Post-orgasmic illness syndrome (POIS) is a rare disorder associated with a debilitating symptoms post-ejaculation associated with significant impairment in quality of life. The mechanism of the disease is unclear, but hypersensitivity to semen and/or seminal fluid has been postulated. We present a case of POIS successfully treated with omalizumab suggesting a possible role for this therapy in POIS treatment and management.

Objective: Synesthesia is a unique experience with an unclear mechanism. The clinical condition usually presents when a sensation stimulates other senses. While more than 150 types of synesthesia have been reported; however, some types are considered uncommon, and co-occurrence of these rare types of synesthesia are rare. In the present report, we described a case of synesthesia with experience of pain and orgasm in color. Method : A 31-year old healthy male presented with visual equity changes during orgasm. In addition, he described a color-pain sensation every time he experienced severe chest pain during his childhood. None of these sensations negatively affected his daily or sexual life. Based on the patient\'s history, a possible diagnosis of synesthesia was made and further clinical evaluations were performed. Results: The patient did not have any color vision abnormalities or problems in solving Hooper visual organization test, bells test, Rey complex figure test, card sorting test, and Trail making tests. The Brief Male Sexual Inventory did not reveal any sexual dysfunction. Therefore, regarding the patient\'s experiences without any visual disturbance and absence of any underlying diseases, the diagnosis of synesthesia was made. Conclusion: The present report demonstrates coexistence of a rare form of synesthesia as orgasm to color with specific pain to color synesthesia. In contrast to previous reports, our case demonstrated color orgasm as a type of synesthesia that might not negatively affect sex life in men.

Clitoral adhesions are characterized by adherence of preputial tissue to the glans clitoris and can be managed using a non-surgical approach in order to relieve symptoms of sexual dysfunction.
To evaluate efficacy and patient satisfaction associated with the non-surgical lysis procedure in order to determine if it is an appropriate treatment for symptomatic clitoral adhesions.
The non-surgical lysis procedure is performed by using a fine Jacobsen mosquito forceps to separate the plane between the prepuce and the glans of the clitoris, removing smegma and/or keratin pearls from underneath the adhesions and allowing for visualization of the entire glans. A chart review of 61 women that were treated for clitoral adhesions using the non-surgical lysis procedure at 1 sexual medicine practice was performed and an online survey was sent to these patients.
Encrypted survey responses were used to evaluate patient satisfaction as well as self-reported improvement in sexual functioning and pain before and after the procedure.
41 survey responses were received out of 61 eligible (67% response rate). A large majority reported improvement in pain (76%), sexual arousal (63%), and ability to achieve orgasm (64%) and no participants reported worsening in these symptoms. Of the 16 women that reported the inability to orgasm from external clitoral stimulation prior to the procedure, 6 (38%) were able to do so afterwards. Seventy-one percent of respondents reported improvement in their satisfaction with sex and 83% reported being satisfied with their decision to have the procedure. Ninety-three percent of participants reported that they would recommend this procedure to a friend with clitoral adhesions.
The results of this study will help clinicians to recognize the non-surgical lysis procedure as a treatment option for clitoral adhesions.
This study is the first of its kind assessing a cohort of patients undergoing the non-surgical lysis procedure for clitoral adhesions. Its limitations include a small sample size from 1 clinic and lack of validated instrument to evaluate sexual function and pain before and after the procedure.
Providers should regularly examine the clitoris of patients with symptoms of sexual dysfunction in order to determine if they have clitoral adhesions. The non-surgical lysis procedure may be a viable therapeutic option for these patients that has demonstrated both satisfaction and symptom relief. Myers MC, Romanello JP, Nico E, et al. A Retrospective Case Series on Patient Satisfaction and Efficacy of Non-Surgical Lysis of Clitoral Adhesions. J Sex Med 2022;19:1412-1420.

Occurrence of retained rectal foreign bodies with bowel perforation resulting from auto-eroticism is rare among males in Africa. Embarrassment attached to this condition may delay or derail acquisition of information and management. A 30-year-old male presented with abdominal pain and constipation for 3 days. Abdominal X-rays revealed free air-stripes under both hemidiaphragms and in the peripherals, a 25cm x 5.9cm lucent foreign body on the left side with proximal tapering. There was no evidence of intestinal obstruction. This was consistent with bowel perforation secondary to foreign body introduction. Exploratory laparotomy was performed, a plastic bottle of 250mls was removed from the colon. Transverse repair of a 10cm laceration extending from the rectum to the sigmoid was done and a colostomy placed. A high index of suspicion, a systematic approach and a lower threshold for imaging studies were key to successful management and favorable outcomes of this patient.

To investigate a novel methodology and explore whether artificially reducing the depth of penetration during intercourse matters to women.
A study with a single-case experimental design (\'n of 1\'), in which a heterosexual couple act as their own control and the study is then replicated in subsequent couples, was conducted. Thirty-five couples were assessed for eligibility to participate. Twenty-nine couples without any sexual problems were randomized and 12 submitted sufficient data to analyse. As a proxy for reducing penis length, we artificially reduced the depth of penetration by using different sizes of silicone rings around the base of the man\'s erect penis. The main outcome measures were provided by the female partner on a scale of 0-100 and comprised: degree of (i) overall sexual pleasure; (ii) sexual pleasure from intercourse alone; and (iii) emotional connection to the male partner. The female partner was also asked before the experiment began to rate the degree of positive or negative change that would be personally meaningful for her.
On average, reducing the depth of penetration led to a statistically significant 18% reduction of overall sexual pleasure with an average 15% reduction in length of the penis. The longer the erect penis, the less likely the rings were to have an impact on sexual pleasure. There was a range of individual responses, however, with a minority of women reporting that reducing the depth of penetration was more pleasurable on some occasions.
Size may matter in women in a healthy stable relationship when there is penile shortening. Because of the small number of couples and the inclusion of men with an apparently long penis, our results are preliminary, and we welcome replication in a larger sample with a more diverse range of penile lengths. Our results should not be misinterpreted as meaning that increasing penile length will increase sexual pleasure in women.

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UNASSIGNED: Modafinil is used for the treatment of narcolepsy and obstructive sleep apnea syndrome, and as add-on therapy for psychiatric diseases such as attention-deficit/hyperactivity disorder, schizophrenia, depression, cocaine addiction. The exact mechanism of action is unknown. Modafinil may be helpful for the treatment of erectile dysfunction and premature ejaculation. The addition of modafinil to antidepressant treatment may provide positive effects on sexual dysfunction. However, side effects such as hypersexuality and unwanted orgasm have been reported with modafinil treatment. In this article, a patient who had developed spontaneous ejaculations after the addition of modafinil for the treatment of depression with venlafaxine is discussed. Although venlafaxine treatment continued after the discontinuation of modafinil, spontaneous ejaculation did not continue. It should be kept in mind that agents with dopaminergic and noradrenergic effects, such as modafinil, can cause undesirable sexual side effects.

UNASSIGNED: Primary headache associated with sexual activity (PHASA) is rare but recognized by the International Classification of Headache Disorders. Although triptans and indomethacin have been suggested as a pharmacological treatment option for acute treatment, indomethacin can be administered preemptively, and β-blockers has been proposed as a treatment option for prophylactic management, pharmacologic efficacy remains uncertain. Manual therapy for PHASA has not been studied and thus has no scientifically proven effect. The purpose of this case study is to present a successful case of chiropractic care for a patient with PHASA.
UNASSIGNED: This case study presents a case where a 19-year-old white European female student presented to a primary care chiropractic clinic complaining of mainly left-sided intense headache, which had acute onset right before or during orgasm. The patient had never suffered headaches before this, and the intense headache never occurred outside sexual activity nor during intercourse if she did not reach orgasm. The diagnosis of PHASA was later confirmed by a hospital neurologist with extensive experience in headache diagnostics.
UNASSIGNED: After 7 manual therapy sessions consisting of spinal manipulative therapy at the lumbosacral area conducted by an experienced chiropractor, the patient reported remission of her PHASA, which remained as such at a 12-month follow-up.
UNASSIGNED: This case study generates the observational hypothesis that a patient with PHASA may respond to chiropractic spinal manipulative therapy. The underlying mechanisms for this symptom amelioration are, however, unclear.

Cerebellar ataxia affects individuals in reproductive age. To date, few clinical cases of cerebellar ataxia and involvement of the cerebellum in sexual response were reported. We report a case of a woman that need to restore skills related for execution of sexual activity and coordination of movements during sexual intercourse.
We present a case of idiopathic cerebellar ataxia in a 25-year-old woman who was referred for sexual health consultation. The patient complained of sexual problems as follows: \"I forgot the behaviors that I should adopt in a sexual encounter, and I know what to do only after paying attention to my movements.\" The history of sexual behavior indicated that this patient presented a \"romantic love\" model. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) reports that this condition involves anorgasmia disorder and female sexual arousal disorder. In addition, there was a loss of automatism and coordination of movements in the pelvis and lower extremities. The patient\'s condition improved with occupational and physical therapy combined with rehabilitation therapy based on cognitive behavioral criteria for sexual therapy.
The case evolved from the romantic-affective model to a realistic model. The patient reported being comfortable during sexual intercourse and could explain her sexual needs to her partner. She managed to coordinate lower limb and pelvic movements, but did not reach an orgasm. Moreover, vaginal lubrication occurred with a time lag of 15-30 min after the end of sexual intercourse or masturbation.

UNASSIGNED: The prevalence of endometriosis in the general population is estimated at 7-10%. There are various risk factors for this disease, including early menarche age, prolonged menstruation or no history of pregnancy. It seems that sexual activity leading to orgasm during menstruation increases the retrograde menstruation, sending endometrial tissue to an abnormal sites and thus increasing the risk of endometriosis. The present study is aimed to determine the association between sexual activity during menstruation and endometriosis.
UNASSIGNED: This case-control study, conducted in the year 2017, recruited 555 women who were visited at Alzahra Hospital in Tabriz, Northwest of Iran. The case group comprised 185 women of reproductive age with confirmed endometriosis. The control group comprised 370 women of reproductive age without endometriosis visiting the hospital for other issues. Data was collected using a researcher-made questionnaire based on previous studies. Bivariate analysis was performed by the chi-squared test and multivariate analysis was done using conditional logistic regression to control confounding variables.
UNASSIGNED: The sexual activity of the two groups during menstruation was significantly different. The occurrence of endometriosis in women who stated they had vaginal intercourse or non-coital sexual activities, leading to orgasm during menstruation, was significantly higher compared to those who stated they did not.
UNASSIGNED: According to our findings, there is an association between sexual activities leading to orgasm during menstruation and endometriosis.