Journal of Sex & Marital Therapy

doi: 10.1080/0092623039015461pmid: 14504011

Dear Dr. Segraves: We read with great interest the article by Burchardt et al. (2002) on sexual dysfunction in women with hypertension. Female sexual dysfunction (FSD) is prevalent, affecting up to 50% of women according to some studies (Laumann, Paik, & Rosen, 1999). Therefore, it is an important area in which to focus further research. Although a number of multidimensional instruments have been developed to assess sexual function, the Brief Index of Sexual Functioning for Women (BISF-W) was used in this study to assess sexual dysfunction in hypertensive women. This instrument, a 22-item selfreport questionnaire assessing levels of female sexual function, was meant to be used by both healthy women and those affected by medical or psychological conditions potentially impacting sexual function (Taylor, Rosen, & Leiblum, 1994). Although this instrument is appropriate to use in this setting, several problems exist with its use in Burchardt’s article.

doi: 10.1080/0092623039015470pmid: N/A

Dear Taylor: We read with interest the comments of the colleagues from the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine. We agree that the although the Brief Index of Sexual Functioning for Women (BISF-W; Mazer, Leiblum, & Rosen, 2000) is appropriate for this study, other instruments have been developed and could be used alternately. The new scoring system for the BISF-W was not used in this descriptive study. We also agree with the hypothesis that hypertension-associated vasculopathy may impair arousal and orgasm. The diagnosis of female sexual dysfunction (FSD) was based on an affirmative answer to the question “Have you had problems with sexual function,” and this was stated in the Results section.

ZUCKER, KENNETH J.; BLANCHARD, RAY

doi: 10.1080/00926230390195489pmid: 14504013

In a recent issue of Gender and Psychoanalysis, Heinemann (2000) published an essay on the fakafefine of Tonga, who appear to be equivalent to the Western transsexuals (individuals with gender identity disorder); they exhibit a predominant homosexual sexual orientation (i.e., sexual attraction to members of one’s birth sex) and are biological males. Indeed, Subject A told Heinemann that “I would like to have a female body. I would save money for an operation, like in America.”

CONAGLEN, HELEN M.; CONAGLEN, JOHN V.

doi: 10.1080/00926230390195498pmid: 14504014

Women presenting with hirsuties/polycystic ovary syndrome have increased production of androgens. Clinical lore suggests that these women may have increased sexual desire. Treatment of hirsuties commonly involves antiandrogen therapy, a form of therapy with a potential for reducing sexual desire. The present study investigated sexual desire in 29 hirsute women aged 19 to 43 years presenting for therapy. We conducted a questionnaire appraisal of the women’s sexual desire, body and self-esteem, and affect at baseline, 3 months, and 12 months and compared the data with a control group of 30 nonhirsute women of similar mean age. Those in the treatment group also had their Ferriman and Gallwey scores and body mass indices calculated at baseline and end of study for those in the treatment group. We determined hormone levels for those in the treatment group with baseline blood tests. Our hypotheses were that the hirsute women would experience different levels of sexual desire than the control group prior to therapy and that therapy would have a demonstrable effect on the self-reported sexual desire of these women. The study demonstrated that women with hirsuties had mean levels of sexual desire and body esteem that were significantly lower than the control group women. During the year-long course of therapy, the sexual desire levels of the hirsute women decreased progressively, while their self-esteem increased. The women’s Ferriman and Gallwey scores fell, indicating diminishing hirsutism. These findings provide empirical data upon which clinicians can base advice to patients seeking therapy.

BABAEE, GHOLAMREZA; JAMALI, B.; MIRMOHAMMAD ALI, M.

doi: 10.1080/00926230390195506pmid: 14504015

The aim of this study was to investigate women’s knowledge about and attitude toward emergency contraception (EC) in women who referred to health centers of Tehran University of Medical Science. The subjects in this study consisted of 250 married women of fertility age who had been selected randomly and interviewed by the researcher. The majority of the subjects had not used EC. Just 5.2% (13 women) had used this method and 8.31% had knowledge and information about EC. There was a significant correlation between knowledge about and use of this method (p = 0.0001). Although the users of this method were more knowledgeable about EC than nonusers, a majority of subjects (76.57%) had a positive attitude toward EC; however, there was not a significant correlation between positive attitude and use of EC (p = 0.184).

KABAKÇI, ELIF; BATUR, SENAR

doi: 10.1080/00926230390195515pmid: 14504016

The purpose of this study was to investigate the characteristics of a group of Turkish vaginismus patients who benefited from Cognitive Behavioral Therapy (CBT) and to study which factors this treatment model changes. Twenty-eight couples who applied to Psychiatry Clinic of Hacettepe University Hospital, Ankara, for treatment of vaginismus within the 6-month period participated in the study. Fourteen subjects quit the therapy after the initial assessment sessions. Other couples successfully completed the treatment. We assessed all the couples that completed the CBT at three times: during the initial session, at the end of the treatment, and during the follow-up session (4 weeks after the end of the treatment). In terms of anxiety levels, and quality of marital and sexual relationships, the characteristics of the couples that quit the therapy could not be identified. But we found that all of the participants were treated effectively by CBT. At the end of the therapy, anxiety levels of the women decreased. There also were improvements on parameters related to marital harmony and overall sexual functioning of the women. We discuss the findings of our study within a cultural perspective.

ROSENBERG, KENNETH PAUL; BLEIBERG, KATHRYN L.; KOSCIS, JAMES; GROSS, CHARLES

doi: 10.1080/00926230390195524pmid: 14504017

Few studies have addressed the effects that iatrogenic sexual side effects have on compliance in the severely mentally ill. The objective of this survey was to assess the levels of self-reported iatrogenic sexual dysfunction within a sample of 51 severely mentally ill outpatients taking a variety of psychiatric medications and to assess the impact of sexual side effects on medication compliance. We found that 62.5% of males and 38.5% of females felt that their psychiatric medications were causing sexual side effects. Despite the fact that they were experiencing sexual side effects, 50% of the subjects “never or infrequently” spoke about sexual functioning with their primary mental health care providers. In particular, women with sexual side effects rarely discussed sex, in fact, 80% of women with sexual side effects failed to discuss sexual dysfunction with their mental health care providers. We found that the presence of sexual side effects affected compliance. We found that 41.7% of men and 15.4% of women admitted that they had stopped their medications at some point during their treatment based on a belief that they were experiencing sexual side effects.

AIZENBERG, DOV; WEIZMAN, ABRAHAM; BARAK, YORAM

doi: 10.1080/00926230390195533pmid: 14504018

Treatment with antidepressants, especially agents with potent serotonergic effects, is frequently associated with sexual side effects. In the present study, we examined the efficacy of sildenafil, a potent phosphodiesterase inhibitor, in the treatment of elderly men (n = 10; 70-81 years) with erectile dysfunction induced by antidepressant treatment for major depressive disorder. Eligible subjects were instructed to add sildenafil (25-50 mg/day) to their current drug treatment. Clinical assessment of erectile function was performed at beginning of treatment with sildenafil and at follow up, 4 weeks later. All patients reported an improvement of their erectile capacity, and in 7 out of 10 subjects, erectile function returned to a normal level. Sildenafil appears to be a safe and well-tolerated agent in elderly subjects. We noted side effects in 2 patients (flashes), but the side-effects were bothersome only to one patient (headache). It appears that sildenafil coadministration improves erectile dysfunction associated with selective serotonin reuptake inhibitor ongoing treatment in elderly patients.

McCABE, MARITA P.; McKERN, SUZANNE; McDONALD, ELIZABETH; VOWELS, LINDSAY M.

doi: 10.1080/00926230390195506-2372pmid: 14504019

Relationship and sexual satisfaction among people with multiple sclerosis (MS) has received little research attention. This article reports on a longitudinal investigation of the impact of coping style and illness-related variables among people with MS and the general population on sexual and relationship functioning. Both men (n = 120) and women (n= 201) with MS and men (n = 79) and women (n = 160) from the general population participated in the study at two points in time, 6 months apart. People with MS experienced lower levels of sexual activity, sexual satisfaction, and relationship satisfaction and higher levels of sexual dysfunction. Generally speaking, the time 1 levels of the health and coping variables explained little of the variance in the time 2 sexual and relationship variables. However, sexual activity at time 1 contributed significant unique variance to relationship satisfaction at time 2 for MS men, and coping strategies at time I contributed to relationship satisfaction among general population women at time 2. Furthermore, for those respondents who had been diagnosed with MS for less than 7 years, levels of sexual activity at time 2 were predicted by levels of sexual and relationship satisfaction, as well as levels of sexual activity at time 1. These results suggest that strategies used to cope with illness may not play a major role in sexual and relationship satisfaction. However, an examination of these strategies over a longer time frame is needed.

doi: 10.1080/00926230390195443pmid: N/A

Lesbian Love and Relationships, edited by Suzanna M. Rose. Binghamton: Harrington Park Press, 2002, 166 pages, $14.95 (paperback).