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  • 1.
    Andersson, Erik
    et al.
    Karolinska Institute.
    Walen, Christian
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Hallberg, Jonas
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Paxling, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Dahlin, Mats
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Almlöv, Jonas
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Källström, Reidar
    Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Östergötland.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Carlbring, Per
    Umeå University, Department Psychol, S-90187 Umeå, Sweden .
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    A Randomized Controlled Trial of Guided Internet-delivered Cognitive Behavioral Therapy for Erectile Dysfunction2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no 10, p. 2800-2809Article in journal (Refereed)
    Abstract [en]

    Introduction. Men with erectile dysfunction are often worried about their condition, have interpersonal difficulties, and have a reduced quality of life. Internet-delivered cognitive behavior therapy (ICBT) has been shown effective for a number of health problems but evidence is limited concerning the treatment of erectile dysfunction. less thanbrgreater than less thanbrgreater thanAim. The study investigated the effects of ICBT for erectile dysfunction. less thanbrgreater than less thanbrgreater thanMethods. Seventy-eight men were included in the study and randomized to either ICBT or to a control group, which was an online discussion group. Treatment consisted of a 7-week Web-based program with e-mail-based therapist support. Each therapist spent an average of 55 minutes per participant. less thanbrgreater than less thanbrgreater thanMain Outcome Measure. The International Index of Erectile Functioning five-item version was administered via the telephone at pretreatment, post-treatment, and 6 months after receiving ICBT. less thanbrgreater than less thanbrgreater thanResults. At post-treatment, the treatment group had significantly greater improvements with regard to erectile performance compared with the control group. Between-group differences at post-treatment were small (d = 0.1), but increased at the 6-month follow-up (d = 0.88). less thanbrgreater than less thanbrgreater thanConclusions. This study provides support for the use of ICBT as a possible treatment format for erectile dysfunction.

  • 2.
    Andersson, Erik
    et al.
    Department of Behavioural Sciences and Learning, Linköping University, Sweden, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm.
    Walén, Christian
    Department of Behavioural Sciences and Learning, Linköping University, Sweden.
    Hallberg, Jonas
    Department of Behavioural Sciences and Learning, Linköping University, Sweden.
    Paxling, Björn
    Department of Behavioural Sciences and Learning, Linköping University, Sweden.
    Dahlin, Mats
    Department of Behavioural Sciences and Learning, Linköping University, Sweden; Psykologpartners, Linköping, Sweden.
    Almlöv, Jonas
    Department of Behavioural Sciences and Learning, Linköping University, Sweden.
    Källström, Reidar
    Department of Urology, University Hospital Linköping, Linköping, Sweden;.
    Wijma, Klaas
    Department of Clinical and Experimental Medicine, Linköping University, Linköping.
    Carlbring, Per
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Andersson, Gerhard
    Department of Behavioural Sciences and Learning, Linköping University, Sweden, †Swedish Institute for Disability Research, Linköping University, Sweden; Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden; .
    A randomized controlled trial of guided internet-delivered cognitive behavioral therapy for erectile dysfunction2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no 10, p. 2800-2809Article in journal (Refereed)
    Abstract [en]

    Introduction: Men with erectile dysfunction are often worried about their condition, have interpersonal difficulties, and have a reduced quality of life. Internet-delivered cognitive behavior therapy (ICBT) has been shown effective for a number of health problems but evidence is limited concerning the treatment of erectile dysfunction.

    Aim: The study investigated the effects of ICBT for erectile dysfunction.

    Methods: Seventy-eight men were included in the study and randomized to either ICBT or to a control group, which was an online discussion group. Treatment consisted of a 7-week Web-based program with e-mail-based therapist support. Each therapist spent an average of 55 minutes per participant.

    Main Outcome Measure: The International Index of Erectile Functioning five-item version was administered via the telephone at pretreatment, post-treatment, and 6 months after receiving ICBT.

    Results: At post-treatment, the treatment group had significantly greater improvements with regard to erectile performance compared with the control group. Between-group differences at post-treatment were small (d =0.1), but increased at the 6-month follow-up (d =0.88).

    Conclusions: This study provides support for the use of ICBT as a possible treatment format for erectile dysfunction.

  • 3.
    Areskoug Josefsson, Kristina
    Samrehab, Värnamo Sjukhus.
    The Role of Physiotherapy to Enhance Sexual Health in Chronic Disease2014In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 11, no Suppl. 1, p. 90-Article in journal (Refereed)
  • 4.
    Axelson, Hans W
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Clinical Neurophysiology.
    Johansson, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Urology.
    Bill-Axelson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Urology.
    Intraoperative Cavernous Nerve Stimulation and Laser-Doppler Flowmetry during Radical Prostatectomy2013In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 10, no 11, p. 2842-2848Article in journal (Refereed)
    Abstract [en]

    Introduction. 

    Erectile dysfunction is a common side effect following radical prostatectomy mainly due to damage of the pelvic autonomic nerve fibers (cavernous nerves). Intraoperative electrical stimulation of the cavernous nerves while measuring changes in penile girth has previously been shown to provide the surgeon with feedback of nerve integrity.

    Aim. 

    To test the feasibility of recording changes in glans penis blood flow by Laser Doppler flowmetry from cavernous nerve stimulation.

    Methods. 

    Fifteen patients with localized prostate cancer undergoing radical prostatectomy had electrical stimulation of the proximal and distal parts of the neurovascular bundles after prostate removal. The stimulation consisted of 30-40 seconds biphasic constant current (10-30 mA) with 0.5 millisecond pulse duration.

    Main Outcome Measures. 

    Stimulus induced changes in penile blood flow was recorded from a Laser Doppler probe attached to the glans penis. Changes in penile girth were simultaneously recorded from a mercury-in rubber strain gauge. Erectile function was evaluated three months after surgery.

    Results. 

    Ten patients had stimulus induced increase in Laser Doppler flow unilaterally (N = 7) or bilaterally (N = 3). Out of 10 patients, 6 reported some preserved erectile function postoperatively at 3 months follow-up (indicating 6 true and 4 false positives). Three patients had no Doppler response from stimulation and had no postoperative erectile function postoperatively (indicating three true negatives). Two patients were excluded from the study due to bad signal quality in the Laser Doppler signal. In the majority of patients, stimulation produced increase in penile girth sensed by the strain gauge.

    Conclusion. 

    This preliminary report provides evidence that Laser Doppler Flowmetry is able to detect increased penile blood flow from intraoperative electrical stimulation of the neurovascular bundles. However, further improvement in the recording technique is required. Laser Doppler Flowmetry may also be feasible to confirm autonomic nerve sparing in women undergoing pelvic surgery.

  • 5.
    Bendas, Johanna
    et al.
    Technical University of Dresden, Germany.
    Georgiadis, Janniko R.
    University of Medical Centre Groningen, Netherlands.
    Ritschel, Gerhard
    Technical University of Dresden, Germany.
    Olausson, Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Weidner, Kerstin
    Technical University of Dresden, Germany.
    Croy, Ilona
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Technical University of Dresden, Germany.
    C-Tactile Mediated Erotic Touch Perception Relates to Sexual Desire and Performance in a Gender-Specific Way2017In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 14, no 5, p. 645-653Article in journal (Refereed)
    Abstract [en]

    Background: Unmyelinated low-threshold mechanoreceptors-the so-called C-tactile (CT) afferents-play a crucial role in the perception and conduction of caressing and pleasant touch sensations and significantly contribute to the concept of erotic touch perception. Aim: To investigate the relations between sexual desire and sexual performance and the perception of touch mediated by CT afferents. Methods: Seventy healthy participants (28 men, 42 women; mean age+/-SD = 24.84+/-4.08 years, range = 18-36 years) underwent standardized and highly controlled stroking stimulation that varied in the amount of CT fiber stimulation by changing stroking velocity (CT optimal = 1, 3 and 10 cm/s; CT suboptimal = 0.1, 0.3, and 30 cm/s). Participants rated the perceived pleasantness, eroticism, and intensity of the applied tactile stimulation on a visual analog scale, completed the Sexual Desire Inventory, and answered questions about sexual performance. Outcomes: Ratings of perceived eroticism of touch were related to self-report levels of sexual desire and sexual performance. Results: Pleasantness and eroticism ratings showed similar dependence on stroking velocity that aligned with the activity of CT afferents. Erotic touch perception was related to sexual desire and sexual performance in a gender-specific way. In women, differences in eroticism ratings between CT optimal and suboptimal velocities correlated positively with desire for sexual interaction. In contrast, in men, this difference correlated to a decreased frequency and longer duration of partnered sexual activities. Clinical Implications: The present results lay the foundation for future research assessing these relations in patients with specific impairments of sexual functioning (eg, hypoactive sexual desire disorder). Strengths and Limitations: The strength of the study is the combination of standardized neurophysiologic methods and behavioral data. A clear limitation of the study design is the exclusion of exact data on the female menstrual cycle and the recruitment of an inhomogeneous sample concerning sexual orientation. Conclusion: The present results provide further evidence that unmyelinated CT afferents play a role in the complex mechanism of erotic touch perception. The ability to differentiate between CT optimal and suboptimal stimuli relates to sexual desire and performance in a gender-specific way. Copyright (C) 2017, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  • 6.
    Björkenstam, Charlotte
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology. University of California, USA; Karolinska Institutet, Sweden.
    Björkenstam, Emma
    Andersson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Cochran, Susan
    Kosidou, Kyriaki
    Anxiety and Depression Among Sexual Minority Women and Men in Sweden: Is the Risk Equally Spread Within the Sexual Minority Population?2017In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 14, no 3, p. 396-403Article in journal (Refereed)
    Abstract [en]

    Introduction

    Sexual minority individuals have a higher risk of anxiety and depression compared with heterosexuals. However, whether the higher risk is spread equally across the sexual minority population is not clear.

    Aim

    To investigate the association between sexual orientation and self-reported current anxiety and a history of diagnosis of depression, paying particular attention to possible subgroup differences in risks within the sexual minority population, stratified by sex and to examine participants' history of medical care for anxiety disorders and depression.

    Methods

    We conducted a population-based study of 874 lesbians and gays, 841 bisexuals, and 67,980 heterosexuals recruited in 2010 in Stockholm County. Data were obtained from self-administered surveys that were linked to nationwide registers. Main Outcome Measures: By using logistic regression, we compared risks of current anxiety, histories of diagnosed depression, and register-based medical care for anxiety and/or depression in lesbian and gay, bisexual, and heterosexual individuals.

    Results

    Bisexual women and gay men were more likely to report anxiety compared with their heterosexual peers. Bisexual individuals and gay men also were more likely to report a past diagnosis of depression. All sexual minority groups had an increased risk of having used medical care for anxiety and depression compared with heterosexuals, with bisexual women having the highest risk.

    Conclusion

    Bisexual women appear to be a particularly vulnerable sexual minority group. Advocating for nondiscrimination and protections for lesbian, gay, and bisexual people is a logical extension of the effort to lower the prevalence of mental illness.

  • 7.
    Byrne, Molly
    et al.
    National University of Ireland, Ireland.
    Murphy, Patrick
    National University of Ireland, Ireland.
    DEath, Maureen
    National University of Ireland, Ireland.
    Doherty, Sally
    Royal Coll Surgeons Ireland, Ireland.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Association Between Sexual Problems and Relationship Satisfaction Among People With Cardiovascular Disease2017In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 14, no 5, p. 666-674Article in journal (Refereed)
    Abstract [en]

    Background: Relationship satisfaction is generally positively correlated with sexual satisfaction, but this relation has been poorly examined in people with cardiovascular disease who are at increased risk of sexual problems compared with the general population. Aim: To document reported changes to sex after a diagnosis of cardiac disease and determine whether there is an association between sexual function and relationship satisfaction. Methods: Semistructured telephone interviews focused on relationship satisfaction and sexual problems were conducted with 201 people with cardiovascular disease who were currently in a sexual relationship with one main partner and were recruited from six hospital cardiac rehabilitation centers in Ireland. Comparisons between groups were conducted using t-tests and multivariate analysis of variance for continuous variables and chi(2) tests for categorical variables. Predictors of relationship satisfaction were assessed using multiple linear regression analysis. Outcomes: Data were gathered on demographic and clinical variables, sexual problems, and relationship satisfaction, including satisfaction with the physical, emotional, affection, and communication aspects of relationships. Results: Just less than one third of participants (n = 61, 30.3%) reported that sex had changed for the worse since their cardiac event or diagnosis, with approximately half of these stating that this was a serious problem for them. Satisfaction with relationships was high among patients surveyed; more than 70% of the sample reported being very or extremely satisfied with the physical and emotional aspects and showing affection during sex. Satisfaction with communication about sex was lower, with only 58% reporting being very or extremely satisfied. We did not find significant associations between reporting of sexual problems or deterioration of sex as a result of disease and relationship satisfaction. Clinical Implications: Cardiac rehabilitation programs should address these sexual problems, potentially by enhancing communication within couples about sex. Strengths and Limitations: The strength is that data are presented on the sexual experiences and relationship satisfaction of a relatively large sample of people diagnosed with cardiac disease, a relatively underexplored research area. Limitations include the possibility of selection bias of study participants and bias associated with self-report measurement. Conclusions: Sexual problems were significant in this population but were not related to relationship satisfaction in this cross-sectional survey. Copyright (C) 2017, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  • 8.
    Castiglione, Fabio
    et al.
    Hospital San Raffaele, Italy .
    Bergamini, Alice
    Hospital San Raffaele, Italy .
    Russo, Andrea
    Hospital San Raffaele, Italy .
    La Croce, Giovanni
    Hospital San Raffaele, Italy .
    Castagna, Giulia
    Hospital San Raffaele, Italy .
    Colciago, Giorgia
    Hospital San Raffaele, Italy .
    Salonia, Andrea
    Hospital San Raffaele, Italy .
    Rigatti, Patrizio
    Hospital San Raffaele, Italy .
    Montorsi, Francesco
    Hospital San Raffaele, Italy .
    Hedlund, Petter
    Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Pharmacology. Hospital San Raffaele, Italy .
    Inhibition of Phosphodiesterase 4 Enhances Clitoral and Vaginal Blood Flow Responses to Dorsal Clitoral Nerve Stimulation or PGE1 in Anesthetized Female Rats2013In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 10, no 4, p. 939-950Article in journal (Refereed)
    Abstract [en]

    Introduction. Cyclic adenosine 35 monophosphate (cAMP) is produced by adenylate cyclase after activation by, e.g., vasoactive intestinal polypeptide or prostaglandin E1 (PGE1). The cAMP-degrading phosphodiesterase 4 (PDE4) is expressed in the vagina and clitoris, but no information is available on the functional role for PDE4-related signals in the female neurovascular genital response. Aim. The aim of this study is to study the effect of inhibition of PDE4 with rolipram on nerve- and PGE1-induced vaginal and clitoral blood flow responses of rat. Methods. Measure of clitoral and vaginal blood flow and blood pressure in anesthetized rats during activation of the dorsal clitoral nerve (DCN) before and after intraperitoneal administration of rolipram or sildenafil (phosphodiesterase type 5 inhibitors [PDE5]) and nitro-L-arginine (L-NNA) (nitric oxide synthase inhibitor). Effect by topical administration of PGE1 on genital blood flow was also evaluated. Main Outcome Measure. Blood flow was recorded as tissue perfusion units (TPU) by a Laser Doppler Flowmeter. Mean arterial blood pressure (MAP) was recorded (cmH2O) in the carotid artery. Blood flow responses are expressed as TPU/MAP. Unpaired t-test and an analysis of variance were used. Results. Compared with control stimulations, rolipram (0.3mg/kg) caused a twofold increase in peak blood flow (Pandlt;0.05) and fourfold increase of the rate of clitoral blood flow during activation of the DCN (Pandlt;0.05). Simultaneously, a twofold increase in peak blood flow and threefold increase in rate of blood flow were noted in the vagina (Pandlt;0.05). Similar effects were noted for sildenafil (0.2mg/kg) (Pandlt;0.05). Inhibitory effects by L-NNA (60mg/kg) on blood flow responses to DCN activation were significantly lower for rats treated with rolipram than with sildenafil (Pandlt;0.05). PGE1-induced (10g) blood flow responses were significantly higher (Pandlt;0.05) in rats treated with rolipram than with sildenafil. Conclusions. These findings suggest that the cAMP/PDE4 system may be of similar functional importance as the nitric oxide/cyclic guanosine monophosphate/PDE5 pathway for neurovascular genital responses of the female rat. Castiglione F, Bergamini A, Russo A, La Croce G, Castagna G, Colciago G, Salonia A, Rigatti P, Montorsi F, and Hedlund P. Inhibition of phosphodiesterase 4 enhances clitoral and vaginal blood flow responses to dorsal clitoral nerve stimulation or PGE1 in anesthetized female rats. J Sex Med 2013; 10: 939-950.

  • 9. Elmerstig, E.
    et al.
    Wijma, Barbro
    Swahnberg, Katarina
    Hälsouniversitetet, Linköping.
    Why continue to have vaginal intercourse despite pain?: Reasons and associated factors among young Swedish women2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no Supplement s3, p. 121-121Article in journal (Other academic)
  • 10.
    Enquist, Magnus
    et al.
    Stockholm University, Faculty of Humanities, Centre for the Study of Cultural Evolution. Stockholm University, Faculty of Science, Department of Zoology.
    Aronsson, Hanna
    Stockholm University, Faculty of Humanities, Centre for the Study of Cultural Evolution. Stockholm University, Faculty of Science, Department of Zoology.
    Ghirlanda, Stefano
    Stockholm University, Faculty of Humanities, Centre for the Study of Cultural Evolution.
    Jansson, Liselott
    Stockholm University, Faculty of Science, Department of Zoology. Stockholm University, Faculty of Humanities, Centre for the Study of Cultural Evolution.
    Jannini, Emmanuele A.
    Exposure to Mother's Pregnancy and Lactation in Infancy is Associated with Sexual Attraction to Pregnancy and Lactation in Adulthood2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no 1, p. 140-147Article in journal (Refereed)
    Abstract [en]

    Introduction.  Several theories, including psychodynamic theories, sexual imprinting and early conditioning have been formulated to explain sexual development. Empirical data, however, remain insufficient for a thorough evaluation of these theories.

    Aim.  In this study, we test the hypothesis that a critical period exists for the acquisition of sexual preferences, as suggested by empirical findings in birds and mammals (sexual imprinting).

    Methods.  An Internet questionnaire was used.

    Main Outcome Measures.  We gather data from individuals with a sexual preference for pregnant and/or lactating women, under the hypothesis that pregnancy or lactation may become sexually attractive in adulthood following an exposure to pregnant or lactating women in infancy.

    Results.  We find that these preferences are more common in older siblings, i.e., in individuals who have been exposed to more maternal pregnancy and lactation. This result is independent of respondent and sibling sex. In addition, only maternal pregnancies and lactations experienced between 1.5 and 5 years of age are associated with the preferences.

    Conclusions.  We discuss our findings in relation to theories of sexual development and to earlier reports of birth order effects on sexual behavior. We suggest that this age range may constitute a sensitive period for the acquisition of sexual preferences.

  • 11. Fugl-Meyer, Kerstin S.
    et al.
    Bohm-Starke, Nina
    Petersen, Christina Damsted
    Fugl-Meyer, Axel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Parish, Sharon
    Giraldi, Annamaria
    Standard Operating Procedures for Female Genital Sexual Pain2013In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 10, no 1, p. 83-93Article in journal (Refereed)
    Abstract [en]

    Introduction. Female genital sexual pain (GSP) is a common, distressing complaint in women of all ages that is underrecognized and undertreated. Definitions and terminology for female GSP are currently being debated. While some authors have suggested that GSP is not per se a sexual dysfunction, but rather a localized genial pain syndrome, others adhere to using clearly sexually related terms such as dyspareunia and vaginismus. Aim. The aims of this brief review are to present definitions of the different types of female GSP. Their etiology, incidence, prevalence, and comorbidity with somatic and psychological disorders are highlighted, and different somatic and psychological assessment and treatment modalities are discussed. Methods. The Standard Operating Procedures (SOP) committee was composed of a chair and five additional experts. No corporate funding or remuneration was received. The authors agreed to survey relevant databases, journal articles and utilize their own clinical experience. Consensus was guided by systematic discussions by e-mail communications. Main Outcome/Results. There is a clear lack of epidemiological data defining female GSP disorders and a lack of evidence supporting therapeutic interventions. However, this international expert group will recommend guidelines for management of female GSP. Conclusions. GSP disorders are complex. It is recommended that their evaluation and treatment are performed through comprehensive somato-psychological multidisciplinary approach. Fugl-Meyer KS, Bohm-Starke N, Damsted Petersen C, Fugl-Meyer A, Parish S, and Giraldi A. Standard operating procedures for female genital sexual pain.

  • 12. Giraldi, Annamaria
    et al.
    Rellini, Alessandra
    Pfaus, James G.
    Bitzer, Johannes
    Laan, Ellen
    Jannini, Emmanuele A.
    Fugl-Meyer, Axel R.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Questionnaires for Assessment of Female Sexual Dysfunction: A Review and Proposal for a Standardized Screener2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no 10, p. 2681-2706Article, review/survey (Refereed)
    Abstract [en]

    Introduction. There are many methods to evaluate female sexual function and dysfunction (FSD) in clinical and research settings, including questionnaires, structured interviews, and detailed case histories. Of these, questionnaires have become an easy first choice to screen individuals into different categories of FSD. Aim. The aim of this study was to review the strengths and weaknesses of different questionnaires currently available to assess different dimensions of women's sexual function and dysfunction, and to suggest a simple screener for FSD. Methods. A literature search of relevant databases, books, and articles in journals was used to identify questionnaires that have been used in basic or epidemiological research, clinical trials, or in clinical settings. Main Outcome Measure. Measures were grouped in four levels based on their purposes and degree of development, and were reviewed for their psychometric properties and utility in clinical or research settings. A Sexual Complaints Screener for Women (SCS-W) was then proposed based on epidemiological methods. Results. Although many questionnaires are adequate for their own purposes, our review revealed a serious lack of standardized, internationally (culturally) acceptable questionnaires that are truly epidemiologically validated in general populations and that can be used to assess FSD in women with or without a partner and independent of the partner's gender. The SCS-W is proposed as a 10-item screener to aid clinicians in making a preliminary assessment of FSD. Conclusions. The definition of FSD continues to change and basic screening tools are essential to help advance clinical diagnosis and treatment, or to slate patients adequately into the right diagnostic categories for basic and epidemiological research or clinical trials. Giraldi A, Rellini A, Pfaus JG, Bitzer J, Laan E, Jannini EA, and Fugl-Meyer AR. Questionnaires for assessment of female sexual dysfunction: A review and proposal for a standardized screener. J Sex Med 2011; 8: 2681-2706.

  • 13.
    Hallberg, Jonas
    et al.
    Karolinska Institutet;Karolinska University Hospital.
    Kaldo, Viktor
    Karolinska Institutet.
    Arver, Stefan
    Karolinska Institutet;Karolinska University Hospital.
    Dhejne, Cecilia
    Karolinska University Hospital;Karolinska Institutet.
    Görts Öberg, Katarina
    Karolinska Institutet;Karolinska University Hospital.
    A Cognitive-Behavioral Therapy Group Intervention for Hypersexual Disorder: A Feasibility Study2017In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 14, no 7, p. 950-958Article in journal (Refereed)
    Abstract [en]

    Background: The proposed criteria of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition for hypersexual disorder (HD) included symptoms reported by patients seeking help for excessive and out-of-control non-paraphilic sexual behavior, including sexual behaviors in response to dysphoric mood states, impulsivity, and risk taking. Although no prior studies of cognitive-behavioral therapy (CBT) for the treatment of HD have been performed, CBT has been found effective for dysphoric mood states and impulsivity. Aim: To investigate the feasibility of a CBT manual developed for HD explored through symptom decrease, treatment attendance, and clients' treatment satisfaction. Methods: Ten men with a diagnosis of HD took part in the CBT group program. Measurements were taken before, during, and at the end of treatment and 3 and 6 months after treatment. Outcomes: The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD: CAS) score that measured the severity of problematic hypersexual symptoms and secondary outcomes were the Hypersexual Disorder Screening Inventory (HDSI) score, the proportion of attended sessions, and the Client Satisfaction Questionnaire (CSQ-8) score. Results: Main results were significant decreases of HD symptoms from before to after treatment on HD: CAS and HDSI scores and a decrease in the number of problematic sexual behaviors during the course of therapy. A high attendance rate of 93% and a high treatment satisfaction score on CSQ-8 also were found. Clinical Implications: The CBT program seemed to ameliorate the symptoms of HD and therefore might be a feasible treatment option. Strengths and Limitations: This study provides data from a CBT program for the treatment of the specific proposed criteria of HD. Because of the small sample and lack of a control group, the results can be considered only preliminary. Conclusion: Although participants reported decreased HD symptoms after attending the CBT program, future studies should evaluate the treatment program with a larger sample and a randomized controlled procedure to ensure treatment effectiveness. Copyright (C) 2017, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  • 14. Hallberg, Jonas
    et al.
    Kaldo, Viktor
    Arver, Stefan
    Dhejne, Cecilia
    Jokinen, Jussi
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Oberg, Katarina Gorts
    A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men2019In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 16, no 5, p. 733-745Article in journal (Refereed)
    Abstract [en]

    Background: Hypersexual disorder (HD) is defined as a condition in which the individual loses control over engagement in sexual behaviors, leading to distress and negative effects on key life areas. Cognitive behavioral therapy (CBT) has been proven to reduce symptoms of hypersexual behavior; however, no randomized controlled study of CBT interventions for HD has been reported previously.

    Aim: To investigate the efficacy of group-administered CBT for HD.

    Methods: Male participants (n = 137) diagnosed with HD, were randomized between 7 weeks of group-administered CBT (n = 70) and a waitlist control receiving the intervention after 8 weeks (n = 67). Measurements were administered at pre-, mid-, and posttreatment, with follow-up after 3 and 6 months.

    Outcomes: The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS), and secondary outcomes were the Sexual Compulsivity Scale (SCS) and measures of depression (Montgomery–Åsberg Depression Rating Scale (MADRS-S), psychological distress (Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), and treatment satisfaction (CSQ-8).

    Results: A significantly greater decrease in HD symptoms and sexual compulsivity, as well as significantly greater improvements in psychiatric well-being, were found for the treatment condition compared with the waitlist. These effects remained stable at 3 and 6 months after treatment.

    Clinical Implications: CBT can ameliorate HD symptoms and psychiatric distress, suggesting that the CBT program may serve as a first-line treatment in clinical settings.

    Strengths & Limitations: This is the first randomized controlled study evaluating the efficacy of a CBT program in a rather large sample of HD-specific diagnosed men. The long-term treatment effects are vague due to the low response rate on follow-up measurements, and the efficacy of this program for hypersexual women remains unknown.

    Conclusion: This study supports the efficacy of a group-administered CBT program as a treatment option for HD; however, future studies should include women, comprise dismantling analysis of the constituting interventions, and evaluate other treatment formats, for example, administration via the Internet.

  • 15.
    Hallberg, Jonas
    et al.
    Karolinska Institutet, Sweden;Karolinska University Hospital, Sweden.
    Kaldo, Viktor
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology. Karolinska Institutet, Sweden;Stockholm County Council, Sweden.
    Arver, Stefan
    Karolinska Institutet, Sweden;Karolinska University Hospital, Sweden.
    Dhejne, Cecilia
    Karolinska Institutet, Sweden;Stockholm County Council, Sweden.
    Jokinen, Jussi
    Karolinska Institutet, Sweden;Stockholm County Council, Sweden;Umeå University, Sweden.
    Oberg, Katarina Gorts
    Karolinska Institutet, Sweden;Karolinska University Hospital, Sweden.
    A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men2019In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 16, no 5, p. 733-745Article in journal (Refereed)
    Abstract [en]

    Background: Hypersexual disorder (HD) is defined as a condition in which the individual loses control over engagement in sexual behaviors, leading to distress and negative effects on key life areas. Cognitive behavioral therapy (CBT) has been proven to reduce symptoms of hypersexual behavior; however, no randomized controlled study of CBT interventions for HD has been reported previously. Aim: To investigate the efficacy of group-administered CBT for HD. Methods: Male participants (n = 137) diagnosed with HD, were randomized between 7 weeks of group-administered CBT (n = 70) and a waitlist control receiving the intervention after 8 weeks (n = 67). Measurements were administered at pre-, mid-, and posttreatment, with follow-up after 3 and 6 months. Outcomes: The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD: CAS), and secondary outcomes were the Sexual Compulsivity Scale (SCS) and measures of depression (Montgomery-Asberg Depression Rating Scale (MADRS-S), psychological distress (Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), and treatment satisfaction (CSQ-8). Results: A significantly greater decrease in HD symptoms and sexual compulsivity, as well as significantly greater improvements in psychiatric well-being, were found for the treatment condition compared with the waitlist. These effects remained stable at 3 and 6 months after treatment. Clinical Implications: CBT can ameliorate HD symptoms and psychiatric distress, suggesting that the CBT program may serve as a first-line treatment in clinical settings. Strengths & Limitations: This is the first randomized controlled study evaluating the efficacy of a CBT programin a rather large sample of HD-specific diagnosed men. The long-termtreatment effects are vague due to the low response rate on follow-up measurements, and the efficacy of this program for hypersexual women remains unknown. Conclusion: This study supports the efficacy of a group-administered CBT program as a treatment option for HD; however, future studies should include women, comprise dismantling analysis of the constituting interventions, and evaluate other treatment formats, for example, administration via the Internet. Copyright (C) 2019, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  • 16.
    Hannan, Johanna L.
    et al.
    Johns Hopkins School of Medicine, Baltimore, MD, USA.
    Kutlu, Omer
    Karadeniz Technical University, Trabzon, Turkey.
    Stopak, Bernard L.
    Johns Hopkins School of Medicine, Baltimore, MD, USA.
    Liu, Xiaopu
    Johns Hopkins School of Medicine, Baltimore, MD, USA.
    Castiglione, Fabio
    San Raffaele Research Institute, Milan, Italy .
    Hedlund, Petter
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Pharmacology. San Raffaele Research Institute, Milan, Italy .
    Burnett, Arthur L.
    Johns Hopkins School Med, MD 21287 USA .
    Bivalacqua, Trinity J.
    Johns Hopkins School of Medicine, Baltimore, MD, USA.
    Valproic acid prevents penile fibrosis and erectile dysfunction in cavernous nerve-injured rats2014In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 11, no 6, p. 1442-1451Article in journal (Refereed)
    Abstract [en]

    Introduction Bilateral cavernous nerve injury (BCNI) causes profound penile changes such as apoptosis and fibrosis leading to erectile dysfunction (ED). Histone deacetylase (HDAC) has been implicated in chronic fibrotic diseases. Aims This study will characterize the molecular changes in penile HDAC after BCNI and determine if HDAC inhibition can prevent BCNI-induced ED and penile fibrosis. Methods Five groups of rats (8-10 weeks, n=10/group) were utilized: (i) sham; (ii and iii) BCNI 14 and 30 days following injury; and (iv and v) BCNI treated with HDAC inhibitor valproic acid (VPA 250mg/kg; 14 and 30 days). All groups underwent cavernous nerve stimulation (CNS) to determine intracavernosal pressure (ICP). Penile HDAC3, HDAC4, fibronectin, and transforming growth factor-1 (TGF-1) protein expression (Western blot) were assessed. Trichrome staining and the fractional area of fibrosis were determined in penes from each group. Cavernous smooth muscle content was assessed by immunofluorescence to alpha smooth muscle actin (-SMA) antibodies. Main Outcome Measures We measured ICP; HDAC3, HDAC4, fibronectin, and TGF-1 protein expression; penile fibrosis; penile -SMA content. Results There was a voltage-dependent decline (Pless than0.05) in ICP to CNS 14 and 30 days after BCNI. Penile HDAC3, HDAC4, and fibronectin were significantly increased (Pless than0.05) 14 days after BCNI. There was a slight increase in TGF-1 protein expression after BCNI. Histological analysis showed increased (Pless than0.05) corporal fibrosis after BCNI at both time points. VPA treatment decreased (Pless than0.05) penile HDAC3, HDAC4, and fibronectin protein expression as well as corporal fibrosis. There was no change in penile -SMA between all groups. Furthermore, VPA-treated BCNI rats had improved erectile responses to CNS (Pless than0.05). Conclusion HDAC-induced pathological signaling in response to BCNI contributes to penile vascular dysfunction. Pharmacological inhibition of HDAC prevents penile fibrosis, normalizes fibronectin expression, and preserves erectile function. The HDAC pathway may represent a suitable target in preventing the progression of ED occurring post-radical prostatectomy.

  • 17.
    Heddini, Ulrika
    et al.
    Karolinska Institutet.
    Bohm-Starke, Nina
    Karolinska Institutet.
    Grönbladh, Alfhild
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Nyberg, Fred
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Nilsson, Kent W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Johannesson, Ulrika
    Karolinska Institutet.
    Serotonin receptor gene (5HT-2A) polymorphism is associated with provoked vestibulodynia and comorbid symptoms of pain2014In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 11, no 12, p. 3064-3071Article in journal (Refereed)
    Abstract [en]

    IntroductionProvoked vestibulodynia (PVD) is a common type of dyspareunia among young women. The patho-physiology remains largely unclear. Women with PVD have general pain hypersensitivity and often report additional pain symptoms. Signs point towards PVD being a chronic pain disorder similar to other syndromes of longstanding pain, including a common comorbidity of anxiety and depression. Polymorphism in the serotonin receptor gene, 5HT-2A, has been associated with other chronic pain disorders such as fibromyalgia but has not been investigated in PVD patients. AimWe aimed to investigate a possible contribution of polymorphism in the 5HT-2A gene to the etiology of PVD as well as a potential influence on pain sensitivity. MethodsIn this case-control study 98 women with PVD and 103 healthy controls between 18 and 44 years and in the same menstrual cycle phase completed questionnaires and underwent quantitative sensory testing. Venous blood samples were collected for DNA isolation. Main Outcome MeasuresConcomitant pain was reported, a bodily pain score was created and pressure pain thresholds (PPTs) on the arm, leg, and in the vestibule were measured. Intensity of coital pain was rated on a visual analog scale, range 0-100. The T102C (rs6313) and A-1438G (rs6311) single nucleotide polymorphisms (SNPs) in the 5HT-2A gene were analyzed. ResultsThe probability of PVD was elevated in participants carrying the 1438G- and 102C-alleles of the 5HT-2A gene (OR 2.9). The G-/C- genotypes were also associated with more concomitant bodily pain in addition to the dyspareunia, but not with experimental PPTs or coital pain ratings. PVD patients reported more concomitant bodily pain and had lower PPTs compared with controls. ConclusionThe results indicate a contribution of alterations in the serotonergic system to the patho-genesis of PVD and gives further evidence of PVD being a general pain disorder similar to other chronic pain disorders. Heddini U, Bohm-Starke N, Gronbladh A, Nyberg F, Nilsson KW, and Johannesson U. Serotonin receptor gene (5HT-2A) polymorphism is associated with provoked vestibulodynia and comorbid symptoms of pain.

  • 18. Heddini, Ulrika
    et al.
    Bohm-Starke, Nina
    Nilsson, Kent W.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
    Johannesson, Ulrika
    Provoked Vestibulodynia-Medical Factors and Comorbidity Associated with Treatment Outcome2012In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 9, no 5, p. 1400-1406Article in journal (Refereed)
    Abstract [en]

    Introduction. Provoked vestibulodynia (PVD) is the most common cause of dyspareunia in young women. The etiology is unclear, and there is little knowledge of how to predict treatment outcome.

    Aim. The aim of this study was to identify medical factors associated with treatment outcome and coital pain in women with PVD.

    Methods. Seventy women previously treated for PVD at a vulvar open care unit completed questionnaires and a quantitative sensory testing session.

    Main Outcome Measures. Concomitant bodily pain and treatment outcome were surveyed using a study specific questionnaire. Coital pain was rated on a visual analog scale (VAS), range 0100. Psychometric screening was carried out using the Hospital Anxiety and Depression Scale. Pressure pain thresholds on the arm, leg, and in the vestibulum were measured using pressure algometers.

    Results. Major improvement/complete recovery was more likely in PVD patients with a maximum of one other concomitant pain disorder compared with patients with four or more (odds ratio = 7.8, confidence interval: 1.249.4, P = 0.03). In a multiple linear regression model, the number of other pain disorders (P < 0.01) and a diagnosis of primary PVD (P = 0.04) were positively associated with the coital VAS pain score. Women with secondary PVD reported major improvement/complete recovery to a higher extent than women with primary PVD (z = 2.11, P = 0.04).

    Conclusion. A successful treatment outcome was more likely in PVD patients with fewer other concomitant pain conditions. The number of other bodily pain conditions was also associated to the intensity of the coital pain. Additionally, the results indicate higher incomplete response rates to treatment in women with primary PVD compared with secondary PVD.

  • 19.
    Joensson, Emma H.
    et al.
    University of Gothenburg, Sweden.
    Backlund Wasling, Helena
    University of Gothenburg, Sweden.
    Wagnbeck, Vicktoria
    University of Gothenburg, Sweden.
    Dimitriadis, Menelaos
    University of Medical Centre Groningen, Netherlands.
    Georgiadis, Janniko R.
    University of Medical Centre Groningen, Netherlands.
    Olausson, Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
    Croy, Ilona
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Technical University of Dresden, Germany.
    Unmyelinated Tactile Cutaneous Nerves Signal Erotic Sensations2015In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 12, no 6, p. 1338-1345Article in journal (Refereed)
    Abstract [en]

    Introduction. Intrapersonal touch is a powerful tool for communicating emotions and can among many things evoke feelings of eroticism and sexual arousal. The peripheral neural mechanisms of erotic touch signaling have been less studied. C tactile afferents (unmyelinated low-threshold mechanoreceptors), known to underpin pleasant aspects of touch processing, have been posited to play an important role. MethodIn two studies, we investigated the relationship between C tactile activation and the perception of erotic and pleasant touch, using tactile brushing stimulation. In total, 66 healthy subjects (37 women, age range 19-51 years) were examined. In study 1 (n=20), five different stroking velocities were applied to the forearm and the inner thigh. The participants answered questions about partnership, mood, and touch. In study 2 (n=46), the same five stroking velocities were applied to the forearm. The participants answered questions about partnership, touch, and sexuality. ResultsBoth touch eroticism and pleasantness were rated significantly higher for C tactile optimal velocities compared with suboptimal velocities. No difference was found between the ratings of the thigh and the forearm. The velocity-dependent rating curves of pleasantness, intensity, and eroticism differed from each other. Pleasantness was best explained by a quadratic fit, intensity by a linear fit, and eroticism by both. A linear transformation of pleasantness and intensity predicted the observed eroticism ratings reliably. Eroticism ratings were negatively correlated with length of relationship. ConclusionTouch was rated most erotic when perceived as pleasant and weak. In human hairy skin, perception of pleasantness is correlated with the firing rate of C tactile afferents, and perception of intensity is correlated with the firing rate of A afferents. Accordingly, eroticism may be perceived most readily for touch stimuli that induce high activity in C tactile fibers and low activity in A fibers. Jonsson EH, Backlund Wasling H, Wagnbeck V, Dimitriadis M, Georgiadis JR, Olausson H, and Croy I. Unmyelinated tactile cutaneous nerves signal erotic sensations. J Sex Med 2015;12:1338-1345.

  • 20.
    Kastbom, Åsa
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Parents' reports on 7-12-years old childrens sexual behavior2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no Suppl. 3, p. 270-270Article in journal (Other academic)
    Abstract [en]

    Aim: To understand if a sexual behaviour in a child is a sign of sexual abuse or neglect we need to investigate sexual behaviours among chil-dren. In the present study we investigated Swedish children age 7–12 to determine what constitutes usual and unusual sexual behaviours.

    Methods: Parents of 418 children answered questionnaires about their child’s behaviour, both general and sexual, and about their own attitudes.

    Results: We found that most sexual behaviours we asked about are common, and are in part related to or vary with age and gender. A small number of sexual behaviours were found to be very unusual in this normative group of children.

    Conclusion: Behaviours usually referred to as sexualized and problematic and perhaps a sign of sexual abuse or neglect were very rare in this normative sample of children 7–12 years of age.

  • 21.
    Kjellgren, Cecilia
    et al.
    Lund University.
    Priebe, Gisela
    Lund University.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Mossige, Svein
    NOVA Norwegian Social Research.
    Langström, Niklas
    Karolinska Institutet.
    Female Youth Who Sexually Coerce: Prevalence, Risk, and Protective Factors in Two National High School Surveys2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no 12, p. 3354-3362Article in journal (Refereed)
    Abstract [en]

    Introduction. Sexual coercion is recognized as a serious societal problem. Correlates and risk factors of sexually abusive behavior in females are not well known. Aim. Etiological theory and empirical study of female perpetrators of sexual coercion are usually based on small or highly selected samples. Specifically, population-based data are needed to elucidate risk/protective factors. Main Outcome Measures. Main outcome measures include a self-report questionnaire containing 65 items tapping socio-demographic and health conditions, social relations, sexual victimization, conduct problems and a set of normative and deviant sexual cognitions, attitudes, and behaviors. Methods. We used a 2003-2004 survey of sexual attitudes and experiences among high school students in Norway and Sweden to identify risk factors and correlates to sexually coercive behavior (response rate 80%); 4,363 females participated (Mean = 18.1 years). Results. Thirty-seven women (0.8%) reported sexual coercion (ever talked someone into, used pressure, or forced somebody to have sex). Sexually coercive compared with non-coercive women were similar on socio-demographic variables, but reported less parental care and more parental overprotection, aggression, depressive symptoms, and substance misuse. Also, sexually coercive females reported more sexual lust, sex partners, penetrative sexual victimization, rape myths, use of violent porn, and friends more likely to use porn. When using the Swedish subsample to differentiate risk factors specific for sexual coercion from those for antisocial behavior in general, we found less cannabis use, but more sexual preoccupation, pro-rape attitudes, and friends using violent porn in sexually coercive compared with non-sex conduct problem females. Conclusions. Sexually coercive behavior in high school women was associated with general risk/needs factors for antisocial behavior, but also with specific sexuality-related risk factors. This differential effect has previously been overlooked, agrees with similar findings in men, and should have substantial etiological importance. Kjellgren C, Priebe G, Svedin CG, Mossige S, and Langstrom N. Female youth who sexually coerce: Prevalence, risk, and protective factors in two national high school surveys.

  • 22.
    Kjellgren, Cecilia
    et al.
    Lund university.
    Priebe, Gisela
    Lund university.
    Svedin, Carl Göran
    Linköping University.
    Mossige, Svein
    NOVA—Norwegian Social Research, Norway.
    Långström, Niklas
    Karolinska Institutet.
    Female youth who sexually coerce: prevalence, risk and protective factors in two national high school surveys2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no 12, p. 3354-3362Article in journal (Refereed)
    Abstract [en]

    Introduction.  Sexual coercion is recognized as a serious societal problem. Correlates and risk factors of sexually abusive behavior in females are not well known.

    Aim.  Etiological theory and empirical study of female perpetrators of sexual coercion are usually based on small or highly selected samples. Specifically, population-based data are needed to elucidate risk/protective factors.

    Main Outcome Measures.  Main outcome measures include a self-report questionnaire containing 65 items tapping socio-demographic and health conditions, social relations, sexual victimization, conduct problems and a set of normative and deviant sexual cognitions, attitudes, and behaviors.

    Methods.  We used a 2003–2004 survey of sexual attitudes and experiences among high school students in Norway and Sweden to identify risk factors and correlates to sexually coercive behavior (response rate 80%); 4,363 females participated (Mean = 18.1 years).

    Results.  Thirty-seven women (0.8%) reported sexual coercion (ever talked someone into, used pressure, or forced somebody to have sex). Sexually coercive compared with non-coercive women were similar on socio-demographic variables, but reported less parental care and more parental overprotection, aggression, depressive symptoms, and substance misuse. Also, sexually coercive females reported more sexual lust, sex partners, penetrative sexual victimization, rape myths, use of violent porn, and friends more likely to use porn. When using the Swedish subsample to differentiate risk factors specific for sexual coercion from those for antisocial behavior in general, we found less cannabis use, but more sexual preoccupation, pro-rape attitudes, and friends using violent porn in sexually coercive compared with non-sex conduct problem females.

    Conclusions.  Sexually coercive behavior in high school women was associated with general risk/needs factors for antisocial behavior, but also with specific sexuality-related risk factors. This differential effect has previously been overlooked, agrees with similar findings in men, and should have substantial etiological importance.

  • 23.
    Knorn, Steffi
    et al.
    Signals and Systems, Uppsala University.
    Varagnolo, Damiano
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Signals and Systems.
    Melles, Reinhile
    Department of Psychology and Neuroscience, Clinical Psychological Science, Behavioural Medicine, Maastricht Universitair Medisch Centrum, Maastricht.
    Dewitte, Marieke
    Department of Psychology and Neuroscience, Clinical Psychological Science, Behavioural Medicine, Maastricht Universitair Medisch Centrum, Maastricht.
    Mathematical Modelling of Pressure Versus Pain Relations in Women Suffering From Dyspareunia2017In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 14, no 5:Suppl. 4, p. e205-e350Article in journal (Refereed)
  • 24.
    Knorn, Steffi
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Signals and Systems Group.
    Varagnolo, Damiano
    Lulea Univ Technol, Dept Comp Sci Elect & Space Engn, Lulea, Sweden..
    Melles, Reinhile
    Maastricht Univ, Med Ctr, Dept Psychol & Neurosci, Clin Psychol Sci,Behav Med, Maastricht, Netherlands..
    Dewitte, Marieke
    Maastricht Univ, Med Ctr, Dept Psychol & Neurosci, Clin Psychol Sci,Behav Med, Maastricht, Netherlands..
    Mathematical Modelling Of Pressure Versus Pain Relations In Women Suffering From Dyspareunia2017In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 14, no 5, p. E335-E335Article in journal (Other academic)
  • 25.
    Lindroth, Malin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Sexual Health Among Young People Forcibly Placed at Group Homes in Sweden (6:21)2017In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 14, no 5, p. e269-e270Article in journal (Refereed)
  • 26.
    Lindroth, Malin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Transgender People and Sexual Health – Findings From a Swedish Interview Study2017In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 14, no 5, p. e270-e270Article in journal (Refereed)
  • 27.
    Liong, Chan Ching Mario
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Factors influencing distress toward erectile dysfunction and attitude toward erectile dysfunction drugs among middle-aged and elderly chinese women and men in Hong Kong2013In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 10, no 3, p. 782-790Article in journal (Refereed)
    Abstract [en]

    Aim.  This study aims to explain distress toward erectile dysfunction (ED), attitude toward ED drugs, and experiences with ED drug use in terms of sexual attitudes, relationship satisfaction, and sociodemographic factors among the middle-aged and elderly Chinese population. Studies show that a significant number of middle-aged and elderly men in Asia suffer from ED. However, people's attitudes toward ED drugs are not positive. Few studies have sought to reveal the influencing factors of this negative attitude.

    Methods.  Nine hundred forty-six Hong Kong women and men aged 36–80 with stable partners were administered a structured questionnaire through face-to-face street-intercept survey. Self-reporting on single-item questions using a five-point Likert scale was adopted for most of the variables, including attitude toward sex, relationship satisfaction, distress toward ED, and attitude toward ED drugs. Perceived importance of sex in an intimate relationship and attitude toward sex were assessed through three items. Respondents were asked to report whether they had taken ED drugs or bought ED drugs for their partners.

    Results.  While perceived importance of sex in an intimate relationship and distress toward ED both contributed to the estimation of attitudes toward ED drugs for both genders, relationship satisfaction was only associated with men's attitude, while women's attitude was related to two other factors: relationship status and income level. Both age and attitude toward ED drugs influenced experiences with ED drug use for women and men. Men's experience with ED drug use was further related to the perceived importance of sex and to men's self-esteem and relationship status.

    Conclusion.  Results of this study could help identify people who are disturbed by ED but reluctant to seek treatment. Clinicians and public health policy makers could make use of the findings to encourage proper understanding of ED.

  • 28. Löfgren-Mårtenson, Charlotta
    et al.
    Sorbring, Emma
    University West, Department of Social and Behavioural Studies, Division of Psychology and Organisation Studies.
    Molin, Martin
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    "Tangled up in blue": Views of parents and professionals on internet use for sexual purposes among young people with intellectual disabilities2015In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 12, no suppl 5, SI, p. 347-347Article in journal (Refereed)
  • 29.
    Löfgren-Mårtenson, Lotta
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Social Work (SA). Malmö högskola, Centre for Sexology and Sexuality Studies (CSS).
    Sorbring, Emma
    Molin, Martin
    “Tangled up in blue”: Views of parents and professionals on internet use for sexual purposes among young people with intellectual disabilities2015In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 12, no Supplement 5, Proceedings from the 22nd Congress of the World Association for Sexual Health, Singapore, July 25–28, 2015, p. 347-347Article in journal (Other academic)
    Abstract [en]

    Introduction & Objectives: This study examines the views of parentsand professionals on internet use for sexual purposes among youngpeople with intellectual disabilities (18–20 yrs.). Although media atten-tion focuses heavily on the risk of deception on the Internet and on easyaccess to pornography, the main concern is articulated in relation tovulnerable groups’ usage. While people with intellectual disabilitiesrequire support by their surroundings, we need to know more abouttheir views on internet usage.Methods: Five semi-structured focus group interviews were con-ducted with professionals (n = 8) working at special schools and withparents (n = 5). The interviews were analysed with thematic analysis,with the theory of sexual scripts guiding the process.Results: The internet is seen as a social arena with complex challengesfor (1) love and sexuality (2), sexual conduct, and (3) sexual risk andopportunities. Even though people with intellectual disabilities areregarded as more vulnerable than other youths, their parents view therisk of their adolescent being lonely as greater than the risk of thembeing abused or misled. Further, girls are viewed as more vulnerableand contact seeking on the internet than boys. Moreover, pornographysites are discussed only when it comes to the boys’ behaviour.Dating unknown persons is connected to the girls’ behaviour. A Net-script consisting of rules is geared towards the young people with anintellectual disability. However, a change to a more nuanced Net-script is shown while the group of youth with intellectual disabilities are seenas more heterogeneous than in earlier research.Conclusion: In-depth knowledge about parents’ and professionals’perspectives on the internet and sexuality is important as their attitudesand behaviour are essential for the young peoples’ access to supportand for opportunities to develop their own capacity and to experiencelove and sexuality.

  • 30.
    Nekoo, Elham Azimi
    et al.
    Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
    Burri, Andrea
    Department of Psychology, University of Zurich, Zurich, Switzerland.
    Ashrafti, Farzaneh
    Neurology Research Center, Department of Midwifery, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. ADULT.
    Koening, Harold G.
    Departments of Medicine and Psychiatry, Duke University Medical Center, Durham, NC, United States and Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
    Derogatis, Leonard R.
    Center for Sexual Medicine at Sheppard Pratt, Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
    Pakpour, Amir H.
    Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran and Department of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran.
    Psychometric properties of the Iranian version of the female sexual distress scale-revised in women2014In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 11, no 4, p. 995-1004Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: 

    Several tools for the assessment of sexuality-related distress are now available. The Female Sexual Distress Scale (FSDS) and its revised version (FSDS-R) are extensively validated and among the most widely used tools to measure sexually related personal distress.

    AIM:

    The aim of the study was to determine the psychometric properties of the Iranian version of the FSDS-R in a population sample of Iranianwomen.

    METHODS:

    A total of 2,400 married and potentially sexually active women were recruited and categorized into three groups including (i) a healthy control group; (ii) a group of women with hypoactive sexual desire disorder (HSDD); and (iii) a group of women suffering from other female sexualdysfunction (FSD). Participants were asked to complete a set of questionnaires including the Iranian version of the Female Sexual Function Index (FSFI-IV), the FSDS-R, and the Hospital Anxiety and Depression Scale.

    MAIN OUTCOME MEASURES:

    Sexuality-related distress and FSD as assessed by the Iranian version of the FSDS-R and the FSFI-IV are the main outcome measures.

    RESULTS:

    Internal consistencies and test-retest reliability of the FSDS-R across the three assessments points for the three groups were >0.70. The FSDS-R correlated significantly with anxiety, depression, and the FSFI total score. Significant differences in the FSDS-R scores were found between healthy women, women with HSDD, and women with other types of FSD. Factor analysis of the FSDS-R yielded a single-factor model with an acceptable fit.

    CONCLUSIONS:

    The Persian version of the FSDS-R is a valid and reliable instrument for the assessment of sexuality-related distress in Iranianwomen and can be used to screen patients with HSDD.

  • 31. Nilsson, Andreas E
    et al.
    Carlsson, Stefan
    Johansson, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Urology.
    Jonsson, Martin N
    Adding, Christofer
    Nyberg, Tommy
    Steineck, Gunnar
    Wiklund, N Peter
    Orgasm-associated urinary incontinence and sexual life after radical prostatectomy2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, The journal of sexual medicine, Vol. 8, no 9, p. 2632-2639Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION:

    Involuntary release of urine during sexual climax, orgasm-associated urinary incontinence, occurs frequently after radical prostatectomy. We know little about its prevalence and its effect on sexual satisfaction.

    AIM:

    To determine the prevalence of orgasm-associated incontinence after radical prostatectomy and its effect on sexual satisfaction.

    METHODS:

    Consecutive series, follow-up at one point in calendar time of men having undergone radical prostatectomy (open surgery or robot-assisted laparoscopic surgery) at Karolinska University Hospital, Stockholm, Sweden, 2002-2006. Of the 1,411 eligible men, 1,288 (91%) men completed a study-specific questionnaire.

    MAIN OUTCOME MEASURE:

    Prevalence rate of orgasm-associated incontinence.

    RESULTS:

    Of the 1,288 men providing information, 691 were sexually active. Altogether, 268 men reported orgasm-associated urinary incontinence, of whom 230 (86%) were otherwise continent. When comparing them with the 422 not reporting the symptom but being sexually active, we found a prevalence ratio (with 95% confidence interval) of 1.5 (1.2-1.8) for not being able to satisfy the partner, 2.1 (1.1-3.5) for avoiding sexual activity because of fear of failing, 1.5 (1.1-2.1) for low orgasmic satisfaction, and 1.4 (1.2-1.7) for having sexual intercourse infrequently. Prevalence ratios increase in prostate-cancer survivors with a higher frequency of orgasm-associated urinary incontinence.

    CONCLUSION:

    We found orgasm-associated urinary incontinence to occur among a fifth of prostate cancer survivors having undergone radical prostatectomy, most of whom are continent when not engaged in sexual activity. The symptom was associated with several aspects of sexual life.

  • 32. Plym, Anna
    et al.
    Folkvaljon, Yasin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Garmo, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Holmberg, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Johansson, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Urology.
    Fransson, Per
    Stattin, Par
    Lambe, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Drug Prescription for Erectile Dysfunction Before and After Diagnosis of Localized Prostate Cancer2014In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 11, no 8, p. 2100-2108Article in journal (Refereed)
    Abstract [en]

    Introduction. Despite the high prevalence of erectile dysfunction (ED) in men with prostate cancer, little is known about the use of ED drugs. Also, the possible influence of socioeconomic factors on ED drug use has not been studied previously. Aim. The aim of this study was to examine determinants and patterns of ED drug use before and after diagnosis in men with localized prostate cancer. Methods. Using a nationwide population-based cohort, 25,390 men with localized prostate cancer diagnosed between 2006 and 2009 and 126,944 control men were identified and followed for filled ED drug prescriptions over a 3-year period, ranging from 1 year before and up to 2 years after diagnosis. Main Outcome Measures. The main outcome measure was the proportion of men with at least one filled ED drug prescription after diagnosis. Results. The number of men using ED drugs increased markedly following diagnosis. Men who underwent radical prostatectomy had the strongest increase, with a cumulative proportion of 74% for at least one filled prescription within the first 2 years after diagnosis. The corresponding proportion was 33% in men treated with radiotherapy, 21% in men on active surveillance, 10% in men on watchful waiting, and 8% in control men. Among men who underwent prostatectomy, usage attenuated over time. Determinants of postdiagnostic use were young age at diagnosis, high income, high education, and a low- or intermediate-risk cancer. Conclusion. Although drugs for ED are commonly prescribed after diagnosis, use among most men is transient and influenced by socioeconomic status. Posttreatment counseling and affordable ED drugs are likely to reduce treatment dropout and disparities in use and help improve sexual health and quality of life in men with prostate cancer.

  • 33. Plym, Anna
    et al.
    Folkvaljon, Yasin
    Garmo, Hans
    Holmberg, Lars
    Johansson, Eva
    Fransson, Per
    Umeå University, Faculty of Medicine, Department of Nursing.
    Stattin, Pär
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Lambe, Mats
    Drug Prescription for Erectile Dysfunction Before and After Diagnosis of Localized Prostate Cancer2014In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 11, no 8, p. 2100-2108Article in journal (Refereed)
    Abstract [en]

    Introduction: Despite the high prevalence of erectile dysfunction (ED) in men with prostate cancer, little is known about the use of ED drugs. Also, the possible influence of socioeconomic factors on ED drug use has not been studied previously.

    Aim: The aim of this study was to examine determinants and patterns of ED drug use before and after diagnosis in men with localized prostate cancer.

    Methods: Using a nationwide population‐based cohort, 25,390 men with localized prostate cancer diagnosed between 2006 and 2009 and 126,944 control men were identified and followed for filled ED drug prescriptions over a 3‐year period, ranging from 1 year before and up to 2 years after diagnosis.

    Main Outcome Measures: The main outcome measure was the proportion of men with at least one filled ED drug prescription after diagnosis.

    Results: The number of men using ED drugs increased markedly following diagnosis. Men who underwent radical prostatectomy had the strongest increase, with a cumulative proportion of 74% for at least one filled prescription within the first 2 years after diagnosis. The corresponding proportion was 33% in men treated with radiotherapy, 21% in men on active surveillance, 10% in men on watchful waiting, and 8% in control men. Among men who underwent prostatectomy, usage attenuated over time. Determinants of postdiagnostic use were young age at diagnosis, high income, high education, and a low‐ or intermediate‐risk cancer.

    Conclusion: Although drugs for ED are commonly prescribed after diagnosis, use among most men is transient and influenced by socioeconomic status. Posttreatment counseling and affordable ED drugs are likely to reduce treatment dropout and disparities in use and help improve sexual health and quality of life in men with prostate cancer.

  • 34. Rosen, Raymond C.
    et al.
    Wu, Frederick
    Behre, Hermann M.
    Porst, Hartmut
    Meuleman, Eric J. H.
    Maggi, Mario
    Romero-Otero, Javier
    Martinez-Salamanca, Juan I.
    Jones, Thomas Hugh
    Debruyne, Frans M. J.
    Kurth, Karl-Heinz
    Hackett, Geoff I.
    Quinton, Richard
    Ströberg, Peter
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Reisman, Yacov
    Pescatori, Edoardo S.
    Morales, Antonio
    Bassas, Lluis
    Cruz, Natalio
    Cunningham, Glenn R.
    Wheaton, Olivia A.
    Quality of Life and Sexual Function Benefits of Long-Term Testosterone Treatment: Longitudinal Results From the Registry of Hypogonadism in Men (RHYME)2017In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 14, no 9, p. 1104-1115Article in journal (Refereed)
    Abstract [en]

    Background: The benefits and risks of long-term testosterone administration have been a topic of much scientific and regulatory interest in recent years. Aim: To assess long-term quality of life (QOL) and sexual function benefits of testosterone replacement therapy (TRT) prospectively in a diverse, multinational cohort of men with hypogonadism. Methods: A multinational patient registry was used to assess long-term changes associated with TRT in middle-age and older men with hypogonadism. Comprehensive evaluations were conducted at 6, 12, 24, and 36 months after enrollment into the registry. Outcomes: QOL and sexual function were evaluated by validated measures, including the Aging Males' Symptom (AMS) Scale and the International Index of Erectile Function (IIEF). Results: A total of 999 previously untreated men with hypogonadism were enrolled at 25 European centers, 750 of whom received TRT at at least one visit during the period of observation. Patients on TRT reported rapid and sustained improvements in QOL, with fewer sexual, psychological, and somatic symptoms. Modest improvements in QOL and sexual function, including erectile function, also were noted in RHYME patients not on TRT, although treated patients showed consistently greater benefit over time in all symptom domains compared with untreated patients. AMS total scores for patients on TRT were 32.8 (95% confidence interval = 31.3-34.4) compared with 36.6 (95% confidence interval = 34.8-38.5) for untreated patients (P < .001). Small but significant improvements in IIEF scores over time also were noted with TRT. Approximately 25% of treated and untreated men also used phosphodiesterase type 5 inhibitors, with notable differences in the frequency of phosphodiesterase type 5 inhibitor prescription use according to physician specialty and geographic site location. Clinical Implications: TRT-related benefits in QOL and sexual function are well maintained for up to 36 months after initiation of treatment. Strengths and Limitations: The major strengths are the large, diverse patient population being treated in multidisciplinary clinical settings. The major limitation is the frequency of switching from one formulation to another. Conclusion: Overall, we confirmed the broad and sustained benefits of TRT across major QOL dimensions, including sexual, somatic, and psychological health, which were sustained over 36 months in our treatment cohort. Copyright (C) 2017, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  • 35. Ryding, Elsa Lena
    et al.
    Blom, Carina
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Validation of the Swedish Version of the Female Sexual Function Index (FSFI) in Women with Hypoactive Sexual Desire Disorder2015In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 12, no 2, p. 341-349Article in journal (Refereed)
    Abstract [en]

    IntroductionThe Female Sexual Function Index (FSFI) has been validated for use in many countries. It has been used for clinical and research purposes in Sweden, but the reliability and validity of the Swedish version have never been tested. AimThe aim of this study was to investigate the psychometric properties of the Swedish version of the FSFI. MethodsAfter informed consent, 50 women with a diagnosis of hypoactive sexual desire disorder (HSDD) and 58 age-matched healthy volunteers completed the questionnaires. Main Outcome MeasuresReliability was tested by Cronbach's alpha and test-retest by Pearson's correlation, convergent validity by correlation of the FSFI and the Sexual Function Questionnaire (SFQ), divergent validity by correlation of FSFI and the Symptoms Checklist-90-Revised (SCL-90-R), and discriminant validity by Student's t-test and chi-square test to assess differences between women with and without HSDD. ResultsCronbach's alpha was 0.90-0.96 and test-retest reliability was good (r=0.86-0.93) for all domains in the whole sample; reliability was low for lubrication and pain in the control group. Correlations between all corresponding domains of the FSFI and the SFQ were high for the whole sample (r=0.74-0.87) and moderate to high for both the clinical and the control group. There was no correlation between most FSFI domains and the SCL-90-R. Discriminant validity was very good for each of the FSFI domains (P=0.001, t=7.05-15.58), although the controls reported relatively low scores on the desire domain. The total FSFI score was 31.37 (standard deviation [SD] 2.66) for the clinical group and 17.47 (SD 5.33) for the controls (P=0.001, t=15.99). ConclusionThe Swedish version of the FSFI can be used as a validated and reliable instrument for assessing sexual function in women with HSDD. Ryding EL and Blom C. Validation of the Swedish version of the Female Sexual Function Index (FSFI) in women with hypoactive sexual desire disorder.

  • 36.
    Santosa, Ailiana
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden.
    Hakimi, Mohammad
    Ng, Nawi
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden.
    Cross-sectional survey of sexual dysfunction and quality of life among older people in Indonesia2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no 6, p. 1594-1602Article in journal (Refereed)
    Abstract [en]

    Introduction.  The burden of sexual dysfunction among older people in many low- and middle-income countries is not well known. Understanding sexual dysfunction among older people and its impact on quality of life is essential in the design of appropriate health promotion programs.

    Aims.  To assess levels of sexual function and their association with quality of life while controlling for different sociodemographic determinants and chronic diseases among men and women over 50 years of age in rural Indonesia.

    Methods.  A cross-sectional study was conducted in the Purworejo District, Central Java, Indonesia in 2007. The study involved 14,958 men and women over 50 years old. The association between sexual dysfunction and quality of life after controlling for potential confounders (e.g., sociodemographic determinants and self-reported chronic diseases) was analyzed by multivariable logistic regression.

    Main Outcome Measures.  Self-reported quality of life.

    Results.  Older men more commonly reported sexual activity, and sexual problems were more common among older women. The majority of older men and women reported their quality of life as good. Lack of sexual activity, dissatisfaction in sexual life, and presence of sexual problems were associated with poor self-reported quality of life in older men after adjustment for age, marital status, education, and history of chronic diseases. A presence of sexual problems was the only factor associated with poor self-reported quality of life in women. Being in a marital relationship might buffer the effect of sexual problems on quality of life in men and women.

    Conclusion.  Sexual dysfunction is associated with poor quality of life among older people in a rural Javanese setting. Therefore, promotion of sexual health should be an integral part of physical and mental health campaigns in older populations.

  • 37.
    Ström, Jakob
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry. Orebro Univ, Sweden.
    Ingberg, Edvin
    Orebro Univ, Sweden.
    Slezak, Julia
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Theodorsson, Annette
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Neurosurgery.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Male Testosterone Does Not Adapt to the Partners Menstrual Cycle2018In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 15, no 8, p. 1103-1110Article in journal (Refereed)
    Abstract [en]

    Background: It has not yet been established whether men in heterosexual relationships adapt their hormone levels to their female partners menstrual cycle to allocate reproductive resources to the period when the female is actually fertile. Aim: This prospective observational study tested the hypothesis that some males have peaks in testosterone or acne (a possible biomarker for androgen activity) near their partners ovulation, whereas other males display the opposite pattern. Methods: 48 couples supplied menstrual cycle data, male salivary samples, and a protocol of daily activities for 120 days. Daily saliva samples were analyzed for testosterone concentrations by enzyme-linked immunosorbent assay. The main hypothesis was tested by analyzing whether each individual males testosterone/acne response to ovulation (either an increase or a decrease in comparison to the individuals average levels) was stable over time. To do this, we analyzed the Spearman correlation between individually normalized periovulatory testosterone and acne during the first half of the study versus the second half of the study. Outcomes: Correlation between each male individuals periovulatory testosterone and acne patterns during the first half of the study versus the second half of the study. Results: No predictability in the male individuals testosterone (Spearmans rho = -0.018, P = .905) or acne (Spearmans rho = -0.036, P = .862) levels during ovulation was found. Clinical translation: The study being "negative," there is no obvious translational potential in the results. Strengths and limitations: The main strength of this study lies in the excellent compliance of the study participants and the large number of sampling timepoints over several menstrual cycles, thereby allowing each male individual to be his own control subject. A limitation is that samples were only obtained in the morning; however, including later timepoints would have introduced a number of confounders and would also have hampered the studys feasibility. Conclusions: The current results strongly indicate that male morning testosterone levels neither increase nor decrease in response to the partners ovulation. This discordance to previous laboratory studies could indicate either that (i) the phenomenon of hormonal adaptation of men to women does not exist and earlier experimental studies should be questioned, (ii) that the phenomenon is short-lived/acute and wanes if the exposure is sustained, or (iii) that the male testosterone response may be directed toward other women than the partner. Copyright (C) 2018, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.

  • 38.
    Ström, Jakob O.
    et al.
    Örebro University, School of Medical Sciences. Örebro University, School of Medical Sciences, Department of Neurology, Örebro, Sweden; Linköping University, Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping, Sweden .
    Ingberg, Edvin
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Infectious Diseases.
    Slezak, Julia K.
    Linköping University, Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping, Sweden .
    Theodorsson, Annette
    Linköping University, Department of Neurosurgery and Department of Clinical and Experimental Medicine, Linköping, Sweden.
    Theodorsson, Elvar
    Linköping University, Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping, Sweden .
    Male Testosterone Does Not Adapt to the Partner's Menstrual Cycle2018In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 15, no 8, p. 1103-1110Article in journal (Refereed)
    Abstract [en]

    Background: It has not yet been established whether men in heterosexual relationships adapt their hormone levels to their female partner's menstrual cycle to allocate reproductive resources to the period when the female is actually fertile.

    Aim: This prospective observational study tested the hypothesis that some males have peaks in testosterone or acne (a possible biomarker for androgen activity) near their partners' ovulation, whereas other males display the opposite pattern.

    Methods: 48 couples supplied menstrual cycle data, male salivary samples, and a protocol of daily activities for 120 days. Daily saliva samples were analyzed for testosterone concentrations by enzyme-linked immunosorbent assay. The main hypothesis was tested by analyzing whether each individual male's testosterone/acne response to ovulation (either an increase or a decrease in comparison to the individual's average levels) was stable over time. To do this, we analyzed the Spearman correlation between individually normalized periovulatory testosterone and acne during the first half of the study versus the second half of the study.

    Outcomes: Correlation between each male individual's periovulatory testosterone and acne patterns during the first half of the study versus the second half of the study.

    Results: No predictability in the male individuals' testosterone (Spearman's rho = -0.018, P = .905) or acne (Spearman's rho = -0.036, P = .862) levels during ovulation was found.

    Clinical translation: The study being "negative," there is no obvious translational potential in the results.

    Strengths and limitations: The main strength of this study lies in the excellent compliance of the study participants and the large number of sampling timepoints over several menstrual cycles, thereby allowing each male individual to be his own control subject. A limitation is that samples were only obtained in the morning; however, including later timepoints would have introduced a number of confounders and would also have hampered the study's feasibility.

    Conclusions: The current results strongly indicate that male morning testosterone levels neither increase nor decrease in response to the partner's ovulation. This discordance to previous laboratory studies could indicate either that (i) the phenomenon of hormonal adaptation of men to women does not exist and earlier experimental studies should be questioned, (ii) that the phenomenon is short-lived/acute and wanes if the exposure is sustained, or (iii) that the male testosterone response may be directed toward other women than the partner. Copyright (C) 2018, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.

  • 39. Sunderg, M.
    et al.
    Lindström, Annika K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna.
    Management of Female Sexual Dysfunction: Knowledge, Attitude and Clinical Experience of General Practitioners and Resident Doctors in Dalarna, Sweden2015In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 12, no S3, p. 269-269Article in journal (Other academic)
  • 40.
    Ugarte Guevara, William J.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Valladares Cardoza, Eliette
    Essén, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Sexuality and Risk Behavior among Men Who have Sex with Men in León, Nicaragua: A Mixed Methods Approach2012In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 9, no 6, p. 1634-1648Article in journal (Refereed)
    Abstract [en]

    Introduction.

    HIV prevalence among men who have sex with men (MSM) is 38 times higher than among the general population in Nicaragua. There are little data about the sexuality and sexual behaviors of MSM. It is essential to gain a better understanding of this understudied population.

    Aims.

    The nature of sexual relationships among MSM, their reasons for engaging in risky sexual behaviors, and the sociocultural context in Leon, Nicaragua, were investigated through in-depth interviews. Our findings resulted in a structured overview of sociodemographic characteristics and HIV-related knowledge, attitudes, and risk behaviors.

    Methods.

    Fifteen participants recruited by purposive sampling completed an in-depth interview that was then thematically analyzed. An additional 104 participants were surveyed by means of an interviewer-administered questionnaire.

    Main Outcome Measures.

    The in-depth interview guide and the survey covered topics related to sociodemographics, childhood, social and sexual relationships, knowledge and attitudes toward HIV and AIDS, identity, and networks.

    Results.

    The resulting ecological model explored sexuality and behaviors in four categories. It showed that despite a homophobic and heterosexist society, there is an increasing gay community and greater social acceptance of homosexuality. Nevertheless, interpersonal and intrapersonal factors continue to negatively influence MSM behavior. Quantitative findings demonstrate a satisfactory understanding of HIV transmission among this population, 75% of whom reported concerns of becoming infected with HIV in the future. Approximately one-half claimed that they always used condoms when having sex with men, but only one-third of the time with women, indicating inconsistent condom use. Negative attitudes toward HIV/AIDS were seldom heard.

    Conclusions.

    This study is the first mixed methods approach in a Nicaraguan context that shows the interrelations among sex, sexuality, and identity at various levels of MSM life, and how they influence the sexual risk behaviors of individuals. Engaging in unprotected sex and postponing HIV testing are seen as cognitive dissonances.

  • 41. Varagnolo, D
    et al.
    Knorn, Steffi
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Signals and Systems Group.
    Oliver-Chiva, E
    Melles, R
    Dewitte, M
    Towards the individualization of vaginal dilatation exercises: A quantitative analysis of the variability of vaginal pressure responses2018In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 15, no 7, p. S303-S303Article in journal (Refereed)
  • 42.
    Varagnolo, Damiano
    et al.
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Signals and Systems.
    Knorn, Steffi
    Uppsala University.
    Oliver Chiva, Ernesto
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Signals and Systems.
    Melles, R.J.
    Maastricht University Medical Center.
    Dewitte, Marieke
    Maastricht University.
    Towards the individualization of vaginal dilatation exercises: A Quantitative analysis of the variability of vaginal pressure responses2018In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 15, no 7 : Suppl. 3, p. S303-Article in journal (Refereed)
  • 43.
    Waldkirch, Eginhard S.
    et al.
    Hannover Medical School—Division of Surgery, Department of Urology and Urological Oncology, Hannover, Germany.
    Ückert, Stefan
    Hannover Medical School—Division of Surgery, Department of Urology and Urological Oncology, Hannover, Germany.
    Sigl, Katja
    MorphoSys AG, Martinsried, Germany.
    Satzger, Imke
    Hannover Medical School—Department of Dermatology and Allergology, Hannover, Germany.
    Geismar, Ulrike
    Private Dermatological Practice, Hannover, Germany.
    Langnäse, Kristina
    Otto-von-Guericke-University, Faculty of Medicine—Institute for Biochemistry and Cell Biology, Magdeburg, Germany.
    Richter, Karin
    Otto-von-Guericke-University, Faculty of Medicine—Institute for Biochemistry and Cell Biology, Magdeburg, Germany.
    Sohn, Michael
    Frankfurter Diakonie-Kliniken, St. Markus Academic Hospital—Department of Urology, Frankfurt am Main, Germany.
    Kuczyk, Markus A
    Hannover Medical School—Division of Surgery, Department of Urology and Urological Oncology, Hannover, Germany.
    Hedlund, Petter
    University Vita Salute, Faculty of Medicine, San Raffaele Hospital—Department of Urology, Urological Research Institute, Milan, Italy.
    Expression of cyclic AMP-dependent protein kinase isoforms in human cavernous arteries: functional significance and relation to phosphodiesterase type 42010In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 7, no 6, p. 2104-2111Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The cyclic adenosine monophosphate-dependent protein kinase (cAK) is considered a key protein in the control of smooth muscle tone in the cardiovascular system. There is evidence that erectile dysfunction might be linked to systemic vascular disorders and arterial insufficiency, subsequently resulting in structural changes in the penile tissue. The expression and significance of cAK in human cavernous arteries (HCA) have not been evaluated.

    AIMS: To evaluate the expression of cAK isoforms in HCA and examine the role of cAK in the cyclic adenosine monophosphate (cAMP)- and cyclic guanosine monophosphate (cGMP)-mediated control of penile vascular smooth muscle.

    METHODS: The expression and distribution of phosphodiesterase type 4 (PDE4) and cAK isoforms in sections of HCA were investigated by means of immunohistochemistry and Western blot analysis. The effects of the cAK inhibitor Rp-8-CPT-cAMPS on the relaxation of isolated preparations of HCA (diameter > 100 µm) induced by rolipram, sildenafil, tadalafil, and vardenafil were studied using the organ bath technique.

    MAIN OUTCOME MEASURES: Investigate the expression of cAK in relation to α-actin and PDE4 in HCA and evaluate the effects of an inhibition of cAK on the relaxation induced by inhibitors of PDE4 and PDE5 of isolated penile arteries.

    RESULTS: Immunosignals specific for cAKIα, IIα, and IIβ were observed within the wall of HCA. Double stainings revealed colocalization of cAK with α-actin and PDE4. The expression of cAK isoforms was confirmed by Western blot analysis. The reversion of tension induced by inhibitors of PDE4 and PDE5 of isolated penile vascular tissue were attenuated significantly by Rp-8-CPT-cAMPS.

    CONCLUSIONS: Our results demonstrate the expression of cAK isoforms in the smooth musculature of HCA and its colocalization with PDE4. A significant role for cAK in the regulation mediated by cAMP and cGMP of vascular smooth muscle tone in HCA can also be assumed.

  • 44.
    Ückert, Stefan
    et al.
    Division of Surgery, Department of Urology and Uro-Oncology, Hannover Medical School, Hannover, Germany.
    Waldkirch, Eginhard S
    Division of Surgery, Department of Urology and Uro-Oncology, Hannover Medical School, Hannover, Germany.
    Albrecht, Knut
    Division of Surgery, Department of Urology and Uro-Oncology, Hannover Medical School, Hannover, Germany.
    Sonnenberg, Julia
    Division of Surgery, Department of Urology and Uro-Oncology, Hannover Medical School, Hannover, Germany.
    Langnäse, Kristina
    Faculty of Medicine, Institute for Biochemistry and Cell Biology, Otto-von-Guericke University, Magdeburg, Germany.
    Richter, Karin
    Faculty of Medicine, Institute for Biochemistry and Cell Biology, Otto-von-Guericke University, Magdeburg, Germany.
    Hedlund, Petter
    Faculty of Medicine, University Hospital, Department of Clinical and Experimental Pharmacology, Lund University, Lund, Sweden.
    Kuczyk, Markus A
    Division of Surgery, Department of Urology and Uro-Oncology, Hannover Medical School, Hannover, Germany.
    Expression and distribution of cyclic AMP- and cyclic GMP-binding protein kinases in the human vagina- an immunohistochemical study2010In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 7, no 2 Pt 2, p. 888-895Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: In contrast to research findings describing the localization of nitric oxide synthases (NOS), guanylyl cyclases, and cyclic adenosine monophosphate (cAMP)- and cyclic guanosine monophosphate (cGMP)-degrading phosphodiesterase isoenzymes in the human vagina, the distribution of proteins known as major targets for cyclic nucleotides has not yet been evaluated. cAMP- and cGMP-dependent protein kinases (cAK, cGKI) have been identified as important receptors for cyclic nucleotides downstream the signaling cascades.

    AIM: To investigate, by means of immunohistochemistry, the expression of cAK and cGKI in relation to endothelial NOS (eNOS), vasoactive intestinal polypeptide (VIP), and protein gene product 9.5 (PGP 9.5) in the human vagina.

    MAIN OUTCOME MEASURES: Expression and distribution of cAK and cGKI(alpha,beta) in relation to eNOS, VIP, and PGP 9.5 in human vaginal tissue.

    METHODS: Immunohistochemical techniques were applied to sections of human vaginal full wall specimens in order to evaluate the presence of cAK and cGKI(alpha,beta) in relation to VIP, PGP 9.5, and eNOS, respectively. Western blot analyses were conducted using cytosolic supernatants of homogenized specimens of the vaginal wall and epithelium.

    RESULTS: Immunostaining specific for cGKIbeta was observed in vascular and nonvascular smooth muscle of the vagina. In the endothelial layer, cGKIbeta was found colocalized with eNOS. In contrast, no signals indicating cGKIalpha were registered. cAK-positive subepithelial vessels were found to be innervated by a dense meshwork of PGP-containing varicose nerve fibers, some of which presented expression of VIP. The expression of cAK and cGKIbeta was confirmed by Western blotting.

    CONCLUSIONS: Our results demonstrate the expression of cAK and cGKIbeta in the human vagina. The colocalization with VIP and eNOS underlines the significance of both the cAMP and GMP pathway in the control of human vaginal vascular and nonvascular smooth muscle.

  • 45.
    Ückert, Stefan
    et al.
    Hannover Medical School, Division of Surgery, Dept. of Urology & Urological Oncology, Hannover, Germany.
    Waldkirch, Eginhard S
    Hannover Medical School, Division of Surgery, Dept. of Urology & Urological Oncology, Hannover, Germany.
    Kauffels, Wolfgang
    Klinikum Hildesheim GmbH, Dept. of Obstetrics & Gynecology, Hildesheim, Germany.
    Kuczyk, Markus A.
    Hannover Medical School, Division of Surgery, Dept. of Urology & Urological Oncology, Hannover, Germany.
    Hedlund, Petter
    Lund University Hospital, Institute for Laboratory Medicine, Dept. of Clinical & Experimental Pharmacology, Lund, Sweden.
    Rho kinase-related proteins in human vaginal arteries: an immunohistochemical and functional study2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no 10, p. 2739-2745Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The calcium-sensitizing Rho A/Rho kinase pathway has been suggested to play a role in the control of nongenital vascular smooth muscle. Rho-associated kinases (ROKs) cause calcium-independent modulation of smooth muscle contraction, and have been demonstrated in the bladder, prostate, and corpus cavernosum. Until now, it is not known whether ROKs and related proteins play a role in the control of vaginal blood flow.

    AIM: To investigate by means of functional studies and immunohistochemistry the significance of the Rho pathway in human vaginal arteries.

    METHODS: Vaginal tissue was obtained from five postmenopausal women. Specimens were processed for immunohistochemistry for ROK1, ROK2, RhoA, and RhoGDI. Segments of sub-epithelial vaginal arteries were mounted in a tissue bath. Effects of Y27632 on the concentration-response curves to phenylephrine (Phe) or Phe-precontracted preparations were investigated.

    MAIN OUTCOME MEASURE: The expression of Rho kinases ROK1, ROK2, and the Rho-associated protein RhoGDI in human vaginal arteries was investigated by means of immunohistochemistry. Tissue bath studies were conducted in order to characterize the effects of the ROK inhibitor Y27632 on isolated vaginal arteries.

    RESULTS: A meshwork of α-actin immunoreactive arterioles was located in the sub-epithelium of human vaginal specimens. Immunoreactivities for ROK1, ROK2, RhoA, and RhoGDI were expressed in the smooth musculature of these arteries. At 0.1 and 1 µM Y27632, the contraction to Phe (10 µM) was 99 ± 17% and 28 ± 12% that of 124 mM K(+) . In Phe-contracted preparations, Y27632 produced relaxant responses.

    CONCLUSIONS: The activation of alpha(1) -adrenoceptors contracts sub-epithelial human vaginal arteries via ROK-sensitive mechanisms. A role for these signals in the regulation of vaginal blood flow might be considered.

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