These results are supportive of the growing evidence against a simple model of midlife sexuality that depicts women as victims of their bodily and hormonal changes. Instead, life stressors, contextual factors, past sexuality, and mental health problems are more significant predictors of midlife women's sexual interest than menopause status itself. Evaluation and treatment approaches require consideration of the full range of contextual factors, including relationship quality, personality factors, past experience, and mental and physical health.

Introduction The literature provides little information about the meaning of sexual satisfaction in women despite debates on new concepts of female sexual experience and on modifications in the classification systems of female sexual dysfunction. Often, not even a differentiation is made between satisfaction with one’s sex life or sexual relationship in general and sexual satisfaction related to a specific sexual activity. Aim To differentiate between satisfaction with sex life in general and sexual satisfaction from sexual intercourse, petting, or masturbation. To gain a deeper understanding of the meaning and experience of sexual satisfaction derived from these specific sexual activities. Methods A self-administered questionnaire was completed by 102 German women of different age groups (median age group: 31–35) and education levels. Main Outcome Measures A multidimensional questionnaire addressing the subjective feelings that constitute sexual satisfaction in women. Results The analysis of sexual satisfaction from sexual intercourse yielded two dimensions: (i) feeling close to one’s partner; and (ii) positive bodily and emotional experiences. Regarding satisfaction with one’s sex life in general, 70% of the variance could be explained by sexual satisfaction through sexual intercourse and frequency of sexual intercourse. Sexual satisfaction and orgasm frequency proved to be interdependent but not identical. Conclusions As a contribution to a better understanding of the complex nature of female sexual satisfaction, our results indicate that sexual intercourse is a far more important activity and source of satisfaction in female sexual life than petting or masturbation.

Introduction Persistent genital arousal disorder (PGAD) is a rare condition in women that causes a lot of suffering. The pathophysiology is not well understood and an approach promising effective treatment has not been established so far. Aim This study aims to make colleagues aware of two treatment options, which proved to be successful in one case each and which might be worth further investigation. Main Outcome Measures Subjective distress from unwanted sexual arousal, unwanted orgasms, and pain in the genital area. Methods Treatment of two women—36 and 41 years old—suffering from PGAD with duloxetine and pregabalin, respectively. Results In both women, the treatment proved to be very successful over a long period of time. One of them experienced full remission (duloxetine) and the other one experienced substantial improvement (pregabalin), over a period now lasting for more than a year. Conclusion Pregabalin and duloxetine, in particular, should be further investigated as possible medication for the treatment of PGAD.

This article describes the results of an independent small-scale trial with the centrally acting agent bupropion for female hypoactive sexual desire disorder. The main goals were to gain insight into the intrapsychic and interpersonal barriers to improvement associated with the pharmacological treatment of this common disorder. Eligible subjects entered a 2-week run-in period and a 4-week placebo phase, followed by a 20-week treatment phase. In addition to semi-structured clinical interviews and a set of standardized questionnaires, we used 2 self-developed questionnaires, addressing the period between visits and the week preceding each visit. Participants were 16 women who entered the placebo phase and 10 who completed the medication period. Analyses of pre-post scores and of the questionnaire addressing the time between visits yielded no significant changes. The questionnaire focusing on the week preceding each visit indicated improvements in sexual desire, arousability, and orgasmic ease after Week 8. In the clinical interviews, half of the women reported subjective improvements of sexual desire and arousability that could not be transferred to the sexual relationship as a result of individual and dyadic barriers. Overall, a centrally acting agent such as bupropion may be a viable option for female sexual dysfunction, but it seems mandatory to embed it in a psychotherapeutic approach.

Reported sensations during sexual arousal and panic attacks were compared in women with panic disorder and in controls. Hypotheses: patients with panic disorders report:(1) similar sensations during sexual arousal and panic attacks, but (2) these sensations do not trigger panic during sexual activity, because (3) there is no sense of loss of control in sexual arousal. Thirty women with panic syndrome and 27 age-matched controls were included in this study. The two groups were compared using a self-developed questionnaire. The results do show a significant overlap of reported sensations (80% of sexual sensations identical with panic sensations), but with a different subjective perception for many women. Unexpectedly, most reported sensations during sex (masturbation and partner activity) were experienced as unpleasant. Contrary to our hypothesis, 30% of our sample did panic during sexual activity, 50% experienced a loss of control and 70% of the sample did not panic during sex, in spite of overlapping sensations. These results provide incentives for further studies on this topic.