BACKGROUND: The concept of sexual satisfaction in menopausal women is very different from that in premenopausal women, and this difference is due to aging and physical, hormonal, cultural, and psychological changes. Therefore, the first step in discovering methods for assessing sexual satisfaction in postmenopausal women is to develop a measurement instrument. This study was conducted to develop and evaluate the psychometric properties of a sexual satisfaction instrument for postmenopausal women.
METHODS: The current study is an exploratory-sequential mixed-methods research project that will be divided into two parts: qualitative and quantitative. Aligned with the primary objective of the research, which is to elucidate the concept of sexual satisfaction in postmenopausal women, the hybrid concept analysis model developed by Schwartz and Kim will be employed. This model comprises three key phases: the theoretical phase, the fieldwork phase, and the final analytical phase. Those who met the inclusion criteria and exhibited maximum variance in terms of age, educational level, employment status, and menopausal duration were recruited. The conventional content analysis will be carried out following the steps proposed by Graneheim and Lundman. Second, in the quantitative phase, the psychometric properties of the instrument were evaluated, including the content, face and construct validity and reliability via internal consistency and stability. The psychometric properties described in the COSMIN checklist will be utilized for designing the instrument.
CONCLUSIONS: A valid and reliable scale for evaluating the sexual satisfaction of postmenopausal women should be developed, and educational content should be designed to improve the sexual satisfaction of this group of women.
Menopause is a natural event that is accompanied by numerous physical and psychological changes that create a complex period in the life of postmenopausal women. Sexual satisfaction is a component related to human sexuality and is known as the last stage of the sexual response cycle. Sexual satisfaction is defined as the emotional response resulting from the mental evaluation of positive and negative things in a sexual relationship. Sexual satisfaction is one of the important factors of satisfaction in married life. People who have sexual satisfaction have a significantly better quality of life than those who do not have sexual satisfaction. The concept of sexual satisfaction in menopausal women is very different from that in premenopausal women, and this difference is due to aging and physical, hormonal, cultural, and psychological changes. Sexual satisfaction is important for researchers for two reasons. First, sexual satisfaction provides a mechanism through which to assess a relationship partner\'s performance. Second, sexual satisfaction is a predictor of other aspects of the relationship, such as marital quality and stability. To discuss feelings and discover methods for achieving sexual satisfaction in postmenopausal women, it is necessary to understand the factors affecting sexual satisfaction and dissatisfaction in this group. The existing tools in the field of women\'s sexual satisfaction are not designed for this age group (menopausal women) and do not have the necessary comprehensiveness and adequacy to assess sexual satisfaction in menopausal women. Therefore, this study will be conducted to develop and evaluate the psychometric properties of the sexual satisfaction of postmenopausal women.

OBJECTIVE: To identify predictors of sexual satisfaction in patients with advanced cancer and their family caregivers.
METHODS: Cross-sectional study using baseline survey data from a randomized controlled trial in six European countries. Patients with advanced cancer and their family caregiver completed measures on sexual satisfaction (one item from Functional Assessment of Cancer Therapy - General questionnaire for patients and Caregiver Quality of Life Index-Cancer scale for family caregivers) and health-related characteristics. Multivariable linear regressions were performed for all predictors (identified based on literature) with sexual satisfaction as dependent variable.
RESULTS: The sample comprised 431 patient-family caregiver dyads. Patients with prostate or gynecological cancer reported lower sexual satisfaction (respectively B = -0.267 95% CI: -1.674, -0.594 and B = -0.196, 95% CI -2.103, -0.452). Higher emotional (B = 0.278, 95% CI 0.024, 0.057) physical (B = 0.305, 95% CI 0.012, 0.025) and social functioning (B = 0.151, 95% CI 0.001, 0.013), global health (B = 0.356, 95% CI 0.007, 0.013) and social wellbeing (B = 0.161, 95% CI 0.013, 0.082) among patients were associated with higher sexual satisfaction. Among family caregivers, sexual satisfaction was lower with increased age (B = -0.142, 95% CI -0.022, -0.004). Higher emotional functioning (B = 0.027, 95% CI 0.011, 0.043) and quality of life (B = 0.165, 95% CI -0.165, 0.716) were associated with higher sexual satisfaction in family caregivers.
CONCLUSIONS: The results underscore that sexual wellbeing of patients and family caregivers is related to health related factors in physical, emotional, and social domains. Patients and family caregivers could benefit from a dyadic approach to address sexual wellbeing.

UNASSIGNED: Sexual satisfaction is directly related to marital sustainability and quality of life. This study assessed the magnitude of sexual satisfaction and associated factors among married women.
UNASSIGNED: A community-based cross-sectional study was conducted from May 18 to June 8/2021 using mixed data collection methods. The sample was calculated using single population proportion formula for the quantitative part while data saturation was applied for the qualitative part. Simple random and purposive sampling techniques were used to get participants for the quantitative and the qualitative parts respectively. The quantitative data were analyzed using Statistical Package for Social Science (SPSS) version 25, and the qualitative data were analyzed manually. Ordinal logistic regression was applied to explore the model. P-value <0.05 and AOR with a 95%CI were used to identify the statistical significance of the association.
UNASSIGNED: About 398 married women participated in the study, making a response rate of 94.3% and 44.7% of them were moderately satisfied with their sexual life. Sexual satisfaction among the married women was significantly associated negatively with attending elementary education 99.9% [AOR=0.1, 95%CI:0.0,0.4)], positively with having social responsibility 19[AOR=19.3, 95%CI: 1.8, 28.3], and negatively with having poor sexual attitude 97%[AOR=0.1, 95%CI: 0.0, 0.3]. The qualitative finding showed that the majority of women engage in sexual intercourse for the satisfaction of their partners, without their needs.
UNASSIGNED: Sexual satisfaction among married women was low in the study area. Comprehensive sexual and reproductive health awareness and strengthening of the prevention of harmful traditional practices are recommended.

As a primitive driving force for biological reproduction, sexual behavior (and its associated mechanisms) is extremely complex, and orgasm plays an essential role. The limbic system plays a very important role in regulating human sexual behavior. However, it is not clear which components of the limbic system are related to orgasm sensation. We studied a rare case of spontaneous orgasmic aura in a male patient with temporal lobe epilepsy. Stereoelectroencephalography (SEEG) revealed that the right amygdala was the origin of orgasmic aura. Surgical removal of the medial temporal lobe, including the right amygdala, completely eliminated the patient\'s seizures. This study demonstrates the critical role of the amygdala in human male orgasm.

UNASSIGNED: Low-dose-rate brachytherapy (LDR-B) is an established treatment for localized prostate cancer. However, while erectile function is relatively well documented, other changes in sexual function are sparsely investigated.
UNASSIGNED: The study sought to investigate orgasmic dysfunction, urinary incontinence during sexual activity (UIS), changes in penile morphology, and sensory disturbances in the penis following LDR-B.
UNASSIGNED: A cross-sectional questionnaire-based study in patients who underwent LDR-B at our center from 2010 to 2020. The questionnaire included the International Index of Erectile Function-Erectile Function Domain (IIEF-EF) and questions on orgasm, UIS, changes in penile morphology, and penile sensory disturbances.
UNASSIGNED: Outcomes were prevalence rates of altered perception of orgasm, orgasm associated pain, anejaculation, UIS, alterations in penile morphology, penile sensory disturbances, and predictors of these side effects.
UNASSIGNED: Overall, 178 patients responded to the questionnaire. The median age was 70 years (range, 51-83 years), and the median time since LDR-B was 93 months (range, 21-141 months).Overall, 142 (80%) were sexually active and 126 (70.8%) had erectile dysfunction (ED). Of the sexually active patients, 8 (5.6%) reported anejaculation and 7 (4.9%) reported anorgasmia. Another 67 (46.9%) had decreased orgasmic intensity, while 69 (49.3%) reported an increased time to orgasm. Twenty-six (18.3%) patients had experienced orgasm-associated pain with a median visual analog pain score of 2. Considering overlap, 44 (31.0%) patients had an unchanged orgasmic function. Six (3.3%) patients had experienced UIS at least a few times. Penile length loss was reported by 45 (25.2%) patients. Seventeen (9.6%) patients reported an altered curvature of their penis and 9 (5%) had experience painful erection. Thirty-three (18.5%) patients had experienced decreased penile sensitivity. On multivariate analyses, ED was the only independent risk factor for altered perception of orgasm (odds ratio [OR], 6.6; P < .0001), orgasmic pain (OR, 5.5; P = .008), and penile shortening (OR, 4.2; P < .0056). No independent risk factors were identified for UIS or sensory penile disturbances.
UNASSIGNED: Patients undergoing LDR-B should be adequately informed about possible side effects, and clinicians should inquire about these during follow-up visits.
UNASSIGNED: We are the first to comprehensively explore the previously neglected side effects of LDR-B for prostate cancer. Limitations are the cross-sectional design assessing the cohort at different time points following their treatment and the response rate.
UNASSIGNED: Orgasmic dysfunction, changes in penile morphology, and sensory disturbances in the penis are common side effects of LDR-B for prostate cancer. UIS is only experienced by a small minority.

Estradiol (E2) has been implicated in sexual functioning in both sexes. E2 levels change distinctively over the menstrual cycle, peaking around ovulation. Data on short-term effects of fluctuating E2 levels on sexual desire are however sparse and mostly based on observational studies. To fill this gap, we ran a double-blind, randomized, placebo-controlled study (N = 126) to investigate the effects of a short-term increase in E2 on sexual desire and orgasm frequency in healthy, young men and women. Circulating E2 levels were elevated through estradiol valerate (E2V) administered over two consecutive days to simulate the rise in E2 levels around ovulation. E2V had no effect on orgasm frequency and only minor effects on sexual desire. On average, the administered E2V dampened change in sexual desire compared to untreated participants with comparable baseline sexual desire in such a way that sexual desire was slightly reduced even in those with higher baseline sexual desire. These findings suggest that short-term increases in E2 have little effect on sexual function and are unlikely to explain the increase in sexual desire around ovulation.

Selective serotonin reuptake inhibitors (SSRIs) are the cornerstone of psychopharmacology. However, they cause side effects such as sexual dysfunction, leading to the discontinuation of treatment. We aimed to investigate the efficacy and safety of drug holidays for women experiencing sexual dysfunction Induced by SSRIs other than fluoxetine. This study was an 8-week randomized, open-label, controlled trial including married women aged between 18 and 50 years who had experienced sexual dysfunction while undergoing treatment with SSRIs. The intervention group implemented drug holidays by not taking medications on Thursdays and Fridays, while the control group continued regular medication use. The female sexual function index (FSFI) and the 28-question general health questionnaire (GHQ-28) were administered to assess sexual function and mental health, respectively. A total of 50 participants completed the trial. The drug holidays\' group showed significant improvements in arousal (p < 0.001), desire (p = 0.001), orgasm (p < 0.001), satisfaction (p < 0.001), lubrication (p = 0.021), and overall sexual health (p < 0.001). The between-group difference of pain was significant (p < 0.001), despite no significant within-group change. Mental health improved in both groups, despite no significant between-group difference. No major adverse effects were reported. Drug holidays did not introduce immediate safety concerns or significant adverse effects during the timeframe of eight weeks, suggesting that it may be a safe and effective strategy for managing SSRI-induced sexual dysfunction in women, alongside improving mental health. Further research is needed to reach a definitive conclusion.

Postorgasmic illness syndrome (POIS) is a rare syndrome in which patients experience various physical and cognitive symptoms after ejaculation, and its pathophysiology remains unknown.
The aim of this study was to characterize the clinical presentations, disease course, and treatment outcomes in outpatients, as well as to examine the validity of the preliminary criteria and symptom clusters of POIS.
This retrospective monocentric study was conducted in a neurourology department, with patients included from 2010 to 2023. The diagnostic criteria and symptom cluster descriptions were based on previous studies.
The study focused on the clinical features of POIS, the complementary tests performed, the treatments tried, and their effectiveness.
Thirty-seven men were included in the study, with symptom onset occurring at a mean ± SD age of 23.6 ± 7.4 years. The mean time from ejaculation to symptom onset was 1 hour 22 minutes ± 3 hours 42 minutes. The mean duration of symptoms was 4.7 ± 3.4 days. Seventeen patients (46%) developed the symptoms primarily, whereas in 20 (54%) they appeared secondarily. All preliminary criteria were met in 19 patients (51%). The most common symptom clusters were \"general\" in all 37 patients (100%; eg, asthenia and concentration difficulties) and \"head\" in 35 patients (95%; mostly headache and a foggy feeling). In terms of treatments, antihistamines and nonsteroidal anti-inflammatory drugs were tried and partially improved symptoms for some patients.
This study helps to further characterize POIS by specifying the most frequent symptoms and comparing them with the initial criteria.
To our knowledge, this is one of the largest cohorts of patients consulting for symptoms suggestive of POIS. There are limitations due to the retrospective nature of the data collection, such as missing data and imprecision of treatment efficacy.
The majority of participants met at least 3 of the preliminary diagnostic criteria, with a majority of symptoms in the general and head clusters. However, the determination of predictive factors for treatment response based on the typology of the disorders remains to be established.

OBJECTIVE:  Women play an essential role in maintaining the family\'s health, and family planning is part of women\'s and families\' health. The couple\'s mutual understanding of family planning methods is essential in selecting contraception. Acceptance of and satisfaction with different contraception methods can impact sexual satisfaction. The present study aimed to compare the effect of the information-motivation-behavioral (IMB) model and psychoeducational counseling on sexual satisfaction and contraception methods of women referring to health centers in Kerman.
METHODS:  This trial was conducted on 81 women aged 18 to 45, in Kerman health centers, from 2021 to 2022. Participants were randomly divided into 3 groups of 27 people (control, psychoeducational counseling, and IMB method). Three online counseling sessions were held for the psychoeducational group, and four were held for the IMB group. The control group received routine care. The IBM SPSS Statistics for Windows, version 22 (IBM Corp. Armonk, NY, USA) was used for data analysis using nonparametric Friedman and Kruskal-Wallis tests.
RESULTS:  The mean age of participants was 32.59 ± 7.04, and the majority of them had university degrees and were homemakers. The mean sexual satisfaction score significantly increased immediately after the intervention and 1 month later in the 2 interventional groups (p < 0.0). Changes in contraception methods after intervention were significant in the psychoeducational group (p = 0.0) CONCLUSION:  The results indicate the positive impact of psychological counseling on women\'s sexual satisfaction and contraception method. The IMB method also impacted men\'s sexual satisfaction but did not lead to any changes in the contraceptive method.
OBJECTIVE:  A mulher desempenha um papel essencial na manutenção da saúde da família, e o planejamento familiar faz parte da saúde da mulher e da família. A compreensão mútua do casal sobre os métodos de planejamento familiar é essencial na seleção da contracepção. A aceitação e a satisfação com os diferentes métodos contraceptivos podem afetar a satisfação sexual. O presente estudo teve como objetivo comparar o efeito do modelo informação-motivação-comportamental (IMB) e aconselhamento psicoeducacional sobre a satisfação sexual e métodos contraceptivos de mulheres encaminhadas para centros de saúde em Kerman. MéTODOS:  Este estudo foi realizado em 81 mulheres de 18 a 45 anos, nos centros de saúde de Kerman, de 2021 a 2022. As participantes foram divididas aleatoriamente em 3 grupos de 27 pessoas (controle, aconselhamento psicoeducacional e método IMB). Foram realizadas três sessões de aconselhamento online para o grupo psicoeducativo e quatro para o grupo IMB. O grupo de controle recebeu cuidados de rotina. O IBM SPSS Statistics for Windows, versão 22 (IBM Corp. Armonk, NY, EUA) foi utilizado para a análise dos dados por meio dos testes não paramétricos de Friedman e Kruskal-Wallis.
RESULTS:  A média de idade das participantes foi de 32,59 ± 7,04, sendo que a maioria delas possuía nível superior e eram donas de casa. A pontuação média de satisfação sexual aumentou significativamente imediatamente após a intervenção e 1 mês depois nos 2 grupos de intervenção (p <0,0). As mudanças nos métodos contraceptivos após a intervenção foram significativas no grupo psicoeducativo (p = 0,0) CONCLUSãO:  Os resultados indicam o impacto positivo do acompanhamento psicológico na satisfação sexual das mulheres e no método contraceptivo. O método IMB também impactou a satisfação sexual dos homens, mas não levou a nenhuma mudança no método contraceptivo.

BACKGROUND: Orgasmic phase disorders in men worsen the burden of erectile dysfunction on sexual satisfaction.
OBJECTIVE: To investigate the prevalence of and predictors of unreported orgasmic phase disorder in a cohort of men looking for their first urological assessment for new-onset erectile dysfunction in a real-life setting.
METHODS: Data from 1107 heterosexual, sexually active men consecutively assessed for new-onset erectile dysfunction were analysed. Throughout a comprehensive medical and sexual history, all patients were asked to self-report any orgasmic phase disorder and to complete the International Index of Erectile Function and the Beck\'s Inventory for Depression (depressive symptoms scored as Beck\'s Inventory for Depression ≥11). Men self-reporting orgasmic phase disorder during the interview were excluded from further analyses. The median value of the International Index of Erectile Function-orgasmic function domain was arbitrarily used to categorise men with (International Index of Erectile Function-orgasmic function ≤5) and without unreported orgasmic phase disorder (International Index of Erectile Function-orgasmic function >5). Circulating hormones were measured in every patient. Descriptive statistics and logistic regression models were used to test the association between clinical variables and unreported orgasmic phase disorder.
RESULTS: Of 1098 patients with non-self-reporting orgasmic phase disorder, 314 (28.6%) had International Index of Erectile Function-orgasmic function ≤5. Patients with erectile dysfunction + unreported orgasmic phase disorder were older (median [interquartile range]: 58 [44-66] years vs. 51 [40-60] years), had higher body mass index [25.8 (23.7-28.1) kg/m2 vs. 25.2 (23.3-27.4) kg/m2 ], higher prevalence of type 2 diabetes (36 [11.5%] vs. 45 [5.7%]) and lower International Index of Erectile Function-erectile function scores (6 [2-10] vs. 18 [11-24]) than men with erectile dysfunction-only (all p < 0.05). Patients with erectile dysfunction + unreported orgasmic phase disorder depicted higher rates of severe erectile dysfunction (75.5% vs. 25%) and Beck\'s Inventory for Depression ≥11 (22.6% vs. 17.9%) (all p < 0.05). In the multivariable logistic regression analysis, older age (odds ratio: 1.02) and lower International Index of Erectile Function-erectile function scores (odds ratio: 0.83) were independently associated with unreported orgasmic phase disorder (all p < 0.05).
CONCLUSIONS: Almost one in three men seeking first medical help for erectile dysfunction depicted criteria suggestive of unreported orgasmic phase disorder. Men with unreported orgasmic phase disorder were older and had higher rates of severe erectile dysfunction and concomitant depressive symptoms. These real-life findings outline the clinical relevance of a comprehensive investigation of concomitant sexual dysfunction in men only complaining of erectile dysfunction to more effectively tailor patient management.