Pubic Hair Removal and Sexual Behavior: Findings from a Prospective Daily Diary Study of Sexually Active Women in the United States

IntroductionPubic hair removal is prevalent among women in the United States. However, most studies related to pubic hair removal are based on cross‐sectional surveys and retrospective recall.AimThe purpose of this research was to, in a prospective event‐level daily diary study, assess demographic, affective, relational, situational, and behavioral factors related to women's pubic hair removal.MethodData collection occurred as part of a 5‐week prospective, Internet‐based daily diary study.Main Outcome MeasuresAge; Affective predictors (positive mood, negative mood, feeling interested in sex, feeling in love); Relational predictors (partner support, partner negativity, partner type, partner gender); Situational predictors (any vaginal symptoms, use of any vaginal hygiene products; having applied any creams to the genitals); Behavioral variables (penile–vaginal sex, penile–anal sex, had finger inserted into vagina, had clitoris stimulated with fingers, inserted toy into vagina, used vibrator on clitoris, inserted finger into anus, inserted toy into anus, duration of penetration, intensity of penetration).ResultsA total of 2,453 women ages 18 to 68 (mean age 32.69) completed the study, contributing 49,287 total diaries (mean per person 24.5; standard deviation 10.3, median 30); 15.2% of all days (N = 7,362) involved pubic hair waxing or shaving, with the vast majority of hair removal days involving shaving (N = 7,302; 99%). Pubic hair removal was significantly associated with younger age, a greater interest in sex, vaginal fingering, finger–clitoral stimulation, having a casual sex partner, using vaginal hygiene products, and applying cream to the genitals. Hair removal was marginally associated with longer duration of vaginal penetration.ConclusionsThese findings provide greater insight into the factors associated with women's pubic hair removal and their sexual experiences on a day‐to‐day level. Clinical and educational implications are discussed. Herbenick D, Hensel D, Smith NK, Schick V, Reece M, Sanders SA, and Fortenberry JD. Pubic hair removal and sexual behavior: Findings from a prospective daily diary study of sexually active women in the United States. J Sex Med 2013;10:678–685.     

Characteristics of Vibrator Use by Gay and Bisexually Identified Men in the United States

IntroductionRecent reports indicate that vibrator use during solo and partnered sexual activities is common among heterosexual men and women in the United States. However, little research has comprehensively assessed vibrator use among gay and bisexually identified men.AimsThis study sought to document the extent to which gay and bisexually identified men report using vibrators, the sexual and relational situations within which they use them, and how men use vibrators on their own and their partners' bodies.MethodsData were collected from 25,294 gay and bisexually identified men from 50 U.S. states and from the District of Columbia via an internet-based survey.Main Outcome MeasureMeasures included sociodemographics, health-related indicators, sexual behaviors, and those related to recent and past use of vibrators during solo and partnered sexual interactions with other men.ResultsApproximately half (49.8%) of gay and bisexually identified men reported having used vibrators. Most men who had used a vibrator in the past reported use during masturbation (86.2%). When used during partnered interactions, vibrators were incorporated into foreplay (65.9%) and intercourse (59.4%). Men reported frequent insertion of vibrators into the anus or rectum when using them during masturbation (87.3%), which was also common during partnered interactions (~60%), but varied slightly for casual and relationship sex partners. For both masturbation and partnered interactions, men overwhelmingly endorsed the extent to which vibrator use contributed to sexual arousal, orgasm, and pleasure.ConclusionsVibrator use during both solo and partnered sexual acts was common among the gay and bisexually identified men in this sample and was described by men as adding to the quality of their sexual experiences. Reece M, Rosenberger JG, Schick V, Herbenick D, Dodge B, and Novak DS. Characteristics of vibrator use by gay and bisexually identified men in the United States.     

Endogenous Deficiency of Brain-Derived Neurotrophic Factor Induces the Downregulation of Tryptophan Hydroxylase-2 Expression in Raphe Nuclei of Rapid Ejaculator Rats

BackgroundPremature ejaculation (PE) is one of the most common ejaculatory disorders. Recent studies have suggested a close relationship between the serotonin (5-hydroxytryptamine [5-HT]) system and brain-derived neurotrophic factor (BDNF), raising the question of whether BDNF plays a role in ejaculation regulation. To our knowledge, no previous studies have explored BDNF level of the central nervous system in ejaculatory disorders. At the same time, the interaction of central BDNF and 5-HT systems has not been undertaken in ejaculation regulation field.AimThe aim of this study was to investigate the interaction between BDNF and 5-HT levels in raphe nuclei which contains the serotonergic neurons in a rat animal model with different ejaculatory behavior.MethodsEighteen male rats were selected and classified as “sluggish,” “normal,” and “rapid” ejaculators on the basis of ejaculation frequency during copulatory behavioral testing. BDNF and 5-HT levels were determined by enzyme-linked immunosorbent assay (ELISA). Real-Time Quantitative PCR and Western blot analyses were used to measure the mRNA level of Tryptophan Hydroxylase-2 (TPH2) gene and the expression of TPH2 protein (the rate-limiting enzyme in central 5-HT synthesis) in raphe nuclei, respectively.OutcomesMale rat sexual behavior, the levels of BDNF and 5-HT in raphe nuclei of rats with different ejaculatory behavior, the mRNA level of gene encoding TPH2 and the expression of TPH2 protein in raphe nuclei.ResultsThe primary finding of our study was that BDNF concentration was significantly decreased in raphe nuclei of rapid ejaculators. There was a strong positive correlation between the levels of BDNF and 5-HT (r = 0.944, P < .001). Further results showed that decreased TPH2 gene expression accompanied by TPH2 protein was shown in rapid ejaculators with lower BDNF level.Clinical ImplicationsWith refinement of current knowledge, BDNF may eventually serve as a promising biomarker in patients with PE.Strengths & LimitationsThere are no previous studies examining the interaction of the brain BDNF and 5-HT in ejaculation regulation field. The main limitation is the limited sample size.ConclusionBDNF may act via increasing the synthesis of central 5-HT in the process of ejaculation regulation. Our results suggest lack of endogenous BDNF induces the downregulation of TPH2 gene expression and the decrease of 5-HT synthesis in raphe nuclei of rapid ejaculator rats. Huang Y, Peng D, Geng H, et al. Endogenous Deficiency of Brain-Derived Neurotrophic Factor Induces the Downregulation of Tryptophan Hydroxylase-2 Expression in Raphe Nuclei of Rapid Ejaculator Rats. J Sex Med 2021;18:1491–1499.     

Aftercare Needs Following Gender-Affirming Surgeries: Findings From the ENIGI Multicenter European Follow-Up Study

BackgroundWhile much emphasis has been put on the evaluation of gender-affirming surgery (GAS) approaches and their effectiveness, little is known about the health care needs after completion of these interventions.AimTo assess post-GAS aftercare needs using a mixed-method approach and relate these to participant characteristics.MethodsAs part of the ENIGI follow-up study, data was collected 5 years after first contact for gender-affirming treatments in 3 large European clinics. For the current analyses, only participants that had received GAS were included. Data on sociodemographic and clinical characteristics was collected. Standard aftercare protocols were followed. The study focused on participants’ aftercare experiences. Participants rated whether they (had) experienced (predefined) aftercare needs and further elaborated in 2 open-ended questions. Frequencies of aftercare needs were analyzed and associated with participant characteristics via binary logistic regression. Answers to the open-ended questions were categorized through thematic analysis.OutcomesAftercare needs transgender individuals (had) experienced after receiving GAS and the relation to sociodemographic and clinical characteristics.ResultsOf the 543 individuals that were invited for the ENIGI follow-up study, a total of 260 individuals were included (122 (trans) masculine, 119 (trans) feminine, 16 other, 3 missing). The most frequently mentioned aftercare need was (additional) assistance in surgical recovery (47%), followed by consultations with a mental health professional (36%) and physiotherapy for the pelvic floor (20%). The need for assistance in surgical recovery was associated with more psychological symptoms (OR=1.65), having undergone genital surgery (OR=2.55) and lower surgical satisfaction (OR=0.61). The need for consultation with a mental health professional was associated with more psychological symptoms and lower surgical satisfaction. The need for pelvic floor therapy was associated with more psychological symptoms as well as with having undergone genital surgery. Thematic analysis revealed 4 domains regarding aftercare optimization: provision of care, additional mental health care, improvement of organization of care and surgical technical care.Clinical ImplicationsDeeper understanding of post-GAS aftercare needs and associated individual characteristics informs health care providers which gaps are experienced and therefore should be addressed in aftercare.Strengths & LimitationsWe provided first evidence on aftercare needs of transgender individuals after receiving GAS and associated these with participant characteristics in a large multicenter clinical cohort. No standardized data on aftercare received was collected, therefore the expressed aftercare needs cannot be compared with received aftercare.ConclusionThese results underline a widely experienced desire for aftercare and specify the personalized needs it should entail.IJ de Brouwer, E Elaut, I Becker-Hebly et al. Aftercare Needs Following Gender-Affirming Surgeries: Findings From the ENIGI Multicenter European Follow-Up Study. J Sex Med 2021;18:1921–1932.     

A novel, self-guided, home-based intervention to promote condom use among young men: a pilot study

Background

Current HIV prevention programs are often expensive to implement and require significant commitment on the part of participants and staff. These factors limit widespread implementation. Thus, there is an increasingly recognized need to develop and test brief interventions designed to promote safer sex.

Methods

This study tested the potential efficacy of a brief, self-guided, home-based intervention to promote consistent and correct condom use among young men by focusing on condom use skill, enjoyment, and self-efficacy. The central focus of The Kinsey Institute^®Homework Intervention Strategy (KIHIS) is that men practice applying, using, and removing condoms alone (a “low pressure” situation) trying various condoms and lubricants. A repeated measures evaluation compared 2-week, 6-week (n = 28) and 4-month (n = 17) follow-up evaluations to baseline (pre-intervention).

Results

Despite the limited sample size, significant post-intervention improvement was found for condom use experiences, confidence in the ability to use condoms, self-efficacy for condom use, and condom comfort as well as a reduction in breakage and erection problems.

Conclusion

Our findings suggest that the KIHIS, with its inherent potential for easy translation to public health sexually transmitted infection (STI) clinics (requiring very little clinic resources), may have lasting and positive effects on subsequent condom use attitudes, skills, and behaviors.