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1.
Ewelina Kowalewska Joshua B. Grubbs Marc N. Potenza Mateusz Gola Małgorzata Draps Shane W. Kraus 《Current Sexual Health Reports》2018,10(4):255-264
Purpose of Review
The current review summarizes the latest findings concerning neurobiological mechanisms of compulsive sexual behavior disorder (CSBD) and provides recommendations for future research specific to the diagnostic classification of the condition.Recent Findings
To date, most neuroimaging research on compulsive sexual behavior has provided evidence of overlapping mechanisms underlying compulsive sexual behavior and non-sexual addictions. Compulsive sexual behavior is associated with altered functioning in brain regions and networks implicated in sensitization, habituation, impulse dyscontrol, and reward processing in patterns like substance, gambling, and gaming addictions. Key brain regions linked to compulsive sexual behavior features include the frontal and temporal cortices, amygdala, and striatum, including the nucleus accumbens.Summary
Despite much neuroscience research finding many similarities between CSBD and substance and behavioral addictions, the World Health Organization included CSBD in the ICD-11 as an impulse-control disorder. Although previous research has helped to highlight some underlying mechanisms of the condition, additional investigations are needed to fully understand this phenomenon and resolve classification issues surrounding CSBD.2.
Stephanie Montgomery-Graham 《Current Sexual Health Reports》2017,9(4):200-206
Purpose of Review
The goals of this article are to review the current research on out-of-control sexual behavior, also known as problematic hypersexuality, or hypersexual disorder, as it relates to women. Specifically, the paper reviews the existing epidemiological data, conceptualization of the symptoms, and measurement instruments used clinically and concludes by critically reviewing the small body of recent empirical research on out-of-control sexual behavior in women.Recent Findings
Women are understudied and often not included in research about out-of-control sexual behavior. Empirical research studies use differing samples—clinical, community, and convenience samples—and use varying scales that capture different elements of the problematic hypersexuality construct. No clear clinical picture of women and problematic hypersexuality exists currently.Summary
Future research should include women so researchers and clinicians can better understand clinical presentations, etiology, case conceptualization, and treatment of women presenting with beliefs and feelings that their sexual behavior is out of control.3.
Lúcia Alves Lara Miguel Fuentealba-Torres Rosana Maria dos Reis Denisse Cartagena-Ramos 《Current Sexual Health Reports》2018,10(4):353-359
Purpose of Review
To determine the impacts of infertility on the sexuality of couples, and the challenges this presents for providing sexual healthcare to these couples.Recent Findings
We thoroughly reviewed multiple databases to identify all publications on this topic from 2013 to 2017.Summary
The included studies had significant heterogeneity in the study population, study design, and instruments used to assess sexual response. This made it difficult to identify the true impact of infertility on the sexual health and sexuality of couples. However, our review shows that infertile couples have moderate-to-high levels of emotional, sexual, and marital problems.4.
Julia Velten 《Current Sexual Health Reports》2017,9(2):90-97
Purpose of Review
The dual control model of sexual response aims to explain sexual behavior and response through two factors, labeled sexual excitation and sexual inhibition. Sexual dysfunctions are common among women and men and pose a threat to the sexual health of both genders. The main objective of this paper was to review the latest findings concerning the predictive value of sexual excitation and sexual inhibition for sexual function and dysfunction in men and women.Recent Findings
Most relevant studies have been conducted in North America and Europe using non-clinical samples. Women and men with high sexual inhibition related to performance concerns and distractibility during sex report lower sexual function. In addition, high sexual excitation is associated with higher sexual function in both genders.Summary
Sexual excitation and sexual inhibition are predictors of sexual function in women and men. More prospective and clinical studies are needed to evaluate the usefulness of both propensities as predictors or moderators of treatment success.5.
Background
Low grade inflammation is associated with both chronic spontaneous urticaria (CSU) and atherosclerosis. Data regarding an association between urticarial inflammation and atherosclerosis and subsequent cardiovascular events are scarce. It has been demonstrated that matrix GLA protein (MGP), a biomarker of arterial calcification, is increased in patients with atherosclerosis.Objectives
To evaluate circulating levels of markers of arterial calcification and acute phase response (APR) in patients with CSU.Methods
Concentrations of MGP and IL-6 were measured in venous blood samples of patients with long-lasting moderate-severe CSU.Results
There were no significant differences in serum MGP concentration between healthy subjects and CU patients. Serum IL-6 concentration was significantly higher in CSU patients as compared with healthy subjects.Conclusions
The results confirm that CSU is accompanied by a low grade systemic inflammatory state. However, the long lasting urticarial inflammation was not paralleled by an increased circulating level of the calcification marker matrix Gla protein.6.
Purpose of Review
In this article, we review the most recent articles examining the use of testosterone for the treatment of erectile dysfunction, reduced sexual desire, and ejaculatory dysfunction.Recent Findings
The treatment of erectile dysfunction with testosterone therapy has long been investigated as a cure for sexual dysfunction. Men who are testosterone deficient can expect to benefit from testosterone therapy to address erectile dysfunction and libido, while ejaculatory function is unlikely to improve.Summary
The literature supports the use of testosterone therapy in testosterone-deficient men with sexual dysfunction. We recommend advising patients about the benefits of testosterone therapy while ensuring that it will address their individual concerns, without delaying adjunct treatments for sexual dysfunction.7.
Maria Manuela Peixoto 《Current Sexual Health Reports》2017,9(3):136-141
Purpose of Review
Current review summarizes the recent literature and contemporary empirical studies on sexual problems and associated distress in lesbian women.Recent Findings
Major sexual problems reported by lesbian women are characterized by decreased levels of sexual interest and desire. Data from recent studies support the idea that prevalence rates decrease when associated distress levels were considered, which is consistent with findings from studies with heterosexual samples.Summary
More research is needed to about prevalence and clinical characterization of sexual problems in lesbian women. Nevertheless, according to the latest empirical studies, lower levels of sexual interest and desire represent a major complain for lesbian women. Additionally, sexual pain and sexual arousal difficulties have been strongly associated to self-perceived distress.8.
Marcela Fernández-Vargas 《Current Sexual Health Reports》2018,10(4):315-328
Purpose of the Review
Rodents produce ultrasonic vocalizations (USV) under different social contexts, including courtship and reproduction. The present review aims to summarize the behavioral, bioacoustical, and physiological evidence that USV are reliable signals of sexual motivation in both male and female rodents.Recent Findings
USV are actively produced by both sexes during sexual interactions, contrary to earlier assumptions. Male-typical and female-typical vocal behaviors can be identified. Calling rates and acoustic parameters, such as call duration, frequency, and energy, can be modulated rapidly over time by motivational state and sexual context. USV produced in response to sexual context could be regulated by the brain on a moment-to-moment basis through non-classical mechanisms of steroid action. Finally, I provide some practical considerations for the acoustic and statistical analyses of these vocal signals.Summary
USV can be used as signals of sexual motivation in both sexes to study brain and hormonal mechanisms underlying sexual behavior or sexual differentiation.9.
Purpose
Although research into the neurobiology of sexual desire in women is active, relatively little is understood about the origins of sexual motivation in women. The purpose of our review is to discuss factors that influence a central sexual motivational state and generalized arousal as potential drivers of sexual motivation in women and female rats.Recent Findings
Sexual motivation is the product of interactions of the central motive state and salient sexually relevant cues. Ovarian hormones and generalized arousal influence the central motive state, and endogenous levels of estradiol and progesterone correlate with sexual motivation and behavior in women. The amygdala is a key integratory site for generalized arousal and sexual sensory stimulation, which could then increase sexual motivation through its downstream projections.Summary
Our model of enhanced female sexual motivation suggests that the combined effects of dopamine and progesterone receptor activation in the medial amygdala increase the incentive properties of a sexual stimulus. Further study into the interactions of ovarian hormones and mediators of generalized arousal on the processing of sexually relevant cues informs our understanding of the neurobiology of female sexual motivation and could lead to the development of therapeutics to treat the dysfunctions of sexual desire in women.10.
Brian Joseph Gillespie Kathleen Hibbert Angela Sanguinetti 《Current Sexual Health Reports》2017,9(3):150-154
Purpose of Review
This brief review identifies a number of psychological, social, and interpersonal barriers to sexual expression among older adults.Recent Findings
Cultural ideas about sexuality and aging as well as attitudes about sex are noted psychological factors that impact sexuality in older adulthood. Social factors, including the availability of a healthy partner, provide the opportunity structure for partnered sexual activity to occur. Among partnered individuals, interpersonal factors, such as sexual communication and relationship quality, impact individuals’ sexual desire, sex frequency, and sexual satisfaction.Summary
Overall, this review highlights the importance of taking a more comprehensive approach to the study of aging and sexuality. In particular, researchers should continue to integrate interpersonal aspects of sexuality in older adulthood into the traditional physiological and psychosocial models.11.
Purpose of Review
The purpose of this article is to review of intravaginal DHEA (prasterone), which has been recently FDA approved for the treatment of moderate to severe dyspareunia. The review includes the epidemiology, pathophysiology, and treatment of GSM and summarizes the safety and efficacy of the newest available treatment, intravaginal DHEA.Recent Findings
DHEA is believed to act through an intracrine mechanism, being metabolized and inactivated intracellularly into both androgens and estrogens. When administered intravaginally, DHEA is believed to result in local action, without impact on systemic hormonal levels.Summary
Intravaginal DHEA has been shown to be effective for the treatment of dyspareunia secondary to GSM and has a favorable safety profile.12.
Purpose of Review
Compulsive sexual behavior (CSB) is widely regarded as a “behavioral addiction,” and is a major threat to quality of life and both physical and mental health. However, CSB has been slow to be recognized clinically as a diagnosable disorder. CSB is co-morbid with affective disorders as well as substance use disorders, and recent neuroimaging studies have demonstrated shared or overlapping neural pathologies disorders, especially in brain regions controlling motivational salience and inhibitory control.Recent Findings
Clinical neuroimaging studies are reviewed that have identified structural and/or function changes in prefrontal cortex, amygdala, striatum, and thalamus in individuals suffering from CSB. A preclinical model to study the neural underpinnings of CSB in male rats is discussed consisting of a conditioned aversion procedure to examine seeking of sexual behavior despite known negative consequences. Using this preclinical model, a role of the medial prefrontal cortex was identified, including neural plasticity during comorbidity of CSB and psychostimulant abuse.Summary
This review summarizes recent human behavioral and neuroimaging studies, in addition to preclinical models that can be used to study the underlying neurobiology of CSB.13.
Stephanie Both 《Current Sexual Health Reports》2017,9(4):192-199
Purpose of Review
This review summarizes the recent literature and empirical studies on psychopharmacological approaches to treating female sexual interest/arousal disorder (FSIAD).Recent Findings
Several new drugs for FSIAD that are intended to increase sexual responsiveness by influencing central excitatory and inhibitory neuromodulatory processes are under development. Studies on flibanserin resulted in the first approved medication for the treatment of low sexual desire in premenopausal women. New drugs under development are testosterone combined with sildenafil or buspiron, bremelanotide, BP101, and nasal testosterone (TBS-2).Summary
Although pharmacological enhancement of sexual responsiveness may be potentially helpful in the treatment of FSIAD, the observed effects of flibanserin and other new drugs under development seem limited in terms of clinical significance. Given the multifactorial character of FSIAD, it may be important to integrate psychopharmacological treatment with sex therapy for optimal treatment efficacy.14.
15.
Purpose of Review
The purpose of this study is to provide a comprehensive summary of the latest developments in the experimental brain study of human sexuality, focusing on brain connectivity during the sexual response.Recent Findings
Stable patterns of brain activation have been established for different phases of the sexual response, especially with regard to the wanting phase, and changes in these patterns can be linked to sexual response variations, including sexual dysfunctions. From this solid basis, connectivity studies of the human sexual response have begun to add a deeper understanding of the brain network function and structure involved.Summary
The study of “sexual” brain connectivity is still very young. Yet, by approaching the brain as a connected organ, the essence of brain function is captured much more accurately, increasing the likelihood of finding useful biomarkers and targets for intervention in sexual dysfunction.16.
Purpose of Review
This paper reviews the recent literature on human asexuality, which is generally defined as an absence of sexual attraction.Recent Findings
Recent work has focused on exploring whether asexuality is best conceptualized as a mental health difficulty, a sexual dysfunction, a paraphilia, a sexual orientation, or as an identity/community, and this literature is reviewed. The authors conclude that asexuality may best be thought of as a sexual orientation and that asexuality as an identity and a community is an important component of the asexual experience.Summary
Overall, the term asexuality likely describes a heterogeneous group of individuals, with a range of experiences. Asexuality is likely a normal variation in the experience of human sexuality, and future research into asexuality might inform our understanding of sexuality in general.17.
Purpose of Review
This paper is written to introduce postpartum sexual functioning through a biopsychosocial lens, including challenges and interventions for optimal sexual functioning during the postpartum period, both for women and their partners.Recent Findings
While considered to be dysfunctional compared to sexual functioning outside of the perinatal period, changes to sexual functioning in the year following childbirth are common. Biological and physiological factors which affect postpartum sexual functioning include method of delivery, breastfeeding and hormonal changes, and sleep. Psychosocial factors impacting postpartum sexual functioning include mental health, identity transition with adjusting to parenting, body image, social support, cultural context, and romantic relationships. Basson’s model of female sexual response is also discussed.Summary
Sexual functioning during the postpartum year is a biopsychosocial process which is challenging for most couples, although there are exceptions. These challenges need to be pathologized. Healthcare providers need to better support new parents with their sexual health.18.
Purpose of Review
This review was conducted to illustrate how the emerging recognition of sexual health in the older adult is informed by research on the growing aging HIV population in the USA and globally. Assessing the sexual health needs of the older adult through the prism of HIV prevention is not ideal. But, there are data and “lessons learned” that advance our understanding of the barriers and needs of older adults’ sexual health.Recent Findings
Data confirm many of these older adults with HIV remain sexually active and do engage in risky behaviors as do their younger counterparts. HIV and other STI testing in older adults is not being done adequately as these individuals carry the disproportionate burden of AIDS diagnoses in the USA.Summary
Under the duress of persistent HIV and AIDS stigma, marginalized older adults living with HIV try to embrace that most elemental human characteristic of sexuality.19.
Purpose of Review
To review approaches since 2013 of the clinical management of low sexual desire.Recent Findings
The history of the treatment of the sexual dysfunctions has emphasized that the couple should be the target of treatment. Recent attempts at treatment of low desire have focused on women rather than couples. Men with low desire or couples with sexual desire discrepancies are generally overlooked. Among pharmaceutical interventions, only flibanserin (Addyi) has been approved by the FDA for treatment of low desire in premenopausal women. Other treatments for low desire in women include bibliotherapy and mindfulness. Models of couples therapy tend to focus on sexual desire discrepancies or enhancing the quality of erotic intimacy within relationships rather than treating the identified patient.Summary
There is a lack of consensus as to how to conceptualize and how to treat low sexual desire in men, women, or couples and on whether to target the identified patient or the relationship.20.