Effects of long and short ejaculatory abstinence on sperm parameters: a meta-analysis of randomized-controlled trials.

Purpose: This study aimed to investigate the effects of ejaculatory abstinence on sperm parameters. Methods: This analysis was registered in PROSPERO (CRD42023472124). We performed a search on PubMed using the following text terms: (("sperm parameters" OR "sperm analysis" [Mesh]) AND ("sperm DNA fragmentation" OR "DNA fragmentation" [Mesh]) AND ("sexual abstinence" [Mesh] OR "abstinence")) and an advanced search in Scopus using the terms ("sperm parameters" OR "sperm parameters" OR "DNA fragmentation") AND ("abstinence"). The sperm parameters that were investigated were sperm volume, total sperm motility, progressive sperm motility, sperm concentration, sperm morphology, and sperm DNA fragmentation (SDF). A two-day cut-off as a "short" or "long" abstinence period has been defined. Results: Thirteen studies published between 2013 and 2022 were included in this meta-analysis. A total of 2,315 patients, ranging from 6 to 836 from each cohort, were enrolled in the study. We showed that longer abstinence time was associated with greater sperm concentration (mean difference [MD]: 8.19; p <0.01), sperm volume (MD: 0.96; p <0.01), and higher SDF (MD: 3.46; p <0.01), but lower progressive sperm motility (MD: -1.83; p <0.01). Otherwise, no statistically significant difference was observed in patients with longer vs. shorter abstinence times regarding total sperm motility (MD: -1.83; p = 0.06). Meta-regression analysis showed that days of abstinence were positively and linearly related to sperm concentration (slope: 3.74; p <0.01) and SDF (slope: 0.65; p = 0.044). Conclusions: According to our data, short ejaculatory abstinence is associated with better sperm quality. Indeed, a higher percentage of progressive sperm motility and lower levels of SDF have been reported in a short abstinence cohort. In contrast, the long abstinence group reported a higher sperm concentration. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023472124.

Abstinence for sperm sample collection and ART outcome: an unsubstantiated myth.

PURPOSE OF REVIEW: Semen analysis is a basic component of male evaluation. Reproductive centers typically instruct men to provide a semen specimen based on recommendations from WHO Standard for semen examination. Evidence that these recommendations optimize sperm reproductive capacity is lacking. Existing data to optimize sperm quality with shorter abstinence were reviewed. RECENT FINDINGS: Several recent studies have reviewed the effects of shorter ejaculatory abstinence of semen quality and assisted reproductive technology (ART) outcomes. Shorter abstinence was defined as 1 h-1 day in one review, and <4 h in the other systematic meta-analysis and review. SUMMARY: Prior instructions for male patients have not been designed to optimize fertility potential for semen analyses. Optimal sperm quality is obtained by instructing men to have a short abstinence (certainly <1 day, and preferably <4 h) for semen specimens used for in vitro fertilization (assisted reproduction).

From Reddit to manifestos: Forensic evaluation of incel online activity.

Forensic evaluators are increasingly called upon to review online collateral information, including social media posts, web forum posts, chat histories, and other sources such as manifestos. This information is especially vital when assessing members of a virtual community such as that of the involuntary celibate, or incel community. While this new wealth of information can add valuable context to the forensic assessment, it presents unique challenges for the evaluator including challenges with authenticity and interpretation. This article will present an approach to evaluations of such collateral, including a review of the relevant empirical research in this area and touch upon important areas to consider in the forensic evaluation of incel online activity.

"Sewed girl" pronounced "virgin": hymenoplasty and the shift in rhetoric of virginity in Iran.

In late 2018, Ayatollah Makarem Shirazi posted a fatwa approving hymenoplasty for women who had lost their virginity before marriage, arguing that the medical procedure could restore a woman's virginity and therefore her honour. Hymenoplasty, which restores a woman's hymen to its 'virgin' state, is a highly controversial procedure in Iranian society because it strikes at the heart of the purist feminine ideal promoted by the Islamic Republic. For an ayatollah with a conservative reputation to sanction such a procedure seemed antithetical to his position in the regime. On closer inspection, however, it is possible to see his comment as a rhetorical attempt to assert control. Recent social changes, including an increase in the number of educated women and the emergence of new communication technologies, have challenged the rigidity of the old order as women take advantage of emerging freedoms of action and expression. Ayatollah Makarem's fatwa endorsing hymenoplasty can be read as a response to this perceived threat. This essay draws on Kenneth Burke's rhetorical theory to argue that Ayatollah's fatwa should be seen less as a tolerant recognition of social change and more as an attempt to maintain order. Fearing that women might begin to question and reject the entire moral order of the regime, he approves of hymenoplasty to prevent what Burke calls the 'weak in virtue' from falling into 'the strong in sin'.

Dyspareunia, signs of epithelial disruption, sexual abstinence, and HIV status in female sex workers in Nairobi: a cross-sectional study.

BACKGROUND: Epithelial trauma is a risk factor of HIV infection in men who have sex with men (MSM) and female sex workers (FSWs). Painful intercourse may be indicative of epithelial tissue disruption. Previous studies on a cohort of Kenyan FSWs established an association between prolonged sexual abstinence and late HIV seroconversion. Our research objective was to establish whether there is a relationship between HIV serostatus and signs of epithelial disruption and between HIV serostatus and sexual abstinence behaviour. METHODS: Participants were selected from a Nairobi health facility. A structured questionnaire was administered to 322 FSWs, who provided data on HIV status, sexual behaviour, abstinence intervals and the level of sexual dysfunction. Sexual dysfunction scores were created using parts of the Female Sexual Function Index (FSFI-19). Additional questions addressed epithelial trauma signs. Descriptive data analysis, bivariate and multivariate logistic regression were used to describe the study population and determine factors associated with living with HIV. Potential factors influencing sexual dysfunction were assessed by FSWs via self-rating. RESULTS: 36% of FSWs reported discomfort or pain during vaginal penetration half the time. 44% noticed genital bleeding half the time. Vaginal tenderness was experienced by 70.6% half the time during or after intercourse. Variables predictive of living with HIV on multivariate analysis included a medium and high score of discomfort or pain during and following vaginal penetration (medium: AOR 2.288, p-value 0.032, 95% CI 1.075-4.871; high: AOR 3.044, p-value 0.031, 95% CI 1.110-8.348). No significant association of HIV status with past abstinence durations as reported by participants could be established in the multivariate analysis. A majority of FSWs agreed that steady partnerships (81% agreement), regularity of intercourse (74%), foreplay (72%) and lubricants (65%) alleviated dyspareunia. CONCLUSIONS: Recurrent exposure to blood during sex was highly prevalent in FSWs, as was sexual dysfunction. Complaint levels were associated with living with HIV, providing evidence that reducing sexual dysfunctions may prevent HIV transmission. Preventive initiatives may be created that address sexual dysfunction in key populations and general populations with a high HIV prevalence. Subjective assessments indicate that prevention may include the promotion of sexual intercourse regularity, foreplay, and lubricant use.

The Variability of Semen Parameters With Sexual Abstinence Using Mail-in Sperm Testing Is Similar to That Seen With Traditional In-Office Semen Analysis.

The impact of ejaculatory abstinence on semen parameters using in-office semen analyses has been well-established; however, their variability has not been evaluated in men using mail-in semen analysis kits. Our study aims to describe how the sperm parameters using mail-in semen analysis tests change with abstinence and validate their equivalence to those seen with in-office semen analysis tests. We retrospectively reviewed the semen analysis results of men using mail-in semen analysis tests provided by Give Legacy, Inc (Legacy) facilities from 2019 to 2021. We collected their demographic information, abstinence duration, and semen parameters (conventional and kinematic) from their records. Semen samples were categorized as normozoospermic and oligozoospermic based on concentration. The shape of the relationship between abstinence duration and semen parameters was assessed via generalized additive models. We have collected 3,469 unique samples provided by 2,609 (75%) normozoospermic men and 860 (25%) oligozoospermic from all over the United States. In normozoospermic men, longer periods of sexual abstinence were linked to higher levels of sperm concentration, total sperm count, and total motile sperm. However, there was a decline in both total and progressive motility. Conversely, in oligozoospermic men, extended periods of abstinence led to a rapid decline in total motile sperm, as well as total and progressive motility. There was no significant correlation observed between sexual abstinence and variations in sperm morphology. Our study shows that variability of sperm parameters with abstinence, as measured through mail-in semen analysis tests, is comparable to the patterns observed with conventional in-office sperm testing.

The Relationship Between Work-Induced Sexual Abstinence and Psychological Health of Chinese Male Seafarers: The Positive Influence of Job Satisfaction.

The specific nature of the seafaring occupation keeps seafarers away from partners and shore life for long periods at sea. Therefore, seafarers suffer many challenges in the workplace including frustration of their sexual needs. This study aimed to investigate the relationship between work-induced sexual abstinence, psychological health and job satisfaction among seafarers. A mixed-method approach focusing on cross-sectional survey-based quantitative research was used. The sample included 617 Chinese active seafarers who experienced sexual abstinence on board. Hierarchical cluster analysis was conducted to divide the respondents into different groups corresponding to 14 psychological problems induced by sexual abstinence and experienced in the workplace. Multiple linear regression analysis was applied to identify the relationship between tolerance level of seafarers to sexual abstinence and their job satisfaction. Four distinct groups of seafarers, influenced differently by sexual abstinence, were identified, namely "Saint," "Adapter," "Average people," and "Sufferer" clusters. Multiple linear regression analysis indicated that tolerance level of seafarers to sexual abstinence was positively influenced by overall job satisfaction, perceived working environment, ability utilization for other jobs, own choice for working as a seafarer and perceived friendliness of co-workers, while it was negatively influenced by perceived job responsibility. The study innovates by examining the relationship between sexual abstinence and the psychological health of seafarers. It also extends the function of job satisfaction, which can contribute positively to the tolerance level to sexual abstinence. Management recommendations to address sexual abstinence issues are proposed to better protect the health and psychological well-being of seafarers and enhance operational safety on board.

The Opaque Language of Sexuality: Medical Students' and Providers' Beliefs About Virginity.

Although virginity is not a medical term and is instead socially constructed, it remains unknown what medical providers believe about the biological basis of virginity. This study explored providers' and medical students' beliefs about virginity and the potential impact of such beliefs on healthcare. This was a concurrent mixed-method survey study of 124 medical students and 216 healthcare providers (Registered Nurse, Physician Assistant, Nurse Practitioner, and Doctor of Medicine) at Penn State Health and The Pennsylvania State University College of Medicine. Participants rated their level of agreement with common misconceptions about virginity on a six-point Likert scale. Open-ended questions gave respondents the opportunity to define virginity and to describe terms like virgin and virginal in the context of sexual experience and the medical lexicon. We identified common themes in the qualitative data using thematic analysis. Frequencies of misconceptions and statistically significant demographic associations were identified in the quantitative data. Definitions of virginity were varied and vague, most with negative connotations. A majority of respondents said that virginity has no biological basis. Many participants identified downsides to use of terms like virgin, virginity, and virginal in medicine. The most prevalent misconceptions about virginity were related to the hymen. Seventeen percent of students and 26% of providers at least somewhat agreed that it was possible to determine whether a person has engaged in vaginal intercourse through a gynecological exam. Misconceptions about virginity persist in medicine and bias, even if unintended, may impact the quality-of-care people with vaginas receive. Language around sexual health should be specific, inclusive, clinically relevant, and free from judgment. Medical education must continue to work to eliminate the concept of a biological basis to virginity.

Sex differences in how ethnic-racial identity informs first coital affect and virginity beliefs among Black college students.

Objective: The present study examined whether ethnic-racial identity (ERI) exploration, resolution, and affirmation informed individuals' beliefs about virginity (ie, virginity as a gift, stigma, process) and first coital affective reactions (FCAR; ie, positive and negative), and whether these relations varied by biological sex. Participants and method: The sample consisted of 184 Black college students (Mage = 19.79, SD = 2.08) enrolled in a large Southern university. Participants completed a virginity beliefs measure, first coital affective reaction measure, and an ethnic-racial identity measure. Results: Findings indicated that for Black females, greater ERI exploration was associated with decreased virginity as a gift beliefs; and ERI resolution was associated with increased virginity as a gift beliefs. Additionally, for Black males and females, ERI affirmation resulted in more positive FCAR, less negative FCAR, and less views of virginity as a stigma. Conclusion: Finding implications are presented in the context of future research.

Impulsivity as a Predictor of Early Dating Initiation in 11-12-Year-Old Youth.

As early initiation of dating behaviors is associated with risky sexual behaviors (e.g., higher number of sexual partners, sex with strangers), the current study examined determinants of early dating behaviors, focusing on impulsivity. Participants were 11-12-year-old boys (n = 109) and girls (n = 61) recruited from a psychiatric clinic and ads targeted to the general public. Ordered logistic regression models were used to examine the association between each facet of impulsivity (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking) and dating behaviors. Youth with higher sensation seeking and negative urgency was more likely to initiate dating behaviors at early ages compared to those with lower scores on those measures. Further, we found that female gender and higher parental education were associated with lower risk of initiating dating behaviors at early age. Advanced pubertal development was associated with higher risk for early dating. Our findings can inform prevention efforts, identifying sensation seeking and negative urgency as predictors of youths' early engagement in dating behaviors, which can be a precursor of early sexual debut and risky sexual behaviors.

Involuntary Celibacy: A Review of Incel Ideology and Experiences with Dating, Rejection, and Associated Mental Health and Emotional Sequelae.

PURPOSE OF REVIEW: Incels (involuntary celibates) have recently garnered media attention for seemingly random attacks of violence. Much attention has centered around the misogynistic and violent discourse that has taken place in online incel forums as well as manifestos written by incels who have perpetrated deadly attacks. Such work overlooks the experiences and issues faced by incels themselves, the majority of which have not engaged in any violent behavior. RECENT FINDINGS: A small number of studies have recruited incels. Results from these studies highlight the nuanced nature of the incel identity. It is also apparent that incels suffer from high levels of romantic rejection and a greater degree of depressive and anxious symptoms, insecure attachment, fear of being single, and loneliness. Incels report significant issues pertaining to their mental, social, and relational well-being and may seek support from forums that often feature misogynistic and violent content.

Adolescent Experience With Dating Violence in Relation to Virginity Status: Findings From a Jamaican Sample.

The association between adolescents' involvement in sexual intercourse and their experiences with adolescent dating violence (ADV) is an understudied topic. This study examined this relationship for 178 Jamaican adolescents in Grades 9-11. The expectation that adolescents who reported having had sexual intercourse would report greater victimization and greater perpetration than adolescents who had not had intercourse was consistent only for sexual abuse. Analyses also showed that sexually experienced males perpetrated and experienced more psychological abuse compared to males who were not so experienced. These results suggest different experiences based on adolescents' sex and so support others' calls for ADV research to do more examinations by sex. Also, it endorses the importance of doing research on both victims and perpetrators of intimate abuse. Implications of these findings for sexual and relationship education of adolescents are discussed.

Correlates of Disclosure of Virginity Status Among U.S. College Students.

Disclosure of virginity status (DVS) refers to the extent to which an individual reveals that they identify as a virgin or not to different individuals in their lives. The purpose of this study was to investigate how generalized self-disclosure, virginity beliefs, and religiosity, as well as interactions with gender and virginity status, relate to DVS to family, peers, and religious communities. Southern U.S. college students (N = 690) took an online sexuality questionnaire. Generalized self-disclosure did not relate to DVS, suggesting that DVS represents a unique form of self-disclosure. Gender by virginity status interactions suggested that societal double standards of gender and virginity status (i.e., non-virgin women and virgin men being stigmatized for their virginity identifications) may be most relevant to one's decision to disclose to family, and somewhat relevant to one's decision to disclose to religious communities. Individuals high in religiosity overall tended to disclose their virginity status when they identified as a virgin, but not as a non-virgin. Virgins concealed their virginity status from religious communities when they stigmatized their own virginity but disclosed to family and peers when they viewed virginity as a gift. Overall, the results suggest that, although religiosity and virginity beliefs indeed play a role in DVS toward certain targets, one's gender and virginity status appear to be most important. Increased education on the double standard regarding gender and virginity status may help reduce stigma and improve sexual well-being.

Virginity Testing.

ABSTRACT: Virginity testing is a human rights violation involving an examination of the female genitalia, often by a healthcare professional, intended to correlate the appearance of the hymen in women or girls with previous sexual intercourse. Virginity testing examinations are conducted under a variety of circumstances and settings: before marriage to establish virginity, to disprove or prove an allegation of sexual violence, to legally assess the allegation of a woman or girl not being a virgin in the absence of bleeding on her wedding night, and to intimidate political activists and detainees. Despite the United Nations Human Rights Office, United Nations Women, and World Health Organization calling for a ban on this practice, it remains common practice in various regions around the world. It is the position of the International Association of Forensic Nurses that virginity testing cannot accurately determine if consensual sexual activity or sexual abuse has occurred and can result in significant physical, psychological, and social consequences.

Religious celibacy brings inclusive fitness benefits.

The influence of inclusive fitness interests on the evolution of human institutions remains unclear. Religious celibacy constitutes an especially puzzling institution, often deemed maladaptive. Here, we present sociodemographic data from an agropastoralist Buddhist population in western China, where parents sometimes sent a son to the monastery. We find that men with a monk brother father more children, and grandparents with a monk son have more grandchildren, suggesting that the practice is adaptive. We develop a model of celibacy to elucidate the inclusive fitness costs and benefits associated with this behaviour. We show that a minority of sons being celibate can be favoured if this increases their brothers' reproductive success, but only if the decision is under parental, rather than individual, control. These conditions apply to monks in our study site. Inclusive fitness considerations appear to play a key role in shaping parental preferences to adopt this cultural practice.

Effect of sexual arousal on semen parameters during abstinence.

Semen analysis and physical examination are performed while first evaluation for patients with male infertility. Alcohol, smoking and dietary habits can affect the semen parameters. This study aimed to evaluate whether semen parameters are changed with sexual arousal. After excluding, 100 patients with ages of 18-45 were included to the study. All semen analysis were performed with three days of sexual abstinence. An identified 20 min video link was determined to the patients and while the sexual abstinence were told to watch this video once a day; after 3 days abstinence semen analysis was examined again. In the detailed examination normal spermatozoa ratio (Tygerberg strict criteria), spermatozoa concentration, semen volume, total motility and progressive motility ratios were noted. When the two semen analysis from the same patient are compared, it was observed that all parameters did not change except semen volume and total motile sperm count (p < 0.001). In conclusion, to understand the effect of sexual arousal during the sexual abstinence, we need studies with high patient number and longer follow-up.

Motivations for Maintaining Virginity Among US Adolescents.

PURPOSE: This study describes trends in virginity and the motivations for maintaining virginity between 2006 and 2019 among 15- to 19-year-old adolescents in the United States. METHODS: We used logistic regression and the margins command in Stata to estimate the proportion reporting virginity and the primary motivation for virginity during each survey period and the lincom command to facilitate statistical comparisons across time. RESULTS: The proportion of males reporting virginity increased (from 56% to 61%), and the distribution of reasons for maintaining virginity shifted over time. Most females and males reported not having "found the right person" (16%-25% for females; 26%-35% for males), and a small percentage of females reported religion and morality (39%-27%) as motivations for abstinence. DISCUSSION: The calculus of adolescents' sexual decision-making is changing, pointing to a need for new, longitudinal data aimed at clarifying the role of sexual (in)activity in teens' lives.

Questioned Virginity Has No Definite Reply.

Virginity is the nullity of sexual experience in females. However, the use of virginity testing as proof of previous involvement in sexual relations is dependent on having an intact hymen, which refers to a hymen with no signs of previous penetrating injury. Although the quality of this evidence in questioned virginity is extremely poor and considered a violation of human rights, it still constitutes a major facet in medicolegal investigations of sexual assaults. This work evaluates virginity testing as currently practiced in many countries, including Egypt, in terms of medical and legal considerations.