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A 31-year-old married man with normal male characteristics requested hormonal treatment to enlarge his breasts and nipples. He did not feel himself to be homosexual or transsexual but considered himself incomplete without female breasts and nipples. Petting of his nipples resulted in sexual excitement and he presumed that feminization of his breasts would improve this function. His wife supported his wish. After treatment with 0.150 mg ethinylestradiol per day for 9 months, moderate breast enlargement occurred and the nipples became the size of normal female nipples. One year afterwards he remained satisfied with his female-type breasts and in particular with the increased sexual function of his nipples. Stimulation of his nipples resulted in erection and ejaculation. 相似文献
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Martin P. Kafka 《Archives of sexual behavior》1997,26(5):505-526
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. 相似文献
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Leuprolide Acetate Suppresses Pedophilic Urges and Arousability 总被引:2,自引:0,他引:2
Schober JM Kuhn PJ Kovacs PG Earle JH Byrne PM Fries RA 《Archives of sexual behavior》2005,34(6):691-705
Cognitive–behavioral psychotherapy was compared with cognitive–behavioral psychotherapy augmented by leuprolide acetate (LA)
for suppression of pedophilic behavior. Five male pedophiles (M age, 50 years; range, 36–58) were administered LA by Depo injection for 12 months, followed by saline placebo for 12 months.
Testosterone levels, sexual interest preference by visual reaction time (Abel Assessment), penile tumescence (Monarch Penile
Plethysmography, PPG), as well as strong sexual urges toward children and masturbatory frequency involving thoughts of children
(polygraph), were measured every 3 months. On LA, testosterone decreased to castrate levels. Penile tumescence was significantly
suppressed compared with baseline, but sufficient response remained to detect pedophilic interest. Pedophilic interest was
also detected by visual reaction times. When asked about having pedophilic urges and masturbating to thoughts of children,
all subjects self-reported a decrease. Polygraph responses indicated subjects were not deceptive. On placebo, testosterone
and physiologic arousal eventually rose to baseline. As noted by polygraph, at baseline and on placebo, subjects were deceptive
regarding increased pedophilic urges and masturbatory frequency. Interest preference, as measured by Abel Assessment and Monarch
PPG, was generally unchanged throughout the study. Cognitive–behavioral psychotherapy augmented with LA significantly reduced
pedophilic fantasies, urges, and masturbation; however, pedophilic interest did not change during 1 year of therapy. Deceptive
responses by polygraph suggested that self-report was unreliable. Follow-up utilizing objective measures is essential for
monitoring efficacy of treatment in pedophilia. Our study supports the premise that suppression of pedophilic behavior is
possible. LA may augment cognitive–behavioral psychotherapy and help break the sequence leading to a re-offense. 相似文献
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Jorge Ponseti Oliver Granert Thilo Van Eimeren Olav Jansen Stephan Wolff Klaus Beier 《The world journal of biological psychiatry》2016,17(1):39-46
Objectives: Objective assessment of sexual preferences may be of relevance in the treatment and prognosis of child sexual offenders. Previous research has indicated that this can be achieved by pattern classification of brain responses to sexual child and adult images. Our recent research showed that human face processing is tuned to sexual age preferences. This observation prompted us to test whether paedophilia can be inferred based on the haemodynamic brain responses to adult and child faces. Methods: Twenty-four men sexually attracted to prepubescent boys or girls (paedophiles) and 32 men sexually attracted to men or women (teleiophiles) were exposed to images of child and adult, male and female faces during a functional magnetic resonance imaging (fMRI) session. Results: A cross-validated, automatic pattern classification algorithm of brain responses to facial stimuli yielded four misclassified participants (three false positives), corresponding to a specificity of 91% and a sensitivity of 95%. Conclusions: These results indicate that the functional response to facial stimuli can be reliably used for fMRI-based classification of paedophilia, bypassing the problem of showing child sexual stimuli to paedophiles. 相似文献
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Background: In recent decades, the diagnosis of sexual or love addiction has increasingly become part of the spectrum of addiction medicine. Although it does not figure under this name in either the BNO‐10 or DSM‐IV, the present scientific position is that it can be regarded as a compulsive sexual behaviour disorder that does not show the criteria of paraphilia.Method: A case report.Results: In the case of the 61‐year‐old patient we observed, the problems of an extramarital relationship play a central part in the syndrome with a serious conflict situation and prolonged personal and family crisis. This sexual addiction can be interpreted as identification with the father and also as the means of masculine identity. The sexual behaviour meets the criteria of addiction. Follow‐up will decide the stability of the diagnosis. In connection with this case, the authors attempt a psychodynamic analysis of triangular relationships destabilizing couple relationships. 相似文献
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We report on a patient with a low testosterone level which occurred during treatment with venlafaxine. The testosterone level increased when the medication was discontinued. Possible clinical correlation with amelioration of paraphilia is discussed. 相似文献
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Alan J. Riley J. A. Steiner R. Cooper C. K. McPherson 《Sexual and Relationship Therapy》2013,28(2):131-138
A questionnaire containing questions on sexual functioning was sent to 800 hypertensive patients. A response rate of 68.3% was obtained. Of these 60 men and 100 women did not have intercourse. 208 men reported on their erectile ability and 201 men reported on their ejaculatory function. The prevalence of erectile inadequacy was age related in the treated patients, and ranged from 27% in 20–39 years to 70% in patients over 60 years. Treatment was associated with a significantly increased prevalence of erectile dysfunction (untreated 26%, treated 55%; P≤0.01). The prevalence of ejaculatory difficulty was age-related only occurring in men over 40 years of age and occurred more frequently in treated (45%) than untreated (14%) patients (P≥0.01). 178 women reported on their ability to become sexually arroused and to attain orgasm. 22% of women reported never having difficulty becoming aroused and 8% reported that they always experienced orgasm. The prevalence of arousal and orgasmic dysfunction was not age or treatment-related 相似文献