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Purpose of Review: Despite the growing attention toward minority stress, there remains a scarcity of studies on its associations with sexual wellbeing. This scoping review aimed to examine the empirical literature from the last five years concerning how minority stress may relate to sexual wellbeing among adults. Recent Findings: Results from the 13 peer-reviewed articles were inconsistent. Internalized negativity (e.g., homophobia) showed varying associations with sexual satisfaction and function. Concealing one's sexual identity was linked to lower sexual satisfaction and sexual function. Fear of being rejected was associated with worse sexual function. Prejudice-related events were negatively associated with sexual satisfaction and function, and positively with sexual distress. Personal discomfort with one's non-monogamous engagement did not correlate with sexual satisfaction. Summary: Findings suggest that greater minority stress tends to be related to lower sexual wellbeing, albeit inconsistently. Further research is needed to better understand the mechanisms involved in these associations. [ABSTRACT FROM AUTHOR]

Purpose of Review: Many transgender and gender non-conforming (TGNC) people seek gender-affirming hormone therapy (GAHT). While GAHT is generally safe and increases well-being, it is essential to accurately understand potential unintended effects and risk factors to better inform and manage treatment. This narrative review covers recent literature documenting changes in sexual function following the initiation of GAHT and explores inflammation as a potential mediator of these changes. Recent Findings: Generally, the initiation of GAHT is correlated with increased sexual desire in transgender men and decreased sexual desire in transgender women, with time-limited effects that return to levels approaching baseline after about a year; there are also changes in inflammation markers that parallel this timeline. Findings on other aspects of sexual function (e.g., orgasm, pain, and sexual quality of life) are more limited. As there is evidence from cisgender populations that inflammation acts as a mechanism by which hormones influence sexual function, we propose applying this model to TGNC people taking GAHT. Summary: Sexual function may change in TGNC patients receiving GAHT, and those changes may be influenced by inflammation. However, these changes often return to baseline as TGNC patients' bodies adjust to a new hormonal equilibrium. [ABSTRACT FROM AUTHOR]

Purpose of Review: Recognizing the link between infertility and sexual health is crucial to providing comprehensive fertility care. The aim of this systematic review was to examine studies investigating the prevalence of sexual dysfunction, factors linked to sexual well-being, and psychosocial interventions targeting sexuality in individuals undergoing medically assisted reproduction (MAR). Recent Findings: An advanced search was conducted in Embase, Web of Science, CINAHL, PubMed, and PsycINFO to find articles published between January 2018 and September 2023. After review for eligibility criteria, 83 articles were reviewed. No studies specifically explored the experiences of sexual and gender/sex diverse individuals. In women, rates of sexual function problems varied from 6.9 to 77.3%, whereas it ranged from 6.7 to 53.6% in men. Most studies revealed significantly lower sexual well-being in individuals with infertility compared to those without. Studies identified that women and men achieving pregnancy through MAR reported lower overall sexual function during pregnancy, compared to women and men who conceived without MAR. Studies identified a range of medical, individual, and relationship factors linked to sexual well-being in the context of MAR and suggested that psychological interventions can enhance the sexual well-being of women with infertility. Summary: This systematic review highlights the clear link between infertility, MAR, and lower sexual well-being in both men and women. Future research should prioritize the use of longitudinal designs to allow for a more in-depth exploration of the dynamic changes in sexual experiences over time. Future research should also consider the distinct challenges of sexual and gender/sex diverse individuals and their experiences of sexual well-being during MAR. Finally, there is a potential gap in research focusing on couple-based interventions. Collaborative efforts between reproductive medicine specialists and mental health professionals could ensure a comprehensive approach to addressing the medical and psychosocial aspects of infertility-related sexual issues. [ABSTRACT FROM AUTHOR]

Purpose of Review: Critically assess and evaluate existing measures of sexual function developed for and validated in gender minority individuals (e.g., transgender, non-binary, Two-Spirit, intersex individuals). Provide recommendations for the development of gender minority inclusive measures of sexual function. Recent Findings: The present review describes the measurement development processes and psychometric properties of sexual function assessment tools that have been developed for and validated in gender minority individuals. Two measures of sexual function were recently developed with the intention of being used specifically in gender diverse groups. The Transmasculine Sexual Function Index (TM-SFI) for sexually active transmasculine individuals with cervixes was adapted from the six-item Female Sexual Function Index (FSFI). The Operated Male-to-Female Sexual Function Index (oMtFSFI) is for individuals who have received gender-affirming surgery (GAS), specifically penile skin inversion vaginoplasty. Although the TM-SFI is validated for use in English, the oMtFSFI is currently validated for use only in Italian. Psychometric properties of both measures are discussed, and recommendations for equity-informed measurement applicable to gender minority individuals are provided. Summary: We present a critical review focused on the psychometric properties of two measures of sexual function for gender minority adults. Existing gaps with current measurement tools for this population are discussed, and recommendations are made using best practices in equity-informed measure development relevant to this population. [ABSTRACT FROM AUTHOR]

Purpose of Review: Gender-affirming vaginoplasty is associated with a high degree of patient satisfaction; however, transgender and gender diverse individuals may face significant challenges regarding sexual dysfunction postoperatively. Sexual function is complex and multifaceted, and data regarding postoperative sexual function can help guide patient counseling and decision-making. Recent Findings: While much of the literature on outcomes of gender-affirming vaginoplasty has focused on capacity to achieve orgasm, numerous parameters of sexual function may impact patient satisfaction and quality of life. Patients may experience decrease in sexual desire and arousal following gender-affirming vaginoplasty; however, the impact of dysphoria vs additional psychosocial factors impacting sexuality vs organic sexual dysfunction remains unclear. Correlation of clitoral function with patient satisfaction is complex and not easily determined. Preoperative anorgasmia may predict postoperative anorgasmia; however, preoperative anorgasmia related to gender dysphoria and incongruence may resolve postoperatively. Summary: While progress has been made in the literature surrounding gender-affirming vaginoplasty, existing limitations may make it difficult to appropriately counsel patients regarding surgical outcomes related to sexual health. Heterogeneity in study methodology and quality limits the ability to make specific recommendations regarding differences in technique, and there remains a significant need for high-quality, validated patient-reported outcome measures regarding sexual function post-gender-affirming vaginoplasty. [ABSTRACT FROM AUTHOR]

Purpose of Review: The purpose of this study was to review the recent literature on the relationship between intimate partner violence (IPV) and sexual health in women (including sexual functioning, sexual satisfaction, and relationship satisfaction). Recent Findings: IPV harms women's health, including their sexual health. Of the negative consequences, IPV is associated with worse sexual functioning, sexual satisfaction, and relationship satisfaction. Summary: Recent findings show that IPV is associated with worse sexual functioning (i.e., partner-focused dyadic and general sexual desire, sexual arousal, and orgasmic capacity), low sexual satisfaction, and low relationship satisfaction. Furthermore, only eight studies have been published in the last 10 years. Although very few articles were identified to have assessed the relation between IPV and sexual health aspects in the literature, it can be stated that IPV is related to worse sexual health in women victims. [ABSTRACT FROM AUTHOR]

Purpose of Review: Erectile dysfunction (ED) is an increasingly common concern that has been a topic of interest to men (and their partners) since time immemorial. In the year 2023, we mark a quarter century since selective phosphodiesterase type 5 inhibitors (PDE5I) came to market as the first United States Food and Drug Administration (USFDA) approved oral pharmacotherapy for ED. Recent Findings: The past 25 years have seen a major shift in public discourse on sexuality and sexual dysfunction, to a large extent prompted by the safety and ease of availability of these drugs. The positive impact of the drug on men and their partners is undeniable. The advent of PDE5I has not been without controversy, and in some regards, the sheer simplicity of the drugs' use may have compromised consideration of more deep-seated psychological and interpersonal dimensions of sexuality. Summary: The clear link between ED and cardiovascular disease and even mortality also underscores how simply taking a pill to address the immediate goal of a rigid penis may lead to the person with ED overlooking potentially serious medical problems, of which ED may be a harbinger. In this manuscript, we outline our perspectives on use (and misuse) of PDE5I as a certified sex therapist and a board-certified urologist with interest in sexual medicine. We highlight areas of agreement and disagreement and hopefully provide readers of all disciplines with perspectives on how to optimize sexual wellness for all of our patients, with or without PDE5I. [ABSTRACT FROM AUTHOR]

Purpose of Review: Currently, there are a lack of systematic and standardized methods to evaluate sensation in individuals who have undergone masculinizing gender affirmation surgery (GAS). An individual's choice to pursue phalloplasty or metoidioplasty is driven by consideration of cosmetic satisfaction, urethral function, phallic rigidity, and penetrative ability. Regardless of the chosen procedure, phallic sensation is desired for satisfactory sexual function, pleasure, and overall well-being. The purpose of this review is to evaluate the current literature on sensory outcomes after masculinizing GAS and to identify gaps in knowledge that may benefit from further research. Recent Findings: There is great variability in the collection and reporting of sensation, orgasm, and sexual function data. Due to design limitations and potential bias, all included studies received "low" or "very low" GRADE of evidence. Tactile and erogenous sensation were the most common types of sensation reported. Although most studies report that their participants are eventually able to achieve erogenous and tactile sensation, it is difficult to draw firm conclusions due to significant variability in methodology and results. Additionally, there is limited available literature poised to compare sexual function outcomes between phalloplasty techniques and donor tissue sites. Percentages of participants able to orgasm via masturbation ranged from 71.8 to 100%, while orgasming with sexual intercourse ranged from 69.5 to 100%. Fewer than half of studies discussed the ability for penetrative sex. Between these studies, the ability to engage in penetrative sex ranged from 39.5 to 75%. Only two studies reported the length of time post-operatively to orgasmic ability; both reported that participants were able to orgasm by 1 year post-op. Summary: Overall, there are a wide variety of surgical techniques for GAS described in the literature. The data on sensation, orgasm, and sexual function remains limited, but the authors of this manuscript feel that this study highlights gaps that future researchers may seek to fill. [ABSTRACT FROM AUTHOR]

Purpose of Review: This review serves to explore minimally invasive BPH therapies, with a focus on the sexual side effects of each given modality. The article seeks to give the reader a better understanding of the risk of erectile and ejaculatory dysfunction following various bladder outlet procedures and surgeries. Recent Findings: Multiple urologic treatment technologies are entering the market and gaining FDA approval. UroLift®, Rezūm™, and Aquablation are now supported by the American Urological Association guidelines for the treatment of BPH-related LUTS. Each modality has a relatively low risk of erectile or ejaculatory dysfunction when compared to traditional transurethral resection of the prostate (TURP). Other treatment options, such as prostatic arterial embolization and the Temporarily Implanted Nitinol Device (iTind), may edge their way toward standard of care as new evidence regarding safety and efficacy becomes available. Summary: Various treatment modalities have been proven to be safe when considering a bladder outlet procedure. Depending on the patient's prostatic size, anatomy, and his goals of care, clinicians should be able to offer a BPH treatment option with a favorable prognosis as well as an acceptable risk profile. [ABSTRACT FROM AUTHOR]

Purpose of Review : Sexual problems after cancer are common and multifaceted, particularly among women. The objective of this paper is to review recent and innovative behavioral (non-pharmacologic) interventions that aim to improve the sexual health of women affected by cancer. The review focuses on studies published within the past 5 years, focusing on interventions in three key areas for women with cancer: interventions to facilitate effective patient–provider communication about sexual health concerns, biopsychosocial interventions targeting women specifically, and interventions using a couple-based approach. Recent Findings: Overall, results suggest advancements in all key areas. First, efforts to facilitate effective clinical communication about sexual health concerns in cancer are growing. Findings from pilot studies were particularly encouraging for brief communication interventions in increasing clinicians' awareness and comfort in discussing sexual health with their patients. Second, studies have also begun demonstrating feasibility, acceptability, and efficacy for biopsychosocial interventions for women to improve sexual health, based on a variety of therapeutic approaches; technology-based approaches are gaining particular traction. Finally, consistent with prior reviews, recent research continues to support the use of couple-based interventions, suggesting that including partners in education and counseling about cancer-related sexual changes and solutions can have positive effects on patients, partners, and relationship functioning. Additionally, although efforts are growing to improve clinical communication and sexual health outcomes in special populations (e.g., adolescent and young adult survivors, sexual and gender minorities), greater efforts are needed. Summary: Findings from the review suggest benefit of recent interventions aimed to address sexual concerns and improve outcomes for women affected by cancer. Limitations of studies include small sample sizes and a lack of tailoring to address individual concerns and diverse populations. Future directions should consider existing barriers to participation while leveraging the opportunities for technology and evidence-based digital health strategies to optimize or individualize content and facilitate delivery. [ABSTRACT FROM AUTHOR]

Purpose of Review: Sexual fantasy has been the subject of scientific scrutiny for nearly a century. This review outlines how, despite that scrutiny, methodological and definitional limitations make it difficult to speak with authority to the clinical, relational, and behavioral implications of sexual fantasy. Recent Findings: Estimates of the frequency and content of sexual fantasy for women are limited by volunteer and social desirability biases and thus difficult to interpret. For the same reasons, the role that fantasy plays in individual and partnered sexual satisfaction and function is challenging to assess. The most reliable and recent evidence suggests that the effects of sexual fantasy on satisfaction and function are, overall, neutral to positive. Summary: Given the complexity and limitations in research investigating sexual fantasy in women, we conclude with a call for new approaches in this field and humility in interpreting the existing evidence. [ABSTRACT FROM AUTHOR]

Purpose of Review: Much research has documented changes in postpartum sexuality, including changes in sexual functioning and satisfaction for both the birthing parent and their partner(s). These changes are often linked to postpartum changes in hormonal and immune responses, which can have both direct and indirect effects on sexuality. Recent Findings: Here, we review how postpartum sexuality may be changed via mental, physical, and social/relationship effects of a variety of hormones, including estrogens, progestogens, androgens, cortisol, and oxytocin. We also review the ways in which inflammation may act alongside hormones to influence postpartum sexuality. Summary: We argue that, as each of these factors strongly influence the action of others, the next phase of research in postpartum sexuality must examine the bidirectional interactions of hormones and their effects on behavior, cognition, and social relationships. [ABSTRACT FROM AUTHOR]

Purpose of Review: The interpersonal context is critical for understanding sexual dysfunction yet has largely been neglected in research and reviews of perinatal sexual dysfunction. In this review, we examine how sexual function changes throughout the perinatal period for both birth-giving individuals and their partners. Using a biopsychosocial framework, we review factors associated with the onset and persistence of sexual function problems. Recent Findings: Dyadic longitudinal studies reveal that sexual function declines from mid-pregnancy until 3 months postpartum and then improves thereafter for both partners. Importantly, there is significant heterogeneity in these patterns, suggesting that some individuals and some couples are at greater risk of problems. Findings support that birth-giving individuals experience more marked changes and report greater distress than do their partners, placing them at greater risk of sexual dysfunction. There is minimal evidence to support the role of biological factors in perinatal sexual dysfunction. Psychological (e.g., depression, fatigue, stress) factors are associated with risk of sexual function problems for both partners. Having a strong connection with one's partner appears to protect against sexual function problems, with other social and interpersonal factors (e.g., dyadic coping and empathy, sexual communal strength, communication) buffering against negative changes to sexual function. Summary: The perinatal period is a vulnerable time for both partners' sexual function; however, some individuals and couples are at greater risk than others. Lack of validated measures and accessible evidence-based interventions specific to perinatal sexual function are barriers to assessment and early intervention. Preliminary evidence suggests that receiving psychoeducation about changes to sexual function benefits expectant and new parent couples because this normalizes these experiences and minimizes distress about these changes. Health care professionals should incorporate perinatal sexual function psychoeducation and assessment of both partners into routine care practices. [ABSTRACT FROM AUTHOR]

Purpose of Review: Over the past 30 years, there has been substantial evidence that women's sexual self-schemas—views of themselves as a sexual person—are associated with their sexual function. The aim of this review was to summarize existing methods of conceptualizing and assessing sexual self-schemas, including their advantages, disadvantages, and implications for understanding women's sexual function. We provide recommendations for the utility of each measure in research and clinical contexts, with a goal toward improving understanding of women's sexuality and enhancing research on assessment and treatment of women's sexual difficulties. Recent Findings: Most studies assessing sexual self-schemas have used a self-report measure in which participants rated how descriptive various adjectives were of themselves; the adjectives were identified as reflecting attributes of a sexual woman (e.g., passionate, open). Novel measures of women's sexual self-schemas have been developed more recently, aimed at assessing additional dimensions of sexual self-views such as schema organization or content. Furthermore, some work has conceptualized sexual self-schemas by intentionally activating sexual self-views and assessing associations with sexual responses or function. Summary: Assessing sexual self-schemas with a one-dimensional scale, used widely in past literature, has many advantages, including demonstrated validity and ease of administration and scoring. A measure of sexual self-schema organization may offer new insights for treatment outcome research, as the interconnectedness of a woman's sexual self-schema network could be amenable to change through therapy. The Meaning Extraction Method of computerized text analysis may be especially pertinent in assessment contexts and for monitoring treatment progress, enabling a rich individualized assessment of a woman's sexual self-schema. We recommend continued development and validation of emerging sexual self-schema measures, including increasing their accessibility, so that they may be more broadly applied to research and clinical practice. [ABSTRACT FROM AUTHOR]

Purpose of the Review: The World Health Association declared COVID-19 a pandemic more than 1 year ago. We conducted a systematic review of the literature on the topic of women's sexual health during the pandemic, with a focus on sexual function and sexual pleasure. Our aim is to describe current findings and to discuss implications for women's sexual health during this period. Recent Findings: Thirty-four articles, from 18 countries, were identified. These studies addressed topics ranging from individual aspects, such as cognitive, emotional, and personality factors affecting sexuality during the pandemic, to contextual factors, including relationship, childrearing, and employment status in this period. Summary: Research identified a deterioration of women's sexual function across countries, with an emphasis on sexual desire. Most studies found decreases in the frequency of sexual intercourse during the pandemic and increases in solitary sexual behavior. Many women also experienced declines in sexual satisfaction and relationship satisfaction. Findings suggested that gender inequalities contributed to lower indices of sexual function and satisfaction, and might have exacerbated the pleasure gap between men and women. [ABSTRACT FROM AUTHOR]

Purpose of Review: Although healthcare providers are increasingly interested in addressing their female patient's sexual well-being in a holistic fashion, most do not receive training in how to conceptualize the complex interactions between mind, body, and spirit that drive health and wellness, let alone how to apply empirical data in any of these dimensions to their individual patients. Here, we present a simple mind-body-spirit model, grounded in an integrative medicine approach, to help translate research on sexual functioning and satisfaction into a shared decision-making plan for the management and enhancement of women's sexual wellness. Recent Findings: In considering the dimensions of physical and behavioral health, spirituality, and sensuality, physicians can help women orient to the ways in which their sexual healthcare can address their core values and connection to others, which in turn can improve sexual satisfaction. The application of the model is outlined in a case study. Summary: Too often female sexual well-being is not discussed in the medical setting and this mind-body-spirit model is a tool that health care providers could use to address this important aspect of well-being. [ABSTRACT FROM AUTHOR]

Purpose of Review: Clinical observation and a growing body of empirical research point to an association between disordered eating and sexual function difficulties. The present review identifies and connects the current knowledge on sexual dysfunction in the eating disorders, and provides a theoretical framework for conceptualizing the association between these important health conditions. Recent Findings: Research on sexuality and eating pathology has focused on clinical samples of women with anorexia nervosa (AN) and bulimia nervosa (BN). All aspects of sexual response can be impacted in women with an eating disorder, with sexual function in women with AN appearing to be more compromised than in women with BN. Research of this nature is extremely limited with respect to BED, non-clinical samples, men, and individuals with non-binary gender identities. Summary: Sexuality should be examined and addressed within the context of eating disorder treatment. Sexual dysfunction and eating disorders, along with commonly comorbid disorders of anxiety and mood, can be seen as separate but frequently overlapping manifestations of internalizing psychopathology. Psychological, developmental, sociocultural, etiological, and biophysical factors likely represent risk and maintenance factors for internalizing disorders. A dimensional, trans-diagnostic approach to disordered eating and sexuality has promising implications for future research and clinical interventions. [ABSTRACT FROM AUTHOR]

Purpose of Review: Sexual well-being and intimacy are critical to overall quality of life and retain a high degree of significance for aging individuals, even though these considerations are often overlooked in older populations. Sexual health may be particularly impacted in older individuals living with HIV, especially women, as a result of both physical and psychosocial disease-specific factors. Despite this, sexuality research related to HIV has traditionally focused on risk reduction, rather than on other elements of sexual wellness. In this review, we examine several aspects of sexual well-being that may be important to older women living with HIV (OWLH). Recent Findings: This review summarizes existing literature on sexuality in OWLH over the age of 50 and explores five themes related to sexual health: physical and emotional intimacy, desire/interest, satisfaction/pleasure, frequency of sexual activity, and abstinence. Reduced intimacy among OWLH was reported across most studies, due to stigma and disclosure concerns, lack of opportunity for relationships, and difficulty communicating sexual preferences. Data on sexual desire/interest and satisfaction/pleasure among OWLH were mixed. Frequency of sexual activity varied widely across studies, and abstinence emerged as both an intentional and inadvertent decision for OWLH. Factors related to menopause as it relates to sexuality and HIV are also discussed. Summary: Sexual health and well-being are important to women living with HIV over 50, though key components such as intimacy, desire, and pleasure remain poorly understood. As this population continues to grow, comprehensive and age-specific interventions are needed to examine positive aspects of sexuality and promote sexual wellness among OWLH. [ABSTRACT FROM AUTHOR]

Purpose of Review: To provide a review on the diagnosis and management of chronic scrotal content pain (CSCP). We cover the anatomy relevant to the scrotum, pathophysiology related to pain, and discuss medical and surgical options. We investigated the impact this condition has on patients and quantified the significant burden on quality of life. Recent Findings: Our review found that among centers that manage chronic scrotal content pain regularly, medical management consistently includes scrotal rest/ice, NSAIDs, tricyclic anti-depressants, or neuropathic pain modulators. Among surgical options, microdenervation of the spermatic cord in some series provides > 90% relief in scrotal pain. With regard to quality of life, we found that in some series, more than half of patients experience a significant reduction in sexual function and marital relationship. Furthermore, these patients are often caught in a vicious cycle whereby pain and diminished sexual function aggravate each other. Summary: Our findings demonstrate that clinicians who manage this condition regularly are using very similar approaches, thus facilitating a standardized approach for this condition, which carries a significant burden on quality of life. [ABSTRACT FROM AUTHOR]

Purpose of Review: Contemporary urologists have myriad options to offer patients when discussing treatments for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). While the primary goal of managing BPH is to improve LUTS, many treatments cause adverse effects on sexual function including erectile and ejaculatory function and libido. In the past 5 years, new literature has continued to evaluate the impact that medical, minimally invasive, and surgical BPH therapies have on sexual function.Recent Findings: Research on medical treatment continues to show high rates of erectile and ejaculatory dysfunction in addition to low libido. Minimally invasive procedures had the lowest risk of developing both ejaculatory and erectile dysfunction. Invasive procedures such as transurethral resection of the prostate (TURP) caused significant ejaculatory dysfunction, while holmium laser enucleation of the prostate (HoLEP) caused significant erectile dysfunction.Summary: Not all existing studies are comprehensive in their analysis of sexual function with impacts on libido being the least reported. Sexual function remains at a high level of patient concern and can be a significant source of procedural dissatisfaction. Appropriate preoperative counseling and further comparison studies are of paramount importance. [ABSTRACT FROM AUTHOR]

Purpose of Review: To determine the impacts of infertility on the sexuality of couples, and the challenges this presents for providing sexual healthcare to these couples.Recent Findings: We thoroughly reviewed multiple databases to identify all publications on this topic from 2013 to 2017.Summary: The included studies had significant heterogeneity in the study population, study design, and instruments used to assess sexual response. This made it difficult to identify the true impact of infertility on the sexual health and sexuality of couples. However, our review shows that infertile couples have moderate-to-high levels of emotional, sexual, and marital problems. [ABSTRACT FROM AUTHOR]

Purpose of Review: The purpose of this review was to assess the results of the Testosterone (T) Trials with regard to their clinical and scientific implications. Recent Findings: The T Trials investigated 1 year of T gel versus placebo in 790 men 65 years and older with unequivocally low serum T concentrations (< 275 ng/dl). Safety monitoring was performed for an additional year. Primary results were improvement over placebo for sexual desire, sexual activity, erection quality, physical activity, and mood. Vitality improved with some instruments, but not all. Improvement was noted in bone density and anemia. Coronary CT provided mixed results-coronary calcium scores were unchanged whereas volume of non-calcified plaque increased more in the testosterone group. There were no worrisome safety concerns. Major adverse cardiovascular events over 2 years occurred in 9 testosterone-treated men and 16 placebo-treated men. Summary: The T Trials provide high-level evidence of strong, broad benefits of T therapy, without substantive safety concerns. [ABSTRACT FROM AUTHOR]

Purpose of Review: This paper is written to introduce postpartum sexual functioning through a biopsychosocial lens, including challenges and interventions for optimal sexual functioning during the postpartum period, both for women and their partners. Recent Findings: While considered to be dysfunctional compared to sexual functioning outside of the perinatal period, changes to sexual functioning in the year following childbirth are common. Biological and physiological factors which affect postpartum sexual functioning include method of delivery, breastfeeding and hormonal changes, and sleep. Psychosocial factors impacting postpartum sexual functioning include mental health, identity transition with adjusting to parenting, body image, social support, cultural context, and romantic relationships. Basson's model of female sexual response is also discussed. Summary: Sexual functioning during the postpartum year is a biopsychosocial process which is challenging for most couples, although there are exceptions. These challenges need to be pathologized. Healthcare providers need to better support new parents with their sexual health. [ABSTRACT FROM AUTHOR]

Purpose of Review: The dual control model of sexual response aims to explain sexual behavior and response through two factors, labeled sexual excitation and sexual inhibition. Sexual dysfunctions are common among women and men and pose a threat to the sexual health of both genders. The main objective of this paper was to review the latest findings concerning the predictive value of sexual excitation and sexual inhibition for sexual function and dysfunction in men and women. Recent Findings: Most relevant studies have been conducted in North America and Europe using non-clinical samples. Women and men with high sexual inhibition related to performance concerns and distractibility during sex report lower sexual function. In addition, high sexual excitation is associated with higher sexual function in both genders. Summary: Sexual excitation and sexual inhibition are predictors of sexual function in women and men. More prospective and clinical studies are needed to evaluate the usefulness of both propensities as predictors or moderators of treatment success. [ABSTRACT FROM AUTHOR]

Physicians often feel challenged in the diagnosis and management of vulvar diseases and their effects on psychosexual health. Vulvar dermatoses must be considered in the differential diagnosis of women experiencing female sexual dysfunction or vulvovaginal pain. This review will focus on the diagnosis and treatment of common vulvar dermatoses, including vulvar contact dermatitis, lichen simplex chronicus, vulvar psoriasis, lichen sclerosus, lichen planus, and vulvar intraepithelial neoplasia. The impact of these disorders on sexual well-being will be emphasized. A detailed history and physical examination, backed by confident knowledge of vulvar dermatoses, will aid in diagnosis and management of these diseases. Current gold-standard treatments will be discussed as well as innovative therapeutic approaches currently being developed. With increased clinician awareness and further research, vulvar dermatoses and resulting sexual dysfunction can be appropriately managed. [ABSTRACT FROM AUTHOR]

Introduction: The biopsychosocial paradigm recognizes that sexual development and sexual difficulties may have multifactorial etiologies related to physical, psychological, and social factors. While physical and psychological factors are acknowledged and identified, the influence of social factors often receive less attention in clinical settings. Aim: This study aims to determine how social, cultural, and religious factors and media influence may influence sexual development, sexual relationships, and sexual function. Method: Review of the most recent literature addressing social and cultural factors related to sexuality was conducted. Conclusions: The impact of culture should be recognized and addressed and clinical recommendations are provided. [ABSTRACT FROM AUTHOR]

Little empirical evidence exists concerning sexual functioning and sexuality in women suffering from anorexia nervosa (AN). The current review of the literature since 2000 on AN and sexual functioning produced only a small number of studies on the subject. Most of the research was conducted with small numbers of individuals and utilized different measurements and methodological approaches. Almost all studies showed that AN was related with lower sexual functionality. The factors that influence this reduction in sexual functionality are various and may differ according to the subtype of AN. There is an almost unanimous view based on the research findings that the biological effect of starvation on the human body is the main reason why AN patients report loss of interest in sex and sparse sexual activities. AN symptomatology itself and, more specifically, body image distortion and body dissatisfaction, seem to increase the feeling of shame associated with nudity and hinder the ability of the sufferers to enjoy unobstructed having sex with their partners. On the other hand, personality traits, and especially obsessionality and emotional restraint, seem to have a negative influence both on the ability of the AN patients to create meaningful romantic relationships and to enjoy their sexual life. It is still unclear whether comorbidity with depression and/or anxiety disorders can further deteriorate AN patients' sexual function. Due to the small number of publications, no definite conclusions can be drawn yet, with the exception that AN can be related with lower sexual function. [ABSTRACT FROM AUTHOR]

Sexual dysfunction is a major public health problem that negatively affects the lives of hundreds of millions of individuals worldwide. There is strong evidence suggesting that tobacco use and sexual dysfunction are linked. In fact, cigarette smoking is independently associated with an increased risk of erectile dysfunction (ED). This relationship has been observed among both current and former smokers and among both passive and active smokers, and many studies suggest a dose-response relationship. Further, prospective studies indicate that cigarette use increases the risk of incident ED, whereas smoking cessation appears to improve erectile function. The link between tobacco use (and disuse) and sexual function in women is relatively understudied, and results remain inconclusive. Future research would benefit from utilizing more prospective designs and assessing the effects of smoking (and particularly passive smoking) on a wider range of sexual function outcomes (physiological, sexual dysfunctions other than male and female arousal disorders), especially among women. [ABSTRACT FROM AUTHOR]

Hysterectomy remains the most common major gynecological surgery. Postoperative sexual function is a concern for many women and their partners. In this respect, a beneficial effect of hysterectomy for benign disease independent of surgical techniques or removal of the cervix has been demonstrated in the past decade by the majority of studies. For about 20 % of women, deteriorated sexual function has been reported and current research is attempting to identify mechanisms and predictive factors explaining these postoperative changes. Alternative treatments of benign uterine disorders or uterus preserving surgery for genital prolapse appeared to have similar outcomes in terms of sexual function. Concomitant oophorectomy had negative effects on sexual function and long-term health, particularly in premenopausal women. This may not be reversed by estrogen replacement. Hysterectomy performed for malignancy had a detrimental effect on sexual function. Individualized risk assessment and information should be aimed at during preoperative decision making. [ABSTRACT FROM AUTHOR]