Method: This cross-sectional study includes 301 infertile married women recruited from the infertility Department of Aakash Fertility Centre and Hospital from March 2013 to April 2014. PCOS was diagnosed based on Rotterdam criteria. Sexual function was assessed using the FSFI questionnaire and scores were calculated using cut off values. Descriptive analysis was done using chi-square test and ANOVA. A total of 185 women diagnosed with PCOS based on Rotterdam criteria, for these patients difference between FSD and absence of FSD was assessed using t-test. Cut-off value was determined using ROC curve to find the sensitivity and specificity of the test.
Result: Prevalence of PCOS among infertile women was 61% (95 % CI 55.9 to 66.8) and the Prevalence of FSD was 51% (95% CI 45.5 to 56.8). The Prevalence of FSD among PCOS in the infertility group was 63% (95% CI 55.5 to 69.3). Most common sexual dysfunction was lubrication (89%) followed by arousal (85%), pain (81%) and desire (74%) in the infertile group. Sexual function revealed significant association among infertile women and PCOS women in relation to age and duration of infertility but not BMI. The mean value of testosterone levels in women with PCOS having sexual dysfunction was 0.61 and having no sexual dysfunction was 1.02. Significant difference was observed among women with PCOS having sexual dysfunction and absence of sexual dysfunction. The groups showed significance with a p value 0.011. ROC curve reveals a cut-off of 0.269 with a sensitivity of 32.8% and specificity of 34.8%.
Conclusion: Definite leading sexual dysfunction questionnaire must be asked to all infertile women who are under fertility treatment. Correcting sexual dysfunction improves the natural pregnancy rate. Periodic evaluation of sexual function of infertile women is a must. PCOS women with sexual dysfunction showed decreased levels of testosterone compared to women with no sexual dysfunction issues.
The condom has been used to prevent unwanted pregnancy as well as sexually transmitted diseases throughout human history since Crete or ancient Egyptians era. In Asian countries, ancient Chinese used the silk made condom with oil lubricant and Japanese also used the leather made hard condom with dual purpose of disease prevention and penile supporter.
The quality of sexual function and desire in aging male will change. Normal age-related change in erectile function will affect sexual desire. These symptoms include a decrease in blood flow to the scrotum and penis; reduced tensing of the scrotal sac and delayed erection. Penile sensitivity also decreases with age. Aging contributed to the process of erectile dysfunction through increased oxidative stress–one of which is due to induced eNOS uncoupling, endothelial dysfunction in the penis, structural changes of the artery, and reduced level of sex hormones in circulation. Many of these changes can be related to or exacerbated by several causes.
As in the Mediterranean and most of the other parts of the world, Korea in the Neolithic era was a matriarchal society. The so called Hong San culture of Ancient Korea, now in north-eastern China, proves it with many remains including the ‘Goddess of Fertility’. However, with the establishment of political community and patriarchy in 3 millennium BC, it changed to a male dominant society. During the Three Kingdom and Unified Shilla Period, Koreans enjoyed relatively free sex and intermarriage was not strange, especially in the Royal Family of Shilla. Unlike in China.
The aim of this presentation is to explain the curative treatment of male psychogenic sexual dysfunction by sex therapy and psychotropic drugs (without PDE5 inhibitors). Normal sexual response is restored and patient remains pill free after 10 to 12 weeks of treatment with weekly or fortnightly session of sex therapy and psychotropic drugs. This reduces the PDE 5 inh dependency and non-responsiveness later on. My experience as sex therapist treating male psychogenic sexual dysfunction since 1996 in Muslim society like Pakistan will be shared. Sexual dysfunctions are either predominantly psychogenic or predominantly organic.
How to understand the erectile function? How to define erectile dysfunction? In general, erectile function is evaluated by the quality of penile erection. If penis shows good erection, we think erectile function is normal. Otherwise, erectile dysfunction occurs. This concept is reflected in the definition of erectile dysfunction (ED). ED is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance1,2. It can occur due to both physiological and psychological reasons. Accordingly, first of all, we need to know what the erection is. The erection of the penis is its enlarged and firm state. It depends on a complex interaction of psychological, neural, vascular and endocrine factors3-6. Penis erection usually results from exposure to sexual stimulation from sexual arousal, but can also occur by such causes as a full urinary bladder or spontaneously during the course of a day or at night, often during REM sleep (Nocturnal Penile Tumescence). In the presence of mechanical stimulation, erection is initiated. The arteries dilate, filling the corpora spongiosum and cavernosa with blood. An erection results in swelling, hardening and enlargement of the penis3-6.
The ultimate aim of Andrological medicine is the study of the maleness, creating the health and well-being of human male. So that, even though the fundamental study of andrology is very essential, we should finally reach to clinical andrology.