Hormonal Contraception and Sexual Function: A Review, Clinical Insights, and Management Considerations

Most sexually active women of reproductive age have used contraception, with hormonal methods constituting approximately 40% of contraceptive choices. Among these hormonal options, combined oral contraceptives stand out as the most selected. Within this same demographic, sexual issues are prevalent. Although specific hormonal contraceptives have been implicated in sexual dysfunction among these women, the correlation lacks consistency across studies and varies between different types of hormonal contraception. This article assesses the available literature on the associations between various hormonal contraceptive methods and sexual function and provides practical management insights.

Encouraging online consumers into making better food choices: The power of nature exposure on healthy food choices

BACKGROUND

online environments can influence food desire and choices. We tested if online calming nature and stressful street environments can affect desire for healthy and unhealthy foods.

METHOD

we asked 238 participants (40 ± 14 yrs) to rate their desire (100 mm VAS) for 7 low calorie nutrient rich foods (Healthy) and 7 high calorie nutrient poor foods (Unhealthy), and perceived stress (state anxiety in STAI), before and after imagining themselves in a control, nature park, or busy street condition.

RESULTS

participants who imagined themselves being in a nature park had a significant higher desire for Healthy foods, than participants in the busy street condition (p < 0.05). Participants in the busy street condition decreased their desire for Healthy foods after they imagined themselves in a busy street (p < 0.05)). However, perceived stress did not impact the association between condition and desire for low calorie foods nor high calorie foods.

CONCLUSION

this study suggests that online environments can have an impact on healthy food desires, which could be of importance for the increased number of food choices which are made in online environments.

How consumption and reward features affect desire for food, consumption intentions, and behaviour

Understanding the mechanisms that underlie desire and intentions may assist in the search for strategies to promote the selection and consumption of more sustainable and healthier products. Therefore, we conducted two experiments to examine how cognitive representations influence desire and intentions for various savoury dishes. In Experiment 1, 1000 participants were allocated to one of five conditions, listing either the typical, sensory, context, hedonic, or health features of 20 popular dishes to assess cognitive representations, before rating their present moment desire to consume each dish. Although there was no direct effect of condition on desire, there was a significant mediating effect of condition on desire through the proportion of consumption and reward features listed (i.e., sensory, context, and hedonic words). In Experiment 2, 892 participants were allocated to one of four conditions, listing either the typical, sensory, context, or health features for the same 20 dishes, before rating their intention to consume each dish over the next four weeks. At a 4-week follow-up, participants rated how often they had consumed each dish. Again, there was no direct effect of condition on intentions, although there was a significant mediating effect of condition on intentions through consumption and reward features. This suggests that mentally simulating a previous consumption experience increases intentions to consume the dish in mind. The results also showed a positive indirect effect of consumption and reward features on behaviour through an increase in intentions. Describing healthy and sustainable products in terms of the rewarding consumption experience may increase desire and intentions to consume them, improving the health of both people and the planet.

People Declare Lowered Levels of Sociosexual Desire in the Presence of an Attractive Audience

Due to social desirability bias, people tend to self-present themselves in the presence of others in a favorable light, which sometimes may lead to deviations from reality. This phenomenon is particularly pronounced when controversial or strictly norm-bounded matters are considered. Here, we tested how a presence of an attractive model-either male or female-influences people's declarations on their sociosexual orientation-the degree of their sexual permissiveness in terms of their past behavior, attitudes toward uncommitted sex, and desire for sexual intercourse with individuals they are not in a relationship with. The participants (N = 244, 52% men) answered questions about their sociosexuality in solitude, or out loud with an attractive model present. The results show that both men and women declare lowered levels of their desire, but not behavior or attitude, in the presence of both male and female attractive models. A follow-up study (N = 188, 51% men) showed that this effect was not due to the differing conditions of responding (out loud vs written down). The research points out to an area of human sexuality that is prone to being falsified in research and which serves as an important factor in self-presentation.

Women's desire to limit child-bearing and its associated factors in rural Ethiopia: A multilevel analysis

Introduction

Ethiopia ranks twelfth globally and second in Africa by population size. High fertility rates, especially in rural areas, contribute to rapid population growth, impacting the country's economy. The decision of women to control the number of children they have is a crucial factor influencing population growth and contributing to elevated health risks for both women and children.Objective: the purpose of this study was to assess women desire to limit childbearing and its associated factor among rural women in Ethiopia.

Methods

A cross-sectional survey dataset of Ethiopian demographic and health survey 2016 was used for this study. A total of 12,019 rural women were included in the study. A multilevel binary logistic regression was used to identify the predictors of women's desire to limit childbearing. The adjusted odds ratio with respective 95 % confidence interval was used to declare statistically significant variables.

Result

In rural Ethiopia, 33.04 % of women had a desired to limit their childbearing. Women in the age group of 25-34 years (AOR = 1.61, 95 % CI = 1.28,2.13), 35-49 years (AOR = 4.96, 95 % CI = 3.64, 6.65), had no children (AOR = 0.06, 95 % CI = 0.04, 0.09), having children 1-3 (AOR = 0.29, 95 % CI = 0.23, 0.36), married (AOR = 0.45, 95 % CI = 0.27, 0.75), living in small peripherals region (AOR = 0.33,95 % CI = 0.24, 0.45) and community level poverty (AOR = 0.72, 95 % CI = 0.57, 0.89) were significant predictors of women's desire to limit the number of children they bear.

Conclusion

In rural Ethiopia, there is a limited inclination to control childbearing. Older women and those with higher number of children express a stronger desire to limit childbearing. Conversely, married women, from smaller peripheral regions and those residing in areas with a higher community poverty rate are less likely to have a desire to limit childbearing. Thus, promoting education on the advantages of smaller family sizes and offering family planning services could be crucial in fostering women's willingness to limit their childbearing.

Low prolactin level identifies hypoactive sexual desire disorder women with a reduced inhibition profile

PURPOSE

Data on the role of prolactin (PRL) in the physiologic range in the female sexual response are scanty. We aimed at investigating the association between PRL and sexual function as assessed by the Female Sexual Function Index (FSFI). We explored the presence of a cut-off level of PRL able to identify Hypoactive Sexual Desire Disorder (HSDD).

METHODS

277 pre- and post-menopausal women consulting for Female Sexual Dysfunction (FSD) and sexually active were enrolled in an observational, retrospective study. 42 women were used as no-FSD controls. A clinical, biochemical and psychosexual evaluation was performed. The main outcome measures were: FSFI, Female Sexual Distress Scale-Revised, Middlesex Hospital Questionnaire and Sexual excitation/sexual inhibition scale (SIS/SES).

RESULTS

Normo-PRL FSD women (n = 264) showed lower FSFI Desire score than controls (n = 42), and higher than hyper-PRL FSD women (n = 13). These differences emerged both in pre-menopausal and post-menopausal subjects. In the normo-PRL FSD group, those with PRL in the higher quintile reported higher FSFI Desire scores than those with PRL in the lowest quintile. Women with HSDD presented a lower PRL level than those without (p = 0.032). A ROC curve analysis for PRL showed an accuracy of 0.610 ± 0.044 (p = 0.014) in predicting HSDD. With a threshold of < 9.83 μg/L, sensitivity and specificity for HSDD were 63% and 56%, respectively. Subjects with PRL < 9.83 μg/L also reported lower sexual inhibition (p = 0.006) and lower cortisol levels (p = 0.003) than those with PRL >  = 9.83 μg/L.

CONCLUSIONS

Hyper-PRL is associated with low desire; however, among normo-PRL FSD women, those with the lowest levels demonstrated a poorer desire than those with the highest levels. PRL < 9.83 μg/L predicted HSDD and a lower sexual inhibitory trait.

The enticement of feeling understood, validated, and cared for: How does perceiving a partner as responsive affect the sexual arena?

Partners' behaviors outside the bedroom may spill over into the bedroom. One such behavior is responsiveness, as it creates a relationship ambiance conducive to the development of intimacy. In this article, I review research demonstrating how perceiving partners as responsive outside the bedroom affects the quality of sexual interactions, highlighting changes in the contextual meaning of partner responsiveness across individuals and relationship stages. I then provide an overview of the costs and benefits of responsiveness within the bedroom. I conclude by suggesting directions for future research on the potential of partner responsiveness for fostering a relationship environment that inoculates against alternative partners as well as for designing social robots and virtual mates for those in need of a surrogate partner.

Affect, desire and interpretation

Are interpersonal comparisons of desire possible? Can we give an account of how facts about desires are grounded that underpins such comparisons? This paper supposes the answer to the first question is yes, and provides an account of the nature of desire that explains how this is so. The account is a modification of the interpretationist metaphysics of representation that the author has recently been developing. The modification is to allow phenomenological affective valence into the "base facts" on which correct interpretation is grounded. To use this extra resource within that theory to vindicate interpersonal comparisons, we will need to appeal rational connections between level of valence and level of desire, which this paper sets out and examines.

Does Sexual Desire Fluctuate More Among Women than Men?

There is a lay assumption that women's sexual desire varies substantially over time, whereas men's is stable. This assumption is mirrored in prominent theories of desire, which posit that women are more variable than men in the extent to which they desire sex, and that women's sexual desire is more contextually sensitive than men's. We tested this assumption across three longitudinal studies. Study 1 assessed desire at 3 time points spanning 13 years (N_observations = 5562), and Studies 2 and 3 (N_observations = 11,282) assessed desire moment-to-moment over 7 days. When desire was measured over years, women were more variable in their sexual desire than men (Study 1). However, we found a different pattern of results when desire was measured over the short term. In Studies 2 and 3, we found no significant differences in women's and men's desire variability. The extent to which desire varied as a function of affective states (e.g., happiness) and relationship-oriented states (e.g., partner closeness) was similar for women and men, with some exceptions; women's desire was more negatively associated with tiredness and anger in Study 2. These data qualify existing assumptions about sex differences in sexual desire variability.

Rational transformative decision-making

According to L. A. Paul (2014), transformative experiences pose a challenge for decision theory, as their subjective value is not epistemically accessible. However, several authors propose that the subjective values of options are often irrelevant to their ranking; in many cases, all we need for rational transformative decision-making are the known non-subjective values. This stance is in conflict with Paul's argument that the subjective value can always swamp the non-subjective value. The approach presented in this paper takes Paul's argument into account and shows how potential swamping can be controlled given that one desires the transformative outcome: If one knows from previous decisions that desired transformative outcomes are associated with positive subjective value and if, in addition, testimony confirms this association for the current decision situation, one can infer that a desired outcome's expected subjective value has a positive valence. Accordingly, one can rationally choose the desired transformative option if its non-subjective value is no lower than the overall value of any other option.

Gender Inequities in Household Labor Predict Lower Sexual Desire in Women Partnered with Men

Low sexual desire in women is usually studied as a problem, one that is located within women. However, other possibilities exist, including known gender inequities related to heteronormative gender roles. In this study, we provide the first test of the theory that heteronormativity is related to low sexual desire in women partnered with men, focusing specifically on inequities in the division of household labor. In two studies with women who were partnered with men and had children (Study 1, N = 677; Study 2, N = 396), performing a large proportion of household labor was associated with significantly lower sexual desire for a partner. Together, the results suggest that this association was mediated by both perceiving the partner as a dependent and perceiving the division of labor as unfair. These results support the heteronormativity theory of low sexual desire in women partnered with men, and show that gender inequities are important, though understudied, contributors to low desire in women partnered with men.

Desire for Alternative Treatment Options in Patients with Atopic Dermatitis in Japan: Results of a Web-Based Cross-Sectional Study (AD-JOIN Study)

INTRODUCTION

Treatment satisfaction in patients with atopic dermatitis (AD) has been investigated in several studies, but the desire for alternative treatment options is unclear and has not been previously evaluated. We conducted a cross-sectional, web-based survey aimed at evaluating the desire for alternative treatment options in adults with AD from a patient registry in Japan.

METHODS

Main eligibility criteria were adults aged ≥ 18 years with AD who were receiving treatment with topical corticosteroids (TCS) and not systemic therapy. Questionnaires included the Patient Oriented Eczema Measure (POEM) and pruritus Numeral Rating Scale. The proportion of patients with a desire for an alternative treatment option was assessed, overall (Overall Desire) and by specific type of alternative treatment option (Specific Desire), including change in medication, hospital transfer, and complementary and alternative medicine (CAM) use. Patient background factors associated with desire were evaluated using multivariate logistic regression.

RESULTS

Of the 1500 patients included in the analysis, 91.5% (n = 1372) had an Overall Desire, with the most common Specific Desire being a change in medication (n = 1213, 80.9%), followed by CAM (n = 593, 39.5%) and hospital transfer (n = 429, 28.6%). Dissatisfaction with current treatment was significantly (p < 0.05) associated with Overall Desire and Specific Desire (p < 0.001 each). Severe disease according to POEM was significantly associated with Overall Desire and a change in medication (p < 0.001 each).

CONCLUSIONS

A high proportion of Japanese patients with AD being treated with TCS had a desire for alternative treatment options. The desire was greatly affected by patients' satisfaction with their current treatment and perception of disease severity. These findings highlight the importance of assessing patients' satisfaction or perception of disease severity, and facilitating early discussions between patient and doctor on their available treatment options, including new treatment options.

Lack of Evidence for a Relationship Between Salivary CRP and Women's Sexual Desire: An Investigation Across Clinical and Healthy Samples

BACKGROUND

Inflammation has been linked to a variety of mental and physical health outcomes that disproportionately impact women, and which can impair sexual function; thus, there is reason to expect a link between inflammation and women's sexual functioning.

AIM

To test the hypothesis that higher concentrations of C-reactive protein (CRP), a general biomarker of inflammation, would predict women's lower sexual desire.

METHOD

As 2 independent research teams, we conducted 3 separate studies (total n = 405) that assessed salivary CRP and various measurements of sexual desire in different women populations.

OUTCOMES

Female Sexual Function Index, Sexual Desire Inventory-2, Decreased Sexual Desire Screener, and Sexual Interest and Desire Inventory.

RESULTS

Regardless of the way sexual desire was measured (e.g., state vs trait; general desire vs. desire functioning) and the population sampled (i.e., healthy vs. clinically diagnosed with sexual dysfunction), all the studies revealed null results.

CLINICAL IMPLICATIONS

While exploratory, the convergence of these null results across studies and researchers suggests that if there is an association between inflammation and women's sexual desire, it is likely very subtle.

STRENGTHS & LIMITATIONS

Across 2 independent research teams, 3 unrelated studies, and various measurements of sexual desire, results were consistent. These points lend to the generalizability of the results. However, study designs were cross-sectional.

CONCLUSIONS

Future research may reveal (i) a non-linear threshold effect, such that inflammation does not begin to impact women's sexual desire until it is at a high level, (ii) inflammatory biomarkers other than CRP might be more sensitive in detecting associations between inflammation and desire, should they exist, or (iii) the mechanisms underlying sexual dysfunction may differ between sexes. Clephane K, et al. Lack of Evidence for a Relationship Between Salivary CRP and Women's Sexual Desire: An Investigation Across Clinical and Healthy Samples. J Sex Med 2022;19:745-760.

A Preliminary Study on Up-regulation of Sexual Desire for a Long-term Partner

BACKGROUND

Declining sexual desire over the course of a relationship may cause distress. Because sexual desire partly depends on who the (imagined) sexual partner is, this study focuses on increasing sexual desire for the long-term partner specifically.

AIM

This study examined 3 regulation strategies: (i) positive reappraisal of the partner, (ii) reappraisal of sexual desire decline, and (iii) sexual imagery about the partner. We tested whether these 3 strategies increased (i) sexual desire for the partner, (ii) motivated attention for the partner, as indicated by the late positive potential (LPP) amplitude, and (iii) infatuation, attachment, and relationship satisfaction.

METHODS

Twenty-five young adults (6 men) who were in a long-term relationship performed the regulation strategies and no regulation before passively viewing a picture of their partner.

OUTCOMES

The LPP amplitude was measured during the partner picture. After each strategy, participants rated their sexual desire, infatuation, attachment, and relationship satisfaction.

RESULTS

Participants felt more sexual desire for and more infatuated with their partner after sexual imagery about the partner than after no regulation. Participants also felt more attached to their partner after positive reappraisal of the partner than after no regulation. There was no evidence that any of the strategies influenced relationship satisfaction or motivated attention.

CLINICAL IMPLICATIONS

Sexual imagery about the partner is a simple strategy that people can use without involving the partner to increase sexual desire for (and infatuation with) their long-term partner.

STRENGTHS & LIMITATIONS

One of the strengths of the current study is the experimental manipulation of strategy use within participants, which allows for conclusions of causality. The main limitation is the small, inclusive convenience sample. This study had good power to detect medium effects but was underpowered to detect small effects. Participants were mostly young adult women in relatively short long-term relationships. Gender differences in the effectiveness of the 3 strategies were not hypothesized or tested.

CONCLUSION

Sexual imagery about the partner increases sexual desire for (and infatuation with) the partner. Langeslag SJE, Davis LL. A Preliminary Study on Up-regulation of Sexual Desire for a Long-term Partner. J Sex Med 2022;19:872-878.

Visceral Visions: Rethinking Embodiment and Desire in Global Mental Health

The globalization of biomedicine poses the problem of finding cross-culturally valid criteria for mental health. Undue pathologization is a major risk for global health, especially when diagnoses rely exclusively on Western nosology. This article focuses on the clinical conflation between involuntary mass possession and conversion disorder. Originally, the diagnosis of "conversion disorder" evolved from the notion of hysteria. Even though the category of hysteria disappeared from psychiatry many decades ago, some of its undergirding assumptions have survived under the new label of conversion. Namely, the assumption that hysteria/conversion is caused by repressed sexual desire is still implicit in widespread explanatory models for mass possession worldwide. Drawing upon an ethnography of demonic possession (grisi siknis) among the Afro-Indigenous Miskitos of Nicaragua, I argue that (1) the label of conversion is eurocentric and inappropriate for mass possession; and (2) emic perspectives on mass possession offer a critical counterpoint to rethink Euro-American and globalized understandings of embodiment and desire.

Does a single consumption imagery event increase food desire?

Food desire is an intense motivational state a consumer experiences toward food that accounts for much of consumption. While extant research has shown that experiencing desire elicits consumption imagery, it remains unclear whether consumption imagery alone instigates desire. Even though this directional relationship has been often speculated upon, little empirical study has considered it. This paper empirically identifies imagined consumption as an antecedent of food desire. Six studies show that consumption imagery increases food desire and suggest that this impact is due to induced feelings of deprivation. Our findings also show that increased desire explains previously researched outcomes of imagery, such as a higher willingness to pay for and consumption volumes of the imagined food.

Situating desire: Situational cues affect desire for food through eating simulations

How do situations influence food desire? Although eating typically occurs in rich background situations, research on food desire often focuses on the properties of foods and consumers, rather than on the situations in which eating takes place. Here, we take a grounded cognition perspective and suggest that a situation that is congruent with consuming a food increases simulations of eating it, which, in turn, affect desire, and the expected and actual liking of the food. We tested this idea in four pre-registered experiments (N = 524). Participants processed an image of a food presented in a congruent situation, an incongruent situation, or no background situation. Compared to the incongruent situation, the congruent situation increased expected liking of the food and desire, and this was partially or fully mediated by eating simulations. The congruent situation also increased salivation, a physiological indicator of preparing to eat. However, there was only weak and indirect evidence for congruence effects on actual liking of the food when tasted. These findings show that situational cues can affect desire for food through eating simulations. Thus, background situations play an important but understudied role in human food desires. We address implications for research using food images, and for applications to promote healthy and sustainable eating behaviour.

Does Addiction Have A Subject?: Desire in Contemporary U.S. Culture

This paper traces the emergence of a new figure of the desiring subject in contemporary addiction science and in three other recent cultural developments: the rise of cognitive-behavior therapy, the self-tracking movement, and the dissemination of ratings. In each, the subject's desire becomes newly figured as a response to objects rather than a manifestation of the soul, measured numerically rather than expressed in language and rendered impersonal rather than individualizing. Together, these developments suggest a shift in the dominant form of the desiring subject in contemporary U.S. culture, one that breaks with the subject-form that Foucault theorized five decades ago.

No effects of sweet taste exposure at breakfast for 3 weeks on pleasantness, desire for, sweetness or intake of other sweet foods: a randomised controlled trial

This work investigated the effects of repeated sweet taste exposure at breakfast on perceptions and intakes of other sweet foods, while also examining the effects due to duration of exposure (1/3 weeks), test context (breakfast/lunch) and associations between taste perceptions and intakes. Using a randomised controlled parallel-group design, participants (n 54, 18 male, mean age: 23·9 (sd 5·8) years, mean BMI: 23·6 (sd 3·5) kg/m2) were randomised to consume either a sweet breakfast (cereal with sucralose) (n 27) or an equienergetic non-sweet breakfast (plain cereal) (n 27) for 3 weeks. On days 0 (baseline), 7 and 21, pleasantness, desire to eat and sweetness were rated for other sweet and non-sweet foods and sweet food consumption was assessed in an ad libitum meal at breakfast and lunch. Using intention-to-treat analyses, no statistically significant effects of exposure were found at breakfast (largest F2,104 = 1·84, P = 0·17, ηp2 = 0·03) or lunch (largest F1,52 = 1·22, P = 0·27, ηp2 = 0·02), and using Bayesian analyses, the evidence for an absence of effect in all rating measures was strong to very strong (smallest BF01 = 297·97 (BF01error = 2·68 %)). Associations between ratings of pleasantness, desire to eat and intake were found (smallest r = 0·137, P < 0·01). Effects over time regardless of exposure were also found: sugars and percentage energy consumed from sweet foods increased throughout the study (smallest (F2,104 = 4·54, P = 0·01, ηp2 = 0·08). These findings demonstrate no effects of sweet taste exposure at breakfast for 1 or 3 weeks on pleasantness, desire for, sweetness or intakes of other sweet foods in either the same (breakfast) or in a different (lunch) meal context.

Changes in Sexual Fantasy and Solitary Sexual Practice During Social Lockdown Among Young Adults in the UK

INTRODUCTION

Pandemic-related social lockdown limited many sexual behaviors, but to date, no study has examined the perceived impact of social lockdown due to COVID-19 on sexual fantasy and solitary sexual behavior.

AIMS

The present study sought to examine the perceived impact of social lockdown on sexual fantasy and solitary sexual behavior among UK young adults in various living situations.

METHODS

A convenience sample of 565 adults aged 18-32 and living in the UK completed anonymous, web-based, study-specific questionnaires between May 14 and 18, 2020, 7 weeks after social lockdown was initiated. Mixed-method analyses were conducted.

MAIN OUTCOME MEASURES

The study presents qualitative and quantitative data. Criterion variables were measured dichotomously as increases (vs no change) in sexual fantasy and increases (vs no change) in pornography consumption. Predictor variables were living arrangement, relationship status, and postlockdown changes in masturbation and pornography consumption.

RESULTS

Of all, 34.3% engaged in more sexual fantasizing during lockdown; women were more likely than men to report this increase. Living context and relationship status were predictors of increased fantasizing. Of all, 30.44% reported an increase in at least one solitary sexual practice. This increase was associated with an increase in sexual fantasizing and also with increased pornography consumption. Nineteen percent of participants reported an increase in pornography use, with men being more likely than women to report this increase. Participants mostly attributed their increases to boredom, increased free time, and replacing partnered sex.

CONCLUSION

Shifts in sexual fantasizing and solitary sexual practices were predicted by living arrangements, relationship status, and gender. The present findings suggest that the assessment of sexual fantasy and solitary sexual activities may benefit patients presenting with pandemic-related stress. Although mostly exploratory, significant changes in sexual fantasy and solitary sexual practices were observed. A cross-sectional design, convenience sampling, and study-specific measures are limitations. Cascalheira CJ, McCormack M, Portch E, et al. Changes in Sexual Fantasy and Solitary Sexual Practice During Social Lockdown Among Young Adults in the UK. J Sex Med 2021;9:100342.

The Psychology of Desire and Implications for Healthy Hydration

This article discusses the cognitive mechanisms underlying the motivation to consume sugar-sweetened beverages (SSBs) and outlines implications for developing healthy hydration habits. While the detrimental health consequences of consuming SSBs are well understood, the psychological processes underlying the motivation to consume them are understudied. To address this gap, the current article applies a grounded cognition theory of desire and motivated behaviour, which can be used as a framework to understand and potentially change the motivation for SSBs and healthier alternatives, such as water. The grounded cognition theory of desire argues that people represent foods and drinks through potentially rewarding simulations, or re-experiences, of consuming them. These simulations, in turn, can increase desire and motivated behaviour. In line with this theory, research on eating behaviour shows that people think about attractive food in terms of what it feels like to eat it and in terms of relevant eating situations and that these simulations predict the desire to eat. Similarly, emerging research on SSBs shows that people represent these beverages in terms of the sensory and rewarding experiences of drinking them, more so than water, and especially if they consume them often. These simulations, in turn, predict the desire for sugary drinks and actual consumption. This has implications for attempts to increase healthy hydration: in order to facilitate healthy choices, the immediate pleasure to be gained from consuming a healthy beverage should be emphasized, rather than its long-term benefits. Repeatedly facilitating healthy drink choices in similar situations can ultimately contribute to the development of healthy hydration habits.

Acute caffeine reverses the disruptive effects of chronic fluoxetine on the sexual behavior of female and male rats

RATIONALE

Sexual side effects of chronic treatment with selective serotonin reuptake inhibitors (SSRIs) in humans include anorgasmia and loss of sexual desire and/or arousal which interferes with treatment compliance. There are few options at present to reduce these effects. Because orgasm and desire are mediated in part by activation of sympathetic arousal, we asked whether the sympathomimetic effects of acute caffeine treatment could reverse these effects.

OBJECTIVE

The present study examined whether acute treatment with caffeine (CAF; 10 or 20 mg/kg, ip) versus vehicle could ameliorate the disruption of appetitive and consummatory measures of copulatory behavior produced by chronic fluoxetine (10 mg/kg, sc) in adult, sexually active female or male rats.

METHODS

Sexually experienced female or male rats received daily injections of FLU over a 24-day period and were tested for sexual behaviors five times at 4-day intervals during this period in bilevel pacing chambers. Females had been ovariectomized and given hormone replacement with estradiol benzoate and progesterone prior to each test. Males were left gonadally intact. Four days after the final FLU test, rats were randomly assigned to one of the three doses of CAF and received ip injections of CAF or the saline vehicle 60 min before testing.

RESULTS

Chronic FLU reduced solicitations and lordosis over time in females and reduced the number of ejaculations in males. Both doses of CAF restored solicitations and lordosis in females and ejaculations in males. On their own, both doses of CAF increased females' pacing behavior and the number of mounts and intromissions in the males.

CONCLUSIONS

Stimulation of sympathetic outflow by CAF may constitute a readily accessible on-demand treatment for the sexual side-effects of SSRIs.

Drivers of desire for more children among childbearing women in sub-Saharan Africa: implications for fertility control

BACKGROUND

Despite the extensive research on fertility desires among women the world over, there is a relative dearth of literature on the desire for more children in sub-Saharan Africa (SSA). This study, therefore, examined the desire for more children and its predictors among childbearing women in SSA.

METHODS

We pooled data from 32 sub-Saharan African countries' Demographic and Health Surveys. A total of 232,784 married and cohabiting women with birth history, who had complete information on desire for more children made up the sample for the study. The outcome variable for the study was desire for more children. Multilevel logistic regression analysis was conducted. Results were presented using adjusted odds ratios (aOR), with their corresponding 95% confidence intervals (CI).

RESULTS

The overall prevalence of the desire for more children was 64.95%, ranging from 34.9% in South Africa to 89.43% in Niger. Results of the individual level predictors showed that women aged 45-49 [AOR = 0.04, CI = 0.03-0.05], those with higher education [AOR = 0.80, CI = 0.74-0.87], those whose partners had higher education [AOR = 0.88; CI = 0.83-0.94], women with four or more births [AOR = 0.10, CI = 0.09-0.11], those who were using contraceptives [AOR = 0.68, CI = 0.66-0.70] and those who had four or more living children [AOR = 0.09 CI = 0.07-0.12] were less likely to desire for more children. On the other hand, the odds of desire for more children was high among women who considered six or more children as the ideal number of children [AOR = 16.74, CI = 16.06-17.45] and women who did not take decisions alone [AOR = 1.58, CI = 1.51-1.65]. With the contextual factors, the odds of desire for more children was high among women who lived in rural areas compared to urban areas [AOR = 1.07, CI = 1.04-1.13].

CONCLUSIONS

This study found relatively high prevalence of women desiring more children. The factors associated with desire for more children are age, educational level, partners' education, parity, current contraceptive use, ideal number of children, decision-making capacity, number of living children and place of residence. Specific public health interventions on fertility control and those aiming to design and/or strengthen existing fertility programs in SSA ought to critically consider these factors.

The nose is hungrier than the eyes

Vision and olfaction are the main sensory channels for appraising food prior to eating. Motivational models often assume that these sensory channels function in an equivalent manner. We tested this notion by asking participants to rate their desire for some snacks only via smell and others only via vision. In the next phase, participants consumed a small sample of every snack, now with all of the senses available, rating liking and desire for more. After consuming a meal, participants repeated the desire/liking test. Sensing via olfaction, relative to vision, led to greater desire ratings irrespective of state. When hungry, judgments of liking and desire for more were higher for foods that were initially smelled relative to those that were initially seen. Across the meal, visually based desire ratings declined more than those based on smell, relative to ratings made when the snacks were tasted. Together, this suggests motivational equivalence does not hold for olfaction and vision. We suggest this may be due to a greater reliance on memory for generating visually based desire.

Assessment of Awareness, Attitude and Desire for Labor Analgesia and Associated Factors Among Pregnant Women in Ethiopia: A Cross-Sectional Study

INTRODUCTION

Labor pain is the worst imaginable pain that women experience during their childbearing years. Untreated labor pain has numerous negative consequences, for both the mother and her fetus. Low levels of awareness and attitudes among pregnant women about labor analgesia is a major challenge that affects outcomes for both the mother and fetus. Therefore, this study aimed to assess the awareness of, attitude towards and desire for labor analgesia and its associated factors among pregnant women who visited an antenatal care facility.

METHODS

An institution-based, cross-sectional study was conducted from February to March 2019. Data were collected using semi-structured questionnaires by a convenience sampling technique. Data were entered using EpiData 4.2 and exported to SPSS version 20 software for analysis. Both bivariate and multivariate binary logistic regression analysis were used to identify factors associated with awareness, attitude and desire for labor analgesia among pregnant women. Crude odds ratio (COR) and adjusted odds ratio (AOR) were calculated to show the strength of association.

RESULTS

A total of 410 participants were included. Thirty-three (8%) of the pregnant women who visited the antenatal care facility were found to have an awareness of labor analgesia. In multivariate analysis, the likelihood of having awareness of labor analgesia was 7.227 times (AOR: 7.227, 95%, CI 2.406-21.720) greater among parous versus nulliparous mothers. The odds of having awareness of labor analgesia were 3.133 times (AOR: 3.133, 95%; CI 1.144-8.581) greater among government employees than among housewives. The odds of having a good attitude towards labor analgesia were 6.488 times (AOR: 6.488, 95% CI 1.894-22.227) higher in government employees than in farmers. Women in the age group of 25-31 years were 1.815 times more likely to want labor analgesia for their next delivery (AOR: 1.815, 95% CI 1.103-2.989).

CONCLUSIONS

The awareness of labor analgesia among pregnant women was low. There is a need for teamwork by all stakeholders in health sectors to improve attitudes and increase the desire for labor analgesia among pregnant women who visit antenatal care facilities.

'They are my future': childbearing desires and motivations among women with disabilities in Ghana - implications for reproductive healthcare

BACKGROUND

Previous research has highlighted widespread public mis/perceptions that portray women with disabilities (WWDs) as asexual, less likely to marry, and often not interested in childbearing. However, evidence from high-income settings shows that many WWDs are sexually active and do have or want to have children. Notwithstanding this, very few studies have focused on understanding childbearing desires and motivations among WWDs in low-income settings. This qualitative research explored childbearing desires and motivations among WWDs in Ghana.

METHODS

A cross-sectional qualitative study was conducted with WWDs aged 18-49 years in Northern Ghana. The distribution of participants by disability types were as follows: physical disability/impairment (n = 37); visual impairment (n = 11); speech and hearing impairment (n = 14); epilepsy (n = ten); and albinism (n = five). A pre-tested open-ended thematic topic guide was designed and used to conduct in-depth interviews. Interviews were tape-recorded and later transcribed for analysis. Transcripts were coded using QSR NVivo 11 software. Thematic content analysis techniques were used to analyse and present the data.

RESULTS

Nearly all the WWDs interviewed were sexually active, desiring to have children, and intended to have as many children as they could support. Strong desire to experience the joy of motherhood; fear of social insecurity; fear of old age economic insecurity; desire to challenge stigma and negative stereotypes about disability, sexuality and motherhood; and desire for self-actualisation, were key motivations for childbearing.

CONCLUSION

Our findings challenge existing negative public perceptions about the status of WWDs in relation to sexuality, childbearing and motherhood. More importantly, our findings suggest that if the Sustainable Development Goals related to universal access to sexual and reproductive healthcare are to be attained, WWDs must be targeted with quality sexual and reproductive healthcare information and services.

"Our Generation…" Aspiration, Desire, and Generation as Discourse Among Highly Educated, Portuguese, Post-austerity Migrants in London

Drawing on 18 months of multi-sited ethnographic fieldwork, this paper brings into dialogue empirical material from young, highly educated Portuguese migrants in London, theoretical work on desire in migration studies and sociological approaches to theorising aspirations. The paper argues that young migrants' narratives of migration shed important light on the working of aspirations in the processes of becoming through migration. Such orientations towards the future are shaped by young migrants' engagements with doxic and habituated logics producing aspirations. The analytical lens of desire illuminates the role of discursive self-positioning, emotions, and the embodiment of lived experiences of migration in the enacting of particular migrant subjectivities and associated aspirations. In a context in which competing discourses of generation constitute important registers of meaning about migration and aspirations, mobilising generation discourses is a key temporal practice in young migrants' constructions of narratives of migration.

Sexual dysfunction and its determinants in women with rheumatoid arthritis

OBJECTIVES

To evaluate sexual function in Tunisian women with rheumatoid arthritis (RA) and to examine factors that are predictors of female sexual dysfunction including sociocultural factors, disease activity, and psychological status.

METHODS

We conducted a cross-sectional study including 71 women with a confirmed diagnosis of RA according to the 2010 American College of Rheumatology/European League against Rheumatism (ACR/EULAR) criteria. Clinical and sociodemographic characteristics were collected. The participants were asked to complete the Female Sexual Function Index (FSFI), which contains 19 questions, assessing six areas of female sexual function in the previous 4 weeks. Sexual dysfunction was defined as an FSFI score less than or equal to 26.55. The psychosocial status was evaluated by the Hospital Anxiety and Depression (HAD) scale. Prevalence of sexual dysfunction and predictors of sexual difficulties were assessed.

RESULTS

The prevalence of female sexual dysfunction in women with RA was 49.3%. All areas were altered especially desire (2.92 ± 1.3), arousal (3.27 ± 1.5), and orgasm (3.77 ± 1.5). In univariate analysis, sexual dysfunction was correlated with the age of patients (p = 0.049), the age of partners (p = 0.013), pain (p = 0.001), number of night awakenings (p = 0.02), morning stiffness (p = 0.010), tender joints (p = 0.05), disease activity score (DAS28 ESR) (p = 0.043), fatigue (p = 0.028), and Health assessment questionnaire (HAQ) (p = 0.02). In multivariate analysis, the age of patients and pain were predictive factors of sexual dysfunction. By analyzing each area of the FSFI score, the age of patients was the independent variable associated with desire. Tender joints were associated with lubrication and the age of partners with arousal, orgasm, and satisfaction.

CONCLUSION

Our study suggests that rheumatoid arthritis has a negative impact on patients' sexuality. Age of patients and partners, pain, and tender joints appear to be the main factors influencing sexual function.

Intersubject representational similarity analysis reveals individual variations in affective experience when watching erotic movies

We spend much of our lives pursuing or avoiding affective experiences. However, surprisingly little is known about how these experiences are represented in the brain and if they are shared across individuals. Here, we explored variations in the construction of an affective experience during a naturalistic viewing paradigm based on subjective preferences in sociosexual desire and self-control using intersubject representational similarity analysis (IS-RSA). We found that when watching erotic movies, intersubject variations in sociosexual desire preferences of 26 heterosexual males were associated with similarly structured fluctuations in the cortico-striatal reward, default mode, and mentalizing networks. In contrast, variations in the self-control preferences were associated with shared dynamics in the fronto-parietal executive control and cingulo-insular salience networks. Importantly, these results were specific to the affective experience, as we did not observe any relationship with variation in preferences when individuals watched neutral movies. Moreover, these results appear to require multivariate representations of preferences as we did not observe any significant associations using single scalar summary scores. Our findings indicate that multidimensional variations in individual preferences can be used to uncover unique dimensions of an affective experience, and that IS-RSA can provide new insights into the neural processes underlying psychological experiences elicited through naturalistic experimental designs.

Investigating properties of imagery-induced flash-forwards and the effect of eye movements on the experience of desire and craving in gamers

Vivid and emotionally laden imagery is a symptom across a wide range of psychiatric disorders. Flash-forwards describe the mental simulation of anticipated future events which might also be relevant in the context of gaming disorder. The aim of this laboratory study was to investigate flash-forwards and the experience of desires and craving in gamers, and to examine the effect of eye movements on their vividness and related desires. A sample of 77 gamers formed a mental picture of themselves gaming in the future and rated the vividness and emotionality of this imagination, and their current desire and craving for gaming. Thereafter, one half of the gamers conducted a dual task (i.e., horizontal eye movements while retrieving the picture), whereas the other half let their eyes rest on the middle of the computer screen while retrieving the picture (non-dual task). Vividness of the flash-forward and intensity of desire and craving were again measured after the dual or non-dual task. In the overall sample, more imagery-related desire correlated positively with associated positive affect and vividness of flash-forwards. However, in a subsample of problematic gamers, flash-forwards are experienced less vivid and less pleasurable with increasing symptom severity. Eye movements while retrieving the flash-forwards led to significantly decreased ratings of imagery-related desire intensity, which was not the case for the non-dual condition. Results suggest different properties of flash-forwards between recreational and problematic gamers. Moreover, an attention-demanding task taxing the working memory seems beneficial for reducing desires related to imagery-induced flash-forwards.

Antidepressant Use During Development May Impair Women's Sexual Desire in Adulthood

INTRODUCTION

Although antidepressants are well known to cause sexual side effects in adults, the long-term effects of antidepressant use during development on adult sexual function is unknown.

AIM

To explore differences in sexual desire and sexual behavior between adults who did vs did not use antidepressants during childhood or adolescence.

METHODS

An online survey of 610 young adults (66% women) assessed childhood and current mental health and use of antidepressants and other psychiatric medications before the age of 16 years and currently, partnered and solitary sexual desire, and frequency of masturbation and partnered sexual activity. Antidepressants were coded into either selective serotonin reuptake inhibitors (SSRIs) or non-SSRI antidepressants.

MAIN OUTCOME MEASURE

Scores on the Sexual Desire Inventory, and self-reported frequency of masturbation and partnered sexual activity.

RESULTS

For women, childhood SSRI use was associated with significantly lower solitary sexual desire, desire for an attractive other, and frequency of masturbation. This was true even when controlling for childhood mental health concerns, current mental health, and current antidepressant use. However, there was no effect of childhood SSRI use on women's partnered sexual desire or partnered sexual activity. There was no significant effect of childhood antidepressant use on men's sexual desire or masturbation. However, in men, childhood use of non-SSRI antidepressants was associated with significantly higher frequency of partnered sexual activity. Childhood use of non-SSRI antidepressants, or nonantidepressant psychiatric medication, was not associated with adult sexual desire or behavior in either women or men.

CLINICAL IMPLICATIONS

It is possible that SSRI use during childhood interrupts the normal development of sexual reward systems, which may be a risk factor for sexual desire dysfunction in adult women.

STRENGTHS & LIMITATIONS

Strengths include a large sample, use of attention checks and validated measures, and careful assessment of childhood mental health history; however, generalizability is limited by a predominantly white, young adult sample. These data are cross-sectional, and therefore, causal explanations for the association between childhood SSRI use and adult sexual well-being should be considered preliminary, warranting replication.

CONCLUSION

These findings point to a critical need for well-controlled, prospective research on possible long-term effects of antidepressant use, particularly SSRI use, on the development of adult sexual well-being. Lorenz TK. Antidepressant Use During Development May Impair Women's Sexual Desire in Adulthood. J Sex Med 2020;17:470-476.

Female sexual dysfunction associated with idiopathic cerebellar ataxia: A case report

BACKGROUND

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.

CASE PRESENTATION

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.

CONCLUSIONS

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.

Getting what you desire: the normative significance of genetic relatedness in parent-child relationships

People who are involuntarily childless need to use assisted reproductive technologies if they want to have a genetically related child. Yet, from an ethical point of view it is unclear to what extent assistance to satisfy this specific desire should be warranted. We first show that the subjectively felt harm due to the inability to satisfy this reproductive desire does not in itself entail the normative conclusion that it has to be met. In response, we evaluate the alternative view according to which the satisfaction of this desire is regarded as a way to meet one's presumed intermediate need for parenthood. This view presupposes that parenthood is one of those general categories of experiences and activities that contribute an irreplaceable value to people's lives, but the central difficulty is to find those characteristics that mark out parenthood as an irreplaceable constituent of a valuable life. We go on to argue, however, that even if one assumes that parenthood is such an irreplaceable constituent that makes life more valuable, this does not necessarily entail a moral duty to satisfy the desire for genetic parenthood. We conclude that there is a pro tanto obligation to help people conceive a genetically related child (if this is what they prefer), but that this can be outweighed by other moral considerations, such as safety and justice concerns.

The effects of food craving and desire thinking on states of motivational challenge and threat and their physiological indices

PURPOSE

Food craving has been shown to induce states of psychological challenge, indexed by increases in adrenaline but not cortisol production. The study aimed to test the relationship between challenge and (1) desire thinking (the active processing of the pleasant consequences of achieving a desired target and planning how to do so) and (2) craving.

METHODS

Participants (N = 61) self-reported their levels of craving and desire thinking. They were then presented with situations in which their craving would be fulfilled or not via a false feedback practice task (a wordsearch task). During this period psycho-physiological measures of challenge and threat were taken.

RESULTS

Higher levels of craving were linked to challenge only when the craved object was likely to be obtained. Whilst anticipating reward fulfillment, higher levels of craving were linked to higher levels of desire thinking. In turn, higher levels of desire thinking were related to lower levels of challenge. In contrast, during the processes of reward fulfillment, desire thinking was linked to increased challenge (i.e., a positive indirect effect).

CONCLUSIONS

Craving is linked to increased levels of psychological challenge when the object of the craving can be obtained, but it is unrelated to craving when it is not. The research also highlights the importance of desire thinking as an important, but complex, mediator in the relationship between craving and motivational states: desire thinking inhibited challenge when anticipating craving fulfillment, but encouraging it during the process of fulfillment itself.

LEVEL OF EVIDENCE

I: Evidence obtained from at least one properly designed randomized controlled trial.

Advertising models in the act of eating: How the depiction of different eating phases affects consumption desire and behavior

In print advertising, the use of static pictures depicting models eating food is common practice. However, less is known about how the depiction of models in different phases of consumption (holding food, moving food to mouth, taking a bite, chewing on food) affects consumers. Theories have proposed that not only do individuals mimic actions, but they also adopt the goals and the motivational patterns underlying these actions by observing others. Building on this view, we hypothesized that consumers' desire to eat a food product and their actual consumption of a food product would be greater when the model in the picture was close to engaging in consumption and that desire and actual consumption would be reduced when the model was shown in the process of finishing consumption. In two studies, we found that the participants experienced an increased desire to eat the depicted food (Study 1) and ate more of the advertised food (Study 2) when the model was shown to engage in eating food compared with when the model was shown during completion of a consumption episode. In addition, the results of Study 1 suggest that even subtle differences such as holding food compared with putting food into the mouth might affect consumers' desire to eat. Overall, our results suggest that advertisements may affect consumers' motivation to engage in food intake differently depending on which consumption state they show with the depiction of a model close to engagement in food consumption being most likely to trigger a desire for consumption and an actual engagement in food intake.

Anxiety symptoms and emotional eating are independently associated with sweet craving in young adults

Sweet craving (SC), defined as a strong desire for sweet foods, seems to be closely related to negative emotions, such as anxiety and unhealthy eating behaviors. The objective was to investigate factors that are associated with SC and to assess the relationships among SC, anxiety symptoms, and eating behavior in university students. This was a cross-sectional study involving 300 students of both sexes (20.5 ± 4.4 years) who were freshmen in a Brazilian public university. Eating behavior was evaluated using the Three Factor Eating Questionnaire, anxiety symptoms were assessed using the Beck Anxiety Inventory, SC was identified by a yes/no question ("Have you had a very strong desire to eat sweet food over the last three months?"), and characterized by the Questionnaire for Assessment of Sweet Substance Dependence. Individuals with SC scored significantly higher for uncontrolled eating (UE), emotional eating (EE), and anxiety symptoms. Logistic regression analysis revealed that anxiety symptoms are independently associated with SC. In conclusion, negative emotions, like anxiety, and eating guided by these emotions can contribute to the SC phenomenon.

The revised four-factor motivational thought frequency and state motivation scales for alcohol control

INTRODUCTION

Elaborated Intrusion (EI) Theory holds that both functional and dysfunctional motivational cognitions are characterized by their intensity, cognitive availability and involvement of imagery, and can be assessed in terms of their frequency and cross-sectional nature. Recently published data on the Motivational Thought Frequency (MTF-A) and State Motivation (SM-A) scales for alcohol control, which were based on EI theory, have shown acceptable fit for a three-subscale structure (Intensity, Imagery, Availability). However, subsequent analyses on the MTF's adaptation to diabetic regimen adherence suggested superior fit from a four-factor model, splitting Imagery into Incentives and Self-Efficacy Imagery. The current paper reanalyzed data on the MTF-A and SM-A, including an additional item on each and using a more robust statistical approach.

METHODS

Participants (n = 504) reporting recent high-risk drinking or were currently trying to control alcohol consumption volunteered to complete an online survey that included the MTF-A, SM-A, Alcohol Use Disorders Identification Test and Readiness to Change Questionnaire. Confirmatory factor analyses employed robust maximum likelihood (MLR) with Yuan-Bentler χ² adjustment, and presented internal consistencies using omega.

RESULTS

After omission of multivariate outliers, SM-A data were available from 399 participants, and MTF-A data from 351. Better fit was found for the four-factor model on both measures, and high internal consistencies were obtained for all subscales. Incentives Imagery and Self-Efficacy Imagery were both associated with greater alcohol problems and readiness to change.

CONCLUSIONS

The four-factor structures are statistically superior and more theoretically coherent, and allow a focused assessment of key targets of motivational interventions.

Sexual desire of French representative prostate cancer survivors 2 years after diagnosis (the VICAN survey)

PURPOSE

The prostate cancer impacts on the future life of survivors. The complexity of sexual health problems in prostate cancer survivors is underestimated or often reduced to the erectile dysfunction. Especially, factors influencing sexual desire of patients have to be more explored. This study aims to describe the therapeutic management of patients with prostate cancer and assess their sexual desire 2 years after diagnosis.

METHODS

This study is part of the National VICAN survey (Vie après le CANcer) implemented in France in 2012. This analysis was performed on a population of 414 men who had prostate cancer. The questionnaire dealt with several topics including socioeconomic status, treatments received, and sexual desire.

RESULTS

Prostatectomy (42.8%), radiotherapy + hormonotherapy (17.6%), and radiotherapy alone (12.8%) were the main treatments used. 41.3% of men stated that their sexual desire was all gone since disease. The "satisfying" perceived financial situation was significantly associated to a sexual desire loss (p = 0.008). Radiotherapy + hormonotherapy treatment only is significantly associated with a loss of sexual desire (P = 0.003).

CONCLUSIONS

Two years after diagnosis, the sexual desire of prostate cancer survivors is deteriorated with the cancer experience. However, clinical characteristics do not seem to be decisive unlike a "satisfying" financial situation. Research about the impact of socio economics characteristics on sexual health should probably be engaged. Programs have to be developed in France to have personalized sexual support progressed for survivors and take spouses into consideration in this context.

Association between comorbidities and female sexual dysfunction: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

INTRODUCTION AND HYPOTHESIS

Although medical comorbidities are widely recognized to be associated with erectile dysfunction, less research has been done on their association with female sexual dysfunction (FSD). The purpose of this study was to assess whether FSD is associated with comorbidities; we hypothesized that there is an association.

METHODS

This is a secondary analysis of the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a prospective stratified probability sample of individuals aged 16-74. We assessed for association between sexual function scores and heart attack, heart disease, hypertension, stroke, diabetes, chronic lung disease, depression, other mental health condition, other neurologic conditions, and incontinence, as well as menopause and smoking status. Correlation between comorbidities and specific domains of sexual function was also assessed.

RESULTS

A total of 6777 women, with an average age of 35.4 (14.1), responded to the survey and reported sexual activity in the past year. There was an association between sexual function score and age, menopause, hysterectomy, heart disease, hypertension, diabetes, obesity, smoking, depression, other mental health condition, stroke, other neurological condition, and homosexual attraction (p < 0.05). On multivariate analysis, age, sexual attraction, smoking status, depression, and other mental health conditions remained significantly correlated with sexual function (p < 0.05). Comorbidities were found to be correlated with specific domains.

CONCLUSIONS

Comorbidities were associated with FSD and specific comorbidities associated with dysfunction in specific domains. Urogynecologists and urologists must assess for comorbidities, as women presenting with sexual dysfunction may provide an opportunity for early diagnosis of life-threatening conditions.

Adolescence With Freud and Flaubert

The text approaches two fundamental aspects of the adolescent crisis from the works of Sigmund Freud and Gustave Flaubert: their encounter with their object in desire, pleasure, sexual act, and the causes the detachment from parental authority and their effects. A study was made on the work of Flaubert on the causes of the enigma, which the author suggests in his Memoirs of a Madman: Am I another or myself? That feeling of strangeness the adolescent experiences on waking up in a dream, with a new feeling and desire of the love object. The ardent desire of being like a grown-up, and the motions toward their parents, influence decisions for which the young are not prepared, given their cradled education and the unsatisfactory answers to their infant sexual investigation. Lacan notes that the sexual relationship does not exist. Freud rates love as being narcissistic and childish. The first amorous manifestations, given the fantasy that cloaks them always remain the same, as explained by Flaubert and Lacan's comment to Wedekind, in The Spring Awakening. In childhood the enjoyment of body is not involved. For this reason, it is so simple, the adolescent would be a representation of the division of the subject, the cut made by their unconscious, which their body, in certain cases, will carry the marks. They will be surprised, puzzled by this new desire that produces their unconscious to step toward the sexual act.

Factors associated with the desire for companionship during labor in a Nigerian community

OBJECTIVE

To determine preferences for companionship during labor and to identify associated factors.

METHODS

The present prospective cross-sectional survey was conducted at a university teaching hospital in Nigeria between September 1, 2011, and February 28, 2012. Participants included women who underwent the first stage of labor and delivery at the facility, male partners, and healthcare workers from the maternity unit. Data were collected using a pretested questionnaire.

RESULTS

There were 226 parturients, 158 male partners, and 69 healthcare workers included in the final analysis; in all, 50 (22.1%) parturients and 37 (23.4%) male partners approved of companionship during labor, whereas 62 (90%) healthcare workers supported it. Among those who approved, a parturient's male partner was stated to be the preferred companion by 33 (66%) parturients, 32 (86%) male partners, and 58 (94%) healthcare workers. The perception of conduciveness of the labor ward for companionship was associated with approving of companionship among both the parturients (adjusted odds ratio [aOR] 2.74) and male partners (aOR 15.79). Previous home delivery (aOR 31.43) and companionship during a previous delivery (aOR 23.00) were also associated with approval.

CONCLUSION

Most couples had negative attitudes toward companionship during labor. Intensive education programs and restructuring of facilities could enable Nigerian labor wards to improve the delivery experience for both parturients and their male partners.

Expanding the Analysis of Psychosocial Factors of Sexual Desire in Men

BACKGROUND

The literature lacks studies of the male sex drive. Most existing studies have focused on hypoactive sexual desire disorder in coupled heterosexual men, highlighting some of the main related biological, psychological, and social factors.

AIM

To evaluate the role of selected psychological and social variables affecting male sexual desire such as quality of life, sexual function, distress, satisfaction, psychological symptoms, emotions, alexithymia, couple adjustment, sexism, cognitive schemas activated in a sexual context, sexual dysfunctional beliefs, and different classes of cognitions triggered during sexual activity about failure anticipation, erection concerns, age- and body-related thoughts, erotic fantasies, and negative attitudes toward sexuality.

METHODS

A wide self-administered survey used snowball sampling to reach 298 heterosexual Italian men (age = 32.66 ± 11.52 years) from the general population.

OUTCOMES

13 questionnaires exploring psychological and social elements involved in sexual response were administrated: International Index of Erectile Function, Short Form 36 for Quality of Life, Beck Depression Inventory-II, Symptom Check List-90-Revised, Toronto Alexithymia Scale, Premature Ejaculation Severity Index, Sexual Distress Scale, Sexual Satisfaction Scale, Dyadic Adjustment Scale, Ambivalent Sexism Inventory, Sexual Modes Questionnaire, Sexual Dysfunctional Belief Questionnaire, and Questionnaire of Cognitive Schema Activation in Sexual Context.

RESULTS

Results showed lack of erotic thoughts (β = -0.328), fear (β = -0.259) and desire to have a baby (β = -0.259) as the main predictors of the level of sexual desire in this group. Energy-fatigue, depression, premature ejaculation severity, sexual distress, compatibility, subjective sexual response, and sexual conservatism had a weaker effect on sexual desire. Sexual functioning (13.80%), emotional response (12.70%), dysfunctional sexual beliefs (12.10%), and negative automatic thoughts (12.00%) had more variable effects on sexual drive.

CLINICAL TRANSLATION

Analyzed variables could represent important factors that should be considered in the assessment of desire concerns and discussed in therapy.

STRENGTHS AND LIMITATIONS

The strength of this study is the analysis of novel psychological and social factors on male sexual desire. Recruitment and sample size do not allow generalization of the results, but some crucial points for future research and clinical practice are discussed.

CONCLUSION

Our findings showed that male sexual desire could be affected by many psychological and social elements. Other factors remain to be explored, in their direct and interactive effects, aiming to better explain male sexual desire functioning. Nimbi FM, Tripodi F, Rossi R, Simonelli C. Expanding the Analysis of Psychosocial Factors of Sexual Desire in Men. J Sex Med 2018;15:230-244.

Sexual Desire in Sexual Minority and Majority Women and Men: The Multifaceted Sexual Desire Questionnaire

Sexual desire is increasingly understood to be multifaceted and not solely erotically oriented, but measures are still generally unitary and eroticism-focused. Our goals in this article were to explore the multifaceted nature of sexual desire and develop a measure to do so, and to determine how multifaceted sexual desire might be related to gender/sex and sexual orientation/identity. In the development phase, we generated items to form the 65-item Sexual Desire Questionnaire (DESQ). Next, the DESQ was administered to 609 women, 705 men, and 39 non-binary identified participants. Results showed that the DESQ demonstrated high reliability and validity, and that sexual desire was neither unitary nor entirely erotic, but instead was remarkably multifaceted. We also found that multifaceted sexual desire was in part related to social location variables such as gender/sex and sexual orientation/identity. We propose the DESQ as a measure of multifaceted sexual desire that can be used to compare factor themes, total scores, and scores across individual items in diverse groups that take social context into account. Results are discussed in light of how social location variables should be considered when making generalizations about sexual desire, and how conceptualizations of desire as multifaceted may provide important insights.

Is Addiction a Brain Disease?

Where does normal brain or psychological function end, and pathology begin? The line can be hard to discern, making disease sometimes a tricky word. In addiction, normal 'wanting' processes become distorted and excessive, according to the incentive-sensitization theory. Excessive 'wanting' results from drug-induced neural sensitization changes in underlying brain mesolimbic systems of incentive. 'Brain disease' was never used by the theory, but neural sensitization changes are arguably extreme enough and problematic enough to be called pathological. This implies that 'brain disease' can be a legitimate description of addiction, though caveats are needed to acknowledge roles for choice and active agency by the addict. Finally, arguments over 'brain disease' should be put behind us. Our real challenge is to understand addiction and devise better ways to help. Arguments over descriptive words only distract from that challenge.

Hormonal Contraceptive Use During Relationship Formation and Sexual Desire During Pregnancy

Women who are regularly cycling exhibit different partner preferences than those who use hormonal contraception. Preliminary evidence appears to suggest that during pregnancy women's partner preferences also diverge from those prevalent while regularly cycling. This is consistent with the general assertion that women's mate preferences are impacted by hormonal variation. During pregnancy, women's preferences are thought to closely resemble those displayed by women who are using hormonal contraception. Here, based on this literature, we compared levels of sexual desire among pregnant women who met their partner while using hormonal contraception and pregnant women who met their partner while regularly cycling. We predicted that women who met their partner while using hormonal contraception would experience higher levels of in-pair sexual desire during pregnancy since these women will have partner preferences that more closely match those prevalent at the time of their partner choice. Our results provided support for the idea that previous contraceptive use/non-use may impact subsequent sexual desire for the partner during pregnancy. Pregnant women who met their partner while using hormonal contraception (N = 37) were shown to have higher levels of in-pair sexual desire than those who met while regularly cycling (N = 47). In contrast, levels of extra-pair desire were not related to previous use/non-use of hormonal contraception. These findings were robust when controlling for a number of relevant individual difference variables known to impact sexual desire. Our results contribute to our understanding of factors affecting relationship functioning during pregnancy.

Desiring foods: Cultivating non-attachment to nourishment in Buddhist Sri Lanka

Food and desire are intimately entangled whereby food becomes a core tool to manage desire in fashioning oneself as a morally virtuous person. This paper looks at the ways in which Buddhist texts conceptualize human interactions with food and formulate prescriptions on how to handle food as a means of developing an attitude of non-attachment that aids in achieving nirvana-the extinguishing of desire to get released from the cycle of death and rebirth. The particular texts-the Agañña Sutta, the Āhāra Patikūlasaññā, and the Vinaya Pitaka- discussed here exhibit an attitude of deep ambiguity towards food in its capacity to incite desire. On the one hand nutrition is required to maintain life, but on the other, food can potentially be the cause of a degenerate state of mankind and a source of moral degradation. Hence, the Buddhist development of a dispassionate attitude towards food seeks to enable both nourishment and the pursuit of the extinction of the flame of desire in nirvana. Even though the texts formulate practical prescriptions for monks on how to relate to food to aid them in their pursuit, they also serve as moral standards for lay Sinhalese Buddhists who seek to model their everyday behaviour accordingly.

Embodied possibilities and disruptions: The emergence of the Experience of Embodiment construct from qualitative studies with girls and women

There are multiple indicators of disruption in the way girls and women inhabit their bodies. The qualitative research program examined lived experiences of embodiment among girls and women by conducting 171 interviews with 69 girls and women in three different studies: (a) A life history study of 30 interviews with 11 women, ages 20-27; (b) A 5-year prospective interview study of 87 interviews with 27 girls, ages 9-14 in the first phase of the study; and (c) A life history study of 54 interviews with 31 women, ages 50-68. Data analyses used a constructivist grounded theory approach. In all three studies the emergent core construct of Experience of Embodiment had five central dimensions, each with a positive and negative pole. These dimensions included: body-self connection, agency, desire, self-attunement, and resisting objectification. The Experience of Embodiment provides a new, integrated perspective on ways girls and women inhabit their bodies.

Miscarriages of transmission: body, text, and method

An introductory and exploratory attempt to examine the possibility of viewing the famous writings of Judge Daniel Paul Schreber as the intimations of translawyering. Volubly convinced he was becoming a woman, Judge Schreber announced that he would nail his flag to the feminine and was incarcerated as mad for his pains and his pleasures. It is time to release him and to read his work not as madness but as a unique conjunction of desire and law.

Assessment of motivation to control alcohol use: The motivational thought frequency and state motivation scales for alcohol control

INTRODUCTION

The Elaborated Intrusion Theory of Desire holds that desires for functional and dysfunctional goals share a common form. Both are embodied cognitive events, characterised by affective intensity and frequency. Accordingly, we developed scales to measure motivational cognitions for functional goals (Motivational Thought Frequency, MTF; State Motivation, SM), based on the existing Craving Experience Questionnaire (CEQ). When applied to increasing exercise, MTF and SM showed the same three-factor structure as the CEQ (Intensity, Imagery, Availability). The current study tested the internal structure and concurrent validity of the MTF and SM Scales when applied to control of alcohol consumption (MTF-A; SM-A).

METHODS

Participants (N=417) were adult tertiary students, staff or community members who had recently engaged in high-risk drinking or were currently trying to control alcohol consumption. They completed an online survey comprising the MTF-A, SM-A, Alcohol Use Disorders Identification Test (AUDIT), Readiness to Change Questionnaire (RCQ) and demographics.

RESULTS

Confirmatory Factor Analysis gave acceptable fit for the MTF-A, but required the loss of one SM-A item, and was improved by intercorrelations of error terms. Higher scores were associated with more severe problems on the AUDIT and with higher Contemplation and Action scores on the RCQ.

CONCLUSIONS

The MTF-A and SM-A show potential as measures of motivation to control drinking. Future research will examine their predictive validity and sensitivity to change. The scales' application to both increasing functional and decreasing dysfunctional behaviours is consistent with EI Theory's contention that both goal types operate in similar ways.