Self-reported Sexual Response in Transgender Women to Audiovisual Stimulation Protocol / Autoinforme de Respuesta Sexual en Mujeres Transgénero ante un Protocolo de Estimulación Audiovisual

Abstract Sexuality changes associated with the medical transition in transgender women are not well known; the few studies present discrepancies in labeling their sexual orientation and controlling surgery conditions. This study aimed to evaluate the self-reported sexual response to audiovisual sexual stimulation protocol in androsexual transgender women on hormone replacement therapy. This study also evaluated their sexual functioning to support the empirical protocol. Participated androsexual transgender women with (n = 16) and without hormone therapy (n = 15) in a non-sex reassignment surgery condition. Androsexual cisgender men (n = 25) and women (n = 24) also were included as contrast groups. All participants were assessed with the Short Form of the Changes in Sexual Functioning Questionnaire; then watched video clips with neutral and sexual content and informed their sexual responses through two self-report scales adapted from the Film Scale. The results showed trans women with hormone therapy, compared to trans women without treatment, experienced a less selective sexual response to sexual stimuli. Also, they registered the lowest scores for every sexual functioning except for pleasure. In conclusion, transgender women on hormone therapy without sex reassignment surgery showed fluidity in their self-reported sexual response and reduced sexual functioning.

Resumen Poco se conoce de los cambios en la sexualidad de las mujeres transgénero que se encuentran bajo un proceso de transición médica. El objetivo de este estudio fue evaluar el autoinforme de la respuesta sexual de las mujeres transgénero bajo terapia hormonal y sin cirugía de reasignación de sexo ante un protocolo de estimulación sexual audiovisual, así como el funcionamiento sexual general para robustecer los resultados del protocolo. Participaron mujeres transgénero sin cirugía de reasignación de sexo con (n = 16) y sin terapia hormonal (n = 15), así como hombres (n = 25) y mujeres (n = 24) cisgénero como grupos de contraste. Todas las personas que participaron reportaron una atracción androsexual. Se evaluaron con la Versión Abreviada del Cuestionario de Cambios en el Funcionamiento Sexual, posteriormente observaron videos con contenido neutro y actividad sexual entre dos mujeres, dos hombres y entre mujer y hombre, y reportaron su respuesta sexual a través de dos escalas de autoinforme adaptadas de la Film Scale. Los resultados mostraron que las mujeres trans bajo terapia hormonal, a comparación de las mujeres trans sin tratamiento, tuvieron una respuesta sexual menos selectiva, aunque esta fue similar a la de las mujeres cisgénero, además puntuaron más bajo para todos los rubros del cuestionario de funcionamiento sexual, excepto para el placer. En conclusión, las mujeres transgénero en terapia hormonal muestran fluidez en su respuesta sexual autoinformada, así como una disminución en el funcionamiento sexual. Estos datos pueden ofrecer un entendimiento más amplio del tratamiento médico y psicológico, con la finalidad de mejorar la atención a la población trans.

The role of androgen in male sexual arousal / 中华男科学杂志

Sexual arousal is an important factor for the success of sexual behavior, and regulated by the central nervous system, its underlying mechanism is very complicated. Androgen is the most important endocrine hormone in men, which is deeply involved in the whole process of male sexual response, but how it regulates male sexual arousal has not been fully clarified and remains one of the hotspots in current andrological research. Therefore, this paper presents an overview of the advances in the studies of the related role and mechanism of androgen in male sexual arousal. In the central nervous system, androgen regulates the release of dopamine neurotransmitters by binding androgen receptors or metabolizing neurosteroids, thus activating the brain reward system. Besides, androgen regulates the neuronal plasticity and spinous process formation in the neural circuit of sexual arousal to ensure successful activation and conduction of the neural circuit. However, the specific regulating mechanism of sexual arousal remains to be further explored.

La autoestima sexual: su relación con la excitación sexual / The sexual self-esteem: Its relationship with the sexual arousal

Resumen En este estudio se tuvo como objetivo analizar la relación entre la autoestima sexual (AS) y la excitación sexual como rasgo, estado y componente de la respuesta sexual. La muestra estuvo compuesta por 65 jóvenes heterosexuales que completaron la subescala Excitación Sexual de las Sexual Inhibition/Sexual Excitation Scales-Short Form, el Massachussets General Hospital Sexual Functioning Questionnaire y la subescala Autoestima sexual del Brief Sexuality Scale. A continuación, realizaron una tarea experimental donde completaron las escalas Valoración de Excitación Sexual y Valoración de Sensaciones Genitales tras visualizar un video neutro y otro con contenido sexual explícito. Los resultados mostraron asociaciones significativas entre la AS y la excitación sexual rasgo y la excitación sexual como componente de la respuesta sexual. Ambas manifestaciones de la excitación sexual explicaron un porcentaje significativo de la AS (R 2 = 0,19). Sin embargo, la excitación sexual estado no se asoció con la AS.

Abstract The aim was to analyze the relationship between sexual self-esteem (SSE) and sexual arousal as a trait, as a state and as a component of the sexual response. The sample consisted of 65 heterosexual young people who completed the Sexual Excitation subscale of the Sexual Inhibition/Sexual Excitation Scales-Short Form, the Massachusetts General Hospital Sexual Functioning Questionnaire, and the Sexual Self-esteem subscale of the Brief Sexuality Scale. Participants performed an experimental task where they completed the Ratings of Sexual Arousal and the Ratings of Genital Sensations after visualizing a neutral film and another one with explicit sexual content. The results showed significant associations between SSE and sexual arousal as a trait and as a component of the sexual response. These two types of excitation explained a significant percentage of the SSE (R 2 = 0.19). However, sexual arousal as a state did not correlate to the SSE.

Excitación sexual: una revisión sobre su relación con las conductas sexuales de riesgo / Sexual arousal: a review of its relationship with sexual risk behaviors

Se plantea una revisión sistemática de las publicaciones que relacionan excitación sexual con conductas sexuales de riesgo. La búsqueda bibliográfica en Scopus, Web of Science Pub Medproporcionó 50 estudios. Los resultados fueron organizados en: (a) consumo de alcohol-drogas en encuentros sexuales; (b) uso de métodos anticonceptivos-barrera/riesgo de infección de transmisión sexual y embarazo no deseado; (c) sexo casual/número de parejas sexuales/sexo como profesión. El instrumento de evaluación de la excitación sexual más usado fue Sexual Inhibition/Sexual Excitation Scales. La excitación sexual se relacionó de forma positiva con consumo de alcohol y drogas en una situación sexual, con sexo casual, número de parejas sexuales y trabajar o pagar por sexo y, de forma negativa, con uso métodos anticonceptivos/barrera. Se considera la necesidad de incluir la excitación sexual como una variable relevante en los programas de prevención e intervención de conductas sexuales de riesgo y de educación sexual.

We conducted a systematic review of the literature about the association between sexual arousal and sexual risk behaviors. The literature search in Scopus, Web of science and pubMed provided 50 studies. The results were organized considering: (a) use of alcohol-drugs in sexual encounters; (b) use of contraceptive methods/ risk of sexually transmitted infections and unwanted pregnancy; (c) casual sex/number of sex partners/sex workers. We observed that the self-reported measure more frequently used to assess sexual arousal was the sexual inhibition/sexual excitation scales. In addition, levels of sexual arousal has been positively associated with the use of alcohol and drugs in a sexual situation, casual sex, number of sexual partners and work or pay for sex, and negatively with using contraceptives methods. This review, highlights the need to include sexual arousal as a relevant variable in programmes for the prevention and intervention of sexual risk behaviors and sexual education.

Increased sexual arousal in patients with movement disorders / Exacerbação do impulso sexual em pacientes com distúrbios do movimento

ABSTRACT Increased of sexual arousal (ISA) has been described in different neurological diseases. The purpose of this study was present a case series of ISA in patients with movement disorders. Method Fifteen patients with different forms of movement disorders (Parkinson’s disease, Huntington’s disease, Tourette´s syndrome, spinocerebellar ataxia type 3), were evaluated in the Movement Disorders Unit of the Federal University of Paraná. Results Among Parkinson’s disease patients there were seven cases with different forms of ISA due to dopaminergic agonist use, levodopa abuse, and deep brain stimulation (DBS). In the group with hyperkinetic disorders, two patients with Huntington’s disease, two with Tourette’s syndrome, and four with spinocerebellar ataxia type 3 presented with ISA. Conclusions ISA in this group of patients had different etiologies, predominantly related to dopaminergic treatment or DBS in Parkinson’s disease, part of the background clinical picture in Huntington’s disease and Tourette’s syndrome, and probably associated with cultural aspects in patients with spinocerebellar ataxia type 3.

RESUMO A exacerbação do impulso sexual (EIS) tem sido descrita em diversas doenças neurológicas. O objetivo deste estudo foi apresentar uma série de casos de EIS em pacientes com distúrbios do movimento. Métodos Quinze pacientes com diferentes formas de distúrbios do movimento (Doença de Parkinson, doença de Huntington, síndrome de Tourette, ataxia espinocerebellar tipo 3), foram avaliados na Unidade de Distúrbios de Movimento-Universidade Federal do Paraná. Resultados Entre os pacientes com doença de Parkinson houve sete casos com diferentes formas de EIS devido ao uso de agonista dopaminérgico, abuso de levodopa ou estimulação cerebral profunda (DBS). No grupo com distúrbios hipercinéticos, dois pacientes com doença de Huntington, dois com síndrome de Tourette, e quatro com ataxia espinocerebelar tipo 3 apresentaram EIS. Conclusões EIS nesses pacientes decorreu de diferentes etiologias, relacionadas com o tratamento dopaminérgico ou DBS na doença de Parkinson, parte do quadro clinico na doença de Huntington e síndrome de Tourette, e provavelmente relacionado com aspectos culturais em pacientes com ataxia espinocerebelar tipo 3.

A study on the differences in ERP during sexual arousal elicited by different types of sexual picture in adult men / 中华行为医学与脑科学杂志

Objective To observe the differences in event related potential(ERP) during sexual arousal elicited by different types of sexual picture in adult men.Methods An implicitly emotional task and a modified oddball paradigm were used.The differences were recorded in EEG with ERP when sexual arousal was induced by heterosexual couple erotic picture,male erotic picture and female erotic picture in fifteen health men.Results The amplitudes of N2 at Fz and P3 at Pz induced by male-female erotic picture ((2.32 ± 1.70) μV,(16.62 ± 2.16) μV),male erotic picture ((1.58 ± 1.33) μ V,(15.82 ± 1.64)μV) and female erotic picture ((1.23 ± 1.47)μV,(14.54 ± 2.00)μV)were not significant differences (P ＞ 0.05).But the amplitudes of N2 and P3 elicited by neutral human picture((-6.01 ± 1.35)μV,(11.36 ± 1.81) μV) were smaller than each type erotic picture (P ＜ 0.05).There was statistical significance in PSW at Cz elicited by different types of erotic picture.The PSW elicited by male-female erotic picture((12.59 ± 1.13)μV) was significantly higher than female erotic picture((10.38 ±0.76) μV) and male erotic picture((8.80 ±0.89) μV) (P＜0.05).However,there was no significant difference in PSW component between male erotic picture and female erotic picture.Conclusion The level of sexual arousal elicited by explicit heterosexual couple erotic pictures is highest and the attention also maintains longest in heterosexual male.

A study on differences of cognitive mechanism in processing different types of sexual picture in female university students / 中华行为医学与脑科学杂志

ObjectiveTo observe female university students' differences of cognitive mechanism in processing different types of sexual picture from International Affective Picture System (IAPS).MethodsUsing event related potential (ERP),the differences of the amplitudes of N2,P3 and PSW were examined induced by the neutral pictures and different types of erotic pictures.ResultsThe amplitudes of N2 ( (0.99 ±1.69 ) μV) and P3 ( ( 17.27 ± 1.45 ) μV) elicited by heterosexual couple erotic pictures were highest,followed by the male erotic pictures( ( -0.02 ± 1.83 ) μV,( 15.92 ± 1.26 ) μV),and then were the female erotic pictures ( ( -0.22 ± 1.56)μV,( 15.49 ±1.34) μV).There was statistical significance in N2 and P3 between heterosexual couple erotic pictures and female erotic pictures ( P ＜0.05 ).There was no significant difference in PSW component between heterosexual couple erotic pictures( ( 15.22 ± 1.98 ) μV) and female erotic pictures ( ( 14.53 ± 1.75 ) μV ),but the PSW induced by male erotic pictures (( 10.93 ± 2.60 )μV) was significantly smaller than the other sexual pictures (P＜0.05).ConclusionThe level of sexual arousal elicited by explicit heterosexual couple erotic pictures is highest and also the attention maintains longest.

Effects of Antidepressant Treatment on Sexual Arousal in Depressed Women: A Preliminary fMRI Study

OBJECTIVE: There was a recent study to explore the cerebral regions associated with sexual arousal in depressed women using functional magnetic resonance imaging (fMRI). The purpose of this neuroimaging study was to investigate the effects of antidepressant treatment on sexual arousal in depressed women. METHODS: Seven depressed women with sexual arousal dysfunction (mean age: 41.7+/-13.8, mean scores of the Beck Depression Inventory (BDI) and the 17-item Hamilton Rating Scale for Depression (HAMD-17): 35.6+/-7.1 and 34.9+/-3.1, respectively) and nine healthy women (mean age: 40.3+/-11.6) underwent fMRI before and after antidepressant treatment. The fMRI paradigm contrasted a 1 minute rest period viewing non-erotic film with 4 minutes of sexual stimulation viewing an erotic video film. Data were analyzed by SPM 2. The relative number of pixels activated in each period was used as an index of activation. All depressed women were treated with mirtazapine (mean dosage: 37.5 mg/day) for 8 to 10 weeks. RESULTS: Levels of brain activity during sexual arousal in depressed women significantly increased with antidepressant treatment (p<0.05) in the regions of the hypothalamus (3.0% to 11.2%), septal area (8.6% to 27.8%) and parahippocampal gyrus (5.8% to 14.6%). Self-reported sexual arousal during visual sexual stimulation also significantly increased post-treatment, and severity of depressive symptoms improved, as measured by the BDI and HAMD-17 (p<0.05). CONCLUSION: These results show that sexual arousal dysfunction of depressed women may improve after treatment of depression, and that this improvement is associated with increased activation of the hypothalamus, septal area, and parahippocampal gyrus during sexual arousal.

Brain Activation in Response to Visually Evoked Sexual Arousal in Male-to-Female Transsexuals: 3.0 Tesla Functional Magnetic Resonance Imaging

OBJECTIVE: This study used functional magnetic resonance imaging (fMRI) to contrast the differential brain activation patterns in response to visual stimulation with both male and female erotic nude pictures in male-to-female (MTF) transsexuals who underwent a sex reassignment surgery. MATERIALS AND METHODS: A total of nine healthy MTF transsexuals after a sex reassignment surgery underwent fMRI on a 3.0 Tesla MR Scanner. The brain activation patterns were induced by visual stimulation with both male and female erotic nude pictures. RESULTS: The sex hormone levels of the postoperative MTF transsexuals were in the normal range of healthy heterosexual females. The brain areas, which were activated by viewing male nude pictures when compared with viewing female nude pictures, included predominantly the cerebellum, hippocampus, putamen, anterior cingulate gyrus, head of caudate nucleus, amygdala, midbrain, thalamus, insula, and body of caudate nucleus. On the other hand, brain activation induced by viewing female nude pictures was predominantly observed in the hypothalamus and the septal area. CONCLUSION: Our findings suggest that distinct brain activation patterns associated with visual sexual arousal in postoperative MTF transsexuals reflect their sexual orientation to males.

Studies on sexual function of patients with erectile dysfunction-no sexual life using self-estimation index of erectile function-no sexual life / 中华泌尿外科杂志

Objective To estabalish a new conception, Erectile Dysfunction-no sexual life (ED-NS), so as create an evaluating questionnaire, Self-estimation Index of erectile function-No sexual life (SIEF-NS) so as to investigate its clinical reliability. Methods The conception of ED-NS was identified and the SIEF-NS questionnaire was established. Patients who complained of ED-NS and normal controls were enrolled into the research and assessed the erectile function was assessed with SIEF-NS.The SIEF-NS includes 12 questions, such as sexual libido, general erectile function, nocturnal penile erection, erectile function during foreplay, erectile function during audio-video sexual stimulation,confidence, depression, etc and each question has 5 point scales. Results Sixty-one ED-NS patients and 57 controls were enrolled into the study and assessed erectile function with SIEF-NS. The mean score of each question and integral score of SIEF-NS in ED-NS patients were significantly different from normal controls (P＜0. 05). When the integral score was 35 points according to the ROC curve of integral score, the sensitivity of SIEF-NS was 88.5% and specificity was 96. 5%. Conclusions ED-NS is a new conception to define patients who have erectile dysfunction without sexual life. SIEFNS is suggested to be a useful method for the evaluation of ED-NS patients.

Time-Course Analysis of the Neuroanatomical Correlates of Sexual Arousal Evoked by Erotic Video Stimuli in Healthy Males

OBJECTIVE: To assess the dynamic activations of the key brain areas associated with the time-course of the sexual arousal evoked by visual sexual stimuli in healthy male subjects. MATERIALS AND METHODS: Fourteen right-handed heterosexual male volunteers participated in this study. Alternatively combined rest period and erotic video visual stimulation were used according to the standard block design. In order to illustrate and quantify the spatiotemporal activation patterns of the key brain regions, the activation period was divided into three different stages as the EARLY, MID and LATE stages. RESULTS: For the group result (p < 0.05), when comparing the MID stage with the EARLY stage, a significant increase of the brain activation was observed in the areas that included the inferior frontal gyrus, the supplementary motor area, the hippocampus, the head of the caudate nucleus, the midbrain, the superior occipital gyrus and the fusiform gyrus. At the same time, when comparing the EARLY stage with the MID stage, the putamen, the globus pallidus, the pons, the thalamus, the hypothalamus, the lingual gyrus and the cuneus yielded significantly increased activations. When comparing the LATE stage with the MID stage, all the above mentioned brain regions showed elevated activations except the hippocampus. CONCLUSION: Our results illustrate the spatiotemporal activation patterns of the key brain regions across the three stages of visual sexual arousal.

Sexual Desire and Sexual Arousal In Malaysian Women : Are They Of The Same Entity?

Objective: To investigate the correlation between sexual desire and sexual arousal among Malaysian women in a primary care setting. Methods: The Malay Version of Female Sexual Function Index (MVFSI) was used to assess low sexual desire and lack of sexual arousal among the respondents. A total of 230 married women aged 18 – 70 years old participated in this study. Their sociodemographic, marital profiles and correlation between low sexual desire and lack of sexual arousal were examined. Results: More than 60% respondents with low sexual desire have co-exist low sexual arousal and 94.4% respondents with high sexual desire do have high sexual arousal ( χ²= 79.6, p <0.001 ), with correlation of r = 0.852. Conclusions: The strong correlation between sexual desire and arousal has both diagnostic and therapeutic indications, and may also strongly support the circular model (Basson-inspired model) of sexual response among women.