Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction

Brotto, Lori A.; Atallah, Sandrine; Johnson‐Agbakwu, Crista; Rosenbaum, Talli Y.; Abdo, Carmita Helena Najjar; Byers, E. Sandra; Graham, Cynthia A.; Nobre, Pedro; Wylie, Kevan

doi:10.1016/j.jsxm.2016.01.019

Cited by 299 publications

(159 citation statements)

References 328 publications

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“…Third, organic causes of erectile dysfunction were identified on the basis of color Doppler findings, and their relationship with risk factors such as hypertension, diabetes, and metabolic syndrome could not be clarified. Various studies have reported diabetes mellitus, hypertension, hyperlipidemia, metabolic syndrome, depression, and lower urinary tract symptoms to be causes of erectile dysfunction [213141516242526]. In this study, we were not able to determine the developmental cause of erectile dysfunction in the study population.…”

Section: Discussionmentioning

confidence: 70%

Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan

Khanzada

Khan

Hussain

et al. 2017

World J Mens Health

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PurposeIn patients with erectile dysfunction, it is important to differentiate psychogenic from organic causes. Penile Doppler ultrasonography is a relatively inexpensive and minimally invasive tool for this purpose. This study was conducted to evaluate the causes of erectile dysfunction in an adult male population, using penile Doppler ultrasonography.Materials and MethodsA retrospective study was conducted in a single center. All patients who presented with complaints of erectile dysfunction and underwent penile Doppler ultrasonography between July 2014 and June 2016 were included in this study. All examinations were performed using GE Voluson S6 and GE Logiq P5 devices. Following baseline scans, an intracavernosal injection of 20 µg of prostaglandin E1 was given. Peak systolic and end diastolic velocities were measured in each cavernosal artery. Patients with a peak systolic velocity of <25 cm/s were considered to have arterial insufficiency, while an end diastolic velocity of >5 cm/s was considered to indicate venous incompetence.ResultsOut of 97 patients (mean age, 37.09±11.59 years; range, 19~69 years), 50 patients (51.5%) had normal findings, 24 patients (24.7%) had arterial insufficiency, 15 patients (15.5%) had a venous leak, and 8 patients (8.2%) patients had arterial insufficiency with a venous leak. Psychogenic erectile dysfunction was significantly higher among patients aged ≤40 years, while arterial insufficiency with or without a venous leak was significantly higher among patients aged >40 years (p=0.022).ConclusionsA majority of the studied individuals demonstrated no organic cause of erectile dysfunction, thus confirming a high prevalence of the psychogenic etiology, particularly in relatively young individuals.

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Section: Discussionmentioning

confidence: 70%

Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan

Khanzada

Khan

Hussain

et al. 2017

World J Mens Health

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“…Nonetheless, studies have begun to clarify the dynamics and reciprocal relationship of one partner’s sexual experience, function, physical and mental health and well-being with the other partner’s sexual functioning and satisfaction (16). …”

Section: The Psychodynamic Of Ejaculatory Dysfunctionmentioning

confidence: 99%

The impact of ejaculatory dysfunction upon the sufferer and his partner

Abdo¹

2016

Transl. Androl. Urol.

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Ejaculatory function cannot be evaluated outside the dyadic process and without taking into account the men’s and women’s cognition of the condition and how their subjective perception impacts on the evaluation of the relationship and sexual quality. Although the distress of the sufferer and his partner has been a motivating factor in leading men with ejaculatory dysfunction to seek medical help, few objective or prospective evaluations of the effects on the couple have been reported. Specialized literature has been dealing with ejaculatory disorders in a heterogeneous manner. Comparatively, there are far more studies on premature ejaculation (PE) than on delayed ejaculation (DE) and even fewer studies on other male orgasm disorders. Therefore, the review focuses on the literature of the two most studied ejaculatory disorders. The matter presented in this article can also be considered for other ejaculatory disorders, since all of them relate to a failure of control, changing the intravaginal ejaculatory latency time (IELT), with consequences for men and their partners. There are multiple psychological explanations as to why a man develops PE or DE. Unfortunately, none of the theories evolve from evidence-based studies. The common final pathway of these factors is the irrational fear of ejaculating intravaginally. These sexual disorders may also cause personal distress for the sexual partner and decreased sexual satisfaction for the couple. An association between pre-existing anxiety disorders and sexual performance anxiety has been found in men and couples with ejaculatory dysfunction. This could reflect a process in which pre-existing anxiety triggers sexual dysfunction, causing performance anxiety and leading to a vicious cycle: anxiety, sexual dysfunction, more anxiety. Men with DE are similar to men with other sexual dysfunctions. They show the same elevated level of sexual dissatisfaction and they also show lower levels of coital frequency. To a lower extent, they use more masturbatory activity relative to controls. The burden of PE for the patient is revealed in three different levels: the emotional burden, the health burden, and the burden on the relationship. In terms of the emotional burden, there is often a sense of embarrassment and shame at not being able to satisfy their partner, and patients often have low self-esteem, feelings of inferiority, anxiety, anger, and disappointment. Men feel frustrated about their PE and how it affects their intimacy with their partners and the sexual relationship. In conclusion, ejaculatory dysfunction has a negative impact on both the man and his female partner and, consequently, it has implications for the couple as a whole. Additionally, ejaculatory dysfunction extending beyond a year elevates the risk of depression in these patients. Although partner perceptions of PE generally indicated less dysfunction than those of subjects, partner outcomes measures play a part in the assessment of PE. Ejaculatory dysfunction involves the integration of physiological, psychobe...

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“…Though the findings of this meta-analysis challenge the conclusions by Pyke and Clayton (2015) On the basis of the Frühauf meta-analysis, and another systematic review (Günzler & Berner, 2012), neither of which were cited in the Pyke & Clayton (2015) critique, the International Consultation on Sexual Medicine, Committee on Psychological and Interpersonal Dimensions of Sexual function and Dysfunction recommended that clinicians consider CBT in the treatment of women with low sexual desire with a Grade A recommendation i.e., a strong recommendation based on high quality evidence (Brotto et al, 2016). We believe that these reviews demonstrating the efficacy of CBT for HSDD should not be taken as -proof‖, or rather in this case lack of proof, for the therapy's benefit.…”

Section: Assumption #1: Psychological Treatments For Hsdd In Women Armentioning

confidence: 72%

Challenges in Designing Psychological Treatment Studies for Sexual Dysfunction

Brotto

Basson

Chivers

et al. 2016

Journal of Sex & Marital Therapy

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Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction

Abstract: Overall, research strongly supports the routine clinical investigation of psychological factors, partner-related factors, context, and life stressors. A biopsychosocial model to understand how these factors predispose to sexual dysfunction is recommended.

Cited by 299 publications

References 328 publications

Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan

Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan

The impact of ejaculatory dysfunction upon the sufferer and his partner

Challenges in Designing Psychological Treatment Studies for Sexual Dysfunction

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