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T09-P-14 Persistent genital arousal in women: about two case reports
Sexologies.book Page 136 Mercredi, 2. avril 2008 4:36 16
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T09-P-11 The use of an eros device as a possible treatment option for a female diabetic patient complaining of female sexual arousal disorder - a case study S. Nicol. Essex Urology, Colchester, United Kingdom Objective: To examine the use of a clitoral engorgement device - an eros device , -in the treatment of a 52 year old diabetic woman complaining of pain at the point of orgasm. Design and methods: Following assessment and prelminary diagnosis initially of female sexual arousal disorder with subsequent orgasmic dysfunction, the patient was offered a trial of an eros device with regular monthly follow-ups in clinic. the patient recorded her experiences in a diary and noted her levels of pain free arousal.and orgasm, reporting back at follow-up. Psychotherapy was not engaged during the treatment period. Results: After using the device daily, over a trial period of 6 months, the patient reported pain-free orgasms with greatly enhanced sexual pleasure and satisfaction. Conclusions: The use of an eros device may be an acceptable treatment option for diabetic women complaining of female sexual arousal disorder. In the case study, the diary recorded the daily use of the device and the patient reported improved clitoral engorgement, thus enabling her to enjoy pain-free orgasms during sexual activity
T09-P-12 Female genital sensation: our experience L. Piero, G. Alei. Sapienza University of Roma Department of Plastic Surgery, Rome, Italy Neurological pathology may be responsible for female sexual dysfunctions. Thanks to a new instrument called the Genito Sensory Analyzer (GSA), we have evaluated the normalcy curves and deviation standards of the external female genitalia. All tests were executed with the GSA (Genital Sensory Analyzer). The GSA is an instrument of great precision with extremely sensitive software capable of registering measurements in vibration and thermal sensitivity of hot and cold on the various zones researched (integrity and evaluation of the small fibers, callipers A- Delta and C). The tests included 46 women. The criteria for GSA testing included patients with the following: females with genital-urinary track infections, systemic maladies (including alcoholism, etc.), neurological pathologies and obviously psychiatric patients, and patients who abuse narcotics. The areas tested with the GSA were as follows: anterior and posterior vagina, the vulva and clitoris. The normogram regarding sensibility to vibration and temperature is clearly demonstrated. The results for thermal and vibratory testing of the vaginal regions and the
Topic 9: Sexual Dysfunctions clitoris are clinically reliable and repeatable. These results may be evaluated as diagnostic instruments for determining neurological female sexual dysfunctions.
T09-P-13 The importance of the Kegel exercises for the erection of the male and female erectile organs (male and female penis) V. Puppo1, J. Abdulcadir2, A. Mannucci3, L. Catania1,2,4, D. Abdulcadir2. 1Centro Italiano di Sessuologia, Bologna, Italy; 2Centro di Riferimento per La Prevenzione e la Cura delle Complicanze delle Mgf/C Firenze Italy, 3Università degli Studi di Firenze - Dipartimento di Scienze dell' Educazione ai Processi Culturali e Formativi, Firenze, Italy; 4Centro Interdisciplinare per la Ricerca in Sessuologia, Genova, Italy The erection of the male and female erectile organs (male and female penis) consists of three phases: a) latent, b) turgid, c) rigid or muscular. Ischiocavernosum muscles (muscles of erection) are much more developed in male than in female. These muscles are innervated by branches of the pudendal nerve, that originates from Onuf’s nucleus located in the sacral spinal cord. The androgens are responsible of the sexual dimorphism of this nucleus. The tonic contraction of ischiocavernosum muscles during erection is necessary for the rigidity of penis. These muscles, as also the bulbocavernosum muscle (muscle of ejaculation and orgasm), though histologically striated, have a semiautomatic function: ischiocavernosum muscles, together with bulbocavernosum muscle, introduce a continuous involuntary reflected hypertonic contraction during erection. This is necessary not only for the rigidity of the penis, but also for the maintenance of erection. The Kegel exercises allow the contraction of the pubovaginalis (elevator of the prostate in male) and the puborectalis muscles, and of all the perineal muscles and especially of the superficial ones (the most important in sexology): only with these exercises it is possible to train the ischiocavernosum and bulbocavernosum muscles. This training could reduce the post-ejaculatory refractory period that increases in every man with age and could facilitate the erection after a first ejaculation. In elderly men the ejaculation takes place with less strength or without squirting. The Kegel exercises, training bulbocavernosum muscle, are important to prevent and postpose the physiologic reduction of the strength of ejection of the seminal liquid.
T09-P-14 Persistent genital arousal in women: about two case reports G. Santos, L. Fonseca. Coimbra University Hospital, Coimbra, Portugal
Sexologies.book Page 137 Mercredi, 2. avril 2008 4:36 16
Topic 9: Sexual Dysfunctions Female sexual psychophysiology research suggests that women are capable of greater sexual responsiveness than previously thought and can experience genital response in the absence of a subjective experience of sexual arousal. There are some women who report persistent genital arousal, both with and without accompanying distress, providing an idea for dissociation between genital and psychological sexual response. In this article, the authors describe two case reports of women with unprovoked genital arousal, intrusive and troubling genital sensations that did not dissipate with one or many orgasms and persisted for many hours or days. These two women assessed at the Clinical Sexology Department of the Coimbra University Hospital had average age of about thirty years old and were married. They both described a bad relationship with their husbands, refusing to have sex because the arousal triggered by sexual activity, persist after several orgasms in unpleasant way.
T09-P-15 Dysmenorrhea and female sexuality R. Sarracino, R. Rossi. Istituto di Sessuologia Clinica, Roma, Italy Objective: The purpose of this research is to find an association between female sexual dysfunctions and dysmenorrhea to understand the general conditions of the sexual life of woman affected by this disorder. Materials and methods: this study is based on data obtained as a result of two surveys, “survey on female sexual dysfunctions” and “survey on dysmenorrhea”, carried-out with two groups of women, one with dysmenorrhea and another without, both including six age ranges. Results: the indications obtained are agreement with the reference literature that underlines how dysmenorrhea is more frequent in women who present sexual dysfunctions and are unsatisfied with their own life. Nevertheless from the data emerges that there is a variation due to age in the connection between dysmenorrhea and sexuality; particularly the negative impact of dysmenorrhea in several aspects of sexual life is greater in women in the age range 26-31 years. Conclusions: According to the results obtained it is recommended that sexologist becomes part of the team who supports the woman with sexual dysfunctions along with the trouble of the dysmenorrhea.
T09-P-16 Evaluation of sexual function, quality of life and depressive aspects in women affected by type 1 diabetes mellitus M. Tagliabue1, M. Trento2, M. Tomelini2, M. Negro3, C. Gottero1. 1Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Turin, Turin,
S137 Italy; 2Department of Internal Medicine, University of Turin, Turin, Italy; 3Ospedale S. Luigi Gonzaga, Department of Mental Health, University of Turin, Orbassano, Italy Sexual function in healthy and particularly in diabetic women has received little attention from clinical researchers. Aim of the study. a) To define which is the most impaired sexual phase in a group of type 1 diabetic females. b) To study the role of biological, psychological, social and relational factors in the same population. Materials and methods. We evaluated clinical and glycometabolic factors as well as the following psycho-cognitive and social variables: Zung Depression Scale, Diabetes Quality of Life, Body Image Scale, Female Sexual Function Index, Multidimensional Scale of Perceived Social Support. Inclusion criteria: type 1 diabetes mellitus, age >18 years, stable heterosexual relationship for at least 1 year. Results: We enrolled 77 diabetic women (age [mean± SD]: 39.0±10.1 yr; duration of the disease: 16.8±10.1 yr; mean HbA1C: 8.1±1.1%). As expected we found a significant correlation between quality of life and: a) depressive aspects (p<0.05), b) body perception (p=0.001), c) social support (p<0.05). Moreover we found a significant association between Depression Scale and Sexual Function Index (p<0.05). Surprisingly we observed an unexpected correlation between poor metabolic control (expressed as HbA1C levels) and a better sexual function (in specific desire, arousal and orgasm). Conclusions. In women affected by type 1 diabetes mellitus psychological factors seem to be predominant with respect to somatic ones; in particular we suppose that a good metabolic control could reflect an attitude to “control” both glucose monitoring and sexual life.
T09-P-17 Type of therapy and sexual functioning among the patients with gynecological tumors S. Tosic Golubovic1, N. Djordjevic2, D. Gugleta2, V. Sibinovic2. 1Medical Faculty, Nis, Serbia; 2Psychiatry Clinic, Nis, Serbia Objective: Complex medical treatment of gynecological tumors includes hemio, surgical and radiation therapy, and may result with recovery, but also with a potential risk of emerging sexual dysfunctions, as well as numerous psychologies, such as: depression, anxiety, loose of libido and orgasm, surgical disruption of the self concept of femiity. This study was an attempt to explore and compare sexual functioning, depending on a type of therapy, before surgery and one year latter, in a period when the final postoperative anatomy was made up. Method: We took a prospective investigation at the University Clinical Center Nis, with a total sample divided in 3 groups, the first group of patients which underwent hysterectomy, than the second group, ones which underwent radiation and the third one, patients that received mixed therapy (surgical and radiation). Except the interview technique, all the patients responded to question-
S136
T09-P-11 The use of an eros device as a possible treatment option for a female diabetic patient complaining of female sexual arousal disorder - a case study S. Nicol. Essex Urology, Colchester, United Kingdom Objective: To examine the use of a clitoral engorgement device - an eros device , -in the treatment of a 52 year old diabetic woman complaining of pain at the point of orgasm. Design and methods: Following assessment and prelminary diagnosis initially of female sexual arousal disorder with subsequent orgasmic dysfunction, the patient was offered a trial of an eros device with regular monthly follow-ups in clinic. the patient recorded her experiences in a diary and noted her levels of pain free arousal.and orgasm, reporting back at follow-up. Psychotherapy was not engaged during the treatment period. Results: After using the device daily, over a trial period of 6 months, the patient reported pain-free orgasms with greatly enhanced sexual pleasure and satisfaction. Conclusions: The use of an eros device may be an acceptable treatment option for diabetic women complaining of female sexual arousal disorder. In the case study, the diary recorded the daily use of the device and the patient reported improved clitoral engorgement, thus enabling her to enjoy pain-free orgasms during sexual activity
T09-P-12 Female genital sensation: our experience L. Piero, G. Alei. Sapienza University of Roma Department of Plastic Surgery, Rome, Italy Neurological pathology may be responsible for female sexual dysfunctions. Thanks to a new instrument called the Genito Sensory Analyzer (GSA), we have evaluated the normalcy curves and deviation standards of the external female genitalia. All tests were executed with the GSA (Genital Sensory Analyzer). The GSA is an instrument of great precision with extremely sensitive software capable of registering measurements in vibration and thermal sensitivity of hot and cold on the various zones researched (integrity and evaluation of the small fibers, callipers A- Delta and C). The tests included 46 women. The criteria for GSA testing included patients with the following: females with genital-urinary track infections, systemic maladies (including alcoholism, etc.), neurological pathologies and obviously psychiatric patients, and patients who abuse narcotics. The areas tested with the GSA were as follows: anterior and posterior vagina, the vulva and clitoris. The normogram regarding sensibility to vibration and temperature is clearly demonstrated. The results for thermal and vibratory testing of the vaginal regions and the
Topic 9: Sexual Dysfunctions clitoris are clinically reliable and repeatable. These results may be evaluated as diagnostic instruments for determining neurological female sexual dysfunctions.
T09-P-13 The importance of the Kegel exercises for the erection of the male and female erectile organs (male and female penis) V. Puppo1, J. Abdulcadir2, A. Mannucci3, L. Catania1,2,4, D. Abdulcadir2. 1Centro Italiano di Sessuologia, Bologna, Italy; 2Centro di Riferimento per La Prevenzione e la Cura delle Complicanze delle Mgf/C Firenze Italy, 3Università degli Studi di Firenze - Dipartimento di Scienze dell' Educazione ai Processi Culturali e Formativi, Firenze, Italy; 4Centro Interdisciplinare per la Ricerca in Sessuologia, Genova, Italy The erection of the male and female erectile organs (male and female penis) consists of three phases: a) latent, b) turgid, c) rigid or muscular. Ischiocavernosum muscles (muscles of erection) are much more developed in male than in female. These muscles are innervated by branches of the pudendal nerve, that originates from Onuf’s nucleus located in the sacral spinal cord. The androgens are responsible of the sexual dimorphism of this nucleus. The tonic contraction of ischiocavernosum muscles during erection is necessary for the rigidity of penis. These muscles, as also the bulbocavernosum muscle (muscle of ejaculation and orgasm), though histologically striated, have a semiautomatic function: ischiocavernosum muscles, together with bulbocavernosum muscle, introduce a continuous involuntary reflected hypertonic contraction during erection. This is necessary not only for the rigidity of the penis, but also for the maintenance of erection. The Kegel exercises allow the contraction of the pubovaginalis (elevator of the prostate in male) and the puborectalis muscles, and of all the perineal muscles and especially of the superficial ones (the most important in sexology): only with these exercises it is possible to train the ischiocavernosum and bulbocavernosum muscles. This training could reduce the post-ejaculatory refractory period that increases in every man with age and could facilitate the erection after a first ejaculation. In elderly men the ejaculation takes place with less strength or without squirting. The Kegel exercises, training bulbocavernosum muscle, are important to prevent and postpose the physiologic reduction of the strength of ejection of the seminal liquid.
T09-P-14 Persistent genital arousal in women: about two case reports G. Santos, L. Fonseca. Coimbra University Hospital, Coimbra, Portugal
Sexologies.book Page 137 Mercredi, 2. avril 2008 4:36 16
Topic 9: Sexual Dysfunctions Female sexual psychophysiology research suggests that women are capable of greater sexual responsiveness than previously thought and can experience genital response in the absence of a subjective experience of sexual arousal. There are some women who report persistent genital arousal, both with and without accompanying distress, providing an idea for dissociation between genital and psychological sexual response. In this article, the authors describe two case reports of women with unprovoked genital arousal, intrusive and troubling genital sensations that did not dissipate with one or many orgasms and persisted for many hours or days. These two women assessed at the Clinical Sexology Department of the Coimbra University Hospital had average age of about thirty years old and were married. They both described a bad relationship with their husbands, refusing to have sex because the arousal triggered by sexual activity, persist after several orgasms in unpleasant way.
T09-P-15 Dysmenorrhea and female sexuality R. Sarracino, R. Rossi. Istituto di Sessuologia Clinica, Roma, Italy Objective: The purpose of this research is to find an association between female sexual dysfunctions and dysmenorrhea to understand the general conditions of the sexual life of woman affected by this disorder. Materials and methods: this study is based on data obtained as a result of two surveys, “survey on female sexual dysfunctions” and “survey on dysmenorrhea”, carried-out with two groups of women, one with dysmenorrhea and another without, both including six age ranges. Results: the indications obtained are agreement with the reference literature that underlines how dysmenorrhea is more frequent in women who present sexual dysfunctions and are unsatisfied with their own life. Nevertheless from the data emerges that there is a variation due to age in the connection between dysmenorrhea and sexuality; particularly the negative impact of dysmenorrhea in several aspects of sexual life is greater in women in the age range 26-31 years. Conclusions: According to the results obtained it is recommended that sexologist becomes part of the team who supports the woman with sexual dysfunctions along with the trouble of the dysmenorrhea.
T09-P-16 Evaluation of sexual function, quality of life and depressive aspects in women affected by type 1 diabetes mellitus M. Tagliabue1, M. Trento2, M. Tomelini2, M. Negro3, C. Gottero1. 1Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Turin, Turin,
S137 Italy; 2Department of Internal Medicine, University of Turin, Turin, Italy; 3Ospedale S. Luigi Gonzaga, Department of Mental Health, University of Turin, Orbassano, Italy Sexual function in healthy and particularly in diabetic women has received little attention from clinical researchers. Aim of the study. a) To define which is the most impaired sexual phase in a group of type 1 diabetic females. b) To study the role of biological, psychological, social and relational factors in the same population. Materials and methods. We evaluated clinical and glycometabolic factors as well as the following psycho-cognitive and social variables: Zung Depression Scale, Diabetes Quality of Life, Body Image Scale, Female Sexual Function Index, Multidimensional Scale of Perceived Social Support. Inclusion criteria: type 1 diabetes mellitus, age >18 years, stable heterosexual relationship for at least 1 year. Results: We enrolled 77 diabetic women (age [mean± SD]: 39.0±10.1 yr; duration of the disease: 16.8±10.1 yr; mean HbA1C: 8.1±1.1%). As expected we found a significant correlation between quality of life and: a) depressive aspects (p<0.05), b) body perception (p=0.001), c) social support (p<0.05). Moreover we found a significant association between Depression Scale and Sexual Function Index (p<0.05). Surprisingly we observed an unexpected correlation between poor metabolic control (expressed as HbA1C levels) and a better sexual function (in specific desire, arousal and orgasm). Conclusions. In women affected by type 1 diabetes mellitus psychological factors seem to be predominant with respect to somatic ones; in particular we suppose that a good metabolic control could reflect an attitude to “control” both glucose monitoring and sexual life.
T09-P-17 Type of therapy and sexual functioning among the patients with gynecological tumors S. Tosic Golubovic1, N. Djordjevic2, D. Gugleta2, V. Sibinovic2. 1Medical Faculty, Nis, Serbia; 2Psychiatry Clinic, Nis, Serbia Objective: Complex medical treatment of gynecological tumors includes hemio, surgical and radiation therapy, and may result with recovery, but also with a potential risk of emerging sexual dysfunctions, as well as numerous psychologies, such as: depression, anxiety, loose of libido and orgasm, surgical disruption of the self concept of femiity. This study was an attempt to explore and compare sexual functioning, depending on a type of therapy, before surgery and one year latter, in a period when the final postoperative anatomy was made up. Method: We took a prospective investigation at the University Clinical Center Nis, with a total sample divided in 3 groups, the first group of patients which underwent hysterectomy, than the second group, ones which underwent radiation and the third one, patients that received mixed therapy (surgical and radiation). Except the interview technique, all the patients responded to question-