Genital Image,Sexual Anxiety,and Erectile Dysfunction Among Young Male Military Personnel

IntroductionMore than a third of young military personnel report experiencing some level of erectile dysfunction (ED). Preoccupation with body image, particularly genitals, is a distraction that can influence sexual anxiety (SA) and sexual functioning problems (SFPs), particularly ED.AimsThis study assessed the relationships between male genital self-image (MGSI), SA, and ED in a sample of male military personnel age 40 or younger.MethodsData were from a larger study on SFPs in military populations. This sample consisted of 367 male military personnel age 40 or younger. Hierarchical regression analyses and process modeling using mediation analysis were performed to examine the effects of MGSI on ED with SA as an intermediate variable. We predicted that SA would mediate the relationship between MGSI and ED.Main Outcome MeasuresED severity was assessed with the International Index of Erectile Function. MGSI was assessed using the MGSI Scale. SA was assessed with the SA subscale of the Sexual Needs Scale.ResultsAs hypothesized, greater satisfaction with MGSI was predictive of significantly lower SA (F[8, 352] = 4.07, P = 0.001) and lower ED (F[8, 352] = 13.20, P = 0.001). Lower levels of SA were predictive of lower levels of ED (F[8, 354] = 21.35, P < 0.001). Additionally, results also revealed a significant indirect effect of MGSI on ED through SA (b = −0.07, standard error = 0.03, confidence interval = [−0.14,−0.02], P < 0.05), indicating mediation of MGSI on ED via SA.ConclusionsThis study underscores the complex etiologic basis of SFPs, particularly ED, and highlights the importance of considering psychologic contributors to ED, such as SA and MGSI. Strategies aimed at reducing SA may be useful in improving ED in young military populations and are worth considering as complements to strategies that improve SFPs. Wilcox SL, Redmond S, and Davis TL. Genital image, sexual anxiety, and erectile dysfunction among young male military personnel. J Sex Med 2015;12:1389–1397.     

Female Sexual Dysfunction Among Egyptian Patients with Chronic Hepatitis C

IntroductionChronic hepatitis C is associated with many extrahepatic manifestations that impact and impair the quality of life. Hepatitis C virus (HCV) infection has a high prevalence in Egypt and carries with the diagnosis many social impacts and stigmatization correlates that further impair social function. This might negatively impact patients and their sexual function. Sexuality and sexual function have not been studied well in patients with HCV, especially in women.AimTo investigate sexual dysfunction in Egyptian women with chronic hepatitis C.Main Outcome MeasuresFemale Sexual Function Index (FSFI) scores of patients with hepatitis C, both total and for individual domains, were compared with those of controls.MethodsThe self‐administered FSFI questionnaire was completed by 112 sexually active female patients with chronic hepatitis C without liver cirrhosis prior to initiation of therapy by pegylated interferon and ribavirin. Their results were compared to those of 225 age‐ and socioeconomic class‐matched sexually active healthy females.ResultsSignificantly more patients than controls had questionnaire scores below the threshold of female sexual dysfunction (FSD) (79% vs. 21%, P < 0.05), and the mean total score for the patients was significantly lower than that for controls (19.54 ± 6.2 vs. 28.43 ± 4.9 P < 0.001). The patients' scores in all domains of the questionnaire were significantly lower than those of the controls.ConclusionChronic hepatitis C negatively impacts female sexual function, affecting all domains of the sex cycle; this warrants further studies and needs to be addressed as part of a comprehensive therapy plan to improve patients' quality of life. Elshimi E, Morad W, Mohamad NE, Shebl N, and Waked I. Female sexual dysfunction among Egyptian patients with chronic hepatitis C. J Sex Med 2014;11:768–775.     

Sexual Dysfunction Among Young Men: Overview of Dietary Components Associated With Erectile Dysfunction

Background

Sexual dysfunction is relatively common in young men, presenting in diverse manifestations, including erectile dysfunction (ED), for which dietary modifications, including increased intake of dietary antioxidants, have been suggested as promising and cost-efficient approaches.

Ruptured uterus: a study of 100 consecutive cases in Ilorin, Nigeria.

OBJECTIVES: To determine the incidence, aetiology, trend, management maternal and fetal outcome of uterine rupture at University of Ilorin Teaching Hospital, Ilorin, Nigeria. To compare the results with previous reports from this centre. MATERIALS AND METHODS: A prospective study of patients with ruptured uterus at the University of Ilorin Teaching Hospital, Ilorin, Nigeria between February, 1992 and December, 1999 was undertaken. The patients were initially assessed in the labour ward where the clinical presentation, relevant socio-demographic data, previous medical and surgical histories were noted. Necessary investigations and resuscitation were carried out before the operation. A structured questionnaire was also administered either before or after the operation. Two consecutive spontaneous vaginal deliveries following each case of uterine rupture served as control. Statistical analysis was done using the Genstat 32 package. RESULTS: Of the 20,960 deliveries during the study period, there were 100 ruptured uteri giving a hospital incidence of 1 in 210 deliveries. Oxytocin use (39%), uterine scar (23%) and obstructed labour (16%) were the common associated factors. When compared with the controls, uterine rupture in the study group was significantly associated with low socio-economic status p < 0.001, lack of antenatal care p < 0.001, and high parity p < 0.012. A maternal age 40 years and above was also a risk factor. The anterior wall of the uterus was the commonest site affected and repair with tubal ligation was the surgical procedure in 36% of cases. Maternal mortality was 13%, while fetal mortality was 92%. When compared with the previous incidence of 1 in 298 deliveries, a slight increase is noted. CONCLUSION: Ruptured uterus is still a common obstetric hazard in our environment and its incidence appears to be on the increase. The condition is significantly associated with advanced maternal age, grandmultiparity, lack of antenatal care and the low socio-economic status of the patients.     

Sexual Dysfunction and Distress Among Childhood Sexual Abuse Survivors: The Role of Post-Traumatic Stress Disorder

BackgroundResearch has revealed that survivors of childhood sexual abuse (CSA) have elevated sexual dysfunction and distress. Nevertheless, a vast majority of studies examining sexual dysfunction and distress among CSA survivors were conducted among women only, and the moderating role of post-traumatic stress disorder (PTSD) symptoms between a history of CSA and sexual dysfunction and distress is yet to be investigated.AimTo fill this gap, the present study aimed to investigate the following: (i) are there sex differences in the relations between CSA and sexual dysfunction and distress and (ii) whether PTSD symptoms mediate the relations between CSA and sexual dysfunction and distress.MethodsThis study was conducted online among 792 Israeli men and women aged 18–70 years; among whom, 367 reported a history of CSA.OutcomesThe findings of the present study suggest that PTSD symptoms mediate the relations between CSA and sexual dysfunction and distress.ResultsResults indicated that those who had a history of CSA reported elevated sexual dysfunction and sexual distress, as compared with non-abused participants, regardless of their sex. Furthermore, PTSD symptoms were related to sexual dysfunction and sexual distress and mediated the relations between a history of CSA and sexual dysfunction and distress. A history of CSA predicted elevated PTSD symptoms, which in turn, were related to elevated sexual dysfunction and distress. Clinical interventions for CSA survivors should incorporate various treatment approaches to alleviate both PTSD symptoms and sexual dysfunction and distress.Clinical translationThe present findings indicate the need for clinicians to identify PTSD symptoms and to conjoin distinctive treatment approaches to relieve survivors’ PTSD symptoms, as well as their sexual dysfunction and distress.Strengths & limitationsThe study included a non-clinical, convenience sample and used self-report measures, which are highly subjective and increase the possibility of social desirability biases. However, on the plus side, it provides important information on CSA survivor’s sexual functioning and can assist in establishing intervention goals, and to evaluate treatment.ConclusionPTSD symptoms were found to mediate the relations between a history of CSA and sexual dysfunction and distress, implying that PTSD symptoms serve as a mechanism underlying sexual dysfunction and distress among CSA survivors.Gewirtz-Meydan A, Lahav Y. Sexual Dysfunction and Distress Among Childhood Sexual Abuse Survivors: The Role of Post-Traumatic Stress Disorder. J Sex Med 2020;17:2267–2278.     

A sixteen year survey of maternal mortality associated with eclampsia in Ilorin, Nigeria

An analysis was made of 94 maternal deaths following eclampsia, occurring over a 16-year period. Maternal deaths were high in the very young, primigravida and in elderly women of higher parity. The overall maternal mortality over the years appears the same; while mortality associated with eclampsia seems dependent on time. Factors attributed to high maternal death rate from eclampsia are examined and recommendations made as to their prevention.     

Behavior and Symptom Change Among Women Treated with Placebo for Sexual Dysfunction

IntroductionIn clinical trials of drug treatments for women's sexual dysfunction, placebo responses have often been substantial. However, little is known about the clinical significance, specificity, predictors, and potential mechanisms of placebo response in sexual dysfunction.AimWe aimed to determine the nature and predictors of sexual function outcomes in women treated with placebo for female sexual arousal disorder (FSAD).MethodsWe conducted a secondary analysis of data from the placebo arm of a 12‐week, multisite, randomized controlled pharmaceutical trial for FSAD (N = 50). We analyzed the magnitude, domain specificity, and clinical significance of sexual function scores at baseline, 4, 8, and 12 weeks (post‐treatment). We examined longitudinal change in sexual function outcomes as a function of several baseline variables (e.g., age, symptom‐related distress) and in relation to changes in sexual behavior frequency during the trial.Main Outcome MeasureFemale Sexual Function Index total score.ResultsThe magnitude of change at post‐treatment was clinically significant in approximately one‐third of placebo recipients. Effect sizes were similar across multiple aspects of sexual function. Symptom improvement was strongly related to the frequency of satisfying sexual encounters during treatment. However, the relationship between sexual encounter frequency and outcome varied significantly between participants.Conclusions.A substantial number of women experienced clinically significant improvement in sexual function during treatment with placebo. Changes in sexual behavior during the trial, more so than participant age or symptom severity at baseline, appeared to be an important determinant of outcome. Contextual and procedural aspects of the clinical trial may have influenced outcomes in the absence of an active drug treatment. Bradford A and Meston CM. Behavior and symptom change among women treated with placebo for sexual dysfunction. J Sex Med 2011;8:191–201.     

A 15-year study of illegally induced abortion mortality at Ilorin, Nigeria

Fifty-three women died from complications of illegally induced abortion over a 15-year period. Seventeen (32.2%) of them were under 20 years of age, while 28 (52.8%) were nulliparous. The abortion rate was 210/100,000 with an abortion mortality rate of 0.9/100,00 women. Also the abortion ratio was 73.4/1000 live-births while the abortion mortality ratio was 4.20/1000 abortions. Sepsis and hemorrhage were the two commonest avoidable causes of death, and preventable measures were discussed.     

The pattern of eclampsia at the University of Ilorin Teaching Hospital (U.I.T.H.) Ilorin, Nigeria

In Ilorin, Nigeria, 788 cases of eclampsia were managed between 1968 and 1987, giving an incidence of 4.2/1000 deliveries. Five hundred thirty-five of the patients were nulliparous and 353 had received some form of antenatal care. There was no apparent change in the pattern of eclampsia over the years. The predisposing factors to developing eclampsia are examined and suggestions offered for the prevention of eclampsia in third world countries.     

Erectile Dysfunction Management Options in Nigeria

IntroductionIn Nigeria, the prevalence of erectile dysfunction (ED) among patients attending primary care clinics, age-standardized to the U.S. population in 2000 is 57.4%. This is considered high enough to warrant the attention of scientist for critical studies and analysis. The high ED prevalence is associated with etiologies such as psychosexual factors, chronic medical conditions, and some lifestyles. ED constitutes a major public health problem, influencing the patient's well-being and quality of life. It also leads to broken homes and marriages, psychological, social, and physical morbidity.AimTo give an account of various ED management options in Nigeria.MethodReview of peer-reviewed literature, questionnaire, and ethnobotanical survey to some indigenous herb sellers and herbalists.Main Outcome MeasuresCross cultural perspectives of ED management in Nigeria.ResultsThe review suggests that traditional (phytotherapy, zootherapy, and occultism) and nontraditional, orthodox practice (drug therapy, psychological, and behavioral counseling) are applicable to ED management in Nigeria.ConclusionThis review should help in creating awareness into various options available for managing ED in the country, but does not recommend self medication of any form, be it the use of orthodox or herbal remedy. Afolayan AJ, and Yakubu MT. Erectile dysfunction management options in Nigeria. J Sex Med **;**:**–**.     

The incidence, sociobiological factors and obstetric complications associated with large infants at Ilorin, Nigeria

The study examined the incidence, sociobiological factors and obstetric complications related to the deliveries of 351 large infants, weighing 4000 g and above, and compared them to the findings among controls, comprising of 6563 full-size term infants; all deliveries took place at the University of Ilorin Teaching Hospital, June-December, 1983. Large infants constituted 4.7% of singleton deliveries and the male/female ratio among large infants was significantly higher than among controls. Significant associations were found in the occurrence of large infants with increasing age, parity and weight, but not with height. Large infants occurred more frequently among the high social class women who could pay for health services. Rate of cesarean section and postpartum hemorrhage increased four-fold with deliveries of large infants. Shoulder dystocia complicated six deliveries resulting in four stillbirths and two cases of Erb's palsy. It is advocated that prenatal screening for gestational diabetes be performed on mothers with advanced maternal age, high parity, overweight and particularly of high social class.     

Maternal mortality--a twelve-year survey at the University of Ilorin Teaching Hospital (U.I.T.H.) Ilorin, Nigeria

This paper concerns an analysis of maternal death at the University of Ilorin Teaching Hospital (U.I.T.H.) Ilorin over a 12-year period (1972-1983). There were 138,577 births and 624 deaths making a maternal mortality rate of 4.50 per 1000 births. Hemorrhage, ruptured uterus and obstructed labor were the major direct obstetric causes of death. The most important indirect causes were cerebrospinal meningitis, pulmonary infections and fulminating hepatitis. The main avoidable factors were ineffective and cumbersome blood transfusion services; poor management of the third stage of labor; large number of unbooked patients and poor delivery room structure encouraging sepsis. Suggestions are made for a more integrated type of maternity services in our hospital, health education programs for the public and particularly the expectant women and availability of an effective blood bank service within the maternity hospital premises for prompt treatment of patients requiring emergency blood transfusion. The analysis underlines the great problem of maternal mortality in the developing world.     

Risk Factors Associated with Primary and Secondary Reduced Libido in Male Patients with Sexual Dysfunction

IntroductionHypoactive sexual desire is defined as a persistent or recurrent deficient or absent sexual fantasies or desire for sexual activity that should not be comorbid with other medical conditions or with the use of psychoactive medications. Reduced libido is a symptom referring more to a reduction in sexual drive for sexual activity.AimTo investigate the risk factors of primary reduced libido (i.e., not associated with conditions causing loss of libido such as hypogonadism, hyperprolactinemia, psychopathology, and/or psychoactive medications) or secondary reduced libido (i.e., with aforementioned conditions) in male patients with sexual dysfunction.MethodA consecutive series of 3,714 men (mean age 53.2 ± 12.5 years) was retrospectively studied.Main Outcome MeasuresPatient's reduced libido was evaluated using question #14 of structured interview for erectile dysfunction (SIEDY) (“Did you have more or less desire to make love in the last 3 months?”).ResultsReduced libido was comorbid with erectile dysfunction, premature ejaculation, and delayed ejaculation in 38%, 28.2%, and 50%, respectively, whereas it was isolated in 5.1%. Reduced libido prevalence was substantially increased by hypogonadism, almost doubled by psychopathology and universally present in subjects with hyperprolactinemia (secondary reduced libido). Subjects with primary reduced libido are characterized by higher postschool qualification, more disturbances in domestic and dyadic relationships, and an overall healthy body (lower glycemia and triglyceride levels). Accordingly, in patients with primary reduced libido, the risk of major cardiovascular events as calculated with the Progetto Cuore algorithm was lower than in the rest of the sample. Features of hypogonadism‐ or psychopathology‐associated reduced libido essentially reflect their underlying conditions. Comorbidity with other sexual dysfunctions did not affect the main characteristics of primary or secondary reduced libido.ConclusionsPrimary and secondary reduced libido have different risk factors and clinical characteristics. Recognizing primary or secondary reduced libido will help clinicians to identify comorbidities and to tailor appropriate treatments.     

Age,Gender, Depression,and Sexual Dysfunction in Taiwan

IntroductionThe effects of age and gender on sexual function have attracted much attention in recent years, though few studies have focused on this issue in Asian populations.AimsThe Changes in Sexual Functioning Questionnaire (CSFQ) was used to: (i) assess the differences in sexual functioning between unmedicated outpatients with depressive disorders and healthy volunteers; and (ii) investigate the influences of gender and age on sexual functioning in both groups.Main Outcome MeasuresThe CSFQ was used to assess sexual dysfunction.MethodsTwo groups of subjects, 73 unmedicated patients with depressive disorders and 116 healthy volunteers, were recruited to the study, and changes in their sexual function were assessed using the CSFQ. Subjects' global depressive level and psychiatric morbidity were assessed using the Taiwanese Depression Questionnaire (TDQ) and the Chinese Health Questionnaire (CHQ).ResultsThe depressed subjects had significantly lower total CSFQ scores than did the controls. A negative correlation between age and total CSFQ score was found in both genders of depressed patients. Age generally predicted the sum of the CSFQ scores for both genders in the depressed group after controlling for TDQ score; however, a positive correlation between age and total CSFQ score was identified in the female controls. We also found that the S‐curve was the best‐fit curve for both the male and female controls, the cut‐off point for which was the age of 40.ConclusionsOur study confirmed that, as a screening tool for clinically significant sexual dysfunction, the CSFQ offered good sensitivity for both the healthy and depressed subjects. In addition, our findings suggested that age and gender differences should be taken into account when measuring sexual satisfaction. It is possible that the age of 40 could be an anchor point in sexual functioning for the female population of Taiwan. Chen KC, Yeh TL, Lee IH, Chen PS, Huang H‐C, Yang YK, Shen WW, and Lu R‐B. Age, gender, depression, and sexual dysfunction in Taiwan.     

The interrelationships between age, physical measurements and body composition at menarche in schoolgirls at Ilorin, Nigeria

A cross-sectional study of age, physical size and body composition at menarche was made at Ilorin, Nigeria among 162 secondary school girls who reached menarche between March and June, 1983. The findings show that the mean age, height and weight are 13.7 +/- 1.0 years, 156.2 +/- 6.3 cm and 47.4 +/- 6.7 kg, respectively. The estimated body composition is: total body water (TBW), 25.7 +/- 2.3 l; lean body mass (LBM), 35.7 +/- 3.3 kg; and fat content, 11.8 +/- 3.8 kg. Whereas the coefficient of variation was highest for fat content (32.2), it was least for height (4.0). Menarcheal age has a weak correlation to all the variables, but strong correlation existed between weight and the parameters of body composition. The findings of body composition at menarche in Nigerian and North American schoolgirls are similar.