The reliability and validity of a sexual functioning questionnaire.

The present study assessed the reliability and validity of a measure of sexual functioning, the CMSH-SFQ, for male patients and their partners. The CMSH-SFQ measures erectile and orgasmic functioning, sexual drive, frequency of sexual behavior, and sexual satisfaction. Test-retest reliability was assessed with 19 males and 19 females for the baseline CMSH-SFQ. Criterion validity was measured by comparing the answers of 25 male patients to those of their partners at baseline and follow-up. The majority of items had acceptable levels of reliability and validity. The CMSH-SFQ provides a reliable and valid device that can be used to measure global sexual functioning in men and their partners and may be used to evaluate the efficacy of treatments for sexual dysfunctions. Limitations and suggestions for use of the CMSH-SFQ are addressed.

A double-blind crossover trial of clomipramine for rapid ejaculation in 15 couples.

BACKGROUND: The purpose of this study was to assess the sexual and psychosocial efficacy of clomipramine for rapid ejaculation. METHODS: Fifteen physically healthy, self-selected couples (men had a mean age of 38 years) who met six eligibility criteria and did not meet five exclusion criteria participated in a variable-length, repeated measures, randomized, double-blind, placebo-controlled crossover study with a 2-month follow-up period. Sexual and psychosocial assessments were conducted at baseline, after placebo, after 25 mg/day of clomipramine, after 50 mg/day of clomipramine, and at the 2-month follow-up point. The major outcome measures included stopwatch timing of ejaculation latencies, modified Case Western Reserve University Sexual Function Questionnaire, Symptom Checklist-90-R, Dyadic Adjustment Scale, State-Trait Anxiety Inventory, and the Harder Self-Esteem Inventory. RESULTS: Baseline mean ejaculatory latency was 81 seconds; 25 mg/day of clomipramine increased it to 202 seconds and 50 mg/day of clomipramine to 419 seconds. This resulted in significantly greater sexual satisfaction scores for men and their partners (men, p < .001; women, p < .05), improvements in partner coital orgasmic attainment, and greater relationship and emotional satisfaction for the men. Withdrawal of the drug caused ejaculatory latencies to return to baseline. CONCLUSION: Clomipramine appears to be effective in significantly lengthening ejaculatory latencies and increasing sexual and relationship satisfaction. It can be a cost-effective chronic therapy for selected patients. These impressive results should not be expected in a less carefully screened population of men concerned about the timing of their orgasm during intercourse.

The impact of systemic lupus erythematosus on women's sexual functioning.

OBJECTIVE: We investigated the impact of systemic lupus erythematosus (SLE) and the mediating effects of psychosocial factors on women's sexual adjustment. METHODS: Data were obtained through structured interviews and psychometric scales administered to 100 female subjects with SLE and 71 disease-free controls. RESULTS: Compared with controls, patients with SLE had a significantly higher rate of abstention (26 vs 4%, p < 0.01), a lower frequency of sexual activity among the sexually active (p < 0.05), diminished vaginal lubrication (p < 0.01), and poorer general sexual adjustment (p < 0.01). Greater disease severity was associated with more impairment in sexual function (p < 0.01). Variables mediating the relationship between diagnostic status and sexual outcome included age (delta R2 = 0.04, p < 0.01), relationship status (delta R2 = 0.03, p < 0.05), weight concerns (delta R2 = 0.05, p < 0.01), premorbid sexual adjustment (delta R2 = 0.04, p < 0.01), and depression (delta R2 = 0.03, p < 0.05). Seventy-two percent of patients with SLE were receptive to physician inquiry about sexual functioning and 82% desired further education about the sexual impact of the disease. CONCLUSION: Our results suggest that sexual impairment is not inevitable among women with SLE. The role that providers can play in helping to prevent sexual difficulties is discussed.

Medical and psychosocial predictors of sexual outcome among women with systemic lupus erythematosus.

The influence of medical and psychosocial variables on sexual outcome in 100 women with systemic lupus erythematosus was examined. Subjects were administered a sexual adjustment interview and scales assessing depression, body image, and relationship quality. Medical data were obtained from patients and physicians. Key predictors of sexual outcome were disease severity (P < 0.001), premorbid sexual adjustment (P < 0.05), and relationship quality (P < 0.05). Results suggest that the impact of systemic lupus erythematosus on sexual response may best be understood by considering a combination of interpersonal, psychological, and medical conditions in a patient's life.