Preliminary Evaluation of Sexual Problems in Combat Veterans with PTSD

This study evaluated the potential relationship between posttraumatic stress disorder (PTSD) and sexual problems. The Golombok Rust Inventory of Sexual Satisfaction was mailed to combat veterans currently in treatment at an outpatient PTSD clinic. Completed questionnaires were received from 90 patients. Results indicated that over 80% of subjects were experiencing clinically relevant sexual difficulties. Impotence and premature ejaculation were the most frequently reported problems that have corresponding psychological diagnoses. The rates of sexual problems for this sample of veterans with PTSD was similar to those reported in other studies and exceeded rates of similar problems found in samples from community samples. These data suggest mat PTSD may be a risk factor for sexual problems.     

Ethical Issues in Psychotherapy

Abstract: The goal of psychotherapy is not only the dissolution of the symptoms, but also to attempt to bring about an improvement in adaptability and deepening the achievement of self-understanding. The nature of psychotherapy is based on the relationship between the therapist and patient. Such a goal and nature mean that some kinds of psychotherapy are beyond the medical model. In this paper ethical issues in psychotherapy are discussed as follows. 1) some complicated matters in informed-consent, 2) the hit or miss techniques of the poorly trained therapist, 3) the protection of privacy, 4) the sexual misconduct of therapists with patients, 5) special consideration for child-adolescent patients.     

Childhood precursors of age at first intercourse for females

Age at first intercourse for a sample of adult white women using variables measured during childhood is predicted. Childhood predictors were measured at birth, and ages 5 and 9–11, using existing public-use data on the women. Median age at first intercourse for the sample was 17.5 years. Early family predictors, early developmental characteristics, and temperamental characteristics during childhood together could predict about a fourth of the variance in age at first intercourse. The strongest predictors were motor skills and nightmares at age 5, church attendance with family at age 9, and domineering and mature personality at age 9.This research was supported by grants R01-HD23454 and P30-HD05798 from the National Institute of Child Health and Human Development. An earlier version of this paper was presented at the annual meetings of the Population Association of America, Denver, Colorado, April 30–May 2, 1992.     

镇痛灵对雄性1型糖尿病大鼠性功能的影响

目的 :本实验以成年雄性大鼠为研究对象 ,观察和探讨中药镇痛灵对糖尿病大鼠性功能的影响。　方法 :3～ 5月龄雄性Wistar大鼠 32只 ,随机分为糖尿病组 2 2只 ,正常对照组 10只。 72h后 ,将造模成功的糖尿病大鼠随机分为 2组 :未治疗组 ;镇痛灵治疗组。第 5周测血糖 ,阿朴吗啡勃起实验后 ,乙醚麻醉下断头取血 ,分离血清 ,取一侧睾丸组织制成匀浆液 ,测定血清及组织匀浆中NO及NOS水平。　结果 :糖尿病大鼠与正常对照组比较 ,血清NO、NOS明显降低 ,差异有高度显著性 (P <0 .0 0 1) ;镇痛灵治疗组血清NO、NOS值与未治疗组比较明显升高 ,差异有显著性 (P <0 .0 1) ;阿朴吗啡勃起实验证实 ,镇痛灵治疗组大鼠阴茎勃起次数明显多于未治疗组 ,差异有显著性(P <0 .0 1) ,而与正常对照组比较 ,差异无显著性 (P >0 .0 5 )。　结论 :复方中药合剂镇痛灵有降血糖作用 ,对糖尿病并发的性功能障碍有一定治疗作用。     

Tadalafil in the treatment of erectile dysfunction; an overview of the clinical evidence

Prevalence and severity of erectile dysfunction (ED) increase with aging and are often associated with illnesses, like diabetes mellitus, heart disease, and hypertension, pathologically characterized by endothelial dysfunction and whose prevalence increases with age. The assumption that ED is mainly a neurovascular disease is supported by the evidence that specific phosphodiesterase type 5 (PDE5) inhibition produces an efficient erection in a wide range of ages and conditions. The availability of specific PDE5 inhibitors has enabled the development of effective treatment strategies, in this contest, tadalafil may be considered as the least “typical” PDE5 inhibitor. In clinical trials, tadalafil significantly enhanced, in patients of different ages, all efficacy outcomes across disease etiologies and severities. With an effectiveness lasting up to 36h, tadalafil allows patients to choose when to have sexual activities without the need to time it, showing positive feedback in terms of quality of life related to the treatment. Headache and dyspepsia were the most frequent side-effects of tadalafil, followed by back pain, nasal congestion, myalgia, and flushing, but the impact that long time action could have on effectiveness and safety is not yet entirely defined. The aim of this article is to critically review the available evidence from the tadalafil clinical research program and give the physician a rational approach for intervention in the treatment of ED and related diseases.     

Clozapine acts as a 5-HT2 antagonist by attenuating DOI-induced inhibition of male rat sexual behaviour

Evidence has been reported that clozapine may derive part of its therapeutic effects in treatment-resistant schizophrenic patients by interacting with the serotonin system. Among the few behavioural models available to test the hypothesis of an interaction of clozapine with 5-HT₂ receptors, male rat sexual behaviour is particularly useful, since in this behaviour 5-HT_1A and 5-HT₂ receptors have opposite functions. Stimulation of 5-HT_1A receptors facilitates ejaculatory behaviour and stimulation of 5-HT₂ receptors inhibit ejaculation. In the present study, male rat sexual behaviour was depressed by treatment with DOI (1.0 mg/kg), a selective 5-HT₂ receptor agonist. The depressive effect of DOI was attenuated by the administration of clozapine (0.1–1.0 mg/kg) in doses that by themselves did not significantly affect sexual behaviour. It was concluded that clozapine in the male rat sexual behaviour model may be interpreted as serving as a 5-HT₂ antagonist.     

男性肝硬化患者血清睾丸酮、雌二醇水平

本文观察了80例男性肝炎后肝硬化患者。检测了血清睾丸酮（T），雌二醇（E2）水平及E2／T比值的变化。与正常对照组及脑血管意外对照组进行了统计比较，发现E2及E2／T比值升高，T值降低2与对照组间比较均有显著差异，但肝硬化各组间无明显差异。文中分析了检测结果并探讨了与性功能变化的关系。认为性功能降低可能是由于血清睾丸酮水平降低所致。     

Role of Estrogens on Human Male Reproductive System

This review focuses on estrogen role on human male physiology. Biological estrogen actions on male reproductive system are summarized with particular regard to the effects of congenital estrogen deprivation in men. The effects of estrogen on spermatogenesis, hormonal secretion and gonadotropin feedback and on sexual behavior are discussed. It is remarked that the role of estrogens in male reproduction is a very recent acquisition in reproductive endocrinology, but it promises new future fields of research to be investigated as well as the possible disclosure of new strategies in clinical practice.     

中药生精冲剂对精索静脉曲张大鼠的治疗

目的：研究中药生精冲剂对大鼠精索静脉曲张的影响及疗效。方法：从80只SD雄性大鼠中随机抽出20只作为假手术组，余60只均建立精索静脉曲张病理模型后随机均分为模型组、生精冲剂组和克罗米芬组。造模后15d生精冲剂组和克罗米酚组分别给予生精冲剂4g/（kg·d）和克罗米芬20mg/（kg·d）灌胃，模型组和假手术组正常喂食。造模后45d放免法测定血清性激素（FSH、LH和T）及观察各组大鼠睾丸组织结构。结果：生精冲剂组大鼠光镜下睾丸组织结构优于模型组和克罗米芬组；血清FSH、LH生精冲剂组显著低于模型组和克罗米芬组（P〈0.05），而克罗米芬组显著高于其他3组。T在生精冲剂组、克罗米芬组和假手术组之间无显著差异，但均显著高于模型组（P〈0.05）。结论：中药生精冲剂对精索静脉曲张引起的睾丸损害有保护及修复作用，且可能优于克罗米芬。     

Hypersexual Desire in Males: An Operational Definition and Clinical Implications for Males with Paraphilias and Paraphilia-Related Disorders

The longitudinal history and temporal stability of total sexual outlet (TSO) in a group of outpatient males with paraphilias (PA) and paraphilia-related disorders (PRD) was assessed. Based on extant normative data from contemporary population-based surveys of sexual behavior, it was hypothesized that a persistent TSO of 7 or more orgasms/week for a minimum duration of 6 months be considered as the lower boundary for hypersexual desire in males. In almost all statistical analyses, the PA (n = 65) and PRD (n = 35) groups were not statistically different. The mean current TSO (PA, 7.4 ± 5.7; PRD, 8.0 ± 4.2) as well as the current average time consumed in all unconventional sexual behaviors (1–2 hr/day) were not statistically different. Unconventional sexual behaviors (i.e., related to PAs or PRDs) leading to orgasm constituted 77% of current TSO. In the combined group (n = 100), 72% (n = 72) reported a hypersexual TSO of 7 or greater. Age of onset of hypersexual TSO in the PAs (19.2 ± 6.8 years; range 10–43) and the PRDs (21.0 ± 8.6; range 10–46) and the duration of hypersexual TSO (PA, 11.1 ± 11.2 years; PRD, 10.5 ± 9.1) were not significantly different. Fifty-seven males (57%) reported a TSO of 7 or more for a minimum duration of 5 years. Clinical implications of reconceptualizing PAs and PRD as sexual desire disorders are discussed.