MS

thesisThe present study assessed the category-specificity of sexual interest/arousal of gay men and lesbian women toward an understanding of the possible interaction of sex and sexual orientation that may exist in this phenomenon. Utilizing viewing time as a measure of sexual interest, participants (N = 99) rated the sexual appeal of sexually provocative pictures while the length of time they spent viewing each picture was unobtrusively measured. As hypothesized, same-sex oriented individuals, both men and women, demonstrated a category-specific pattern of sexual interest. That is, (1) men and women viewed preferred sex pictures significantly longer than nonpreferred sex pictures; (2) men and women rated preferred sex pictures significantly more sexually appealing than nonpreferred sex pictures; (3) the differences in viewing time and appeal ratings between preferred and nonpreferred sexual stimuli were greater for lesbian women than that demonstrated by their heterosexual counterparts; (4) the differences in viewing time between preferred and nonpreferred sexual stimuli were greater for heterosexual men than for gay men; and (5) the appeal ratings between preferred and nonpreferred sexual stimuli were comparable for gay men and their heterosexual counterparts. The results of this study suggest that self-identified gay and lesbian men and women are categoryspecific in their sexual interest

A Treatment-Oriented Typology of Self-Identified Hypersexuality Referrals

Men and women have been seeking professional assistance to help control hypersexual urges and behaviors since the nineteenth century. Despite that the literature emphasizes that cases of hypersexuality are highly diverse with regard to clinical presentation and comorbid features, the major models for understanding and treating hypersexuality employ a "one size fits all" approach. That is, rather than identify which problematic behaviors might respond best to which interventions, existing approaches presume or assert without evidence that all cases of hypersexuality (however termed or defined) represent the same underlying problem and merit the same approach to intervention. The present article instead provides a typology of hypersexuality referrals that links individual clinical profiles or symptom clusters to individual treatment suggestions. Case vignettes are provided to illustrate the most common profiles of hypersexuality referral that presented to a large, hospital-based sexual behaviors clinic, including: (1) Paraphilic Hypersexuality, (2) Avoidant Masturbation, (3) Chronic Adultery, (4) Sexual Guilt, (5) the Designated Patient, and (6) better accounted for as a symptom of another condition

Association Between Alcohol Use and Female Sexual Dysfunction From the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS)

Introduction: Sexual dysfunction is a common problem in women and the nature of its association with alcohol use remains unclear. Aim: To explore the association between alcohol use and female sexual dysfunction (FSD). Methods: Associations between self-reported drinking and sexual function were evaluated in 2,253 women presenting for consultation to a women’s health specialty clinic. A short version of the Alcohol Use Disorders Identification Test (AUDIT-C) was used to evaluate alcohol use. Women with an AUDIT-C ≥3 were considered at risk for hazardous drinking. Multivariable regression, controlling for depression, anxiety, and abuse (childhood and recent), was used to assess the association between alcohol consumption and FSD (defined as a Female Sexual Function Index [FSFI] ≤26.55 and Female Sexual Distress Scale [FSDS] ≥11) in sexually active women. Main Outcome Measure: The main study outcome measure was the presence of FSD as defined by a score ≤26.55 on the FSFI and ≥11 on the FSDS. Results: 57% of the 1,649 sexually active women were classified as having FSD; 80% reported any alcohol use and 38% reported drinking patterns with the potential to be hazardous. The women at risk for hazardous drinking had significantly higher FSFI domain scores indicating better sexual function (P ≤ .001). However, in multivariable analyses, there was no significant difference in the rates of FSD across alcohol use categories in women. Conclusion: In women presenting for consultation to a women’s health specialty clinic, an association between alcohol use and FSFI scores was seen, in which greater risk of hazardous drinking was associated with better sexual function scores. However, when sexual distress was included to define sexual dysfunction, those with FSD were not at higher risk of hazardous drinking. Given the complex nature of FSD, additional study is needed to further clarify these relationships.Kling JM, Sidhu K, Rullo J, et al. Association Between Alcohol Use and Female Sexual Dysfunction From the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS). Sex Med 2019;7:162–168. Key Words: Alcohol, Female Sexual Dysfunction, Sexual Distress, Hazardous Alcohol Us

Biopsychosocial Management of Female Sexual Dysfunction: A Pilot Study of Patient Perceptions From 2 Multi-Disciplinary Clinics

Background: Sexual dysfunction is often complex and biopsychosocial. Traditional sexual health care management involves individual providers not in a multi-disciplinary setting. A multi-disciplinary team may consist of a medical provider, pelvic floor physical therapist, and sex therapist. Aim: The aim was to explore the patient perceptions of benefit from management of their sexual dysfunction by a biopsychosocial multi-disciplinary team. Methods: A survey was e-mailed to women patients seen by multi-disciplinary teams at 2 different settings: San Diego Sexual Medicine or Mayo Clinic Women's Health Clinic during a 27-month period. Data are reported using summary statistics for age and count for remaining survey responses. Cochran-Armitage tests for trend were used to compare pre- and post-comfort levels. Outcomes: Main outcome measures included perceived benefit of being managed in a team-based model of care, level of benefit and satisfaction from each provider, and difference from pre-conceived level of comfort to actual comfort after each provider visit. Results: 89 of 270 e-mailed surveys were analyzed. Patient populations (mean age 47.6, range 23–77 years) were similar between sites. Overall, 82% of respondents reported moderate/great benefit from the team-based model; 72.1% reported management by all 3 providers valuable/extremely valuable; and 84.3% were somewhat/very satisfied with the model. Women endorsed specific ways in which they benefitted from the team-based model including: improved sexual function (58.1%), feeling validated (72.1%) and listened to (62.8%), that they better understood their health concerns (65.1%), that their partner better understood their health concerns (46.5%), and feeling normal (46.5%). There were no significant differences between the 2 clinics in terms of patient-perceived benefit, value, or satisfaction. Conclusions: The team-based model of care for management of sexual dysfunction in women including a medical provider, physical therapist, and sex therapist is associated with patient-perceived benefit, satisfaction, and value.Rullo J, Faubion S, Hartzell R, et al. Biopsychosocial Management of Female Sexual Dysfunction: A Pilot Study of Patient Perceptions From 2 Multi-Disciplinary Clinics. Sex Med 2018;6:217–223. Key Words: Biopsychosocial, Multi-disciplinary, Satisfaction, Benefi