Background Endometriosis-associated pain and dyspareunia influence female sexuality, but little is known about men's experiences in affected couples. Aim To investigate how men partners experience sexuality in partnership with women with endometriosis. Methods A multi-center case-control study was performed between 2010 and 2015 in Switzerland, Germany, and Austria. 236 Partners of endometriosis patients and 236 partners of age-matched control women without endometriosis with a similar ethnic background were asked to answer selected, relevant questions of the Brief Index of Sexual Functioning and the Global Sexual Functioning questionnaire, as well as some investigator-derived questions. Outcomes We sought to evaluate sexual satisfaction of men partners of endometriosis patients, investigate differences in sexual activities between men partners of women with and without endometriosis, and identify options to improve partnership sexuality in couples affected by endometriosis. Results Many partners of endometriosis patients reported changes in sexuality (75%). A majority of both groups was (very) satisfied with their sexual relationship (73.8% vs 58.1%, P = .002). Nevertheless, more partners of women diagnosed with endometriosis were not satisfied (P = .002) and their sexual problems more strongly interfered with relationship happiness (P = .001) than in partners of control women. Frequencies of sexual intercourse (P < .001) and all other partnered sexual activities (oral sex, petting) were significantly higher in the control group. The wish for an increased frequency of sexual activity (P = .387) and sexual desire (P = .919) did not differ statistically between both groups. Clinical Translation There is a need to evaluate qualitative factors that influence sexual satisfaction in endometriosis patients. Conclusions This is one of the first studies to investigate male sexuality affected by endometriosis. The meticulous verification of diagnosis and disease stage according to operation reports and histology allows for a high reliability of diagnosis. Our men's response rate of almost 50% is higher compared to other studies. Recruiting men through their woman partner may have caused selection bias. The adjustment to the specific situation in endometriosis by selecting questions from the Brief Index of Sexual Functioning and Global Sexual Functioning and adding investigator-derived questions likely influenced the validity of the questionnaires. Despite the fact that both partners of endometriosis patients and of control women largely reported high sexual satisfaction, there are challenges for some couples that arise in the context of a sexual relationship when one partner has endometriosis. Challenges such as sexuality-related pain or a reduced frequency of sexual activities should be addressed by health care professionals to ameliorate any current difficulties and to prevent the development or aggravation of sexual dysfunction.
Background Dyspareunia, one of the main symptoms of the chronic gynecological pelvic pain disorder endometriosis, may interfere with the likelihood of reaching an orgasm, yet for women with dyspareunia, no data on orgasm rates in different sexual activities are available. Aim The aim of this study was to evaluate the ability to reach an orgasm and its association with sexual satisfaction during different sexual activities in women with a chronic pelvic pain disorder and in healthy control women. Methods A set of questionnaires including the brief index of sexual functioning and global sexual functioning was used to evaluate sexuality in women affected with endometriosis (n = 434) and a nonaffected control group (n = 434) recruited in German-speaking countries. Outcomes The primary outcome measure of this study was the orgasm rate during different types of sexual activities. Results Only the ability to have an orgasm during sexual intercourse (P = .002) but not during masturbation (P = .509) or partnered noncoital sexual activities (P = .229) is affected by endometriosis. Dyspareunia was associated with a reduced ability to experience an orgasm during intercourse for endometriosis patients (P = .020) and control women (P = .006). The ability to orgasm during noncoital sexual activities (P = .006) and sexual intercourse (P = .038) was associated with a higher sexual satisfaction in women with endometriosis. For controls, only the ability to achieve an orgasm with sexual intercourse was associated with sexual satisfaction (P = .038). Clinical implications Sexual counselling as part of medical support could help couples living with chronic pelvic pain of the female partner integrate noncoital sexual activities in their sex lives, leading to fewer sex-related problems and higher sexual desire and satisfaction. Strengths and limitations This study is the first to examine different ways of achieving an orgasm and sexual satisfaction in a large group of women with endometriosis and a matched control group. The breadth of the questionnaire allowed a differentiated analysis of factors influencing the likelihood of achieving an orgasm and overall sexual satisfaction. The one limitation is that the length and the intimate nature of the questionnaire possibly resulted in reluctance to answer this part of the questionnaire. Conclusion Partnered noncoital sexual activities may represent an alternative to reach orgasm for women with endometriosis-related chronic pelvic pain or anorgasmia during sexual intercourse.
Purpose: The length of sexual abstinence seems to influence sperm quality. However, few data on the relevance of abstinence time in pathological sperm samples are available. With our study, we look for associations of abstinence length and semen quality. Methods: We studied semen samples from 4423 men undergoing fertility evaluation. Sperm concentration, percentage of progressively motile spermatozoa, total motile sperm count, percentage of spermatozoa with normal morphology, were compared after each day and 0-2, 3-7 and >7 days of abstinence. Results: We found that a longer abstinence time was related to higher sperm concentration in normal semen samples (P<0.001) and in semen samples with any sperm pathology (P<0.001, P=0.004) with the exception of oligozoospermia (P=0.125). Longer abstinence time was also associated with significantly reduced progressive motility in normal samples (P<0.001) and in cases of teratozoospermia (P<0.001). In normal samples a higher percentage of sperm were morphologically normal after a shorter abstinence period (P=0.03); in oligoasthenoteratozoospermia (OAT) samples, this was the case after a longer abstinence period (P=0.013). Conclusion: A longer abstinence time is associated with higher sperm concentration, whereas sperm motility is optimal after shorter abstinence times; results on morphology are controversial. The recommendation on abstinence time needs to be adjusted in relation to the parameter that needs to be improved.
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