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Background: Mindfulness facets can be trained with structured mindfulness interventions, but little is known regarding application on a broader level within sex therapy (e.g. men, partners and different sexual dysfunctions). Aim: To evaluate the feasibility and preliminary efficacy of an 8-week intervention—specifically, mindfulness for sex and intimacy in relationships (MSIR)—as a supplement to treatment as usual (TAU) as compared with only TAU in a clinical sample of men and women referred for sexual difficulties with or without a partner. Methods: In this randomized controlled feasibility pilot study, 34 participants were randomized to MSIR + TAU (n = 15) or TAU (n = 19). Six healthy partners were also included in the study. MSIR was administered as 2 individual evaluations and six 2-hour group sessions of mixed gender and different types of sexual dysfunction. Outcomes: The primary outcome measures were as follows: (1) feasibility, defined as the implementation of recruitment, acceptance, and attendance of intervention in daily clinical practice and the MSIR completion rate; (2) sexual functioning, as measured on a visual analog scale ("bothered by problem") and by validated questionnaires (Changes in Sexual Function Questionnaire for Females and Males, Female Sexual Function Index, Female Sexual Distress Scale, International Index of Erectile Function). Results: MSIR was feasible and well received by patients, with high rates of acceptance and intervention completion. As compared with pretreatment, the MSIR + TAU group and TAU control group were significantly less bothered by their sexual problems at the end of treatment, but the change was significantly larger in the MSIR + TAU group (P = .04). Participants in the MSIR + TAU group did not receive fewer TAU sessions than the TAU group (MSIR + TAU mean, 6 sessions; TAU mean, 8 sessions). Clinical Implications: MSIR could be effectively used in a clinical setting as an add-on to TAU in the treatment of female and male sexual dysfunction and healthy partners. Strengths and Limitations: The major strength of the study is that it is a randomized controlled study. This study is novel in the sense that it included men and women with different types of sexual dysfunction in the same mindfulness group. Limitations include the pilot nature of the study (e.g. a small sample size), and statistical conclusions should be made with caution. More accurate results may be found in a larger sample. Conclusion: Results from this study support already existing evidence that mindfulness-based interventions are feasible and effective for targeting sexual dysfunctions in men and women. [ABSTRACT FROM AUTHOR]

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Introduction The female sexual response is complex and influenced by several biological, psychological, and social factors. Testosterone is believed to modulate a woman's sexual response and desire, because low levels are considered a risk factor for impaired sexual function, but previous studies have been inconclusive. Aim To investigate how androgen levels and psychosocial factors are associated with female sexual dysfunction (FSD), including hypoactive sexual desire disorder (HSDD). Methods The cross-sectional study included 428 premenopausal women 19 to 58 years old who completed a questionnaire on psychosocial factors and had blood sampled at days 6 to 10 in their menstrual cycle. Logistic regression models were built to test the association among hormone levels, psychosocial factors, and sexual end points. Main Outcome Measures Five different sexual end points were measured using the Female Sexual Function Index and the Female Sexual Distress Scale: impaired sexual function, sexual distress, FSD, low sexual desire, and HSDD. Serum levels of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate, and androsterone glucuronide were analyzed using mass spectrometry. Results After adjusting for psychosocial factors, women with low sexual desire had significantly lower mean levels of free testosterone and androstenedione compared with women without low sexual desire. None of the androgens were associated with FSD in general or with HSDD in particular. Relationship duration longer than 2 years and mild depressive symptoms increased the risk of having all the sexual end points, including FSD in general and HSDD in particular in multivariate analyses. Conclusion In this large cross-sectional study, low sexual desire was significantly associated with levels of free testosterone and androstenedione, but FSD in general and HSDD in particular were not associated with androgen levels. Length of relationship and depression were associated with FSD including HSDD. Wåhlin-Jacobsen S, Kristensen E, Tønnes Pedersen A, et al. Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women. J Sex Med 2017;14:366–379. [ABSTRACT FROM AUTHOR]

Background: There is a lack of long-term register-based follow-up studies of sex-reassigned individuals concerning mortality and psychiatric morbidity. Accordingly, the present study investigated both mortality and psychiatric morbidity using a sample of individuals with transsexualism which comprised 98% (n = 104) of all individuals in Denmark.Aims: (1) To investigate psychiatric morbidity before and after sex reassignment surgery (SRS) among Danish individuals who underwent SRS during the period of 1978–2010. (2) To investigate mortality among Danish individuals who underwent SRS during the period of 1978–2010.Method: Psychiatric morbidity and mortality were identified by data from the Danish Psychiatric Central Research Register and the Cause of Death Register through a retrospective register study of 104 sex-reassigned individuals.Results: Overall, 27.9% of the sample were registered with psychiatric morbidity before SRS and 22.1% after SRS (p = not significant). A total of 6.7% of the sample were registered with psychiatric morbidity both before and after SRS. Significantly more psychiatric diagnoses were found before SRS for those assigned as female at birth. Ten individuals were registered as deceased post-SRS with an average age of death of 53.5 years.Conclusions: No significant difference in psychiatric morbidity or mortality was found between male to female and female to male (FtM) save for the total number of psychiatric diagnoses where FtM held a significantly higher number of psychiatric diagnoses overall. Despite the over-representation of psychiatric diagnoses both pre- and post-SRS the study found that only a relatively limited number of individuals had received diagnoses both prior to and after SRS. This suggests that generally SRS may reduce psychological morbidity for some individuals while increasing it for others. [ABSTRACT FROM PUBLISHER]

Objective. Sexual problems are common in people with diabetes. It is unknown whether early detection of diabetes and subsequent intensive multifactorial treatment (IT) are associated with sexual health. We report the prevalence of low sexual desire and low sexual satisfaction among people with screen-detected diabetes and compare the impact of intensive multifactorial treatment with the impact of routine care (RC) on these measures. Design. A cross-sectional analysis of the ADDITION-Denmark trial cohort six years post-diagnosis. Setting. 190 general practices around Denmark. Subjects. A total of 968 patients with screen-detected type 2 diabetes. Main outcome measures. Low sexual desire and low sexual satisfaction. Results. Mean (standard deviation, SD) age was 64.9 (6.9) years. The prevalence of low sexual desire was 53% (RC) and 54% (IT) among women, and 24% (RC) and 25% (IT) among men. The prevalence of low sexual satisfaction was 23% (RC) and 18% (IT) among women, and 27% (RC) and 37% (IT) among men. Among men, the prevalence of low sexual satisfaction was significantly higher in the IT group than in the RC group, p = 0.01. Conclusion. Low sexual desire and low satisfaction are frequent among men and women with screen-detected diabetes, and IT may negatively impact men's sexual satisfaction. [ABSTRACT FROM AUTHOR]

Objective This randomized prospective study examines durability of improvement in general symptomatology, psychosocial functioning and interpersonal problems, and compares the long-term efficacy of analytic and systemic group psychotherapy in women 1 year after completion of treatment for childhood sexual abuse. Design and Methods Women ( n = 106) randomly assigned to analytic or systemic psychotherapy completed the Symptom Checklist-90-R, Global Assessment of Functioning, Global Life Quality, Registration Chart Questionnaire, and Flashback Registration at pre-treatment, post-treatment, and at a 1-year follow-up. Results Post-treatment gains were significant for both treatment modalities on all measures, but significantly larger after systemic therapy. Significant treatment response was maintained 1-year post-treatment, but different trajectories were observed: 1 year after treatment completion, improvements for analytic therapy were maintained, whereas they decreased after systemic therapy, resulting in no statistically significant difference in gains between the groups at the 1-year follow-up. Despite maintaining significant gains, more than half of the patients remained above cut-off for caseness concerning general symptomatology at post-treatment and at 1-year follow-up. Conclusion The findings stress the importance of long-term follow-up data in effect studies. Different trajectories were associated with the two treatments, but improvement in the two treatment groups did not differ significantly at the 1-year follow-up. Implications of the difference in trajectories for treatment planning are discussed. Practitioner points Both analytic and systemic group therapy proved efficient in improving general symptomatology, psychosocial functioning, and interpersonal problems in women with a history of CSA and gains were maintained at a 1-year follow-up., Despite maintaining statistically significant gains at the 1-year follow-up, 54% of the patients remained above the cut-off for caseness with respect to general symptomatology, which may indicate a need for further treatment., Different pre-post follow-up treatment trajectories were observed between the two treatment modalities. Thus, while systemic group therapy showed a significantly better outcome immediately after termination, gains in the systemic treatment group decreased during follow-up, while gains were maintained during follow-up in analytic group therapy. [ABSTRACT FROM AUTHOR]

This study investigated sexual function in women with a history of severe intrafamilial childhood sexual abuse (CSA) and the correlation between sexual problems and the severity of CSA, adult support during childhood and current psychiatric symptoms. The sample consisted of 158 women who subsequently began specialized group psychotherapy for CSA sequellae. Clinical interview and questionnaires (Present Sexual Function, Sexual and Body Satisfaction, Symptom Check List 90-R) were used for data collection in a cross sectional study design. Non-parametric analysis, linear and logistic regression analysis were applied. Of the women, 63% were unsatisfied with their current sexual life, 39% felt uncomfortable with physical endearments and 71% were unsatisfied with their body. Only 82% had an active sexual life and, of these, 73% reported at least one sexual problem, 48% orgasmic problems and 45% dyspareunia. The occurrence of sexual problems was significantly correlated to childhood physical violence, current psychological distress, flashbacks in sexual situations and discomfort with physical endearment. The prevalence of sexual pain disorders were also positively correlated to “no adult support” in childhood. The present study finds that psychiatric patients in terms of women with a history of intrafamilial CSA have wide-ranging sexual problems. It is crucial to screen for sexual problems and address them during treatment. [ABSTRACT FROM PUBLISHER]

Background: Child and adolescent sexual abuse (CSA) increases the risk for adult sexual assault (ASA), and psychological vulnerability as well as aspects of CSA and upbringing might influence the risk. Aims: The aims of this study were to investigate whether women who reported both CSA and ASA: 1) have been exposed to more severe CSA and 2) have greater psychological distress and vulnerability than women who were not revictimized. Methods: The study was a cross-sectional study of 161 adult women with a reported history of intrafamilial CSA. Thirty-six per cent of the women stated they had been exposed to ASA. The severity of CSA, psychological distress (Symptoms Checklist-90-R) and Cognitive Distortion were assessed. Five factors of Cognitive Distortion (fearful, scared, shy, mistrust and vulnerable) were identified by factor analysis of Symptoms Checklist-90-R sub-scale. Results: The CSA was significantly more severe (penetration: 77%/60%; multiple offenders: 67%/25%) in women exposed to ASA compared with their counterparts, as was the rate of suicide attempts (47%/30%). Also, the psychological distress and the factors: fearful, scared, shy and mistrust were significant higher. Conclusion: The results showed an increased psychological vulnerability among women with ASA, but whether the results are cause or effect of sexual revictimization or can be generalized to other clinical samples are not clear. Interventions targeting the increased risk of ASA should be developed, implemented and tested in prevention as well treatment programmes. [ABSTRACT FROM AUTHOR]

The article presents the author's opinions on David L. Bowland's article "Will Medical Solutions to Sexual Problems Make Sexological Care and Science Obsolete?". Arguments are presented which suggest that medical solutions have improved the treatment of sexological problems and created more demand for sexological care rather than helping it and sexological science become obsolete, and that the benefits of medical solutions far outweigh the disadvantages for the future of sexological care and treatment of sexual problems.

The socio-demographics and psychiatric diagnoses in a clinical sample of women with a history of mainly intrafamilial childhood sexual abuse (CSA) are described. The women were referred to five psychiatric centres for incest group psychotherapy. Data were gathered using interviews and self-administered questionnaires. Over a period of 2.5 years, 385 women with mean age of 33 years were referred with a history of CSA. Three hundred and forty of those had experienced intrafamilial CSA. The average age at first abuse was 6.8 years, and it lasted for a mean of 6 years. The women had been abused by a mean of 1.5 perpetrators. A quarter of the women had been subjected to violence in connection with the sexual abuse. The likelihood of violence having occurred rose significantly if there was more than one perpetrator and/or if penetration had been part of the sexual abuse. Violence was less common if the perpetrator was a brother. The women suffered from a broad spectrum of psychiatric symptoms and illnesses. More than half of the women had previously received psychiatric treatment. Compared to a random sample of the general female population, these women were less advantaged with regards to education, financial circumstances and cohabitation. The results emphasize the importance of offering comprehensive social and psychiatric intervention to help reducing the problems following CSA in women. [ABSTRACT FROM AUTHOR]

The establishment of an educational programme in sexology in a Danish university hospital is described and an overview of the historical background of the Nordic Association for Clinical Sexology (NACS) and the Nordic educational programme is presented. The Nordic Association for Clinical Sexology was founded in 1978. In 2000, agreement was reached on a three-level educational programme for sexologists and identical rules for authorization in the Nordic countries. After analysis of the Nordic educational programme, curricula on levels 1 and 2 as well as logbooks were designed. Employees of the clinic with relevant clinical work could enter the programme. Twelve employees entered the programme at different points; one junior doctor graduated in March 2004. The NACS curricula secure a similar standard of authorized Nordic sexologists. The use of specialist teachers from non-Nordic countries links the Nordic traditions to orientations encountered in other parts of the world. In continuation of the NACS curricula, we have established an educational programme for sexologists. We suggest that this can be carried out at any major sexological unit. [ABSTRACT FROM AUTHOR]

Objective: To identify objective clinical signs of vulvodynia and determine specific diagnostic tests for vulvodynia in women referred to a vulvar outpatient clinic for vulval complaints., Study Design: A retrospective study was performed of the medical records of 201 consecutive Danish patients suspected of suffering from vulvodynia who were referred to a vulvar outpatient clinic (Department of Gynecology, Rigshospitalet University Hospital) between October 2003 and January 2006., Results: Of 201 women, 117 were diagnosed with vulvodynia and 84 had other diagnoses. Of the women diagnosed with vulvodynia in the vulvar clinic, 88.9% were correctly diagnosed before referral. The women with vulvodynia were more likely to report dyspareunia (chi2 = 7.89, p = 0.005) and stinging pain (chi2 = 3.74, p = 0.05). The nonvulvodynia group was more likely to report a tendency toward fissures (chi2 = 5.94, p < 0.05)., Conclusion: Self-reported dyspareunia and stinging pain are strongly associated with vulvodynia. Self-reported pruritus and a tendency toward fissures are not likely to be associated with vulvodynia. Whether vulvar biopsies should be performed regularly when redness and pain is present must be explored further in prospective studies.

Patients treated for testicular cancer have increased risk of ejaculatory, orgasmic and erectile dysfunction compared with healthy men. The underlying relations are unclear. This review describes sexual dysfunctions that are associated with various treatment modalities. One meta-analysis and 11 original works were examined. About one third of the patients experience one or more sexual problems in relation to the treatment. Only retroperitoneal surgery can cause a specific sexual dysfunction, namely loss of ejaculation ability or ejaculatory functioning. Psychosexual causes are important for understanding sexual dysfunctions in patients with testicular cancer.

The majority of psychotropic drugs entail sexual side effects. The sexual side effects may reduce quality of life and may give rise to non-compliance. For example, 30-60 per cent of patients treated with antidepressants are known to develop a sexual dysfunction. However, some psychotropic drugs with no or very few sexual side effects have begun to emerge. The treatment of sexual side effects induced by psychotropic drugs may consist of: modified sexual habits, reduction in dosage, switching to another medication, possibly in combination with different psychotropic agents, other varieties of pharmacologically active substances or specific products for the treatment of sexual dysfunction such as sildenafil. Above all, it should be acknowledged that relatively few data are available in this field and in particular that there is a lack of controlled studies.