular pattern appears to track sexual desire and love progressively. Conclusions. This specific pattern of activation suggests that love builds upon a neural circuit for emotions and pleasure, adding regions associated with reward expectancy, habit formation, and feature detection. In particular, the shared activation within the insula, with a posterior-to-anterior pattern, from desire to love, suggests that love grows out of and is a more abstract representation of the pleasant sensorimotor experiences that characterize desire. From these results, one may consider desire and love on a spectrum that evolves from integrative representations of affective visceral sensations to an ultimate representation of feelings incorporating mechanisms of reward expectancy and habit learning. Cacioppo S, Bianchi-Demicheli F, Frum C, Pfaus JG, and Lewis JW. The common neural bases between sexual desire and love: A multilevel kernel density fMRI analysis. J Sex Med 12;9:1048-1054. [ABSTRACT FROM AUTHOR]

Although philosophers, psychologists, artists, and poets have been interested in the nature and origin of passionate love throughout the ages, only in the 1960s have social psychologists begun to systematically investigate its complexity (Berscheid & Hatfield 1969, Hatfield & Rapson 1993, Hatfield & Rapson 2009). And in the last decade did social neuroscientists begin to contribute to a better understanding of passionate love by unraveling its specific network in the human brain (Ortigue et al. 2010 for review). In the present article, we review what social psychologists and social neuroscientists have learned about the complex phenomenon of passionate love, present the most relevant data on human brain network (as shown by electroencephalogram and/or functional magnetic resonance imaging), which is thought to be involved in the physiology of passionate love, and compare the neuroimaging results with other types of love (such as maternal love). Based on recent neuroimaging findings, passionate love does not only activate subcortical brain areas mediating basic emotions, reward or motivation, but also higher-order cortical brain areas that are involved in social cognition, attention, memory, mental associations, and self-representation. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Although there is an abundant debate regarding the mechanisms sustaining one of the most common sexual complaints among women, i.e., female hypoactive sexual desire disorder (HSDD), little remains known about the specific neural bases of this disorder. Aim. The main goal of this study was to determine whether women with HSDD showed differential patterns of activation within the brain network that is active for sexual desire in subjects without HSDD. Methods. A total of 28 right-handed women participated in this study (mean age 31.1 ± 7.02 years). Thirteen out of the 28 women had HSDD (HSDD participants), while 15 women reported no hypoactive sexual desire disorder (NHSDD participants). Using event-related functional magnetic resonance imaging (fMRI), we compared the regional cerebral blood flow responses between these two groups of participants, while they were looking at erotic vs. non-erotic stimuli. Main Outcome Measure. Blood-oxygenation level dependent (BOLD) signal changes in response to erotic stimuli (compared with non-erotic stimuli). Statistical Parametric Mapping was used to identify brain regions that demonstrated significant differential activations between stimuli and between groups. Results. As expected, behavioral results showed that NHSDD participants rated erotic stimuli significantly higher than HSDD participants did on a 10-point desirable scale. No rating difference was observed for the non-erotic stimuli between NHSDD and HSDD participants. Our functional neuroimaging results extended these data by demonstrating two distinct types of neural changes in participants with and without HSDD. In comparison with HSDD participants, participants without HSDD demonstrated more activation in brain areas involved in the processing of erotic stimuli, including intraparietal sulcus, dorsal anterior cingulate gyrus, and ento/perirhinal region. Interestingly, HSDD participants also showed additional activations in brain areas associated with higher order social and cognitive functions, such as inferior parietal lobule, inferior frontal gyrus, and posterior medial occipital gyrus. Conclusion. Together, these findings indicate that HSDD participants do not only show a hypo activation in brain areas mediating sexual desire, but also a different brain network of hyper activation, which might reflect differences in subjective, social, and cognitive interpretations of erotic stimuli. Collectively, these data are in line with the incentive motivation model of sexual functioning. Bianchi-Demicheli F, Cojan Y, Waber L, Recordon N, Vuilleumier P, and Ortigue S. Neural bases of hypoactive sexual desire disorder in women: An event-related fMRI study. J Sex Med 2011;8:2546-2559. [ABSTRACT FROM AUTHOR]

Brain imaging is becoming a powerful tool in the study of human cerebral functions related to close personal relationships. Outside of subcortical structures traditionally thought to be involved in reward-related systems, a wide range of neuroimaging studies in relationship science indicate a prominent role for different cortical networks and cognitive factors. Thus, the field needs a better anatomical/network/whole-brain model to help translate scientific knowledge from lab bench to clinical models and ultimately to the patients suffering from disorders associated with love and couple relationships. The aim of the present review is to provide a review across wide range of functional magnetic resonance imaging (fMRI) studies to critically identify the cortical networks associated with passionate love, and to compare and contrast it with other types of love (such as maternal love and unconditional love for persons with intellectual disabilities). Retrospective review of pertinent neuroimaging literature. Review of published literature on fMRI studies of love illustrating brain regions associated with different forms of love. Although all fMRI studies of love point to the subcortical dopaminergic reward-related brain systems (involving dopamine and oxytocin receptors) for motivating individuals in pair-bonding, the present meta-analysis newly demonstrated that different types of love involve distinct cerebral networks, including those for higher cognitive functions such as social cognition and bodily self-representation. These metaresults provide the first stages of a global neuroanatomical model of cortical networks involved in emotions related to different aspects of love. Developing this model in future studies should be helpful for advancing clinical approaches helpful in sexual medicine and couple therapy. [ABSTRACT FROM AUTHOR]

Introduction. Electroencephalogram (EEG) combined with brain source localization algorithms is becoming a powerful tool in the neuroimaging study of human cerebral functions. Aim. The present article provides a tutorial on the various EEG methods currently used to study the human brain activity, notably during sexual response. Main Outcome Measures. Review of published literature on standard EEG waveform analyses and most recent electrical neuroimaging techniques (microstate approach and two methods of brain source localization). Methods. Retrospective overview of pertinent literature. Results. Although the standard EEG waveform analyses enable millisecond time-resolution information about the human sexual responses in the brain, less is clear about their related spatial information. Nowadays, the improvement of EEG techniques and statistical approaches allows the visualization of the dynamics of the human sexual response with a higher spatiotemporal resolution. Here, we describe these enhanced techniques and summarize along with an overview of what we have learned from them in terms of chronoarchitecture of sexual response in the human brain. Finally, the speculation on how we may be able to use other enhanced approaches, such as independent component analysis, are also presented. Conclusions. EEG neuroimaging has already been proven as a strong worthwhile research tool. Combining this approach with standard EEG waveform analyses in sexual medicine may provide a better understanding of the neural activity underlying the human sexual response in both healthy and clinical populations. Ortigue S, Patel N, and Bianchi-Demicheli F. New EEG neuroimaging methods of analyzing brain activity applicable to the study of human sexual response. J Sex Med 2009;6:1830–1845. [ABSTRACT FROM AUTHOR]

Abstract: Recent neuroimaging research suggests that human sexual desire (SD) recruits both the limbic system and higher-order cognitive brain areas. Because of the temporal limitation of this technique, the chronoarchitecture of SD remains however unresolved. Here, we investigated the spatio-temporal dynamics of SD by combining a behavioral desire decision task with high-density visual event-related potential (VEP) recordings and brain source estimations. VEPs were recorded from thirteen healthy participants when presented with pictures from two different stimulus categories (i.e., high and low desirability). In agreement with the literature, behavioral results showed that participants were faster to rate non-desired stimuli than desired stimuli (p =0.028). Electrophysiological results extended these behavioral data. Group-averaged VEPs peaked at 90 to 140 ms (P100), at 142 to 220 ms (N200), and at 222 to 360 ms (P300). Desired stimuli (DS) were distinguished from non-desired stimuli (NDS) over the N200 period, notably from 142 to 187 ms. Over this time period, DS processing was characterized by a significant scalp potential field. Although both conditions (DS and NDS) showed the recruitment of the occipito-temporal region (including the extrastriate body area, EBA), LAURA source estimation of the DS scalp potential field revealed a more right-lateralized current source density maximum in the posterior superior temporal sulcus (STS) extending to the temporo-parietal junction (TPJ). The recruitment of STS and TPJ for desired stimuli indicates that these brain areas, known to be respectively involved in social cognition, attention, integration of body-related information and self-processing, play a crucial role for the coding of desirability of visual sexual human stimuli within the first 200 ms after stimulus onset. These findings support the hypothesis that complex cognitive processing for desire occurs much faster than previously thought and open new perspectives with respect to the role of both bottom-up and top-down mechanisms in visual processing of sexual stimuli. [Copyright &y& Elsevier]

Abstract: The way women experience orgasm is of interest to scientists, clinicians, and laypeople. Whereas the origin and the function of a woman''s orgasm remains controversial, the current models of sexual function acknowledge a combined role of central (spinal and cerebral) and peripheral processes during orgasm experience. At the central level, although it is accepted that the spinal cord drives orgasm, the cerebral involvement and cognitive representation of a woman''s orgasm has not been extensively investigated. Important gaps in our knowledge remain. Recently, the astonishing advances of neuroimaging techniques applied in parallel with a neuropsychological approach allowed the unravelling of specific functional neuroanatomy of a woman''s orgasm. Here, clinical and experimental findings on the cortico-subcortical pathway of a woman''s orgasm are reviewed and compared with the neural basis of a man''s orgasm. By defining the specific brain areas that sustain the assumed higher-order representation of a woman''s orgasm, this review provides a foundation for future studies. The next challenge of functional imaging and neuropsychological studies is to understand the hierarchical interactions between these multiple cortical areas, not only with a correlation analysis but also with high spatio-temporal resolution techniques demonstrating the causal necessity, the temporal time course and the direction of the causality. Further studies using a multi-disciplinary approach are needed to identify the spatio-temporal dynamic of a woman''s orgasm, its dysfunctions and possible new treatments. [Copyright &y& Elsevier]

Romantic love has been the source for some of the greatest achievements of mankind throughout the ages. The recent localization of romantic love within subcortico–cortical reward, motivation and emotion systems in the human brain has suggested that love is a goal-directed drive with predictable facilitation effects on cognitive behavior, rather than a pure emotion. Here we show that the subliminal exposure of a beloved's name (romantic prime) during a lexical decision task dramatically improves performance in women in love (Experiment 1), as the subliminal presentation of a passion's descriptive noun does (Experiment 2). The parallel between love and passion allows us to interpret these facilitation effects as corresponding to cognitive top-down processes within a motivation-enhanced neural network. [ABSTRACT FROM AUTHOR]

This article proposes a model of rapid intervention in clinical sexology. The approach uses a method developed by Davanloo, which consists of first identifying and clarifying the defense mechanisms at work and then placing them under pressure. This pressure provokes a heightened anxiety, an intensification of the defense mechanisms, and the development of an intrapsychic crisis disclosing painful emotions linked to past traumas and intrapsychic conflicts. Such stimulation of the unconscious can bring about somatic and sexual symptoms that reveal links between physical and psychic elements. The approach provides rapid access to painful emotions underlying sexual symptoms and allows the therapist to identify appropriate areas and levels of therapeutic intervention. This method helps to translate psychic and sexual realities in a simple, rapid, and efficient manner. It provides opportunities for awareness and comprehension to the therapist and the patient. [ABSTRACT FROM AUTHOR]

This study is part of a larger prospective research program focusing on termination of pregnancy (TOP). One hundred and three women requesting TOP were interviewed before the intervention and 6 months later using open and closed questions and psychological tests. This paper focuses on contraceptive practices before and after abortion. The analysis took into account specific aspects of contraceptive practices and patients’ behaviors. The aims were to assess: the level of women’s knowledge and practice of contraception at the time of request for a TOP; the behavioral modifications following professional counseling 6 months after TOP; the influence of psychological and sexual factors, and those linked to the women’s use of contraception. Most women (n = 101) had already used recommended contraception. During the cycle that had resulted in pregnancy, more than half (n = 58) had used recommended contraception and one third had not used any contraception. Six months later, 86 women used recommended contraception, and 17 did not. The majority of women reported changes in their contraceptive methods (n = 82). Most changes were within recommended methods. The women (n = 10) who continued to practice unprotected intercourse post-TOP were slightly older, satisfied with their sexual relations with their partner, often involved in a long-term and good relationship. During post-TOP period, it is essential to take into account the psychological dynamics involved in the choice of contraceptive methods. Counseling should emphasize not only protection against an unwanted pregnancy but also protection against sexually transmitted diseases, which is often perceived as a less important issue following TOP. [Copyright &y& Elsevier]

• There is a lack of knowledge about the comorbidity between ADHD, hypersexuality and paraphilias. • We provide the first systematic review about hypersexuality and paraphilias in subjects with ADHD. • Findings do not clearly support the idea that hypersexuality and paraphilias are more frequent in ADHD population. • Some studies showed a strong prevalence of ADHD in hypersexual and paraphilic subjects. Subjects with ADHD suffer from inattention, hyperactivity, and impulsivity. Clinicians often assume that specific symptoms of ADHD are bound to affect sexual desire by increasing the frequency of hypersexuality. There is a lack of knowledge about the comorbidity between ADHD, hypersexuality, and paraphilias. The aim of this article was to provide a review of the literature on the association of ADHD and hypersexuality and paraphilias and to discuss the screening and the management of these syndromes when associated with ADHD. A systematic review of the literature was performed in PubMed, PsychInfo, and Embase databases. The studies reviewed show that some individuals who suffer from ADHD report hypersexuality and paraphilias, but no clear data emerged supporting the idea that hypersexuality and paraphilias are more frequent in an ADHD population. On the other hand, some studies showed a high prevalence of ADHD in hypersexual and paraphilic subjects. This is the first systematic review of hypersexuality and paraphilias in individuals with ADHD. However, the results are limited by differences in the methodology and measurement instruments for hypersexuality and paraphilias as well as by the small number of studies and the small sample sizes of many studies. [ABSTRACT FROM AUTHOR]

Cybersex is increasingly associated with concerns about compulsive use. The aim of this study was to assess the roles of motives and sexual desire in the compulsive use of cybersex. The sample consisted of 306 cybersex users (150 men and 156 women). The participants were assessed using the Compulsive Internet Use Scale (CIUS) adapted for cybersex, the Cybersex Motives Questionnaire (enhancement, coping, and social motives), and the Sexual Desire Inventory-2 (dyadic and solitary sexual desire). For both genders, coping motive was associated with CIUS score. For women, an additional association with social motives was found whereas an association with sexual desire was found for men. The study showed gender differences in the contributors to sex-related CIUS scores. [ABSTRACT FROM AUTHOR]

Although the stressful psychological impact on women of an abnormal Pap smear is well documented, little research has been undertaken on its sexual impact. Our objective was to assess the impact of an abnormal Pap smear on the sexual function of affected women. A prospective study compared the sexual function of 48 women with an abnormal Pap smear (case group) with that of 48 women with a normal Pap smear (control group). Sexual function was assessed using the Female Sexual Function Index and the Hospital Anxiety Depression Scale. The questionnaires were mailed to the participants. Surprisingly, the risk of sexual dysfunction was comparable between women with and without an abnormal Pap smear (odds ratio [OR] 0.7; p = 0.4). The OR remained statistically non-significant after adjustment for risk factors. Multivariable analysis showed that only older age at first intercourse, depression and anxiety were identified as factors significantly associated with sexual dysfunction. Contrary to our clinical experience, female sexual function is not impaired by an abnormal Pap smear. Further research is needed to better understand how sexuality in women with abnormal Pap smears may be affected. [ABSTRACT FROM AUTHOR]

Recent theories of embodied cognition suggest that congruence between observed actions and integrated templates of self-related motor experiences facilitates intention understanding of significant others. We tested this hypothesis in 60 participants using response latency measures and a motor intention inference task, which involved video clips of actions performed either by themselves, their beloved partner, or by acquaintances or strangers (as controls). Results show significantly faster reaction times when participants had to understand the intentions of themselves and their significant others, especially if they reported being passionately in love with their significant others. These findings provide an account for facilitation effects of embodied cognition on intention understanding among dyads in love. [ABSTRACT FROM PUBLISHER]

Abstract: Current multidimensional models of women''s sexual function acknowledge the implicit impact of psychosocial factors on women''s sexual function. Interaction between human sexual function and intensity of love has been also assumed, even if love is not an absolute condition. Yet, whereas great insights have been made in understanding the central mechanisms of the peripheral manifestations of women''s sexual response, including orgasm, the cerebral correlates sustaining the interaction between women''s sexual satisfaction and the unconscious role of the partner in this interpersonal experience remain unknown. Using functional imaging, we assessed brain activity elicited when 29 healthy female volunteers were unconsciously exposed to the subliminal presentation of their significant partner''s name (a task known to elicit a partner-related neural network) and correlated it with individual scores obtained from different sexual dimensions: self-reported partnered orgasm quality (ease, satisfaction, frequency), love intensity and emotional closeness with that partner. Behavioral results identified a correlation between love and self-reported partnered orgasm quality. The more women were in love/emotionally close to their partner, the more they tended to report being satisfied with the quality of their partnered orgasm. However, no relationship was found between intensity of love and partnered orgasm frequency. Neuroimaging data expanded these behavioral results by demonstrating the involvement of a specific left-lateralized insula focus of neural activity correlating with orgasm scores, irrespective of dimension (frequency, ease, satisfaction). In contrast, intensity of being in love was correlated with a network involving the angular gyrus. These findings strongly suggest that intimate and sexual relationships are sustained by partly different mechanisms, even if they share some emotional-related mechanisms. The critical correlation between self-reports of orgasm quality and activation of the left anterior insula, a part of the partner-related neural network known to play a pivotal role in somatic processes, suggests the importance of somatic information in the integration of sexual experience. On the other hand, the correlation between activation of the angular gyrus and love intensity reinforces the assumption that the representation of love calls for higher order cognitive levels, such as those related to the generation of abstract concepts. By highlighting the specific role of the anterior insula in the way women integrate components of physical satisfaction in the context of an intimate relationship with a partner, the current findings take a step in the understanding of a woman''s sexual pleasure. [Copyright &y& Elsevier]

Background and aims: The Internet is widely used for sexual activities and pornography. Little is known, however, about why people look for meetings and sexual interactions through the Internet and about the correlates of cybersex addiction. The goal of this study was to construct a questionnaire for cybersex motives [Cybersex Motives Questionnaire (CysexMQ)] by adapting the Gambling Motives Questionnaire to cybersex use and validating its structure. Methods: Two online samples of 191 and 204 cybersex users were collected to conduct a principal component analysis (PCA) on the first sample and a confirmatory factor analysis (CFA) on the second. Cronbach's α and composite reliability were computed to assess internal consistency. Correlations between the CysexMQ and the Sexual Desire Inventory (SDI) were also evaluated. Results: Two competing models were retained from the PCA, one with two factors and the other with three factors. The CFA showed better fit for the three-factor solution. After three cross-loading items were removed, the results showed that a final 14-item three-factor solution (enhancement, coping, and social motives) was valid (adjusted goodness-of-fit index: 0.993; normed-fit index: 0.978; Tucker-Lewis index: 0.985; comparative fit index: 0.988; root mean square error of approximation: 0.076). Positive correlations were found between the different motives and the subscales of the SDI. Discussion: The results suggest that the CysexMQ is adequate for the assessment of cybersex motives. [ABSTRACT FROM AUTHOR]

Background: Evidence on clitoral reconstruction after female genital mutilation is lacking.Case: A woman with female genital mutilation experiencing clitoral pain during sex consulted to undergo clitoral reconstruction. The surgery was complicated by a wound infection responsible for severe postoperative pain. Such genital pain made our patient recall the traumatic experience of genital mutilation and experience a relapse of posttraumatic stress disorder symptoms. She reported anxiety; spontaneous, intrusive recurrent memories of the cutting; hypervigilance; and depressed mood. We successfully treated the infection and posttraumatic stress disorder. At 6 months postsurgery, she reported no clitoral pain and improved sexual function.Conclusion: Genital pain after clitoral reconstruction may cause recall of memories of the genital mutilation. We recommend multidisciplinary comprehensive psychosexual care and adequate analgesia. [ABSTRACT FROM AUTHOR]

Background: Sexual function is an important aspect of health and quality of life and is influenced by both medical conditions and health-care interventions, especially when gynecologic disorders are involved. Coital pain is among the main factors that affect sexual functioning, and this symptom is reported by almost half of women suffering from endometriosis. However, sexuality is a complex phenomenon driven by social, psychological and biological/hormonal factors and the presence of endometriosis might further affect domains of sexual function and the quality of a sexual relationship.Objective and Rationale: The objective of this report is to review the current state of knowledge on the impact that endometriosis and its treatments have on the sexual function of women and their sexual partners.Search Methods: A systematic literature search was performed to identify studies evaluating sexual function in endometriosis patients, and a narrative analysis of results is presented. The review discusses relevant quantitative and qualitative studies analyzing the effect of endometriosis and its hormonal and surgical treatments on measures of sexual function and quality of sexual relationship.Outcomes: Endometriosis negatively affects different domains of sexual function, and the presence of dyspareunia is not the only determinant of sexual health in these women. Chronic pelvic pain, advanced stages of disease and the presence of physical and mental comorbidities affect sexual function, as well as personality traits and women's expectations. Although a number of studies have evaluated the effect of surgery and hormonal treatment on deep dyspareunia, overall sexual function and quality of the relationship with the partner are often under-investigated.Wider Implications: Multiple clinical and personal determinants affect sexual function in women with endometriosis, with potentially negative consequences on the sexual function of partners and quality of the relationship. Additional prospective and longitudinal investigations are warranted using specific instruments to analyze biopsychosocial variables of sexual pain in endometriosis patients and the effects that actual treatments have on measures of quality of sexual function and relationship. [ABSTRACT FROM AUTHOR]

Introduction A recent study by Cheval et al (J Sex Med 2016;13:825–834) found that individuals high in homophobia look significantly less long at sex-related photographs, regardless of their nature (ie, homosexual or heterosexual). Because viewing time is under some conscious control, this result could indicate that individuals high in homophobia have a low sexual interest in any sexual stimuli or are consciously motivated to avoid sexual material in line with their conscious values. Aim To determine the mechanism underlying shorter viewing time of sex-related photographs in individuals high in homophobia using pupil dilatation, which is considered a spontaneous, unconscious, and uncontrollable index of sexual interest. Methods Heterosexual men (N = 36) completed a questionnaire assessing their level of homo-negativity and then performed a picture-viewing task with simultaneous eye-tracking recording to assess their pupillary responses to the presentation of sexually related or neutral photographs. Main Outcome Measures Non-linear mixed models were carried out to fit the individual non-linear trajectories of pupillary reaction. Different parameters were obtained including the final asymptote of the pupillary response. Results Results showed that the final pupil size of men high in homophobia increased significantly less to the presentation of sex-related images (ie, heterosexual and homosexual) than the pupil size of men low in homophobia. In contrast, no significant difference in the final pupil size reaction toward homosexual images (vs heterosexual images) emerged between men high and men low in homophobia. Conclusion Theoretically, these findings reinforce the necessity to consider that homophobia might reflect concerns about sexuality in general and not homosexuality in particular. [ABSTRACT FROM AUTHOR]

ABSTRACT It has long been posited that among emotional stimuli, only negative threatening information modulates early shifts of attention. However, in the last few decades there has been an increase in research showing that attention is also involuntarily oriented toward positive rewarding stimuli such as babies, food, and erotic information. Because reproduction-related stimuli have some of the largest effects among positive stimuli on emotional attention, the present work reviews recent literature and proposes that the cognitive and cerebral mechanisms underlying the involuntarily attentional orientation toward threat-related information are also sensitive to erotic information. More specifically, the recent research suggests that both types of information involuntarily orient attention due to their concern relevance and that the amygdala plays an important role in detecting concern-relevant stimuli, thereby enhancing perceptual processing and influencing emotional attentional processes. J. Comp. Neurol. 524:1668-1675, 2016. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Introduction Some models suggest that homophobia can be explained as a denied attraction toward same-sex individuals. While it has been found that homophobic men have same-sex attraction, these results are not consistent. Aim This study drew on the dual-process models to test the assumption that sexual interest in homosexual cues among men high in homophobia will depend on their specific impulses toward homosexual-related stimuli. Methods Heterosexual men ( N = 38) first completed a scale measuring their level of homonegativity. Then, they performed a manikin task to evaluate their impulsive approach tendencies toward homosexual stimuli (IAHS). Main outcomes measures A picture-viewing task was performed with simultaneous eye-tracking recording to assess participants' viewing time of the visual area of interest (i.e., face and body). Results IAHS positively predicted the viewing time of homosexual photographs among men with a high score of homonegativity. Men with a high homonegativity score looked significantly longer at homosexual than at heterosexual photographs but only when they had a high IAHS. Conclusion These findings confirm the importance of considering the variability in impulsive processes to understand why some (but not all) men high in homophobia have homosexual interest. These findings reinforce the theoretical basis for elaborating a dual-process model for behaviors in the sexual context. [ABSTRACT FROM AUTHOR]

Introduction Despite the high prevalence of hypoactive sexual desire disorder ( HSDD), especially among women, this sexual disorder remains poorly understood. Among the multiple factors possibly involved in HSDD, particularities in the cognitive evaluations of social stimuli need to be better characterized. Especially, beauty and attractiveness judgments, two dimensions of interpersonal perception that are related but differ on their underlying motivational aspects, may vary according to the level of sexual desire. Aim The main goal of this study was to investigate whether women with and without HSDD differ in their evaluations of beauty and attractiveness of men's faces and voices. Methods Young women from the general population (controls, n = 16) and with HSDD (patients, n = 16) took part in the study. They were presented with a series of neutral/nonerotic voices and faces of young men from the GEneva Faces And Voices database. Main Outcome Measures Ratings of beauty (i.e., assessments of aesthetic pleasure) and of attractiveness (i.e., assessments of the personal propensity to feel attracted to someone) and the frequency to which the participants pressed a key to see or listen to each stimulus again were the main outcome measures. Results Ratings of attractiveness were lower than ratings of beauty in both groups of women. The dissociation between beauty and attractiveness was larger in women with HSDD than in control participants. Patients gave lower attractiveness ratings than the controls and replayed the stimuli significantly less often. Conclusion These results suggest that women with HSDD are characterized by specific alterations of the motivational component of men's perception, very early in the process of interpersonal relationships. Our findings have significant implications, both in better understanding the specific cognitive processes underlying hypoactive sexual desire and more largely the evaluative processes involved in human mate choice. Ferdenzi C, Delplanque S, Vorontsova-Wenger O, Pool E, Bianchi-Demicheli F, and Sander D. Perception of men's beauty and attractiveness by women with low sexual desire. J Sex Med 2015;12:946-955. [ABSTRACT FROM AUTHOR]

Sexual disturbances in patients with severe mental disorders can be related to medication, to psychological issues such as self-stigma and anhedonia, but also to the social context. This research aims to gain knowledge of desire and sexual practices in women suffering from schizophrenia. Women outpatients suffering from schizophrenia were compared with healthy women. Contrary to previous research, women with schizophrenia featured dyadic and individual desire similar to women of comparable age. Yet, only half of women with psychosis had sexual practice, either alone or with a partner. They were less satisfied with their activity, both in terms of function and psychological issues such as sexual self-esteem. Keeping into account the fact that most clinicians avoid this topic, this finding underscores the stigmatization these women suffer from, which prevents the opportunity of a possible improvement in this important interpersonal domain. [ABSTRACT FROM AUTHOR]

Objective: Our first objective in this paper was to review the literature on psychodynamic rating scales of sexual disorders. Our second objective, based on the findings from our review, was to develop a psychodynamic rating scale for people with sexual disorders: the KAPP-SD. Method: We developed the KAPP-SD by modifying an existing psychodynamic rating scale, which assesses stable modes of mental functioning and character traits, the Karolinska Psychodynamic Profile (KAPP). We removed items 13 and 14 of the KAPP and replaced them with three other items-sexual fantasies, conceptions and role of gender identity, and conceptions and role of sexual orientation. These items are part of the assessment of an individual's sexuality and are used to evaluate a person with a sexual disorder psychodynamically. Results: The KAPP-SD, a modified version of the KAPP, can be found in the Appendix. Conclusion: We developed the KAPP-SD in order to help sex therapists make a rigorous psychodynamic evaluation of persons with sexual disorders, which would give information on the prognosis and on the type of treatment to offer. [ABSTRACT FROM AUTHOR]

Abstract: Aromatase inhibitors (AI) block the last enzymatic step of estrogen production, the aromatization of the A-cycle of aromatizable androgens and particularly, androstenedione (Δ4) and testosterone (T). Molecules designed for interfering with aromatase activity have existed for many years. Yet the activity of products of the aminogluthetimide era was unspecific and these substances carried too many side effects for being used clinically. Newer third generation AIs, however, are highly specific and essentially devoid of side effects. These molecules have recently been approved for treating breast cancer in postmenopausal women either, in advanced forms or, as part of adjuvant therapy. In women whose ovaries are active, a temporary inhibition of E2 production will raise gonadotropins and in turn, stimulate follicular growth. In cancer patients, this property precludes the use of AIs in women whose ovaries are still active, unless gonadotropins are blocked. But in infertility patients, this property of AIs has been put to play for inducing ovulation. AIs have been used both in women who do not ovulate but whose hypothalamo-pituitary-gonadal (HPG) axis is active (oligo-anovulators of PCOD type) and those who ovulate regularly but in whom multiple ovulation is sought for treating unexplained infertility or as part of IVF. Like clomiphene citrate (CC), AIs are not usable in women whose gonadotropins are suppressed, as in the case of hypothalamic amenorrhea. The sum of data available on the use of AI for inducing ovulation remains however meager to this date and is mainly constituted of pilot and non-randomized trials. Yet mounting evidence tends to support AIs’ advantages over CC for induction of ovulation. Hence, we think that the likelihood that these drugs will play a key role in induction of ovulation in the future is high. AIs appear particularly interesting for treating unexplained infertility because AI-FSH/hMG regimens are lighter than FSH-only regimens while retaining the high pregnancy rates of these latter treatments. [Copyright &y& Elsevier]

This is the first report of a patient who experienced a recurrence of PTSD repeatedly after 2 attempts to initiate antiretrovirals including efavirenz for HIV infection. After recurrence of PTSD, the patient showed an important decrease in viral load and a higher CD4 level despite a bad compliance to antiretrovirals. [ABSTRACT FROM AUTHOR]